Great article about Acapuncture

NeuroLogica Blog » Why I Am Skeptical of Acupuncture

Acupuncture is the practice of placing very thin needles through the skin in specific locations of the body for the purpose of healing and relief of symptoms. This practice is several thousand years old and is part of Traditional Chinese Medicine. As practiced today it is often combined with other interventions, such as sending a small current of electricity through the needles or burning herbs on the acupuncture points (a practice called moxibustion).

Acupuncture has recently been transplanted to the West, riding the wave of tolerance for unscientific treatment practices marketed as “complementary and alternative medicine.” While advocates have been successful at pushing acupuncture into the culture, the scientific medical community has still not accepted the practice as a legitimate scientific practice. I count myself among those extremely skeptical of acupuncture. I outline here the reasons for my continued skepticism.

1) Acupuncture is a pre-scientific superstition

Proponents often cite acupuncture’s ancient heritage as a virtue, but I see it as a vice. Acupuncture was developed in a pre-scientific culture, before anything significant was understand about biology, the normal functioning of the human body, or disease pathology. The healing practices of the time were part of what is called philosophy-based medicine, to be distinguished from modern science-based medicine. Philosophy-based systems began with a set of ideas about health and illness and based their treatments on those ideas. The underlying assumptions and the practices derived from them were never subjected to controlled observation or anything that can reasonably be called a scientific process.

An example from Western culture of philosophy-based medicine was the humoral theory - the notion that health was the result of the four bodily humors being in proper balance while illness reflected one or more humors being out of balance. Treatments therefore sought to increase or decrease one or more of the humors (such as the practice of blood-letting) to re-establish balance. The humoral theory survived for several thousand years in Western societies, perpetuated by culture and the power of deception inherent in anecdotal evidence.

Acupuncture is based upon the Eastern philosophy of chi (also spelled qi), which is their name for the supposed life force or vital energy that animates living things. In Traditional Chinese Medicine (TCM) chi flows through pathways in the body known as meridians. Illness results from the flow of chi through the meridians being blocked, or by the two types of chi (yin and yang) being out of balance. Acupuncture is the practice of placing thin needles at acupuncture points, which are said to coincide with points at which meridians cross, to improve the flow and restore the balance of chi.

There is no more reason to believe in the reality of chi than there is in the four humors, or in the effectiveness of acupuncture than the effectiveness of blood letting.

2) Acupuncture lacks a plausible mechanism

Centuries of advancement in our understanding of biology has made the notion of life energy unnecessary. Further, no one has been able to detect life energy or formulate a scientifically coherent theory as to what life energy is, where it comes from, and how it interacts with matter or other forms of energy. Withn science, the vitalists lost the debate over a century ago.Without chi, there is no underlying basis for acupuncture as a medical intervention.

Recent attention given to acupuncture has attempted to bring it into the scientific fold by hypothesizing physical mechanisms for its alleged effects. For example, some proponents argue that the needles may stimulate the release of pain-killing natural chemicals, or relax tense muscles, or inhibit the conduction of pain through counter-irritation.

These potential mechanisms, while more plausible than the non-existent chi, remain speculative. Further, they would only explain a very non-specific effect of acupuncture (no better than rubbing your elbow after accidentally banging it against something hard). They might account for a temporary mild reduction in pain. Such mechanisms could not account for any of the medical claims made for acupuncture, or the alleged existence of acupuncture points.

Further, it is misleading to say that such mechanisms could explain “acupuncture.” Acupuncture is the needling of acupuncture points to affect the flow and balance of chi. Using needles to mechanically produce a temporary local counter-irritation effect is not acupuncture - even though it may be an incidental consequence of this practice and may have contributed to its perceived effectiveness.

3) Claims for efficacy are often based upon a bait-and-switch deception.

The most common example of the “bait-and-switch” for acupuncture are studies that examined the effects on pain of electrical stimulation through acupuncture needles. This is not acupuncture - it is transcutaneous electrical stimulation (TENS), which is an accepted treatment for chronic pain, masquerading as acupuncture.

This is not a quibble. Science requires unambiguous definition of terms and concepts. If acupuncture is said to be something scientifically then it must have some specific and unique characteristics. In medicine that means it should have a specific mechanism of action - and it is that mechanism that we would call acupuncture. Electrical stimulation is no more acupuncture than if I injected morphine through a hollow acupuncture needle and then claimed that any resulting pain relief was due to “acupuncture.”

Further, during a typical acupuncture treatment there are many other incidental effects that may occur. The atmosphere is often relaxing, and practitioners typically will palpate the “acupuncture points” prior to inserting the needles, for example. Practitioners also provide their kind attention, which has a positive psychological therapeutic value. There are therefore many nonspecific subjective effects that could lead to clients feeling better, making the actual insertion of needles an unnecessary component.

Reports of acupuncture anaesthesia are also misleading. Independent investigation shows that patients having surgery under anaesthesia (dramatic reports of which are largely credited with acupuncture’s popularity in the West) reveal that patients were receiving morphine in the IV fluid. Other reports indicate that patient were experiencing great pain, but were simply instructed to remain quiet by the surgeon (a product of Eastern culture). There are no verified reports of acupuncture serving as effective anesthesia during surgery.

4) Clinical trials show that acupuncture does not work

The previous points are all reasons to be highly skeptical of the claims made for acupuncture, but they are all also trumped by the ultimate consideration - the direct scientific evidence. There is a surprisingly large published literature on the clinical effects of acupuncture. Most people are equally surprised to learn that the literature is essentially negative - probably because the press cherry picks apparently positive studies and re-prints without investigation the press releases of acupuncture proponents.

It is important to evaluate the literature as a whole to see what pattern emerges. The pattern that does emerge is most consistent with a null effect - that acupuncture does not work.

