Snake Oil Science: The Truth about Complementary and Alternative Medicine (Hardcover)

~ R. Barker Bausell PhD (Author)
Key Phrases: placebo boost, experimental attrition, opioid blocker, Making Valid Inferences, Therapies Are Hypothesized, Few Loose Ends (more...)

Editorial Reviews

From Publishers Weekly

A biostatistician, author and Senior Research Methodologist at the University of Maryland, Bausell looks at the alternative methods used by more than 36 percent of Americans to treat pain and illness by posing the question, "Is any complementary and alternative medical therapy more effective than a placebo?" In short, his answer is no; what, then, is actually happening in patients (and professionals) who swear by the medical utility of such complementary and alternative medicines ("CAMs") as acupuncture, deep breathing exercises and megavitamin therapy? Step by step, Bausell builds a rigorous case against CAM, beginning with a look at the history of CAMs and placebos, then the "poorly trained scientists" and flawed studies (among more than 300 analyzed for this book) that have historically supported CAM's efficacy. A breakdown of the placebo effect's hows and whys follows (are people hardwired for susceptibility?), along with a look at "high-quality studies" and "systematic reviews" (including an Italian study that finds natural opioid secretion in the brain responsible for the perceived benefits of placebos) which largely support Bausell's answer. Entertaining and informative, with plenty of diverting anecdotal examples, Bausell offers non-professionals and pros a thorough look at the science on CAM, along with a complementary lesson in the methods of good medical research.
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Review

"Hang up your lantern Diogenes, an honest man has been found. Barker Bausell, a biostatistician, has stepped out of the shadows to give us an insider's look at how clinical evidence is manipulated to package and market the placebo effect. Labeled as "complementary and alternative medicine," the placebo effect is being sold not just to a gullible public, but to an increasing number of health professionals as well. Bausell knows every trick, and explains them in clear language." --Robert L. Park, Ph.D., Professor of Physics, University of Maryland, and author of Voodoo Science: The Road from Foolishness to Fraud
"At Skeptic magazine there is no topic for which we receive more requests to comment on than alternative and complementary medicine. It is big business with big claims and big demands on it to produce, but there is very little science behind most of it. Unfortunately, what has long been lacking is a well-written, clear, and concise analysis of its major claims to which we can direct our readers. That problem has now been remedied by R. Barker Bausell's authoritative and highly readable analysis Snake Oil Science, which should be read by anyone contemplating the use of any of the hundreds of alternative and complementary medical treatments out there that promise hope but usually deliver disappointment."--Michael Shermer, publisher of Skeptic magazine, monthly columnist for Scientific American, and the author of Why People Believe Weird Things
"Anyone who reads Bausell's rigorous scientific analysis of the risks and benefits of complementary and alternative medicine will be left wondering why they are spending so much on so many useless products."--Jerome P. Kassirer, M.D., Tufts University School of Medicine, Editor-in-Chief Emeritus, New England Journal of Medicine, and author of On the Take: How Medicine's Complicity with Big Business Can Endanger Your Health
"The book is aimed at the consumer, and it is written in a simple, entertaining style such that the consumer will understand it and enjoy reading it. So the consumer should and, I'm sure, will buy this book. But in addition I would also warmly recommend it to healthcare professionals who work in CAM or have an interest in this area. They will not easily find a harder hitting, more eloquent, or smarter critique of CAM!"--Edzard Ernst, M.D., Ph.D., Complementary Medicine, Peninsula Medical School, UK
"Readable, entertaining and immensely educational...[Bausell] writes with a sense of humor and palpable compassion for all involved."--New York Times
"...An overview of alternative and complementary treatments. [Bausell] explains why most such treatments can't possibly do what their proponents claim, but he rarely takes on the scoffing tone that many skeptics use when discussing these issues."--ScienceNews
"His book is highly informative, easy to read and full of entertaining wit and humor...I warmly recommend it to healthcare professionals who work in CAM or have an interest in this area. One would have to search hard and long to find a more eloquent or intelligent critique of CAM!"--Focus on Alternative and Complementary Therapies
"Hang up your lantern Diogenes, an honest man has been found. Barker Bausell, a biostatistician, has stepped out of the shadows to give us an insider's look at how clinical evidence is manipulated to package and market the placebo effect. Labeled as "complementary and alternative medicine," the placebo effect is being sold not just to a gullible public, but to an increasing number of health professionals as well. Bausell knows every trick, and explains them in clear language." --Robert L. Park, Ph.D., Professor of Physics, University of Maryland, and author of Voodoo Science: The Road from Foolishness to Fraud
"At Skeptic magazine there is no topic for which we receive more requests to comment on than alternative and complementary medicine. It is big business with big claims and big demands on it to produce, but there is very little science behind most of it. Unfortunately, what has long been lacking is a well-written, clear, and concise analysis of its major claims to which we can direct our readers. That problem has now been remedied by R. Barker Bausell's authoritative and highly readable analysis Snake Oil Science, which should be read by anyone contemplating the use of any of the hundreds of alternative and complementary medical treatments out there that promise hope but usually deliver disappointment."--Michael Shermer, publisher of Skeptic magazine, monthly columnist for Scientific American, and the author of Why People Believe Weird Things
"Anyone who reads Bausell's rigorous scientific analysis of the risks and benefits of complementary and alternative medicine will be left wondering why they are spending so much on so many useless products."--Jerome P. Kassirer, M.D., Tufts University School of Medicine, Editor-in-Chief Emeritus, New England Journal of Medicine, and author of On the Take: How Medicine's Complicity with Big Business Can Endanger Your Health
"The book is aimed at the consumer, and it is written in a simple, entertaining style such that the consumer will understand it and enjoy reading it. So the consumer should and, I'm sure, will buy this book. But in addition I would also warmly recommend it to healthcare professionals who work in CAM or have an interest in this area. They will not easily find a harder hitting, more eloquent, or smarter critique of CAM!"--Edzard Ernst, M.D., Ph.D., Complementary Medicine, Peninsula Medical School, UK
"Readable, entertaining and immensely educational...[Bausell] writes with a sense of humor and palpable compassion for all involved."--New York Times
"...An overview of alternative and complementary treatments. [Bausell] explains why most such treatments can't possibly do what their proponents claim, but he rarely takes on the scoffing tone that many skeptics use when discussing these issues."--ScienceNews
"His book is highly informative, easy to read and full of entertaining wit and humor...I warmly recommend it to healthcare professionals who work in CAM or have an interest in this area. One would have to search hard and long to find a more eloquent or intelligent critique of CAM!"--Focus on Alternative and Complementary Therapies
"....[a] readable study of the science behind the placebo effect..."--The New York Times Book Review

