More surgical "woo." Gynecological surgeons added this procedure to their repertoire

[pnwmom]

more than 20 years ago, without any research demonstrating its safety and effectiveness.

Since then, the procedure of morcellation -- usually using an electric medical device -- has been performed on more than a million patients with fibroid tumors in their uteruses, and in other organs as well.

http://www.nytimes.com/2014/02/07/health/uterine-surgical-technique-is-linked-to-abnormal-growths-and-cancer-spread.html

Uterine Surgical Technique Is Linked to Abnormal Growths and Cancer Spread

Concerns are increasing among doctors about the safety of a procedure performed on tens of thousands of women a year in the United States who undergo surgery to remove fibroid tumors from the uterus, or to remove the entire uterus.

The procedure, morcellation, cuts tissue into pieces that can be pulled out through tiny incisions. The technique is part of minimally invasive surgery, which avoids big incisions, shortens recovery time and reduces the risks of blood loss, infection and other complications.

Surgeons can perform morcellation by hand with a knife, or with an electrical device that has a rapidly spinning blade. But problems have emerged with the procedure, most likely from the power device, according to two articles published on Thursday in The Journal of the American Medical Association. The technique can spray bits of uterine tissue or fibroids around inside the abdomen like seeds. Even benign tissue (fibroids are benign) can take hold and grow on organs where it does not belong, causing pain, infection or bowel obstruction.

In a few cases, a rare and hard-to-diagnose uterine tumor called a sarcoma was hidden in the uterus or mistaken for a fibroid, and morcellation apparently spread cancer cells through the patient’s abdomen. Advanced cancer followed.

SNIP


http://en.wikipedia.org/wiki/Morcellator

Morcellation devices in surgery

Laparoscopic morcellation is commonly used at surgery to remove bulky specimens from the abdomen using minimally invasive techniques. Historically, morcellation was performed using a device that required the surgeon or assistant to manually 'squeeze' the handle. Other reports describe using a scalpel directly through the abdomen to create small specimens that can be drawn out of the abdominal cavity. In 1993, the first electric morcellator was introduced in the US market. It was initially used for uterine extraction, but later applied to other organs. The use of morcellators at surgery has now become commonplace, with at least 5 devices currently on the US market. Despite decades of experience, there remains limited understanding of the short-term and long-term sequelae of morcellation. Concerns have been raised about injury to surrounding organs including bowel, bladder, ureters, pancreas, spleen and major vascular structures. Long-term issues may include parasitic growth of retained tissue with the potential to cause adhesions, bowel dysfunction and potentially disseminate unrecognized cancer.

[VanillaRhapsody]

1. I wouldn't consider this "woo"...

this is an adverse side effect unforeseen...It does for the most part work as expected BUT there is new evidence that there is an issue with the procedure.

Woo implies "like magic"....lacking scientific evidence as proof of concept.

[pnwmom]

9. Morcellation, from the very beginning, lacked scientific evidence

as to its safety and effectiveness. It was a procedure invented and used by surgeons and eventually turned into an electric device that was promoted by manufacturers.

Yes, there is "new" evidence now -- but the procedure has been widely used for decades without proof of its long term safety.

[VanillaRhapsody]

15. still not Woo....

[pnwmom]

19. Of course it is. It has been used without scientific evidence showing its

safety and effectiveness.

Unless your definition of woo excludes any treatment, whether or not backed by sound science,that is used by conventional western doctors.

[VanillaRhapsody]

47. My definition of woo means that it hasn't been proven to be effective beyond a placebo effect.

[pnwmom]

52. Morcellation wasn't proven to be safe and effective in any research

before it was widely used, just as acupuncture wasn't. The difference is that morcellation was eventually found in research studies to cause cancer and acupuncture has not.

[VanillaRhapsody]

53. It was safe and effective for MOST people...it DID what it was designed to do...

it has been shown to have some serious risks that must be evaluated....there is no placebo effect possibility here so still not woo...

[pnwmom]

58. The research wasn't done BEFORE the procedure was widely used.

It was widely used in the absence of the research.

Using it was never scientifically validated, and yet it has been practiced for decades.

[VanillaRhapsody]

62. because it was done by HAND before....

seriously.....you are trying too damn hard to prove some point that is non existent.

[pnwmom]

64. No. The electric morcellator was invented in 1993. n/t

[VanillaRhapsody]

67. and it was done by hand prior to that.....

this is not a new treatment....just a new technology...

[pnwmom]

68. Right. And it was a treatment that developed without scientific research.

As with many medical procedures, it was developed on an ad-hoc basis.

[VanillaRhapsody]

69. No the treatment is fine....the device though it does as intended...

may have some unforeseen risks...NOT that it didn't do what it was intended to do....there is no "placebo effect"

as I said...you are being willful. This is NOT the same as acupuncture....which requires you to believe you have a "chi"

Are you trying to say that those in a great deal of pain with fibroid tumors should just get acupuncture instead?

[pnwmom]

70. Using acupuncture doesn't require you to believe in "chi."

Many MD's use it who don't believe in chi. It's just one more medical treatment that often works even though medical researchers don't understand why -- like drugs that are effective even though researchers don't understand the mechanism.

[VanillaRhapsody]

72. Yes it does....

it hasn't been proven to work any better than a placebo....

by your definition then the IUD would be woo.....but it is EFFECTIVE at preventing pregnancy isn't it?

[MattBaggins]

75. It...Does....Not...Work

[pnwmom]

77. Tell that to the doctors who reviewed the 29 studies with 18,000 subjects

and concluded that it helps with pain relief, and the Harvard doctors who also think it can significantly relieve pain.

http://www.health.harvard.edu/newsletters/Harvard_Mens_Health_Watch/2013/April/is-acupuncture-for-you

[VanillaRhapsody]

91. those are "studies" not peer reviewed science....

[pnwmom]

92. All the studies published in the Archives of Internal Medicine are peer-reviewed science.

Each and every one of the "studies" published within. Do you even know what a medical study is?

Or are you just joking?

https://archinte.jamanetwork.com/public/about.aspx

JAMA Internal Medicine (formerly the Archives of Internal Medicine) is an international peer-reviewed journal providing innovative and clinically relevant research for practitioners in general internal medicine and internal medicine subspecialities. We strive to publish articles that are stimulating to read, educate and inform readers with the most up-to-date research, and lead to positive change in our health care systems and the way we deliver patient care.
JAMA Internal Medicine receives regular attention from major media, including New York Times, Wall Street Journal, Reuters Health, and US News and World Report, as well as social media outlets around the world. Articles published in JAMA Internal Medicine have led to actions by the FDA and congressional hearings on matters of patient safety that have put into place better measures to protect the public. The journal's impact factor is 10.58.

The editor of JAMA Internal Medicine is Rita F. Redberg, MD, MSc, University of California San Francisco School of Medicine, San Francisco, California. Dr Redberg leads a team of recognized and respected experts who serve as deputy, associate, and section editors and as members of the journal's editorial board.

The journal is published online each week, with most major manuscripts published online first, followed by a complete print issue published every month. The journal receives approximately 3.7 million online visits annually, with 7.3 million page views and 4 million article downloads. We receive more than 3000 submissions per year, of which we accept approximately 12%. Manuscripts undergo rigorous peer review and careful statistical assessment within 2 to 3 weeks of submission; the interval between acceptance and publication is 87 days.

[VanillaRhapsody]

94. No and studies that show it is no more effective than the Placebo Effect

do not a peer reviewed and empirical evidence mean....

