Statistical inference - invalid research

[Guest guest]

Stephen,

 

-

" Stephen Morrissey " <stephen

 

Wednesday, October 29, 2003 4:02 AM

RE: Re: Statistical inference - invalid research

 

 

> ...why we need research.

> ...Who needs proving to?

>

> Good questions. I agree with Rory's response. And, the majority of

> press on in recent years has been very negative, mostly

> related to quality control issues. I was initially drawn to safety and

> efficacy research but a majority of the research that I have been

> involved with in the past 3-4 years has related to QC issues such as:

> 1) comparatively evaluating the heavy metals, agrochemicals, and

> phytochemical content of the same plant grown in 5-10 different

> geographic and climatic regions of China; 2) The effects of different

> extraction processing methods on the composition of finished materials;

> 3) Plant species differentiation; and 4) Analytical methods development.

> This is obviously different than what is being referred to as research

> on CM in this venue, but it illustrates the range of questions that can

> and perhaps needs to be studied under the heading of " research " in order

> to improve the delivery of optimal CM health care.

 

In the UK, much of the position of CM rests with the profession

undertaking the sort of work you're talking about, yet, unfortunately,

many herbs seem to be under threat.

 

 

>

> Another example of research that I personally feel would be greatly

> beneficial to CM practitioners and consequently their patients, is dose

> ranging studies. I personally believe that the effect-size consequent

> to varying ones dosages and dose protocols is highly under-rated. There

> are enough unanswered questions posed among the elite of CM that

> frequent this group to illustrate the need for better information on the

> many questions that fall under the umbrella of questions on dose. I

> believe the best way to answer this type of question is through

> thoughtfully designed research. I have evaluated dosage as a secondary

> question in studies that I have been involved with, however to do it

> properly requires more $ and dose-ranging specific research than I have

> been willing to undertake. And yes, one could label that

> biomedicalization, to use Wainright's term. To me dose ranging research

> is an example of the potential value to selectively integrating elements

> of modern science with CM research.

 

This is a good point. Of course, people respond very differently to

drugs - the concentration of a drug in a person's blood can vary by a

factor of about 20, depending on how they metabolise it. So, I'm not

sure research would necessarily reveal too much about optimal dosage

in an exact way - it's still important for the herbalist to judge what

is appropriate for the patient.

 

 

>

> I'm sure that the articulate voices on this list can make reasonable

> points about concerns related to biomedicalization and invalidation. I

> agree with some of it. Yet I think it possible to selectively identify

> the areas where potential benefits of integration outweigh the cost of

> inaction these concerns may effect. In terms of turning the results of

> CM research against the profession, I don't believe historical precedent

> bears out this concern, unless you leave the research on CM to those in

> other professions with different agendas. Yes, there is the null

> hypothesis view of the world. I'm of the opinion that you search for

> the answers that you want to know to improve the quality of health care

> you deliver. By doing so you might even create the news you think is

> important rather than hope what others in society choose to say about

> you is what you want to hear.

 

I agree with the tenor of the individual points you make. I certainly

think that, in principle, research of various sorts could potentially

benefit our profession, practically and politically. However, and this

is the big problem, for us this is a double edged sword. We have very

little control over the way that research gets done. The biomedical

profession has its own agenda for CAM - I don't want to look articles

up at the moment, but you may remember the New England Journal of

Medicine issue a few years back in which there was an impassioned call

for CAM to be subjected to scientific validation, with the phrase

'there is only one medicine' - and guess which type of medicine that

is. [i think the article in question may be Angell, M. and Kassirer,

P. (1998). Alternative Medicine -- The Risks of Untested and

Unregulated Remedies. The New England Journal of Medicine -- September

17, 1998 -- Volume 339 Number 12] Straus' article in JAMA that I

forwarded to this group a while back was quite explicit about the

NIH's intentions [Marsha F. Goldsmith (ed.). 2020 Vision: NIH Heads

Foresee the Future. JAMA Vol. 282 No. 24, December 22/29, 1999].

 

As Emmanuel has pointed out many times, the money for research is

unlikely to come our way, so it may not be so easy for us to create

the news we think is important, but rather, to have a well reasoned

and developed critique, to have found productive ways of cultivating

our own garden - Ken has been making valuable suggestions about that -

and, as well as we can, to try to influence the direction research is

taken, and how it is related to in our society, by a rooted and

cultivated position of our own.

 

Wainwright

[Guest guest]

Ken,

It's early in the morning here, and late at night where you are. It's

nice to have that sense of silence that I'm perceiving at the moment

in our conversation.

 

Do you remember Rousseau's description of his epiphany as he became

one with the ocean while in a boat? Do you, or anyone else, have that

account available?

 

Pleasant dreams.