See all Editorial Reviews

Product Details

• Hardcover: 352 pages
• Publisher: Oxford University Press, USA; 1 edition (October 31, 2007)
• Language: English
• ISBN-10: 0195313682
• ISBN-13: 978-0195313680
• Product Dimensions: 8.3 x 5.7 x 1.4 inches
• Shipping Weight: 1.1 pounds (View shipping rates and policies)
• Average Customer Review: 4.0 out of 5 stars  See all reviews (25 customer reviews)
• Amazon.com Sales Rank: #355,729 in Books (See Bestsellers in Books)

Customer Reviews

Most Helpful Customer Reviews

38 of 44 people found the following review helpful:

5.0 out of 5 stars A great explanation of why so many get hoodwinked, January 26, 2008

By	J. Seidman "Jim" (Illinois, USA) - See all my reviews (REAL NAME)

Bausell does a great job in this book of explaining why Complementary and Alternative Medicine (CAM) is so popular, even though there's no good evidence that it works. To do this, he goes through several steps.

He explains how both consumers and medical practitioners could be convinced of the efficacy of CAM when it's not there. He explains the basics of good research, especially using a placebo control. He shows how bad most CAM research is. He provides compelling evidence that the placebo effect, at least for pain relief, is a real, physiological phenomenon. And he pulls this all together to show that CAM is no more effective than placebo.

I've seen criticisms that he lumps all CAM together. That's true, because every CAM technique suffers from the same two characteristics: there is no scientific basis for why it should work, and the research on it lousy. Most CAM therapies don't lend themselves towards placebo controls - how do you do a sham chiropractic adjustment? In fields such as homeopathy and acupuncture where there are good placebos, placebo-controlled trials are overwhelmingly negative. That's probably why most trials don't use placebos.

Note that Bausell doesn't say that CAM doesn't work. On the contrary, he just says it's no more effective than placebo. Since placebo effects are real, CAM effects are real, and CAM practitioners can provide some real relief. Does that put them on a par with allopathic (mainstream Western) medicine, which can provide treatments that greatly exceed the placebo effect? Of course not.