[pnwmom]

95. So now you're saying acupuncture IS more effective than placebo, because

that's what a peer-reviewed analysis of 29 peer-reviewed studies showed.

[VanillaRhapsody]

108. NO saying it HAS NOT been proven any more effective than the placebo effect....

stop trying to play games to prove your non-existent point....

[MattBaggins]

74. Don't waste your time. That one has an agenda.

Papagei papagei papagei

[MADem]

60. I agree with you. This is an "antiquated surgical technique," not woo--rather like the old

method of slicing open a half moon in one's chest and breaking a rib to get at a gallbladder, or a cancerous lobe in a lung. Now they poke a couple of holes and go in and out with a little camera watching the whole business through one of the holes.

I thought that ablation and embolization--not slicing and dicing-- were the preferred methodologies for that kind of surgery these days, anyway, but I haven't kept up.

[VanillaRhapsody]

71. that may well be true.....I have no idea....but I know that removing the uterii when the patient

has severe fibroid tumors hasn't changed....they perform a hysterectomy...that is not woo....the fact that a surgical technique is replaced by a better one....doesn't mean the old one was woo as this poster suggests.

[MADem]

81. I agree; as I said, it's nothing more than an antiquated surgical technique.

Many antiquated surgical techniques solved one problem and sometimes created others. That didn't make them "woo."

I think the poster is confused as to what "woo" is. It's basically this:

http://dictionary.reference.com/browse/woo-woo

This surgical technique may have not been carefully vetted, but it did what the surgeon wanted, it solved the immediate problem. The fact that it created another down the line has nothing to do with irrational belief or superstition.

[pnwmom]

99. It is woo in the sense that it is a medical treatment not based on scientific evidence

that it is safe and effective.

[MADem]

104. Chopping those things out, for many years, was the safest and most effective option short

of removing the whole works, which some found objectionable if it could be avoided. All this was, was a different and mechanized way to chop 'em out. The process created other difficulties, but the action of removing the growths was never a "woo" issue.

It wasn't based on figments of anyone's imagination, or beliefs not borne out by science, which is what "woo" is. It was just a sloppy way of doing an established job. I can't call that "woo."

It's just using the wrong tool to do a job. A different thing entirely.

[pnwmom]

98. It isn't antiquated, and it was put into widespread use despite the lack of evidence-

based research showing that it was safe and effective. Like many surgical techniques, it was developed on an ad-hoc basis.

[MADem]

105. It is antiquated--the preferred methodology now is ablation or embolization--no cutting at all. nt

[pnwmom]

106. Up to 150,000 U.S. women still have this procedure every year.

It's still used and accepted by many doctors.

[MADem]

110. Some dentists still use those silver fillings, but they're not the optimal way of filling a tooth

anymore.

And some doctors still sew up wounds that can be closed faster with superglue.

It's not wrong, it's just old school. Ablation is pretty much an outpatient procedure; embolization is done by a radiologist.

[pnwmom]

111. The Boston Globe says it has become the "standard of care across the country,"

with up to 150,000 performed yearly.

That's why the FDA announcement is so important.

http://www.bostonglobe.com/lifestyle/health-wellness/2014/04/17/fda-issues-safety-warning-discouraging-power-morcellation-for-fibroids-hysterectomies/TvASpwy85K4Plx3LRC75DM/story.html

Between 500,000 and 600,000 women a year undergo hysterectomies, up to 40 percent for painful fibroids, which can also cause bleeding, Maisel said. It’s unclear how many involve morcellation but estimates range from 50,000 to 150,000.

The procedure has grown over the past decade into the standard of care across the country. It has enabled doctors to move away from traditional surgery, using a long incision across the belly, to laparoscopic surgery, which requires several much-smaller cuts and allows patients to recover more quickly with less pain and fewer infections.


http://online.wsj.com/news/articles/SB10001424052702304626304579507642833016758?mg=reno64-wsj&url=http%3A%2F%2Fonline.wsj.com%2Farticle%2FSB10001424052702304626304579507642833016758.html

This was the situation that ensnared Amy Reed, a 41-year-old mother of six and anesthesiologist at Boston's Beth Israel Deaconess Medical Center, who developed advanced uterine cancer shortly after a routine hysterectomy in October. The hospital where she was treated, Boston's Brigham and Women's Hospital, acknowledged that use of morcellation worsened her cancer.

The FDA began its review in December, "when some high-profile cases covered in the media came to our attention," Dr. Maisel said. The agency also noted there are many alternatives, including minimally invasive surgery without morcellators, vaginal hysterectomies and open surgery. There are also nonsurgical options including drug therapy and ultrasound treatment.

SNIP

The agency's alert prompted some to act immediately Thursday. Dr. Isaac Schiff, chief of the Department of Obstetrics & Gynecology at Massachusetts General Hospital, said, "I have asked our doctors to stop the procedure immediately until we have more information."

[MADem]

114. There's no way to know how many ablations are done--it could be double that number.

It's an outpatient procedure and those are not as well tracked; similarly, embolizations are a radiological, not a surgical procedure.

While morcellations may be the standard of SURGICAL care, they are not the standard of care for those who can relieve their symptoms with those other methodologies which don't require any incisions. Embolization is managed with a puncture to the vein, and mini ping pong balls are fed up there which block the flow of blood and cause the fibroids to infarct and die.

In any event, though, a "standard of care" procedure, is, even if not optimal, even if it has unintended consequences, by definition, not "woo."

It did what it said it would do--it just caused other issues as well.

[pnwmom]

115. If morcellations are the standard of surgical care, isn't that significant?

And if the standard of surgical care turns out NOT to be based on scientific evidence, but just a kind of medical faith passed from one practitioner to another, why isn't that woo?

[MADem]

117. You are still missing the point. Not sure why.

Does the morcellation remove the fibroid? Yes.

Is the purpose of the surgery to rid the patient of fibroids? Yes.

No woo. The procedure does what it says it will do.

Are there unintended consequences to this procedure? Yes.

The surgeons will either have to proceed by hand, or give up their patients to the outpatient ablation procedure or the embolization.

It's like a medication that works to cure a patient's illness, but has an unintended side effect. That's not woo, either. That's a side effect, an unanticipated consequence of use.

Woo is magical thinking--like believing that homeopathic water will cure you, or a shaman can yell words at you and make your cancer shrink. It's not a bad side effect.

[pnwmom]

118. The point is that the procedure has been in use for decades without research backing it up.

And this isn't uncommon in medicine. Knee surgery for meniscus tears is another procedure that has been done by surgeons for decades without research showing that it is more useful than placebo. Since 2002, several studies have been released showing that in the majority of cases -- degenerative tears-- the surgery doesn't work. There was finally a study involving sham surgeries last year, which confirmed that meniscus surgery wasn't any more effective than a sham surgery. And yet the procedure is still used by orthopedic surgeons across the country in patients with degenerative tears, who are unlikely to benefit (as opposed to the minority of patients with tears from sudden accidents, who may benefit.)

Acupuncture has been shown in research to be both safe and effective for pain relief. So why is it considered "woo" by many here? Probably because the mechanism of action is unknown -- and it isn't "chi." And yet there are many accepted drugs that have been proven effective over decades of use that still have an unknown mechanism of action.

I don't know what would explain all the people who call acupuncture "woo" except for a bias in favor of western medicine. We take for granted that all treatments in western medicine are evidence-based, and have a known mechanism of action -- and that's simply not true.

[MADem]

119. It. is. not. woo.

How many people have to tell you this?

It does what it says it will do--it removes fibroids.

You need to go back and get clear in your mind what "woo" is. You don't have a grasp of that.

