Wednesday, March 24, 2010

Introducing Your NIH

The National Institutes of Health, as a part of the United States Department of Health and Human Services is "the nation’s medical research agency - making important medical discoveries that improve health and save lives."1

The NIH is made up of 27 institutes. Some examples are:

  • The National Cancer Institute: "NCI leads a national effort to eliminate the suffering and death due to cancer."2

  • The National Eye Institute: "NEI conducts and supports research that helps prevent and treat eye diseases and other disorders of vision."3

    So far so good. I can get behind my tax dollars going towards the research of cancer and vision.

    There are also seven "centers" under the umbrella of the NIH. These include such organizations as:

  • Center for Information Technology: "CIT incorporates the power of modern computers into the biomedical programs and administrative procedures of the NIH..."4

  • National Center on Minority Health and Health Disparities: "The mission of NCMHD is to promote minority health and to lead, coordinate, support, and assess the NIH effort to reduce and ultimately eliminate health disparities."5

    Awesome... if we're going to fund an NIH, let's do it right... let's apply the latest in science and technology and let's make sure we address some really key and fundamental problems like the health disparities among different groups of Americans. Most of the other centers have similar missions.

    And now to the punchline. There is a center in the NIH called the National Center for Complementary and Alternative Medicine6: "NCCAM is dedicated to exploring complementary and alternative medical (CAM) practices in the context of rigorous science; training CAM researchers and disseminating authoritative information."

    I have to admit to being skeptical to start with when it comes to complimentary and alternative medicines. Things like ear candling and therapeutic touch are silly on the face of their claims and there is no one who has ever articulated any mechanism for how these modalities might work that shows even an ounce of understanding about how the natural world actually works. But some stuff, like acupuncture and chiropractic, while born of superstitious nonsense, actually do things to the body, so it is not literally physically impossible that those modalities could affect the human body and health. So I can understand the value of studying those things.

    Let's explore the NCCAM a bit.

    In the "About" page, the NCCAM tells us:

    The National Center for Complementary and Alternative Medicine (NCCAM) is the Federal Government's lead agency for scientific research on the diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine.

    It has been said by smarter people than I that if any of these things worked, they would start to become conventional medicine. I have several friends who are medical doctors. I guarantee that if homeopathic pills were shown to work, they'd prescribe them as gladly as they currently prescribe any other pill.

    The thing is, the most of these things don't show a lot of efficacy. But let's read more about NCCAM.

    In their introduction on Traditional Chinese Medicine they say:

    Although TCM is used by the American public, scientific evidence of its effectiveness is, for the most part, limited. Acupuncture has the largest body of evidence and is considered safe if practiced correctly. Some Chinese herbal remedies may be safe, but others may not be.


    * Yin-yang theory—the concept of two opposing, yet complementary, forces that shape the world and all life—is central to TCM.
    * In the TCM view, a vital energy or life force called qi circulates in the body through a system of pathways called meridians. Health is an ongoing process of maintaining balance and harmony in the circulation of qi.
    * The TCM approach uses eight principles to analyze symptoms and categorize conditions: cold/heat, interior/exterior, excess/deficiency, and yin/yang (the chief principles). TCM also uses the theory of five elements—fire, earth, metal, water, and wood—to explain how the body works; these elements correspond to particular organs and tissues in the body.

    Nothing above has any basis in anything even vaguely scientific. Nothing about it is proven, or indeed even hinted about, in any rigorous study of the natural world. Vital life forces or energies are unknown, undiscovered and undescribed by science. "Meridians" have never been found by any doctor, scientist or anatomist. There is no coherent theory explaining why any of this should work.

    The explain about acupuncture:

    Acupuncture. By stimulating specific points on the body, most often by inserting thin metal needles through the skin, practitioners seek to remove blockages in the flow of qi.

    So they are trying to unblock the flow of something they can't adequately describe and which has never been demonstrated or measured in any way.

    In the NCCAM's section on "If You Are Thinking About Using TCM" they advise"

  • "Do not use TCM as a replacement for effective conventional care or as a reason to postpone seeing a doctor about a medical problem."

    In discussing more CAM modalities, NCCAM discusses "Energy Medicine thusly:

    Energy medicine uses energy fields with the intent to affect health. Some fields, such as magnetic fields, have been measured. Others, such as biofields, have not. Therapies involving biofields are based on the idea that people have a subtle form of energy; energy medicine practitioners believe that illness results from disturbances of these subtle energies.


    Examples of energy medicine include magnet therapy, healing touch, and Reiki (pronounced "ray-kee").

    Magnet therapy uses magnets or magnetic devices to treat or ease the symptoms of various diseases and conditions, including pain.

    Healing touch practitioners pass their hands over or gently touch a person's body to try to identify imbalances in the body's energy field.

    Reiki is based on the idea that there is a universal (or source) energy that supports the body's innate healing abilities. Practitioners seek to access the energy and allow it to flow to the body to help with healing. In a Reiki session, the practitioner's hands are placed lightly on or just above the client's body.