The book would have benefited from a discussion of how any CAM treatment that can survive quality research then ceases to be CAM. For example, he talks briefly about willow bark, which contains aspirin, and how it used to be an herbal remedy. There are other medicines or treatments that started as CAM and have moved into mainstream medicine as they were proven. This condemns CAM perpetually to be a wasteland of ineffective treatments. But Bausell doesn't really make that point, which I'm sure will leave some readers wondering if their local practitioner may this time have the miracle cure that's the one exception.

But that's a minor criticism for a book that tackles a very ambitious topic. I heartily recommend this book to anyone who cares about their health or their health care dollar.

10 of 10 people found the following review helpful:

5.0 out of 5 stars An excellent treatise on the science of clinical trials, July 12, 2008

By	Ronald P. Ng (Singapore) - See all my reviews (REAL NAME)

I am a practicing physician in Singapore and at one time, on staff teaching hematology in University College Hospital Medical School, London University and then Hong Kong University. Many years ago, while sitting on the Singapore National Medical Research Council, there was one grant applicatioin that asked for money to do a piece of research on "Acupuncture for the relief of osteoarthritic knee pain." There was no sham acupuncture control group mentioned. When I said in order to make the trial valid, there must be a control group. The answer came back, "We know no matter where we stick the needle, the pain will improve." That started me on my quest for more knowledge regarding acupuncture and other forms of Complementary and Alternative Medicine (CAM).

This book by R. Barker Bausell is the best one I have ever read. Bausell is a biostatistician, a Professor at the University of Maryland and at one time Research Director of an NIH funded CAM Specialized Research Center. The structure of the book could roughly be outlined as an attempt to finding answers to the following questions:
1. Is there such a thing as a therapeutic placebo effect?
2. Is there a plausible biochemical analgesic mechanism of action that could explain such an effect?
3. Is there such a thing as a CAM therapeutic effect over and above what can be attributed to the placebo effect (assuming that there is such a thing as the latter)?
4. Are there plausible biochemical mechanisms of action that could explain these CAM therapeutic effects (assuming there are such things)?

In the process of answering those questions, he explained in very clear terms the necessity for Randomized Control Trials (RCT), and preferably Double blinded RCT, where neither the physician nor the patient knew whether the patient was receiving the treatment or just a placebo, was necessary. As an aside, his book could be an introductory treatise on running RCTs for the rookie clinical research working planning his/her first clinical trial. Towards the end of the book, having laid out the criteria of what were meant to be good clinical trials, he found virtually nothing in the literature that pointed to the efficacy of CAM other than that due to placebo effects.

In summary his answers to those four questions posed at the beginning are:
1. The placebo effect is real and is capable of exerting at least a temporary pain reduction effect. It occurs only in the presence of the belief that an intervention (or therapy) is capable of exerting this effect. This belief can be instilled through classical conditioning, or simply by the suggestion of a respected individual that this intervention (or therapy) can reduce pain.
2. The placebo effect has a plausible, biochemical mechanism or action (at least for pain reduction), and that mechanism of action is the body's endogenous opiod system.
3. There is no compelling credible scientific evidence to sugges that any CAM therapy benefits only medical condition or reduces any medical symptom (pain or otherwise) better than a placebo.
4. No CAM therapy has a scientifically plausible biochemical mechanism of action over and above those proposed for the placebo effet.

FINAL CONCLUSION: CAM therapies are nothing more than cleverly packaged placebos.

Those of you who are old enough to remember the hu-ha that surrounded the stories regarding acupuncture anaesthesia that came out of China at the time of the Nixon-Mao meeting in the 70's perhaps would like to know what a professor of medicine in Beijing told me. They are no longer using that, and the party leaders, when they go for surgery of any form, inevitbaly would choose anaesthesia given conventionally over acupuncture.

I think that says it all.

39 of 48 people found the following review helpful:

5.0 out of 5 stars Expect a bi-modal rating for this book, December 25, 2007

By	James V. Porto "Jim Porto" (Carrboro) - See all my reviews (REAL NAME)

Those who appreciate any effort to improve critical thinking within the public will rate this book highly.

Those who are CAM practitioners, researchers, or devotees will say that this is a simplistic book because it doesn't take into account the sophistication that their particular CAM therapy requires to understand its effect.

Its worth repeating Bausell's conclusion: "CAM therapies are nothing more than cleverly packaged placebos." This is sure to annoy about 36% of the population.