[pnwmom]

120. Maybe not. But then neither is acupuncture.

Acupuncture has been shown in many studies to relieve pain, and MD's across the country have successfully used it. The mechanism of action is unknown, but that's also true for many of the drugs they prescribe.

Just because something wasn't developed as a part of western medicine doesn't make it woo. Especially when it has now been studied by western researchers and adopted by western doctors.

http://nccam.nih.gov/research/results/spotlight/091012

NIH: National Center for Alternative and Complementary Medicine

For all pain types studied, the researchers found modest but statistically significant differences between acupuncture versus simulated acupuncture approaches (i.e., specific effects), and larger differences between acupuncture versus a no-acupuncture controls (i.e., non-specific effects). (In traditional acupuncture, needles are inserted at specific points on the body. Simulated acupuncture includes a variety of approaches which mimic this procedure; some approaches do not pierce the skin or use specific points on the body.) The sizes of the effects were generally similar across all pain conditions studied.

The authors noted that these findings suggest that the total effects of acupuncture, as experienced by patients in clinical practice, are clinically relevant. They also noted that their study provides the most robust evidence to date that acupuncture is more than just placebo and a reasonable referral option for patients with chronic pain.

[MADem]

121. I'm not arguing about acupuncture, that's someone else. nt

[VanillaRhapsody]

180. Counterpoint...ALSO from NIH!

Sham acupuncture may be as efficacious as true acupuncture: a systematic review of clinical trials.
Abstract
OBJECTIVE:
This study sought to determine whether sham acupuncture is as efficacious as true acupuncture, as defined by traditional acupuncture theories.

METHODS:
A systematic review was conducted of clinical trials that used sham acupuncture controls with needle insertion at wrong points (points not indicated for the condition) or non-points (locations that are not known acupuncture points). This study used a convenience sample of 229 articles resulting from a PubMed search using the keyword "acupuncture" and limited to "clinical trials" published in English in 2005 or 2006. Studies were categorized by use of wrong points versus non-points and the use of normal insertion and stimulation versus superficial insertion or minimal stimulation.

RESULTS:
Thirty-eight acupuncture trials were identified. Most studies (22/38 = 58%) found no statistically significant difference in outcomes, and most of these (13/22 = 59%) found that sham acupuncture may be as efficacious as true acupuncture, especially when superficial needling was applied to non-points.

CONCLUSIONS:
The findings cast doubt on the validity of traditional acupuncture theories about point locations and indications. Scientific rationales for acupuncture trials are needed to define valid controls, and the theoretical basis for traditional acupuncture practice needs to be re-evaluated.

http://www.ncbi.nlm.nih.gov/pubmed/19250001

[Jesus Malverde]

174. How "science" works in america...

The FDA began its review in December, "when some high-profile cases covered in the media came to our attention

Same with fen fen, hormone replacement therapy, the treatment of ulcers, etc.

[pnwmom]

178. That's a important point. Why did it take so long for these problems to be acted on?

The FDA is almost purely reactive with approved or established drugs. Even reporting the adverse effects reports on newly released drugs is at the discretion of the doctors.

[Jesus Malverde]

179. They listen to industry, only when the lies and omissions of the businesses are laid bare...

do they feel forced to act.

Even then they minimize the problem and don't focus on patient protection, instead deferring to conflicted "experts".

This announcement is costing the industry millions in lost revenue.

The bigger question, why do so many women need hysterectomies. $$$$$$

[La Lioness Priyanka]

2. how is this woo?

[tammywammy]

3. What part of this is "woo"? n/t

[boston bean]

4. Why are you calling this woo?

I would like you to answer.

[NuclearDem]

7. Probably because some people think woo or pseudoscience are just general epithets

When in fact they have definitions.

[pnwmom]

13. No, because this procedure was used for decades without scientific research

showing that it was safe and effective.

Meanwhile, dozens of studies by reputable researchers show that acupuncture helps relieve pain while not causing harm -- and yet people here persist in calling it "woo."

[VanillaRhapsody]

16. acupuncture scientifically proven....no

http://www.theguardian.com/science/2013/jul/26/acupuncture-sceptics-proof-effective-nhs

Given the popularity and wide usage of acupuncture, patients self-refer to acupuncturists for a variety of indications. Trained physicians need to become familiar with when and how they might refer their patients to an acupuncturist. To inform clinicians and researchers, the National Institutes of Health (NIH) convened a consensus panel to review the available literature about acupuncture.[15] They wished to assess not only clinical efficacy and effectiveness but also biological effects, implications on the healthcare system, and the need for further research. Because much acupuncture research has been done by enthusiastic practitioners rather than trained researchers, the quality of many studies was poor. Because of this, the NIH Consensus Panel concluded that acupuncture was proven to be evidence-based for only two indications: dental pain and nausea (postsurgical, chemotherapy induced, or nausea related to pregnancy).

http://www.medscape.com/viewarticle/501973_3

[pnwmom]

17. Even if you believe that, rather than the Harvard and Chicago researchers,

it still says that acupuncture has been proven for dental pain and for nausea.

Unlike morcellation, which has been in wide use without the backing of scientific research.

[VanillaRhapsody]

18. please provide links to those....

scientifically proven IS scientifically proven...and acupuncture is NOT! (and they weren't even convinced that it wasn't placebo effect in nausea and dental pain.)

and you are saying that this procedure has LESS effectiveness than that? Um no.....for most that procedure worked....however it has some risks not taken into account....

MUCH Different....

[pnwmom]

20. You just did. Your own link says its use is evidence-based for dental pain and nausea. n/t

[VanillaRhapsody]

21. but they weren't convinced it was any more effective than a placebo....

you still do not have scientifically proven...

[pnwmom]

22. From a Harvard site:

http://www.health.harvard.edu/newsletters/Harvard_Mens_Health_Watch/2013/April/is-acupuncture-for-you

Science has put acupuncture to the test on a wide variety of conditions, including chronic pain. The results have been mixed. But a recent study in Archives of Internal Medicine added to the evidence that acupuncture provides real relief from common forms of pain.

The researchers pooled the results of 29 past studies involving nearly 18,000 participants. Overall, acupuncture relieved pain by about 50%, which is comparable to the relief that many people get from conventional care, such as pain medication. That means that if a man rated his pain at the start as 60 on a scale zero to 100, acupuncture dropped it to 30, compared with people who did not have acupuncture.

The study is not the last word on the issue, but it is one of the best quality studies to date and has made an impression. "The question here is whether acupuncture is worthwhile to try," says Dr. Donald Levy, medical director of the Osher Clinical Center at Harvard-affiliated Brigham and Women's Hospital, where doctors combine conventional and alternative medical approaches. "I think there is evidence to support that recommendation."

[VanillaRhapsody]

24. this has been published and peer reviewed?

or just spoken about in a "newsletter"?

scientists are NOT going to agree that you have a "chi" which is what acupuncture is based on...

"Many medical experts remain deeply skeptical about acupuncture, of course, and studies of its effectiveness have been mixed. "Something measurable is happening when you stick a needle into a patient—that doesn't impress me at all," says Edzard Ernst, a professor of complementary medicine at the University of Exeter in England and co-author of the book, "Trick or Treatment." Acupuncture "clearly has a very strong placebo effect. Whether it does anything else, the jury is still out."

http://online.wsj.com/news/articles/SB10001424052748704841304575137872667749264

[pnwmom]

25. Yes. Ever hear of the Archives of Internal Medicine?

If you seriously care about this, you could try reading the article I've linked to. Then you wouldn't have to ask questions that are easily answered.