 

Wainwright

 

-

" kenrose2008 " <kenrose2008

 

Wednesday, October 29, 2003 7:21 AM

Re: Statistical inference - invalid research

 

 

> Wainwright,

>

> I've never once said that anything

> I've talked about is all we should

> be thinking about, talking about or

> paying attention to. I do believe

> that issue related to nomenclature

> and developing real access to the knowledge

> base of the subject are primary issues.

>

> It's hard to talk about how to design

> a thoughtful study that relates to

> Chinese medicine with a room full

> of people who share no common understanding

> of what qi is.

>

> There are lots and lots of things to

> talk about, worry about, study, learn,

> practice, and so on. The subject is

> not over stated as an ocean.

>

> It's best to explore it as such

> and not with the bearing of landlubbers.

>

> Ken

[Guest guest]

Wainwright,

 

I see two possible courses: one, the brilliantly simple idea

suggested by Phil of measuring outcomes of therapy using a panel of

tests, and establishing norms to compare from. Two, as I have promoted

in my last two posts, aggressively making friends in high places, in

order to establish self-regulating standards, independant of the Western

Medical establishment, and then conducting r & d of a high calliber, on

our terms, and not have to look over our shoulders for approval from

those who do not speak our language.

 

Yehuda

 

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[Guest guest]

Emmanuel and Rory,

You might want to check out the research of Hugh McPherson in the UK.

He has obtained funding to do research that I think is along the lines

that we're talking about, i.e. according to CM paradigms, for low back

pain and more recently depression.

 

It takes careful thought, commitment, etc., and there may be

limitations, but if it is possible to do such research in theory, it

should or at least may be possible to do it in practice. To a large

extent, I think it's down to the determination of individuals, and the

Western CM profession as a whole, to follow this through.

 

I still register the various concerns that I've raised.

 

Best wishes,

Wainwright

 

 

 

-

" Rory Kerr " <rory.kerr

 

Wednesday, October 29, 2003 1:58 PM

Re: Statistical inference - invalid research

 

 

> At 12:36 AM -0800 10/29/03, Emmanuel Segmen wrote:

> >So here's my real bottom line question. Who here is going to do

> >that research? It seem rather " precious " on the part of some people

> >to demand research without either knowing how to do it nor being

> >willing to learn enough to carry it out. Are the people who are

> >demanding this research going to be the ones to do it? To pay for

> >it? And if you decide to do it and/or pay for it, it's not clear to

> >me from any discussion here what the mission is.

> --

>

> At the risk of being labeled precious by you, (well, no risk really,

> you have already done so it seems) this is another red herring and

> false characterization to add to your other ones about research

> costing half a billion dollars, and that we'd all need to become PhD

> statisticians.

>

> First of all, no-one is " demanding research " . We are discussing the

> implications of research in our field, and trying to understand the

> potential costs and benefits. One of the first questions that started

> this thread was whether we should include research in our education

> of OM practitioners, so that our profession could become research

> savvy. You argued against that idea. Now you are arguing that we

> shouldn't do research because we don't know enough about it, because

> we are uneducated. Perhaps you should try to reconcile these

> inconsistent thoughts in your own mind before lobbing any more of

> your highly educated opinions into the debate.

>

> Rory

[Guest guest]

Hi all

 

" wainwrightchurchill " wrote:

> Emmanuel and Rory,

> You might want to check out the research of Hugh McPherson in the

UK.

 

-----------------

For more information about this, check out the Website of the

Foundation for Tradtional at: http://www.ftcm.org.uk/

 

Alwin

[Guest guest]

What IS the purpose of research

>>>>>The purpose is to see if things work, for me that is all i care about.

alon

 

 

[Guest guest]

Rory, Wainwright, Stephen and All,

 

Rory, you indicated that the intention of research is to " communicate " with

Americans about CM. This may be because you see the " language " of communication

in this country to be the scientific method. Alon says he just wants to " see if

things work " . Again there is a " belief " in the scientific method. I'm going to

state here emphatically that this is fundamentally a religious question ... not

spiritual ... ethnically religious. I see that Rory, Stephen and Alon are

unable to " let go " of that nagging need to apply the American paradigm to the

Chinese practices. There is a " need " to ritualize the practice of Chinese

medicine in the American paradigm of the Scientific Method. Ladies and

gentleman, speaking as one of it's priests, I can assure you that the

presupposition for the scientific method is belief. The Scientific Method is

our own personal cultural substrate, using Ken's expression. As many have

pointed out, modern Chinese are attempting to introject the Scientific Method as

quickly as possible into their culture as a cultural substrate. It's a clumsy

fit, but they are shoving it in there as best they can.

 

Rory, I don't blame you a bit for trying to satisfy this nagging feeling of

carrying out American rituals and also for trying to communicate to Americans in

their own " language " . However, how will you then break the news to your

audience that most of the story you have to tell can " not " be told in the

cultural substrate of the Scientific Method?

 

Emmanuel Segmen

 

P.S. It's been years now since I've put " food " between two slices of bread. I

feel like such a rebel!