Controlled clinical trials of actual acupuncture (uncontrolled trials should only be considered preliminary and are never definitive) typically have three arms: a control group with no intervention or standard treatment, a sham-acupuncture group (needles are placed but in the “wrong” locations or not deep enough), and a real acupuncture group. Most of such trials, for any intervention including pain, nausea, addiction, and others, show no difference between the sham-acupuncture group and the acupuncture group. They typically do show improved outcome in both acupuncture groups over the no-intervention group, but this is typical of all clinical trials and is clearly due to placebo-type effects. Such comparisons should be considered unblinded because patients know if they were getting acupuncture (sham or real).

The lack of any advantage of real over sham acupuncture means that it does not matter where the needles are placed. This is completely consistent with the hypothesis that any perceived benefits from acupuncture are non-specific effects from the process of getting the treatment, and not due to any alleged specific effects of acupuncture. In other words, there is no evidence that acupuncture is manipulating chi or anything else, that the meridians have any basis in reality, or that the specific process of acupuncture makes any difference.

More recent trials have attempted to improve the blinded control of such trials by using acupuncture needles that are contained in an opaque sheath. The acupuncturist depresses a plunger, and neither they nor the patient knows if the needle is actually inserted. The pressure from the sheath itself would conceal any sensation from the needle going in. So far, such studies show no difference between those who received needle insertion and those who did not - supporting the conclusion that acupuncture has no detectable specific health effect.

Taken as a whole, the pattern of the acupuncture literature follows one with which scientists are very familiar: the more tightly controlled the study the smaller the effect, and the best controlled trials are negative. This pattern is highly predictive of a null-effect - that there is no actual effect from acupuncture.

Criticism of an Acapuncture trial

Respectful Insolence: The largest "randomized" acupuncture study ever done: Why did they even bother?

Believe it or not, there was one area of so-called "alternative" medicine that I used to be a lot less skeptical about than I am now. Homeopathy, I always realized to be a load of pseudoscientific magical thinking. Ditto reiki, therapeutic touch, and other forms of "energy healing." It didn't take an extensive review of the literature to figure that out, although I did ultimately end up doing fairly extensive literature reviews anyway. Then, the more I looked into the hodge-podge of "healing" modalities whose basis is not science but rather prescientific and often mystical thought, the less impressed I was.

Even so, there was always one modality that I gave a bit of a pass to. There was one modality that, or so I thought, might actually have something to it. There was one modality that seemed to have a bit of suggestive evidence that it might do something more than a placebo. I'm referring to acupuncture. No, I never bought all the mystical mumbo-jumbo about how sticking needles into "meridians" somehow alters or "unblocks" the flow of a mysterious "life force" known as qi that is undetectable by science. I did wonder if perhaps it worked as a counterirritant or by releasing endorphins.

Then I actually started paying attention to the scientific literature regarding acupuncture, including literature like this and this. The more I read, the more I realized something. I realized that there was far less to acupuncture than I had previously thought, and, even with my previous openness to it, I hadn't thought all that much about it anyway. What I had thought about it was that it might have a very mild beneficial effect. What I know now is that acupuncture is almost certainly no more than an elaborate placebo. What I know now is that virtually every study of acupuncture claiming to show a positive effect has serious methodological flaws and that the better-designed the study the less likely there is to be an effect. What I now know is that any study without a true "sham" acupuncture arm is worthless, and that well-designed studies show "sham" acupuncture to be no different than "real" acupuncture; i.e., no different than placebo.

And now comes yet another in a long line of studies that is consistent with just that, and, worse, it's billed as (and probably is) the "largest randomized study of acupuncture ever done." Too bad it depends on what you mean by "randomized." Too bad the press coverage misses the point:

For the current study, published in the journal Cephalalgia, German researchers followed more than 15,000 adults with chronic headaches; all had been suffering from either migraine or tension-type headaches at least twice a month for 1 year or more.

Of these patients, nearly 3,200 agreed to be randomly assigned to either have acupuncture added to their regular therapy or to stay with their usual care alone. The rest of the patients began on acupuncture treatment.

All of the acupuncture patients received up to 15 sessions over 3 months, and all study patients were reassessed after 6 months.

In the end, the study found, acupuncture patients reported greater pain improvements than those who stayed with their usual care only. At the outset, they reported an average of 8.4 headache days over 3 months; that dropped to 4.7 by the study's end.

Take a minute here. If you're a regular reader of this blog, I'm betting that you can pick out the huge methodological flaw in this study from just the press report alone. Do you have it yet? Don't worry, I'll get to it very soon. However, I don't like to rely on just the news coverage of such a study. Whenever possible, I always like to go to the original study, and, as I usually do, I did just that. Here's the abstract:

We aimed to investigate the effectiveness of acupuncture in addition to routine care in patients with primary headache (> 12 months, two or more headaches/month) compared with treatment with routine care alone and whether the effects of acupuncture differ in randomized and non-randomized patients. In a randomized controlled trial plus non-randomized cohort, patients with headache were allocated to receive up to 15 acupuncture sessions over 3 months or to a control group receiving no acupuncture during the first 3 months. Patients who did not consent to randomization received acupuncture treatment immediately. All subjects were allowed usual medical care in addition to study treatment. Number of days with headache, intensity of pain and health-related quality of life (SF-36) were assessed at baseline, and after 3 and 6 months using standardized questionnaires. Of 15 056 headache patients (mean age 44.1 ± 12.8 years, 77% female), 1613 were randomized to acupuncture and 1569 to control, and 11 874 included in the non-randomized acupuncture group. At 3 months, the number of days with headache decreased from 8.4 ± 7.2 (estimated mean ±s.e.) to 4.7 ± 5.6 in the acupuncture group and from 8.1 ± 6.8 to 7.5 ± 6.3 in the control group (P < 0.001). Similarly, intensity of pain and quality of life improvements were more pronounced in the acupuncture vs. control group (P < 0.001). Treatment success was maintained through 6 months. The outcome changes in non-randomized patients were similar to those in randomized patients. Acupuncture plus routine care in patients with headache was associated with marked clinical improvements compared with routine care alone.

Got it yet?