Now please tell me, when doctors started using morcellation, and later, electric morcellators pushed by device manufacturers, what published and peer reviewed study did they have access to showing that the procedure was safe and effective?

[VanillaRhapsody]

26. No they are not....I just replied with the appropriate response from that doctor

"placebo effect" and "the jury is still out"


Acupuncture is not proven "not woo".

[pnwmom]

28. Results are mixed on acupuncture, but the 29 studies of 18,000 subjects analyzed in

the Annals of Internal Medicine indicate it is safe and effective.

Acupuncture is less "woo" than morcellation, which was used in the absence of those studies and has been demonstrated more than 20 years later to be unsafe.

[VanillaRhapsody]

30. Mixed doesn't mean what you think it means....

and certainly doesn't support your contention that it is definitely not woo....

[pnwmom]

32. It doesn't mean what you think it means. n/t

[VanillaRhapsody]

35. I means I probably do not have a "chi"

[pnwmom]

97. Acupuncture, like a number of accepted drugs, has an unknown mechanism of action.

No western researcher thinks it has to do with "chi."

But research by investigators at Harvard, Chicago, University of Washington, the Fred Hutchinson Cancer Research Center, and elsewhere has shown that it can be helpful in pain relief -- even though the mechanism of action is unknown.

http://en.wikipedia.org/wiki/Mechanism_of_action

However, some drug mechanisms of action are still unknown. For example, phenytoin is used to treat symptoms of epileptic seizures, but the mechanism by which this is achieved is still unknown, despite the fact that the drug has been in use for many years.

[MattBaggins]

78. Results are not even remotely mixed

Acupuncture is nonsense

[pnwmom]

100. You're not keeping up with the research. It's used at Harvard, U. Chicago,

U. Washington, U. California, and by M.D.'s all over the country, based on the scientific research showing it helps relieve pain.

[MattBaggins]

76. Accupuncture harms

http://www.ncbi.nlm.nih.gov/pubmed/18684094

[magical thyme]

80. it harms when a single practitioner doesn't follow sterile practice.

You left something out there.

"To describe an outbreak of invasive methicillin-resistant Staphylococcus aureus (MRSA) infection after percutaneous needle procedures (acupuncture and joint injection) performed by a single medical practitioner."

"This outbreak most likely resulted from a breakdown in sterile technique during percutaneous needle procedures, resulting in the transmission of MRSA from the medical practitioner to the patients. This report demonstrates the importance of surveillance and molecular typing in the identification and control of outbreaks of MRSA infection.

[pnwmom]

96. Any surgery harms when it fails to use sterile instruments. So?

Does that make all surgeries woo?

[joeglow3]

131. Using your definition of woo, yes.

[pnwmom]

10. It is woo because it was promoted and used as a treatment without the scientific

research to back up its safety and effectiveness.

[NuclearDem]

5. This is something that hasn't been properly independently tested.

Woo on the other hand cannot be independently tested.

[pnwmom]

14. Then why do people here keep calling acupuncture woo?

It has been tested in numerous studies, at Harvard, Chicago, and elsewhere, and found to be an effective method of pain relief.

[mathematic]

27. Because there's no such fucking thing as qi.

THINGS THAT EXIST:
fibroid tumors
uterine tissue
blood loss
infection

THINGS THAT DO NOT EXIST:
qi

[pnwmom]

29. As a procedure, it has been shown to be effective and without harm,

unlike morcellation, which has now been shown to be harmful.

There are also many drugs that are commonly prescribed even though researchers don't know exactly why they work -- and also drugs such as SSRI's which turn out to not work any better than a placebo in the majority of patients who take them. And yet, we never call these products of Big Pharma "woo."

[VanillaRhapsody]

33. No it hasn't....

No SSRI's have NOT proven that either.....they HAVE been proven to be better than placebo....that is the difference here....

You are very misinformed....

[pnwmom]

36. You don't keep up. I didn't say SSRI's are never effective.

I said they're no more effective than placebos in the majority of people -- those with moderate levels of depression -- who are prescribed them.

http://jama.jamanetwork.com/article.aspx?articleid=185157

Conclusions The magnitude of benefit of antidepressant medication compared with placebo increases with severity of depression symptoms and may be minimal or nonexistent, on average, in patients with mild or moderate symptoms.

[VanillaRhapsody]

49. It has to be beyond PLACEBO EFFECT to not be Woo....

this is a very simple construct to understand.

[pnwmom]

54. Then SSRI's for moderate and mild depression are a form of "woo."

Because they don't work better than a placebo.

[VanillaRhapsody]

56. No that is NOT what it said at all.....

they DO work better for moderate....but for less severe...it hasn't....BECAUSE depression is not measurable the same way that say cancer is.....


You are just being willful now...

[pnwmom]

88. That's not what the research says:

http://jama.jamanetwork.com/article.aspx?articleid=185157

Conclusions The magnitude of benefit of antidepressant medication compared with placebo increases with severity of depression symptoms and may be minimal or nonexistent, on average, in patients with mild or moderate symptoms.

[Union Scribe]

86. You are spreading dangerous bullshit.

Seriously, cut it out. Beyond being wildly irresponsible, it makes DU look stupid.

[pnwmom]

87. You might try reading the research. This isn't news anymore -- it has been

widely discussed. Obviously not widely absorbed. For people with depression that is not severe (moderate or mild), SSRI's have not been shown to work better than placebos. And yet doctors continue to write millions of these prescriptions.

From a meta-analysis of numerous studies conducted between 1980 and 2009:

http://jama.jamanetwork.com/article.aspx?articleid=185157

Conclusions The magnitude of benefit of antidepressant medication compared with placebo increases with severity of depression symptoms and may be minimal or nonexistent, on average, in patients with mild or moderate symptoms.

[Union Scribe]

89. Vanilla is handling your nonsense well enough for me.

My problem is that you're implicitly encouraging people to distrust or even disregard their doctors and the medications and procedures they advise. Frankly, you're getting into Jenny McCarthy territory. If someone who needs psychiatric help reads this, and decides that instead of going to a doctor they're going to try to align their chakras or some bullshit, the result is on your head.

[pnwmom]

112. Do you also have a problem with Scientific American and all the scientific journals

that are publishing articles on this topic?

All I'm doing is pointing to them.

http://www.scientificamerican.com/article/antidepressants-do-they-work-or-dont-they/

A controversial article just published in the prestigious Journal of the American Medical Association concluded that antidepressants are no more effective than placebos for most depressed patients. Jay Fournier and his colleagues at the University of Pennsylvania aggregated individual patient data from six high-quality clinical trials and found that the superiority of antidepressants over placebo is clinically significant only for patients who are very severely depressed. For patients with mild, moderate, and even severe depression, placebos work nearly as well as antidepressants.

There have been at least four other review articles published in the last eight years that have come to similar conclusions about the limited clinical efficacy of antidepressants, and one of the study authors, psychologist Irving Kirsch, has recently published a book on the topic, provocatively entitled The Emperor’s New Drugs: Exploding the Antidepressant Myth.

The recent review articles questioning the clinical efficacy of antidepressants run counter to the received wisdom in the psychiatric community that antidepressants are highly effective. Indeed, it wasn’t so long ago that psychiatrist Peter Kramer wrote in his best-selling book Listening to Prozac that this miracle drug made patients “better than well.” Prozac was a Rock Star. Its extraordinary success even led to a photograph of the green and white capsule on the cover of Newsweek Magazine in 1990.

SNIP

[VanillaRhapsody]

90. bullshit

that is NOT true.....it said people with "MILD" depression.....