    In other words, "Someone had some concept of 'energy fields' and named them, no one has ever measured those energy fields or proven them to exist, but someone will not touch you in order to manipulate those fields, and that will heal you."

    I defy you to find a more coherent description of healing touch than what I have just supplied.

    So what do we know? We know that nearly $3 Billion has gone into the NCCAM over the last 10 or 11 years, and it is apparently using that money to study whether not touching a patient might effect a cure. If not touching me might cure disease, why aren't all shut-ins 100% healthy all of the time?

    1. NIH's Mission
    2. NCI
    3. NEI
    4. CIT
    5. NCMHD
    6. NCCAM

  • Tuesday, March 23, 2010

    Dying Old

    What you're looking at is a graph depicting the death rates in different eras.

    Take the low blue line. This is the 1900-1902 line, showing what befell the people in the United States, base on a per-100,000 live birth rate. At the left you can see that since this is live births, everyone survived to birth. There is a steep decline showing that only 89% of Americans survived to 1 year old. The next data point along that line shows another decline and only 82% of the original group survived to 5 years old. And so on.

    What does this show? Well we're getting better and better at surviving to the elbow of the curve... no line shows a lower survival at any point than a previous era except in one spot. Between 1919-1921, humans in the United States survived to five years old in a lower percentage than between 1909-1911. I think that must be related to the 1917/1918 flu epidemic. It shows what a real pandemic actually looks like... imagine what it was like when children were dying at such a rate....

    The other curious thing it shows is that the advantages over our very recent forebears is still holding up... in 2004 we still see the same advantage over 1989-1991 as 1909-1911 saw over 1900-1902. I would have thought we'd be compressing more than we are.

    Also, while the data stops at 100, it's clear that we converge at the extreme old age... we aren't getting a greater percentage of people beyond about 95 than we ever have.

    At the big bulge we can see how well we're getting people into their 50s. For Americans born in 1850 we were getting about 54% into their 50s. 94% of Americans born in 1954 were still alive in 2004.

    That's pretty amazing, and shows that we seem to have gotten people over the childhood disease rate... the curve is flat until heart attacks take people out in their 50s and 60s. I suspect that cancer is killing us at the far right, and we clearly are making great strides there as well. Born in 1920? Only 14% of people made it into their 80s. Born in 1920? 54%. In 100 years we now are as good at getting people into their 80s as we used to be at getting them into their 50s.

    Still, we need to crack the top end before I relax.

    Tuesday, March 16, 2010

    96 ways to kill a good thing

    So we're going to get 96 teams.

    I will gripe only once in a general sense: John Feinstein had it right when he pointed out that the NCAA is so stupid it's literally doing the exact opposite of what makes sense--they refuse to address their football championship system which is clearly the worst champion-picking exercise of any major sporting season, college or pro.  At the same time they are messing with arguably the greatest sporting spectacle EVER DEVISED.  I don't even mean that facetiously, it's possible that March Madness is more fun for the serious-down-to-casual fan of anything yet devised in sports.

    And now they are going to add tons of mediocre-to-bad teams.  But my main reason for bringing this up is an aspect to this travesty that I haven't seen discussed yet: what does this do to filling out brackets?  64 teams is hard to bracketize as it is, but it can be done with a single piece of 11.5 x 8 inch paper if you write small.  It can be integrated into a website form if it's done well.  When you make it one round bigger it's going to be harder to manage.  Not impossible, but you aren't going to carry around your bracket in as pleasant a way anymore.

    If that's the case, does it make the 96-team tournament really unfriendly to the casual fan?  Is my mother, who has actually filled out brackets before, ever going to sit down long enough to decide if the 8th place Big-Ten team might beat the third best Mountain West school?  No way.  A 96-team bracket makes the obscure match-ups just that much more abstract to people on the margins of caring.

    The office pool goes from something fun for $5 to an annoyance to deal with... that will be as hard on the popularity of the event as anything.

    Tuesday, March 09, 2010

    Giving Way to Hating

    Are we reaching the point where a legislator being actively anti-gay will make us all believe the legislator himself is gay?  It's becoming too common to be a joke anymore, and is just a sad reality.  How much does a man have to hate himself to spend the first 55 years of his life actively denying rights to those of his own sexuality.

    [Mr. Ashburn] also voted in the statehouse against efforts to expand anti-discrimination laws...

    As a kind-of meta comment on this episode, does anyone else find it sad to read a statement like "voted... against efforts to expand anti-discrimination laws..."?  I am a pretty libertarian guy.  If I am radical politically, it is along the lines of believing the government has no place in my personal life.  How can there be laws governing behavior that doesn't affect anyone but the primary actor?  But general libertarianism aside, I can't imagine a better use of extraneous laws than to be anti-discrimination. 


    If there is any value to the fact that humans have to get old and die, perhaps it's so that this generation can leave and let the rest of us get on with more important things that the previous generation's hang-ups.  Note that I know people like this do not represent everyone, and I am aware that I must have hang-ups that my children will abhor.  So maybe it's good that someday I'll die so that they can get on with whatever terrible thing it is that they think is more important.