I'm sure that most of you do; so I'll just move on. This study has three design flaws so glaring that I almost don't even care what it shows because the flaws are so significant that they scuttled the study before it even started. Here they are:

1. The study is not only not double-blind, it's not even blinded in any way. Both the patients and the health care practitioners know who is receiving what therapy. That alone makes its result entirely explainable by placebo effects.
2. There isn't even an attempt at a sham acupuncture group. Remember my previous posts on the importance of sham acupuncture and how sham acupuncture is indistinguishable from "real" acupuncture.
3. The "randomization" isn't even really a randomization. Of 15,056 patients with a complaint of headache, only 3,404 accepted randomization to control or acupuncture. Normally a clinical investigator, when faced with this situation, studies only the patients who agreed to be randomized. Not these intrepid woo-mavens! They included the remaining 11,652 patients anyway. Actually, they included 11,874 nonrandomized patients.

There are a number of other flaws, but, really, they pale in significance to the three above and are hardly worth mentioning except in passing. For example, there were significant differences between the randomized and nonrandomized groups, including higher pain intensity and a shorter duration of chronic headaches, making them prime candidates to be prone to regression to the mean. The study is also suspect because it lumps together all headaches, rather than separating out the migraine headaches, which have a different physiological mechanism behind them than run-of-the-mill headaches. Another problem was that the authors relied on questionnaires, rather than a pain diary. Because a questionnaire relies on patient memory, rather than the patient writing down an incident as it happens, it's prone to recall bias. There are also numerous other nits to pick, but none of them even come close to the three flaws listed above.

Regarding the failure to use a sham acupuncture group or to blind, it makes me wonder if all the studies coming out showing that sham acupuncture and "real" acupuncture are indistinguishable are starting to get to acupuncture advocates to the point where they really aren't even trying anymore. After all, an unblinded study is almost guaranteed to produce an effect, but an investigator has no way of knowing whether that effect is greater than placebo if there is no valid placebo group. True, the authors did all sorts of fancy statistics and handwaving to try to take the reader's mind off of this fundamental fatal flaw, but none of that changes anything.

Reading the discussion is very instructive, as it demonstrates very well the torturing of language and logic that is used by advocates of "alternative" medicine. While they admit flat out that this was an unblinded study and that , the excuse used was that this was a "pragmatic" study designed "chosen to reflect general medical practice." Yes, that's a great excuse not to do the necessary placebo/sham acupuncture control that would make the results of this study interpretable. It's also a lovely excuse to allow patients in essence to self-select for acupuncture by refusing randomization, thus making the likelihood of a placebo effect even greater--except that there's no control that allow us to know if it's just a placebo effect or not. Here's part of what they argue:

Although differences with respect to both baseline characteristics and treatment outcomes between randomized and non-randomized patients were small in absolute numbers, our findings indicate that randomization was associated with some selection effects. Therefore, the use of study designs that also include non-randomized patients appears to be desirable.

It is of note, however, that treatment benefits were similar in the randomized and nonrandomized acupuncture groups after adjusting for baseline differences. This suggests that the results of randomized trials can be representative of routine medical care situations, at least in large pragmatic studies.

No, it suggests that the placebo effect was operative in both the randomized patients and the patients who refused to be randomized. The use of study designs that include non-randomized patients is only "desirable" if you want to maximize the chances of a seemingly positive result. Bravo, though, to the study authors for having the chutzpah to try to change this study's most glaring weakness into a strength. It was a nice try, but it won't fly.

What's truly depressing is the editorial by Dr. H-C Diener of the University Hospital Essen in Germany, where he actually makes this argument:

Despite the fact that I have major design issues with the study, my view is that studies like this have to be published in high ranked journals to promote discussion on trial design in non-drug trials

Dr. Diener actually lists two of the same flaws that I did, namely the unblinded nature of the study and the lack of adequate "sham" acupuncture controls. In spite of this, he still argues that this article should be published in high ranked journals "to promote discussion"? Funny, but I always thought that high ranked journals are high ranked because they post the most scientifically sound and medically interesting articles. Think New England Journal of Medicine. I always thought the reason for such journals to publish an article is because it is scientifically sound and studies a clinically important and/or interesting question. As a reason to publish such an article, "to promote discussion" is about as far down on the list of reasons as "because the author has nice hair."

The bottom line is that this study is yet another of a long line of studies of "complementary and alternative" medicine that are entirely consistent with the placebo effect. Worse, it didn't even really try to distinguish between a treatment effect and placebo effect. Maybe that's the point. Whatever the point was, what I do know is that if I were a German citizen, I'd be mightily pissed off that so much money was wasted on this study. I'd also wonder why it was a consortium of insurance companies who funded the study. Maybe I was wrong about insurance companies funding woo. Maybe it is cheaper in the long run for them to pay for CAM than actual scientific medicine that's more than just a highly elaborate placebo.

REFERENCES:

1. Jena, S., Witt, C., Brinkhaus, B., Wegscheider, K., Willich, S. (2008). Acupuncture in patients with headache. Cephalalgia, 28(9), 969-979. DOI: 10.1111/j.1468-2982.2008.01640.x

2. (2008). Acupuncture for the treatment of headaches: more than sticking needles into humans?. Cephalalgia, 28(9), 911-913. DOI: 10.1111/j.1468-2982.2008.01650.x

A great article about Evidence and Bias

NeuroLogica Blog » An Acupuncture Debate

An Acupuncture Debate
Published by Steven Novella under Science and Medicine
Comments: 15

Recently I was invited to write my views on acupuncture for a website called Opposing Views. I pre-published (with permission) my side of the debate on “Does Acupuncture Work” here at NeuroLogica. Taking the pro-acupuncture side is Bill Reddy - his profile states that he is “currently serving on the Executive Committee of the American Association of Acupuncture and Oriental Medicine.”

The format of the website allows for moderated comments, which are intended to allow for a written debate with the two sides. Here are my responses to the first round of arguments.

Bill Reddy wrote:

The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (NIH) worked with the World Health Organization (WHO) in 1983 to develop a consensus on the use of Acupuncture to treat a number of common illnesses.