[VanillaRhapsody]

51. Oh and you forgot this part...from your link...

"relative to pill placebo for patients with less severe depression."


fixed that for ya....

[pnwmom]

55. The majority of people prescribed SSRI's are those with less severe depression.

SSRI's are no better than a placebo for them, unlike people with severe depression.

[VanillaRhapsody]

57. No that is not true....

do you decide who has "less severe depression"?

For less severely depressed patients, the antidepressants were found to work no better than placebos, leading the researchers to conclude that most patients who take antidepressants probably shouldn't be on them.

The findings are published in the February issue of the journal PLoS Medicine.


"There seems little reason to prescribe antidepressant medication to any but the most severely depressed patients, unless alternative treatments have failed to provide a benefit," says study researcher Irving Kirsch, PhD, of England's University of Hull.

But in a statement, American Psychiatric Association President-elect Nada Stotland, MD, maintained that studies like those reviewed by Kirsch and colleagues, which compare a single drug to placebo, do not accurately reflect the way doctors prescribe antidepressants.

"We know that many people who are depressed do not respond to the first antidepressant they try," she says. "It can take up to an average of three different antidepressants until we find the one that works for a particular individual. Therefore, testing any single antidepressant on a group of depressed individuals will show that many of them do not improve."

http://www.webmd.com/mental-health/news/20080227/antidepressants-no-better-than-placebo

[pnwmom]

59. No, the researchers did. Read the article again. And here's more:

http://www.scientificamerican.com/article/antidepressants-do-they-work-or-dont-they/

[VanillaRhapsody]

61. No I did....the fact that YOU are comparing the results of SSRI's to acupuncture says it all...

[MattBaggins]

79. If you can show that acupuncture will cure cancer

that we will stop dismissing your nonsense comparisons.

[pnwmom]

85. Acupuncture can relieve pain and reduce nausea. It doesn't have to cure cancer

to have been demonstrated as safe and effective in numerous peer-reviewed, published, scientific studies.

[VanillaRhapsody]

109. but hasn't been proven more effective than to make people THINK they received the treatment

that is the placebo effect.

[pnwmom]

116. Yes, it has been shown to be more effective in many studies. And since it is so much safer than

drugs such as opioids, it is well worth trying -- according to reputable scientific researchers, who do not consider it "woo."

http://www.health.harvard.edu/newsletters/Harvard_Mens_Health_Watch/2013/April/is-acupuncture-for-you

Science has put acupuncture to the test on a wide variety of conditions, including chronic pain. The results have been mixed. But a recent study in Archives of Internal Medicine added to the evidence that acupuncture provides real relief from common forms of pain.

The researchers pooled the results of 29 past studies involving nearly 18,000 participants. Overall, acupuncture relieved pain by about 50%, which is comparable to the relief that many people get from conventional care, such as pain medication. That means that if a man rated his pain at the start as 60 on a scale zero to 100, acupuncture dropped it to 30, compared with people who did not have acupuncture.

The study is not the last word on the issue, but it is one of the best quality studies to date and has made an impression. "The question here is whether acupuncture is worthwhile to try," says Dr. Donald Levy, medical director of the Osher Clinical Center at Harvard-affiliated Brigham and Women's Hospital, where doctors combine conventional and alternative medical approaches. "I think there is evidence to support that recommendation."

[VanillaRhapsody]

124. No....not more than placebo....

if you look at studies where they included the possibility of placebo....you would see that it is no better than placebo...

THAT is the difference between woo or not....


But YOU know that.....

You don't win this.....

The new study bolsters the evidence for acupuncture but doesn't quite put to rest the idea that patients are largely responding to the placebo effect, says Dr. Andrew L. Avins, an epidemiologist at the University of California, San Francisco and a research scientist at Kaiser Permanente, a large nonprofit health plan based in Oakland, California.

Although genuine acupuncture clearly benefited the study participants, Avins says, the fact that the effectiveness rate was much higher than treatment as usual but only slightly higher than the sham treatment suggests that most of the benefit associated with acupuncture is indeed attributable to the placebo effect....

[Demit]

128. Kudos

Can't comment knowledgeably on the science, but I just read thru this extended volley & I'd say your post is a very nice passing shot down the line

[VanillaRhapsody]

129. Thanks.....

I do my best!

[joeglow3]

132. Prayer doesn't cause harm, so it is not woo.

I don't think you know what woo is

[Orrex]

6. If there is clear evidence that the device does no good or causes harm...

then by all means its use should be abandoned. This isn't "woo" at all.

Further, if the device offers no benefit or causes harm, then it's very likely that this will be determined through empirical, scientific review. This stands in stark contrast to "woo" therapies that never self-correct and never disprove other "woo" techniques.


It is indeed a shame that ill-justified medical procedures gain popularity in this way. Fraudulent or dishonest practices should be condemned outright, but even those techniques that don't work but are put forth in good faith should be eliminated.

[pnwmom]

11. Why is the standard any different than with acupuncture, for example?

Doctors for decades used morcellation without scientific evidence that it was safe and effective. Now acupuncture has been shown in numerous studies to help in pain relief, without causing harm, and yet people here still call it "woo."

But morcellation, which came into wide use in the absence of studies proving its safety, is somehow not-woo.

[Orrex]

23. A very fair question

The practice should absolutely have been subjected to rigorous testing and peer review. No dispute there.

However...

If we're looking for a simple test for woo vs. not-woo, then it would probably be the degree to which a particular practice is consistent with established science. A procedure that contradicts no scientific principle and makes no science-contradictory claims is probably not woo. A procedure that relies on inherently pseudoscientific principles (e.g. homeopathy) or which bastardizes scientific principles (e.g. referring to "chi" as "energy&quot is probably "woo." In nearly all cases "woo" directly contradicts established science, or else it has no way to be verified empirically (e.g., non-falsifiable claims, etc.)

Again, morcellation was not debunked via "woo" or pseudoscience but through actual science, meaning that the science self-corrected a bogus practice. Pseudoscientific alternative medicine does not self-correct and is inherently resistent to correctly. Advocates of a given scientific principle may resist correction, but the principle itself does not.


That's not an ironclad distinction, but it's useful as a back-of-the-napkin test.

[pnwmom]

113. Thank you for a reasoned response.

But, as I'm certain you know, many drugs currently in use have an unexplained mechanism of action. How is this different from acupuncture, which has been shown in many studies to be effective for reducing pain, and is used by MD's across the country, but has an explained mechanism of action?

[Orrex]

123. Acupuncture is claimed to rely on a function never shown to exist

Last edited Fri Apr 18, 2014, 09:59 AM - Edit history (1)

That is, it claims to alter the flow of "chi" along "meridians," neither of which has been demonstrated. I know that there was a recent report claiming to have identified these meridians, so I guess we'll have to wait and see.

But nothing in medicine claims to rely on a mechanism that doesn't exist or which defies our understanding of physics. Even when the precise mechanism isn't known, the effect is (in principle) shown to have a certain statistical probability better than placebo. And ethical medicine never depends on deceiving the patient while relying on the famous placebo effect.

If acupuncture works by conventional means, then let its proponents say so. Ditto for reiki or homeopathy. But when the advocate invokes magical concepts, we move from medicine to woo.

[Squinch]

8. I see the woo aspect. A procedure was used without testing, on faith alone, without proof of its

long term safety. We now see that faith was misplaced, and it has resulted in the spread of cancers.

