Tuesday, November 29, 2005

Proving Once Again That the MSM Can't Report Science

Quite simply, this is not news. Perhaps others don't find this kind of mainstream media reporting offensive (it was reported as a lead story by Yahoo) but I sure do.

The article is about a Chinese neurosurgeon understatedly described as "controversial" who treats paralyzed patients in his clinic in Beijing. Apparently Dr Huang Hongyun has given new hope to patients suffering from catastrophic spinal cord injuries and amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease). His therapy consists of injecting olfactory ensheathing cells (OEC) obtained from aborted fetuses. His adherents, not to mention his public relations office, extol the virtues of his methods.

The article cites the response to such treatments in Leo Hallan, a 49-year-old man who suffered a massive cord injury 29 years prior in a tragic motorcycle accident that left him paralyzed from the chest down. After Hongyun's procedure, Hallan reports

"He started perspiring below his chest and could feel the chill of the wind for the first time when he went outdoors in his wheelchair.

"When I was outside, I felt cold in my arm, the hair of my arm was moving, I had to look down to believe it," said a cheerful-looking Hallan. "Words cannot express my emotions.

"It was total amazement, just unbelievable," he said. "Twenty-nine years ago ... many doctors said I'd never walk again. At least now I can say there is quite a bit of hope."

Now before my readers wish to accuse me of being a Philistine and close-minded to new ideas, let clarify this issue: If someone can cure these terrible injuries by waving a magic wand over his patient, by muttering mystical incantations or by invoking the healing power of the Lord, I would be the first to embrace these "nontraditional" approaches. In fact, if Dr Hongyun speaks the truth, I know of many patients that I'd be sending on the next plane to the orient.

My job is reasonably secure. I haven't been "bought" by the government-big pharma elite. I don't have an empire destined to collapse in the wake of such momentous scientific developments. In fact, I'd go so far as to assert that only the most parochial, most selfish, most avaricious of humankind could hope that such claims will evaporate into evanescent nothingness leaving the hopeful stranded yet again in their beds, their wheelchairs and in their damaged bodies.

However, I'm convinced that Dr. Hongyun has achieved nothing. Why? Because he refuses to subject his findings to the impersonal meat grinder we in medicine call the scientific method. He refuses to perform randomized clinical trials, the gold standard for establishing clinical benefit. He disingenuously invokes some no doubt nonexistent Chinese law that makes such studies illegal:

it would mean effectively deceiving patients into believing they had been treated when they hadn't.

"For someone like Mr Hallan who had been ill for 29 years, it would be cruelty to let him have that done to him..."

Fancy footwork, the last refuge of the scoundrel.

The fact of the matter is, clinical benefit of any medical treatment is based on well...clinical benefit. The treatment itself is irrelevant. If it's effective, its benefit by definition has to be measurable. And the most effective instrument of measuring and quantifying benefit is the randomized clinical trial.

Basing an assessment of benefit on the unquantified speculations of desperate patients hungry for the slightest whiff of hope is fraught with countless, well-established, well-characterized biases documented in all their gory details in the various articles, books, monographs, etc. that deal with such methodological issues. Read my own small contribution to this end here and my discussion of the consequences of not performing trials in a methodologically sound manner here.

So why my initial assertion that this entire story isn't news? Because to publish such a story is to publish the scientific version of rumor and innuendo. The story is completely unsubstantiated and putting it in print gives it weight and a veneer of veracity that is unwarranted. Let the National Enquirer (or my favorite tabloid, the Weekly World News) waste their ink on this nonstory.

And just as soon as Dr. Hongyon validates the benefits of his miracle treatment...I'll beg, borrow or steal to get my patients to him. Until that time, I'm going to have to waste my time explaining to hopeful patients that, despite reading about his work on Yahoo, at least right now it's without a scientific basis.

3 Comments:

Blogger Fred said...

You wrote: "The story is completely unsubstantiated and putting it in print gives it weight and a veneer of veracity that is unwarranted".

I don't know that the story itself is unsubstantiated as you're not disputing the events in question occured. Maybe the conclusions as a result of the events are unsubstantiated.

Then again, the story might also lead to the publicity and further scrutiny the procedure may deserve. Maybe some in the medical community, like you have, will take notice and either debunk the procedure, or, might find there is some merit to it. That might not have happened had it not made the news.

November 30, 2005 7:07 AM  
Blogger The Medicine Man said...

Fred,

I'm simply saying that this story isn't newsworthy. Should the mainstream media report every sensational science story regardless of whether the science itself is sound or not?

If I make an unsubstantiated claim that I have a cure for cancer, should the mainstream media report this story just because of its sensational aspect? I think not. Unless I have data or at a minimum am working to acquire such data, my claim for such a cure is the equivalent of unsubstantiated rumor. It's appropriate for the National Enquirer, not as a lead story on Yahoo.

Also, let me reiterate that I'm not suggesting that nontraditional approaches to healthcare don't have their place. I don't care HOW far outside the mainstream his therapy is, if it has established efficacy, I'll send him my patients.

John

December 01, 2005 4:49 PM  
Blogger Dr John Crippen said...

Excellent blog. Yes, this guy has had huge media exposure in the UK (how does he arrange it?) and consequently there is a lot of patient demand and interest. Acupuncture is very big over here, and more recently Chinese Herbal Medicine. You can buy bags of herbs/powders or whatever all over Chinatown which allegedly "cure" all sorts of things. But where are the trials...oh! you are so right. Sometimes I feel my day would go better if I could start it by shooting a journalist!

December 10, 2005 3:25 PM  

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