He then give a long list of medical conditions acupuncture is supposed to treat.

Bill Reddy asserts that the WHO and NCCAM in 1983 have reviewed the evidence and support acupuncture as safe and effective for a number of medical conditions, but this assertion is simply wrong. Bill does not provide a specific reference or any quotes.

One reason to doubt the claim is that the NCCAM did not exist in 1983. It began its existence as the Office of Alternative Medicine in 1993.

The WHO had this to say about acupuncture in 2002:

“Since the methodology of clinical research on acupuncture is still under debate, it is very difficult to evaluate acupuncture practice by any generally accepted measure.”

and

“Only national health authorities can determine the diseases, symptoms and conditions for which acupuncture treatment can be recommended.”

Finally, reviews of the acupuncture literature performed by scientists and academics, rather than political organizations, have consistently found that there is no compelling evidence that acupuncture is effective for any condition.

Even politically motivated and biased panels, when constrained by the scientific evidence, must admit that the evidence does not support any specific effect from acupuncture. The 1997 NIH consensus conference on acupuncture was packed with acupuncture proponents and did not contain any skeptics or scientists who had found negative results. Despite this obvious bias the panel had to concede that the best controlled trials showed no difference between “sham” acupuncture and “true” acupuncture for any indication, but then tried to spin these results by saying that well-controlled trials must therefore be unreliable.

Bill’s strategy is ultimately deceptive. He cites a 25 year old political assessment of acupuncture, then vaguely refers to later research. In fact later better-designed trials of acupuncture have been essentially negative.

In his next point he writes:

As a former Aerospace Engineer who flight tested helicopters and performed cutting-edge research in the field of turbulent aerodynamics, I can honestly say that acupuncture is a thoroughly proven system of healthcare. Proving acupuncture efficacy is relatively easy - western medicine and modern science are having a difficult time understanding the underlying mechanisms as to how acupuncture works.

If you type in the key word “acupuncture” into the NIH national library of medicine “PubMed” database, it will return over 13,000 peer reviewed journal articles.

This argument shows very poor scientific reasoning. Arguments concerning mechanism of action and efficacy are mixed together in a confusing way. The lack of a plausible mechanism makes acupuncture very suspect, and raises the bar for an appropriate level of evidence before accepting acupuncture as a treatment. But the clinical evidence of acupuncture stands on its own – and is convincingly negative.

Bill Reddy gives us his anecdotal experience (combined with an argument from authority logical fallacy) and cherry-picked studies to support his claims for acupuncture effectiveness in fertility. However, systematic reviews of the evidence are negative. Most recently, this review of acupuncture for fertility rates following IVF was completely negative. (A systematic review and meta-analysis of acupuncture in in vitro fertilisation. BJOG. 2008 Sep;115(10):1203-13. Epub 2008 Jul 23.)

In response to this study, Paul Robin, the chairman of the Acupuncture Society, said:

“I’m really surprised by these findings. I’ve been treating people for 20 years and in my experience treatment does seem to improve their chances of becoming pregnant. This study has shown that there’s no proof that acupuncture can help - so that suggests that there should be lots more studies to examine the question. I’m convinced it can help.”

Robin shows the closed-mindedness of dedicated proponents. He is perplexed that the scientific evidence does not support his personal anecdotal experience, and concludes that therefore we need more evidence. Rather he should conclude that anecdotal experience is unreliable – something the scientific community has learned long ago.

Bill concludes with the argument that because there is a great deal of research going on there must be something to acupuncture, but this is a flawed argument ad populi. The research reflects cultural interest and belief, not necessarily scientific validity. If you actually review that research, as many have, it is clearly negative.

Bill Reddy next launches into the tired argument that scientific medicine is dangerous and acupuncture is at least safe, writing:

In a Japanese survey of 55,291 acupuncture treatments given over five years by 73 acupuncturists, 99.8% of them were performed with no significant minor adverse effects and zero major adverse incidents (Hitoshi Yamashita, Bac, Hiroshi Tsukayama, BA, Yasuo Tanno, MD, PhD. Kazushi Nishijo, PhD, JAMA).

According to wikipedia “A recent study by Healthgrades found that an average of 195,000 hospital deaths in each of the years 2000, 2001 and 2002 in the U.S. were due to potentially preventable medical errors.

This argument is yet another logical fallacy – a non sequitur. The state of modern science-based medicine says nothing about the purported mechanisms and effectiveness of acupuncture. You could use the same line of argument to falsely support any medical claim. The data cited, which is now a standard argument among proponents of dubious health claims, are also highly misleading. They only consider the risk of medical intervention, not the benefit. A proper assessment of any intervention should include risk vs benefit. This is the standard calculation of science-based medicine, and treatments are only considered justified if they can demonstrate benefit in excess of risk. Focusing only on risk is designed to create a misleading impression.Direct risk is generally a function of the invasiveness of any intervention. No one doubts the fact that less invasive interventions are less directly risky. But if only risk were considered then doing nothing would always be the best option – and it clearly isn’t. Acupuncture is certainly closer to doing nothing than many legitimate medical interventions, but even the small risk of acupuncture is not justified until there is compelling evidence of benefit – and there isn’t.

Further, indirect risk must also be considered. While direct harm from acupuncture is rare (but does occur) there is the potential for tremendous indirect harm, including the delay in proper medical assessment and treatment.

Bill concludes with a classic argument ad populi:

If you had a severe case of tennis elbow, and you went to see an oriental medicine practitioner and he stuck needles in you and you didn’t get better, would you ever go back to see him again? Probably not.

1.3 billion Chinese are hard to argue with. The system of healing would not last over 5000 years if it weren’t effective.

This is nothing more than an argument ad populi and appeal to anecdotal evidence. As I have already argued, blood letting survived for over 2,000 years as the standard accepted practice. The placebo effect is well documented, as well as a variety of psychological effects, such as confirmation bias. There are also statistical effects, such as regression to the mean (the tendency for any ailment to get better if one seeks treatment during an exacerbation). All of these combine to create the illusion that ineffective treatments have some effect.