Another complaint about woo is that it wastes money, and has a large profit motive behind it. I will wager that, because there are "at least 5 devices currently on the market" for morcellation, and because someone is profiting from those devices, morcellation will not be stopped during these surgeries any time soon.

[pnwmom]

12. Thanks. You explained my point better than I did. n/t

[ret5hd]

37. Which was...

the uterus/organ was removed by the placebo effect???

[joeglow3]

133. Not woo

It served the original intent. Problem is that it led to consequences that were unforeseen. That is potentially shitty medical practice, but is NOT woo.

[Squinch]

135. The original intent of removing the tumors was to prevent their spread. The method they used on

faith actually contributed to their spread.

Woo is what you define it to be. Maybe using something on faith that has the opposite effect to your goal is not your definition. It is mine.

[mathematic]

31. No evidence has been provided that this is not effective

or more dangerous than alternative surgery techniques.

You seem to have fabricated the non-effectiveness of this technique out of whole cloth.

[pnwmom]

34. It has been proven more likely to spread cancer than

removing a whole uterus. If "effectiveness" includes not spreading cancer, than it isn't as effective as it should be.

[VanillaRhapsody]

38. That is not what determines "effectiveness"....

a guillotine is proven effective at decapitating you....the fact that you lose your head in the process doesn't make a guillotine woo....

[pnwmom]

39. It's not enough to be "effective" if it isn't proven safe, too. As your example demonstrates. n/t

[VanillaRhapsody]

41. That is nothing to do with woo....woo is about magic....

it may not be AS effective because it can increase risk of cancer.....but it was effective to to the job it was designed to do....MOST did not get Cancer after this treatment.

A sugar pill can be "effective"....but doesn't mean it isn't woo.

[pnwmom]

42. Woo is about treating medical conditions in the absence of scientific research showing

that the procedure or drug or treatment is safe and effective.

[VanillaRhapsody]

44. No it isn't and you don't get your own version of a definition.....

Acupuncture is most likely woo....this procedure is might be too risky....

Big differnce...

[pnwmom]

40. You don't get it. It wasn't proven effective or safe BEFORE it came into wide use.

It was put into wide use in the absence of scientific research showing it was safe and effective.

So the fact that it may effectively remove a uterus doesn't mean that it was scientifically proven as a procedure.

[VanillaRhapsody]

45. So some uteri were left intact afterward?

[pnwmom]

48. That would be an anecdotal piece of evidence, not a research study. nt

[VanillaRhapsody]

63. that some uteri were left intact after this procedure?

hardly....

[G_j]

43. Obviously some prefer to pick and choose their woo

I've seen just about everything under the sun called woo here, but not this?
Lets just drop the ridiculous term and be done with it.

[VanillaRhapsody]

46. No lets not....there is woo and there are scientifically proven procedures determined NOT to be

the safest or most effective technique...

Woo means it is NOT proven beyond the possibility of a placebo effect.

[G_j]

50. the above is a "scientifically proven procedure"?

where do you see that?

[VanillaRhapsody]

65. the above is a device designed to do a procedure PREVIOUSLY done by hand

that has been shown to have some problems.....

so have stints placed into the arteries of heart patients...but they still did what they were intended to do...

[pnwmom]

102. Exactly. And morcellation has proven NOT to be a scientifically proven procedure.

Therefore, according to you, it must be "woo."

[VanillaRhapsody]

107. No as been told to you over and over and over again....it DID its intended job.....

it has just since been proven to have some risks not forseen....NOT the same thing.

NOT being more proven more effective than the placebo effect is what is WOO.

This procedure still doesn't fail the placebo effect requirement....

[Coventina]

66. Wow! Questions of "woo" aside, I'm feeling good about my big ol' myomectomy scar right now.

And my photograph of my big ol' fibroids that were taken out of me, intact!

[VanillaRhapsody]

73. glad you didn't opt for acupuncture instead!

[Coventina]

82. It was not an option presented to me by my ob/gyn

[VanillaRhapsody]

83. Cannot imagine why....

it is "scientifically proven" and all!

[SidDithers]

84. That's not woo...

but keep trying.

Sid

[ecstatic]

93. Wow.

I had a Davinci/robotic myomectomy 4 years ago. This is the first time I'm hearing about the potential consequences. Thanks for sharing.

[pnwmom]

103. A good friend of mine had it, too. And I remember she was so happy at the time

to have avoided a regular hysterectomy. Now, not so much.

[zappaman]

101. Lol! This ain't woo.

Missed it by that much!

?w=780

[intaglio]

122. All too often surgeons guess. n/t

[VanillaRhapsody]

125. Uh WTF is that supposed to mean?

You do know there are millions of successful surgeries everyday right? MILLIONS....

surgery is NOT woo.

[intaglio]

126. Unfortunately some surgeons tend not to function on evidence

But prefer fashion.

Consider the fashions for prefrontal lobotomy. There are also many unnecessary procedures. In the 1950s 60s and 70s adenoid surgery, tonsillectomy and circumcision were often performed so as to avoid problems later on. Currently there is a fashion for hysterectomies and certain arthroscopies. Gall bladder removal now being an easier task using keyhole procedures is far more common and up to 40% are thought to be unnecessary. Many cardiac procedures have no evidence to support their effectiveness (stents in particular often cause more problems than they solve.)

Please review the following

http://jama.jamanetwork.com/article.aspx?articleid=1104138

http://thinkprogress.org/health/2013/06/20/2190041/study-doctors-unnecessary-surgery/

http://fhs.mcmaster.ca/source/ebs.html

[VanillaRhapsody]

139. Oh so throw the baby out with the bathwater because SOME are not ethical?

so ALL surgery is Woo?

No....simply no...

[intaglio]

144. Did I say that all surgeries are woo? NO

Please do not put words into my mouth, it is a vile habit.

I support EVIDENCE based medicine but unfortunately, as my Grandfather observed 35 years ago, not all surgeries are based upon evidence.

Oh, he was a consultant surgeon at Carshalton Hospital.

[VanillaRhapsody]

145. This is about Woo....not some unethical doctors...

what does that have to do with Woo?

[intaglio]

161. Because "unethical" doctors and scientists are as big a source of Woo as snake oil salesmen

The whole prefrontal lobotomy scam was Woo.

The highly educated and qualified Andrew Wakefield sold woo

Do you know why Freud gave up a general medical practice? Because he damn near killed a woman following the fashion for removing the nasal turbinate bones to cure hysteria.

[VanillaRhapsody]

163. No that is not what WOO means...

the prefrontal lobe lobotomies...did what they were intended to do...

[intaglio]

165. Prefrontals were the worst type of woo

The process could not be carried out in a reproducible way and the extent of trauma to the lobes varied between patients. What is more the results were variable; some patients became passive, some became violent, some became vegetative and some died. The process was carried out for a wide variety of patient including schizophrenics, bipolars, depressives, people we would now recognise as autistics and some epileptics.

The variation in effect is not surprising given that the methodology was to hammer a sharpened rod (similar to a knitting needle) through the orbit to the eye and then sweep this rod in a variety of arcs (according to the whim of the surgeon). The motion was completely unguided, there being no real time x-ray projection, and completely random as little if any knowledge of the real function of brain structures existed at the time.

[VanillaRhapsody]

166. No....bad medicine is NOT woo...read the definition

[VanillaRhapsody]

167. and its still based on Science....

woo is NOT....

[intaglio]

175. Wrong, absolutely and completely wrong

Science is based on evidence not supposition. There - was - no - evidence, none, zip, nada, zilch.

None to support either the original operative procedure or its continuance. The effects were not reproducible, they were variable; there was no foundational hypothesis that could be falsified only the random guesses of a man who was little more than a butcher; there was no restricted cadre of test subjects; there was little if any monitoring of test subjects either before or after the operation.

What do you call science that is not based on evidence, that is not falsifiable, that ignores starting conditions and that does not monitor closing conditions (carry out follow up assessments) and that sells itself purely by the claims of the inventor and his publicity of unproven effects?

A hint - the word has 3 letters begins with W and ends in o

[VanillaRhapsody]

164. definition

woo-woo adj. concerned with emotions, mysticism, or spiritualism; other than rational or scientific; mysterious; new agey. Also n., a person who has mystic beliefs

http://www.waywordradio.org/woo_woo/

also:

Many of mainstream medicine’s conventional treatments are not evidence based. Aren’t they a form of woo?
No. Although some conventional methods fail to measure up to best evidence they are at least based on known anatomy and physiology. They have some plausibility in the observable biophysical model in contrast to the “vital forces”, nebulous “energy fields” and “non-local powers of the mind” which are characteristic of woo.

You seem to focus a lot of your criticism on woo. Isn’t non-evidence based conventional medicine harmful too?
Yes, of course. Moreover, there are harmless forms of woo just as there are harmless conventional breaches of EBM. All departures from best evidence are problematic and need to be addressed, whether woo-based or not.

Then why make a distinction?
Because of important differences in the ways the problems manifest themselves. Mainstream medicine applies a double standard and that’s what I’m trying to expose. People in the mainstream are appropriately critical of conventional deviations from best evidence and are trying to correct the situation. But due to the nature of the problem---a complex interplay of system and cognitive failures---the fix is not easy. In contrast (and here’s where the real hypocrisy comes in) mainstream medicine uncritically embraces woo, applying to it a much easier evidentiary standard and often no standard at all. The remedy for the problem of woo would be much simpler, too. Mainstream medicine could simply say no. Woo, by definition patently implausible, is easy to spot. There’s nothing complicated about it. It’s not a system problem. It’s there in mainstream medicine purely by choice. That fact raises another important distinction. If mainstream departure from EBM is a complex system problem and woo is there by choice then woo constitutes a more serious ethical problem. http://doctorrw.blogspot.com/2006/12/frequently-asked-questions-on-woo-and.html

[intaglio]

168. If there is no evidence to support a treatment it fulfills the definition of Woo

If there is no evidence as to effect it is woo

If there is no known mechanism of action it is woo.

Evidence based medicine insists that there be a rational reason for undertaking a course of treatment.
Evidence of effect.
Evidence of action.
Evidence of effectiveness.

[VanillaRhapsody]

169. NO not if it doesn't do better than placebo

it is not evidence based medicine...and therefore not Science


You don't get your own definition of woo....

[intaglio]

170. I am saying that there has to be evidence of effect and evidence of method of action

Placebos do NOT fulfill that second element.

[VanillaRhapsody]

171. No that is not what that means....

there has to be recreatable results....AND it has to do BETTER than the placebo....then it is scientific...

Acupuncture doesn't do any better than the "pretend acupuncture" in studies....therefore...woo.

(oh and by the way....placebos sometimes work by just believing in them just sayin' but the placebo would be woo)

[intaglio]

176. Not recreatable, the word is repeatable

PLs effects varied, the damage varied, the supposition underlying the procedure changed with time, the method harmed brain areas at random. The effects varied from loss of motivation through impulsive behaviours and violence to vegetative withdrawal.

What element of science was included in any part of this perversion of rational action?

[Squinch]

138. Some surgeries are no more effective than placebo, but are widely performed. Example:

http://www.medscape.com/viewarticle/438238

http://www.huffingtonpost.com/david-h-newman-md/placebo-surgery_b_4545071.html

So, I could sprinkle jelly bean juice over a bunch of meniscal tears for a few weeks and chant, and I would have the same success rate as meniscal repair surgeons.

The first of those studies was done in 2002. The second in 2014. So there has been evidence for a long time that this isn't effective, yet surgeons continue to perform these.

How is that not woo?

[VanillaRhapsody]

140. Oh come on....surgery is NOT woo....no matter how much the Woo propagandists

want to believe so....

Surgery is not woo...simply NOT.

[Squinch]

141. Well, let me introduce another study:

http://www.ncbi.nlm.nih.gov/pubmed/12539881

Not double blind, but it shows that rubbing Arnica cream on painful knees results in reduction in knee pain. Other studies showed that, though there was an improvement with the Arnica, there was no more improvement than with the placebo group.

I think for those who refer to woo, use of Arnica (aka Wolf's Bane) would definitely be considered woo.

But Arnica is as effective against knee pain as placebo, and surgery is ALSO only as effective against knee pain as placebo.

Exact same results. So how is it that Arnica is woo, and the surgery is not?

Another old folk remedy that I was aware of for knee pain was eating the cartilage in chicken legs. Gross, but it was thought to be effective. This would definitely count as woo, until you realize that the cartilage is very rich in hyaluronic acid, which is the rate limiting factor in the human body's reconstruction of damaged cartilage. So really, not woo at all. Or much more scientifically supportable than the surgery, at least.

[VanillaRhapsody]

142. I don't need studies....

if it is NOT more effective than placebo or sham acupuncture....it is woo...

[Squinch]

143. But the SURGERY is NOT more effective than placebo. But you say that the surgery simply isn't woo.

So which is it?

Personally, my feeling is that that particular knee surgery is absolutely, hands down, woo.

And there are many other surgeries whose results are no better than placebo, as well.

[VanillaRhapsody]

146. Surgery IS more effective than placebo....geebus....

A placebo (/pləˈsiboʊ/ plə-see-boh; Latin placēbō, "I shall please"[2] from placeō, "I please&quot [3][4] is a simulated or otherwise medically ineffectual treatment for a disease or other medical condition intended to deceive the recipient. Sometimes patients given a placebo treatment will have a perceived or actual improvement in a medical condition, a phenomenon commonly called the placebo effect.

In medical research, placebos are given as control treatments and depend on the use of measured deception. Common placebos include inert tablets, vehicle infusions, sham surgery,[5] and other procedures based on false information.[1] However, placebos may also have positive effect on a patient's subjective experience who knows that the given treatment is without any active drug, as compared with a control group who knowingly did not get a placebo.[6]

[Squinch]

147. Read the sources I linked. This surgery is NOT more effective than placebo.

And yes, we all know what placebo means.

This particular surgery, and many others, DO NOT perform better than placebo. My previous posts link to many of the studies that have proven that it does not have better outcomes than the placebo.

You just keep saying over and over that surgery is better than placebo, but you are wrong.

All those multiple studies say that THIS SURGERY DOES NOT HAVE BETTER RESULTS THAN PLACEBO.

Geebus, yourself.

[VanillaRhapsody]

149. "A" surgery does not make surgery Woo.....

if one person is "cured" by a placebo does not mean that the placebo is a cure....

period...end of sentence.

[Squinch]

152. Will you PLEASE read the links? We are not talking about a single surgery. We are talking

about a type of surgery, namely meniscal repair. Which is performed hundreds of thousands of times each year.

Studies of meniscal repair surgery, multiple studies encompassing many participants, have shown, over and over again, that meniscal repair surgery does not have a better outcome than placebo.

I don't know why you don't seem to be able to understand this.

I can also provide links that show that other kinds of surgeries - other types of knee surgery and various types of back surgeries - which are widely practiced, do not have better outcomes than placebo.

The studies at the links PROVE THIS about one of these types of surgery, meniscal repair surgery, according to all the criteria you SAY you require.