The scientific method as applied to medicine evolved to address this potential for self-deception. Appealing to anecdotes is a decidedly unscientific approach to any medical question, and defies the well-documented history of medicine – which gives countless examples of treatments that were believed to work but failed to show any effect when properly studied.

Bill concludes with a discussion of the limitations of acupuncture:

Musculoskeletal pain, internal conditions, dermatological and neurological conditions all respond favorably to acupuncture. Where the modality falls short is in structural problems such as spinal stenosis (gradual narrowing of the spinal canal leading to nerve compression). All the needles in the world won’t remove the built-up calcifications to relieve the pressure on a nerve root.

I certainly agree with this point - acupuncture does not treat any anatomical or mechanical medical problem. However, this does not imply that it does treat non-mechanical problems, nor does it render any of the other arguments put forth for acupuncture more reasonable.

I would also point out that this is a common feature of dubious medical interventions - they do not treat anything which is objectively demonstrable. They thrive in the realm of subjective symptoms where anecdotes and placebo effects are strong and carefully controlled trials more difficult. They tend to thrive where the data is poor. Eventually, when well-controlled data is obtained, any alleged effects vanish.

Conclusion

I only gave representative quotes from Bill Reddy’s arguments here, not wanting to reprint the entire debate. Go to Oppossing Views to take a look at the full debate and even leave a comment if you wish.

Another anti-evolution law in the United States - the disease is spreading!

More insanity from the States.....yet again the nutters are trying to catch them early in schools and indoctrinate them in the madness of the Discovery Institute philosophy. The only real chance that they have of spreading this nonsensical irrationalist religious claptrap is if they try and stop people getting an education....so that's what they're trying to do.

Amazingly, the idea that Intelligent Design is actually a theory (rather than an embarassing joke) is starting to drip into the public consciousness, and it is getting frightening.

Here in HK, much of the heirarchy at HK University comes from the fundamentalist christian diaspora and despite world renowned evolutionary biology departments working on H5N1, students do not leave school with any understanding of evolution and consequently very few local students enter the department from the local school system.

I teach students who actually think there is evidence for ID and that the evidence for evolution is debatable!!!! These are nice students who have adults around them telling them lies, afraid that the whole basis for their belief system will crumble around them if they learn about one of the most clearly understood theories. This is almost criminal....certainly an intellectual crime. People actually exist who think we didn't evolve from other life forms..that we're somwhow special. It would be funny if it wasn't so sad.

The recent worldwide Darwin's Evolution week celebrating his life had to be renamed in HK to Darwin's Legacy as the Evolution title was considered by the 'Government' to be too controversial!!!!

Louisiana passes first antievolution "academic freedom" law

Louisiana passes first antievolution "academic freedom" law

By John Timmer | Published: June 27, 2008 - 02:13PM CT

As we noted last month, a number of states have been considering laws that, under the guise of "academic freedom," single out evolution for special criticism. Most of them haven't made it out of the state legislatures, and one that did was promptly vetoed. But the last of these bills under consideration, the Louisiana Science Education Act (LSEA), was enacted by the signature of Governor Bobby Jindal yesterday. The bill would allow local school boards to approve supplemental classroom materials specifically for the critique of scientific theories, allowing poorly-informed board members to stick their communities with Dover-sized legal fees.
Related Stories

* Mixed messages on science education in the election
* Scientific outreach: providing clergy a resource
* Intelligent Design tries rebranding as PBS looks at landmark Dover trial
* New journal to target education in evolution

The text of the LSEA suggests that it's intended to foster critical thinking, calling on the state Board of Education to "assist teachers, principals, and other school administrators to create and foster an environment within public elementary and secondary schools that promotes critical thinking skills, logical analysis, and open and objective discussion of scientific theories." Unfortunately, it's remarkably selective in its suggestion of topics that need critical thinking, as it cites scientific subjects "including, but not limited to, evolution, the origins of life, global warming, and human cloning."

Oddly, the last item on the list is not the subject of any scientific theory; the remainder are notable for being topics that are the focus of frequent political controversies rather than scientific ones.
The opposition

The bill has been opposed by every scientific society that has voiced a position on it, including the American Association for the Advancement of Science. AAAS CEO Alan Leshner warned that the bill would "unleash an assault against scientific integrity, leaving students confused about science and unprepared to excel in a modern workforce."

Jindal, who was a biology major during his time at Brown University, even received a veto plea from his former genetics professor. "Without evolution, modern biology, including medicine and biotechnology, wouldn't make sense," Professor Arthur Landy wrote. "I hope he [Jindal] doesn't do anything that would hold back the next generation of Louisiana's doctors."
Louisiana

Lining up to promote the bill were a coalition of religious organizations and Seattle's pro-Intelligent Design think tank, the Discovery Institute. According to the Louisiana Science Coalition, Discovery fellows helped write the bill and arranged for testimony in its favor in the legislature. The bill itself plays directly into Discovery's strategy, freeing local schools to "use supplemental textbooks and other instructional materials to help students understand, analyze, critique, and review scientific theories in an objective manner."

Discovery, conveniently, has made just such a supplemental text available. As we noted in our earlier analysis, Discovery hopes to use these bills as a way to push its own textbook into the classroom. Having now read the text of the book, it is clear that our earlier analysis was correct; the book badly misrepresents the scientific community's understanding of evolution in order to suggest that the basics of the theory are questioned by biologists. In doing so, it ignores many of the specific questions about evolution that are actively debated by scientists.

Courts in Pennsylvania and Georgia have both ruled that laws which single out evolution serve no secular purpose and are evidence of unconstitutional religious motivations. Those precedents, however, do not apply to Louisiana, and it's possible that the LSEA will either be ruled constitutional or remain in force for years before a court rejects it. That will leave the use of supplemental scientific material to be determined by local school boards in the intervening years and, if boards in Florida are viewed as evidence, they are likely to be spectacularly incapable of judging scientific issues.

As such, most observers are expecting the passage of the LSEA by the state to unleash a series of Dover-style cases, as various local boards attempt to discover the edges of what's constitutionally allowable. The AAAS' Leshner suggested that the bill's passage would "provoke an expensive, divisive legal fight." In vetoing similar legislation in Oklahoma, Governor Brad Henry suggested it would end up "subjecting them [school officials] to an explosion of costly and protracted litigation that would have to be defended at taxpayers' expense." In essence, Jindal is inviting local school boards to partake in that explosion without committing the state to paying the inevitable costs.

In the meantime, the students of the state will be subjected to an "anything goes" approach to science—if it looks scientific to a school board, it can appear in the classroom.

The HK Ark

Biblical structure: Noah’s Ark

There’s a hulking, brown colossus looming over Tung Wan Beach on Ma Wan (Park Island). It’s biblical in proportion. Seriously.

In 2004, Andrew Yuen Man-Fai and Pastor Boaz Li Chi-Kwong of evangelical Christian media organisation Media Evangelism climbed Mt Ararat in eastern Turkey and found what they claimed were the remnants of Noah’s Ark. Excited and inspired by their discovery – which they documented on blurry video that was unfortunately corrupted by a “mysterious force” – they returned to Hong Kong determined to build a replica of the famous life-raft.

Four years later, they’ve done just that, with the help of Sun Hung Kai.

Built to scale on government-owned land at Ma Wan Park according to the dimensions mentioned in the Bible, the ark is one-and-a-half football fields long, 22.5 metres wide, and four storeys tall. It will house a museum to educate and enlighten the public, a 3D movie theatre, 200 hotel rooms, and several restaurants. In and around the edifice, there’ll also be both live and model animals, including, curiously, some two-headed turtles that, according to Yuen, exhibit the genius of God’s intelligent design.

Yuen also wants the Ark to spread a message of love and unity – after all, he reasons, we’re all in the same boat. “We have witnessed many crises on earth – not only global warming but also animals going extinct, as well as natural disasters like the tsunami,” he explains. “We want to remind people to love the earth and love life.”

The Ark is expected to open to the public by Easter 2009. There are also plans for a smaller, floating replica (estimated cost: up to $40 million) that will ferry passengers direct from Central to Ma Wan. So far the landed Ark has cost $10 million, which has been funded by a flood of donations from well-wishing Christians. Media Evangelism hopes to raise another $18 million.

Wikipedia Expeditions to the Ark

Science Cannot Provide all the Answers

How to make decisions

ToK Reason Scheme of Work

Brain Gym

Here's a lovely little idea from California discussed on BBC TV:



Follow this link on YouTube for the second part of Newsnight where Paxman interviews the company founder.

Read Bad-Science about it. A really wonderful discovery from Mr Goldacre.

Knowledge claims study

The end of Homeopathy?

Propoganda parody

Beyond Belief - In place of God

Beyond belief: In place of God

• 20 November 2006
• Exclusive from New Scientist Print Edition.
• Michael Brooks
• Helen Phillips

It had all the fervour of a revivalist meeting. True, there were no hallelujahs, gospel songs or swooning, but there was plenty of preaching, mostly to the converted, and much spontaneous applause for exhortations to follow the path of righteousness. And right there at the forefront of everyone's thoughts was God.

Yet this was no religious gathering - quite the opposite. Some of the leading practitioners of modern science, many of them vocal atheists, were gathered last week in La Jolla, California, for a symposium entitled "Beyond belief: Science, religion, reason and survival" hosted by the Science Network, a science-promoting coalition of scientists and media professionals convening at the Salk Institute for Biological Studies. They were there to address three questions. Should science do away with religion? What would science put in religion's place? And can we be good without God?

First up to address the initial question was cosmologist Steven Weinberg of the University of Texas, Austin. His answer was an unequivocal yes. "The world needs to wake up from the long nightmare of religion," Weinberg told the congregation. "Anything we scientists can do to weaken the hold of religion should be done, and may in fact be our greatest contribution to civilisation."

Those uncompromising words won Weinberg a rapturous response. Yet not long afterwards he was being excoriated for not being tough enough on religion, and admitting he would miss it once it was gone. Religion was, Weinberg had said, like "a crazy old aunt" who tells lies and stirs up mischief. "She was beautiful once," he suggested. "She's been with us a long time. When she's gone we may miss her." Science, he admitted, could not offer the "big truths" that religion claims to provide; all it can manage is a set of little truths about the universe.

Richard Dawkins of the University of Oxford would have none of it. Weinberg, he said, was being inexplicably conciliatory, "scraping the barrel" to have something nice to say about religion. "I am utterly fed up with the respect we have been brainwashed into bestowing upon religion," Dawkins told the assembly.

He was soon joined by Carolyn Porco of the Space Science Institute in Boulder, Colorado, who had been charged with providing an answer for the second question: if not God, then what? Science, she said, could do at least as well as religion. "If anyone has a replacement for God, then scientists do." Porco said. "At the heart of scientific inquiry is a spiritual quest, to come to know the natural world by understanding it... Being a scientist and staring immensity and eternity in the face every day is about as meaningful and awe-inspiring as it gets."

Astronomers in particular, she suggested, regularly confront the big questions of wonder. "The answers to these questions have produced the greatest story ever told and there isn't a religion that can offer anything better." Religious people, she claimed, use God to feel connected to something grander than they are, and find meaning and purpose through that connection. So why not show them their place in the universe and give them a sense of connectedness to the cosmos? The answers to why we are here, if they exist at all, will be found in astronomy and evolution, she said.

A secular icon

Science provides an aesthetic view of the cosmos that could replace that provided by religion - a view that could even be celebrated by its own iconography, Porco added. Images of the natural world and cosmos, such as the Cassini photograph of Earth taken from beyond Saturn, Apollo 8's historic Earthrise or the Hubble Deep Field image, could offer a similar solace to religious artwork or icons.