[VanillaRhapsody]

153. What does even ONE type of surgery prove?

It still doesn't mean surgery is woo.....

[Squinch]

155. It means that that type of surgery is woo, according to your definition. And I can show you studies

of a lot of other TYPES of surgeries, also widely performed, that do not perform better than placebo.

So when you say, "Surgery simply isn't woo, end of sentence, hands down, no questions, I don't need no stinkin studies" you are incorrect.

According to your definition, many of the most commonly performed surgeries ARE woo.

[VanillaRhapsody]

156. bloodletting is woo....so what....it still doesn't make the whole thing woo

and visa versa...

If one person has a miraculous recovery while taking a placebo...it doesn't mean that placebo or "sugar pill" becomes a miracle cure....and in research....some of those taking the placebos....will miraculously heal.

[Squinch]

158. OMG! This is too ridiculous. Have a nice night.

[VanillaRhapsody]

159. That is the first thing you have said that made sense....

[SwampG8r]

148. cross argueing

you are both correct
you argue surgery isn't woo which in the greater sense it is not
the poster you are arguing with argues only the merits of one procedure and that procedure is likely useless
the fact that one surgical procedure could be called "woo" does not make all surgery "woo"

[VanillaRhapsody]

150. exactly!

This is the weirdest discussion ever....and I thought I had seen them all...

[SwampG8r]

151. i am married to an arnp and

most of our families both sides are populated with medical people
there is a saying
a little knowledge is a dangerous thing
and most peoples beliefs inre medicine are based on a little knowledge

[Squinch]

154. But it does make THAT type of surgery woo. And it is performed about 700,000 times per year.

There are many other types of surgery which are equally useless in that their results are not better than the placebo.

So you can't say "Surgery is not woo." Many types of surgery ARE woo, according to the poster's definition.

[SwampG8r]

160. yes THAT surgery is woo

but one useless surgery does not negate the value of surgery overall
heart surgery is not woo nor are transplants

[Squinch]

172. No one said it does. But first, there are, as I have pointed out repeatedly,

a large number of types of commonly performed surgeries that ARE woo. Many kinds of knee surgeries, many kinds of back surgeries, and many kinds of gynecologic surgeries, for example, do not produce better results than placebo.

Second, the point is that a black and white attitude of "conventional medicine is scientifically based, therefore valuable, and any alternative technique is useless" is an ignorant one.

MUCH of conventional medicine is NOT scientifically based, and has no more evidence behind it than bleeding with leeches (which, by the way, has been tested recently and found to be effective in clearing congested blood from wounds.)

The lines between medicine and woo are a lot more blurry than many here seem to need to believe they are.

[Jesus Malverde]

127. It may not be woo but it is a for profit business.

and we all know that money talks and the patient walks.

[Amaril]

130. I am a first hand "witness", if you will......

.....to the efficacy of morcellation.

I developed severe menorrhagia March 17, 2012. I didn't stop bleeding until they removed my uterus May 14, 2012. During my pre-surgery consult with my GP on the Friday before my surgery, my hemoglobin was 5.2 (normal, for women, is 12.0 to 15.5) -- my GP said that if it had been even a couple points lower -- or my surgery hadn't been scheduled for Monday -- that she would be sending me to the ER via ambulance for a blood transfusion. I was so low on blood that when they tried to take a sample post-op prior to sending me home, they literally could not get more than a couple teaspoonfuls despite trying veins in both arms in several different spots.

In my two month journey to what should have been done in the first place, they put me through numerous transvaginal ultrasounds, a failed ablation / embolization (which they should have known wasn't going to work -- based on what I have learned since -- due to the size / number of fibroids that were present), and doses of estrogen so high (at one point, they had me taking three birth control pills per day in an attempt to stop the bleeding) that I literally felt like I was going to jump out of my skin.

So, I had my hysterectomy via morcellation - or as they call it, "robotic-assisted laparoscopic" -- 1 day post-op, I was discharged home. 4 days post-op, I went for a short walk around the local craft store (looking for something to occupy my mind -- I was going stir crazy watching TV) with a cart to hold on to in case I got wobbly and my daughter in attendance to supervise. 2 weeks post-op, I was back to work, full-time. I had three small incisions and almost zero pain (except when I would cough -- for some reason that action aggravated sensitive spots). The worst complaint I had was that I developed an allergic reaction to the tape they told me to use to cover the wounds (which were glued shut instead of stitched).

A friend of mine had an "old fashioned" hysterectomy approximately 15 years ago -- she was in the hospital for 1 week post-op, no prolonged standing / walking for 3 weeks post-op (she could basically get up to go to the bathroom only, and someone had to be with her on the walk to / from) and was unable to return to work until 6 weeks post-op.

I think my experience (even with the needless procedures and prolonging of my misery) was vastly better than hers.

[joeglow3]

134. Was the use of Thalidomide woo?

[Squinch]

137. If the use of, say, Bella donna for migraines is woo, how is that different from the use of

Thalidomide to prevent morning sickness?

Both are compounds which ARE effective against the intended problem. Both have dire side effects.

What is the difference?

The only distinction I see is that one was developed in a laboratory and one is plant based. But aspirin and morphine are plant based, and certainly not woo. So what makes one woo and the other not?

[LeftyMom]

157. Thalidomide was never approved for use in the US.

[joeglow3]

181. And?

I was aware of that. My question stands, as the US is not the only country in the world.

[IdaBriggs]

136. Please - seriously? Take a procedure for WOMEN through rigorous investigation

in an attempt to verify efficacy?

Are you nuts?

Obviously it is a genetic thing, otherwise those smart men doctors would have figured it out sooner.

For the obtuse, this is -

Sigh.

[LostOne4Ever]

162. Thats not woo

http://rationalwiki.org/wiki/Woo

Woo is a term used among skeptical writers to describe pseudoscientific explanations that have certain common characteristics.

Woo generally contains most of the following characteristics:

1. A simple idea that purports to be the one answer to many problems (often including diseases)


2. A "scientific-sounding" reason for how it works, but little to no actual science behind it; for example, quote mines of studies that if bent enough could be described in such a way to support it, outright misapplication of studies, or words that sound scientific but make no sense in the context they are used in


3. It involves the supernatural and paranormal (not necessarily)


4. A claim of persecution, usually perpetrated by the government or the pharmaceutical, medical, or scientific community (see Galileo gambit)


5. An invocation of a scientific authority


6. Prefers to use abundant testimonials over actual scientific research


7. A claim that scientists are blind to the discovery, despite attempts to alert them


8. A disdain for objective, randomized experimental controls, especially double-blind testing (which are kind of what makes epidemiology actually, y'know, work)


9. And, usually, an offer to share the knowledge for a price.

Woo is usually not the description of an effect but of the explanation as to why the effect occurs. For example, homeopathy may occasionally give results, but as a placebo — the explanations for these occasional results, e.g. water memory, are woo.
Woo is used to blind or distract an audience from a real explanation or to discourage people from delving deeper into the subject to find a more realistic explanation. You can't make money if nobody buys your bullshit. (As such, "woo" that has zero paying customers is more like just ordinary batshit crazy.)

[LiberalElite]

173. ok I'm not a doctor and

and I don't play one on tv so don't have an opinion about alleged "woo" however when you get a minute, could you please explain how "commonplace" this got with "at least 5 devices currently on the US market." Five in the whole country?

[Squinch]

177. I think it's 5 brands of the device, and there are a lot of each brand out there spreading tumors.

[whatchamacallit]

182. Wonder what kills more people

Woo or Shit Science?