The big challenge, according to Porco, will be dealing with awareness of our own mortality. The God-concept brings a sense of immortality, something science can't offer. Instead, she suggested highlighting the fact that our atoms came from stardust and would return to the cosmos - as mass or energy - after we die. "We should teach people to find comfort in that thought. We can find comfort in knowing that everyone who has ever lived on the Earth will some day adorn the heavens."

“We can find comfort in knowing that everyone who has ever lived on the Earth will some day adorn the heavens”

Like many of the others at the meeting, Porco was preaching to the choir, and there was no more animated or passionate preacher than Neil deGrasse Tyson, director of the Hayden Planetarium in New York. Tyson spoke with an evangelist's zeal, and he had the heretics in his sights. Referring to a recent poll of US National Academy of Sciences members which showed 85 per cent do not believe in a personal God, he suggested that the remaining 15 per cent were a problem that needs to be addressed. "How come the number isn't zero?" he asked. "That should be the subject of everybody's investigation. That's something that we can't just sweep under the rug."

This single statistic, he said, gave the lie to claims that patiently creating a scientifically literate public would get rid of religion. "How can [the public] do better than the scientists themselves? That's unrealistic."

DeGrasse Tyson clearly found it hard to swallow the idea that a scientist could be satisfied by revelation rather than investigation. "I don't want the religious person in the lab telling me that God is responsible for what it is they cannot discover," he said. "It's like saying no one else will ever discover how something works."

For others, the idea that it is somehow unacceptable for scientists to maintain a religious belief was going too far. "They're doing science, they're not a problem," said Lawrence Krauss, a physicist based at Case Western Reserve University in Cleveland, Ohio. Scientists are not a special class of humanity, he pointed out, so it is hardly surprising that a small number of academy members are also believers. "It would be amazing if that figure were zero," he said. "Scientists are people, and we all make up inventions so we can rationalise about who we are."

Krauss says he found the meeting at La Jolla a peculiar experience. He is a veteran of campaigns against religious incursion into science, and testified against the scientific credentials of "intelligent design" in the Dover school board trial in Pennsylvania last year. "I'm not usually the person who defends faith," he told New Scientist.

Krauss wasn't the only participant who seemed to think some of the more militant speakers were a tad over the top. Joan Roughgarden, a professor of geophysics and biology at Stanford University, California, described some of the statements being made as an "exaggerated and highly rose-coloured picture of the capabilities of science" while presenting a caricature of people of faith. Attempts by militant atheists to represent science as a substitute for religion would be a huge mistake, she said, and might even set back science's cause. "They are entitled as atheists to generate more activism within the atheist community," she told New Scientist. "But scientists are portraying themselves as the enlightened white knights while people of faith are portrayed as idiots who can't tell the difference between a [communion] wafer and a piece of meat." People of faith are being antagonised, and this is "a lose-lose proposition", she said.

She also suggested that science, like religion, had dogma and prophets of its own, citing as an example the "locker-room bravado" of many biologists in promoting the received wisdom regarding sexual selection. What's more, she said, science's ethics were open to being manipulated - notably by biotechnology companies - leading her to seriously doubt that a workable morality could be developed by the rationalist scientific community.

Biology rules

This was not a view shared by Patricia Churchland of the University of California, San Diego, who was charged with answering the question "can we be good without God?". Values, Churchland said, are set by what we care about, and as social animals we care about mates, kin and insider-outsider relationships. Every human social value and moral, she said, can be traced back to group dynamics and biochemistry; there is no need for a scriptural mandate. Thus the answer to the third question of the meeting became an overwhelming yes.

With three positive verdicts in the bag, the mood was clear: science can take on religion and win. "We've got to come out," urged chemist Harry Kroto of Florida State University, Tallahassee. Dawkins also used the same phrase, and compared the secular scientists' position to that of gay men in the late 1960s. If everyone was willing to stand up and be counted, they could change things, he said. "Yes I'm preaching to the choir," Dawkins admitted. "But it's a big choir and it's an enthusiastic choir."

Kroto certainly declared himself ready to fight the good fight. "We're in a McCarthy era against people who don't accept Christianity," he said. "We've got to do something about it." His answer is to launch a coordinated global effort at education, media outreach and campaigning on behalf of science. Such an effort worked against apartheid, he said, and the internet now provided a platform that could take science education programmes into every home without being subject to the ideological and commercial whims of network broadcasters. He has schools run by religious groups firmly in his sights too. "We must try to work against faith schooling," he said.

For all the evangelical fervour, some attendees suggested that a little more humility might be in order. "This is Alice in Wonderland, it's just a neo-Christian cult," Scott Atran of the CNRS in Paris told New Scientist. "The arguments being put forward here are extraordinarily blind and simplistic. The Soviets taught kids in schools about science - religiously - and it didn't work out too well. I just don't think scientists, when they step out of science, have any better insight than the ordinary schmuck on the street. It makes me embarrassed to be an atheist."

Krauss was similarly critical. "The presumption here was that any effort to respect the existence of faith is a bad thing," he told New Scientist. "Philosophically I'm in complete agreement, but it's not a scientific statement, and I've seen how offensive it is when scientists say 'I can tell you what you have to think'. They make people more afraid of science. It's inappropriate, and it's certainly not effective."

Dawkins, though, is ready to mobilise. The meeting, he says, achieved "probably a little" - but every little helps. "There's a certain sort of negativity you get from people who say 'I don't like religion but you can't do anything about it'. That's a real counsel of defeatism. We should roll our sleeves up and get on with it."

From issue 2578 of New Scientist magazine, 20 November 2006, page 8-11

Should science do away with religion?

"It is just as futile to get someone to give up using their ears, or love other children as much as their own... Religion fills very basic human needs."

Mel Konner, ecologist, Emory University, Atlanta, Georgia

"Religion is leading us to the edge of something terrible... Half of the American population is eagerly anticipating the end of the world. This kind of thinking provides people with no basis to make the hard decisions we have to make."

Sam Harris, author of The End of Faith

"Religion allows billions of people to live a life that makes sense - they can put up with the difficulties of life, hunger and disease. I don't want to take that away from them."

Francisco Ayala, biologist and philosopher, University of California, Irvine

"No doubt there are many people who do need religion, and far be it from me to pull the rug from under their feet."

Richard Dawkins, biologist, University of Oxford

"Science can't provide a sense of magic about the world, or a community of fellow-believers. There's a religious mentality that yearns for that."

Steven Weinberg, physicist, University of Texas, Austin

"Science's success does not mean it encompasses the entirety of human intellectual experience."

Lawrence Krauss, physicist and astronomer, Case Western Reserve University, Ohio

If not God then what?

"It is the job of science to present a fully positive account of how we can be happy in this world and reconciled to our circumstances."

Sam Harris, author of The End of Faith

"Let me offer the universe to people. We are in the universe and the universe is in us. I don't know any deeper spiritual feeling that those thoughts."

Neil deGrasse Tyson, astrophysicist, Hayden Planetarium, New York

"Let's teach our children about the story of the universe and its incredible richness and beauty. It is so much more glorious and awesome and even comforting than anything offered by any scripture or God-concept that I know of."

Carolyn Porco, planetary scientist, Space Science Institute, Boulder, Colorado

"I'm not one of those who would rhapsodically say all we need to do is understand the world, look at pictures of the Eagle nebula and it'll fill us with such joy we won't miss religion. We will miss religion."

Steven Weinberg, cosmologist, University of Texas, Austin

Can we be good without God?

"The axiom that values come from reason or religion is wrong... There are better ways of ensuring moral motivation than scaring the crap out of people."

Patricia Churchland, philosopher, University of California, San Diego

"What about the hundreds of millions of dollars raised just for Katrina by religions? Religions did way more than the government did, and there were no scientific groups rushing to help the victims of Katrina - that's not what science does."

Michael Shermer, editor-in-chief, Skeptic magazine

"It doesn't take away from love that we understand the biochemical basis of love."

Sam Harris, author of The End of Faith

Enemies of Reason Part 2

Enemies of Reason Part 1

Enemies of Reason - Interview

Does a cat always land on it's feet?

Does a Cat Always Land on Its Feet?

by Fiorella Gambale, Ph.D.
Institute for Feline Research
Milano, Italy

Cats have excellent balance, and are remarkably acrobatic. When turned upside down and dropped from a height, a cat generally has the ability to land on its feet. Until now, no one has systematically investigated the limits of this phenomenon. In this study, I dropped a cat upside down from various heights, and observed whether the cat landed on its feet.

Dropping a Cat Upside Down from a Height of 6 Feet
I dropped the cat from a height of six feet. I did this one hundred times. The cat always landed on its feet.
Dropping a Cat Upside Down from a Height of 5 Feet
I dropped the cat from a height of five feet. I did this one hundred times. The cat always landed on its feet.
Dropping a Cat Upside Down from a Height of 4 Feet
I dropped the cat from a height of four feet. I did this one hundred times. The cat always landed on its feet.
Dropping a Cat Upside Down from a Height of 3 Feet
I dropped the cat from a height of three feet. I did this one hundred times. The cat always landed on its feet.
Dropping a Cat Upside Down from a Height of 2 Feet
I dropped the cat from a height of two feet. I did this one hundred times. The cat always landed on its feet.
Dropping a Cat Upside Down from a Height of 1 Foot
I dropped the cat from a height of one foot. I did this one hundred times. The cat never landed on its feet.

Discussion
Popular belief is that "a cat will always land on its feet." My experiments show this to be true for drop heights ranging from six feet down to two feet. It is not true at a drop height of one foot.

Does a cat land on its feet when dropped from a height of less than one foot? This preliminary study indicates that the answer may be no. However, further experiments, preferably with the same cat, are needed to settle the question.

Acknowledgments
I want to thank the cat, "Esther," for her initial cooperation in this experiment. Thank you, also, to Esther's owner, M.R. Young. And special thanks to the organization PFTAR (People For the Tarring-and-Feathering of Animal Researchers), whose indiscriminate yacketing inspired this project.

Original article

Bayes Theorem - Lets Make a Deal

The Let's Make a Deal Applet
As a motivating example behind the discussion of probability, an applet has been developed which allows students to investigate the Let's Make a Deal Paradox. This paradox is related to a popular television show in the 1970's. In the show, a contestant was given a choice of three doors of which one contained a prize. The other two doors contained gag gifts like a chicken or a donkey. After the contestant chose an initial door, the host of the show then revealed an empty door among the two unchosen doors, and asks the contestant if he or she would like to switch to the other unchosen door. The question is should the contestant switch. Do the odds of winning increase by switching to the remaining door?

The intuition of most students tells them that each of the doors, the chosen door and the unchosen door, are equally likely to contain the prize so that there is a 50-50 chance of winning with either selection. This, however, is not the case. The probability of winning by using the switching technique is 2/3 while the odds of winning by not switching is 1/3. The easiest way to explain this to students is as follows. The probability of picking the wrong door in the initial stage of the game is 2/3. If the contestant picks the wrong door initially, the host must reveal the remaining empty door in the second stage of the game. Thus, if the contestant switches after picking the wrong door initially, the contestant will win the prize. The probability of winning by switching then reduces to the probability of picking the wrong door in the initial stage which is clearly 2/3.

Despite a very clear explanation of this paradox, most students have a difficulty understanding the problem. It is very difficult to conquer the strong intuition which most students have in this case. As a challenge to students who don't believe the explanation, an instructor may ask the students to actually play the game a number of times by switching and by not switching and to keep track of the relative frequency of wins with each strategy. An applet has developed which allows students to repeatedly play the game and keep track of the results. The applet is given below.

APPLET LINK

How to make up your mind

This is a news article from the New Scientist magazine about the science behind making a decision. It includes information about the various bias's that we are prone to.

Ali G on Science, Creationism & Evolution