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4 out of 5
by
Lena
from
Boulder, CO | Jul 21, 2008
This is the third book I've read this year that examines the evidence for and against alternative medicine, so much of the ground it covers was already familiar to me. Despite that fact, I enjoyed this book a great deal and think it is likely to be the most accessible to those who have personal experience with alternative medicine.
The authors take an in-depth look at the four most popular modalities in the alternative medicine world: acupuncture, homeopathy, chiropractic and herbal medicine. They briefly discuss the history and public perception of each before they analyze what science has to say about the true effectiveness of these techniques.
The authors are not shy about stating those cases in which science does indicate possible effectiveness of these modalities, such as acupuncture for pain and nausea, chiropractic for low back pain, and certain herbs for various specified conditions. They take things a step further, however, by comparing these treatments with their conventional counterparts in terms of both cost and risk. While chiropractic may be effective for certain types of back pain, it has not been shown to be more effective than conventional therapies, is usually much more expensive, and carries a rarely discussed but very real risk of stroke, leading the authors to recommend against it.
Though the bulk of the book is spent on the four most popular CAM treatments, the appendix contains brief summary of their findings for 36 other CAM modalities from Ayuveda to spiritual healing that I found particularly informative.
I hope that the authors' willingness to give credit to those therapies that do warrant further study will make this book more likely to be read by those who could best benefit from this information. Unlike the authors of Suckers and Snake-Oil Science, Ernst knows this world from the inside. He is world's first professor of complementary medicine and also a former homeopath.
As the authors discuss, the placebo effect, the empathetic nature of CAM practitioners, and the preference we give to anecdotal over scientific evidence are likely to continue keeping the public confused about the true effectiveness of some of these methods. Those who would like to make certain they are getting good value for their hard-earned cash before trying one of these treatments, however, will find this book an invaluable resource.
3 people found this review helpful
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3 out of 5
by
Michael
from
Vancouver, BC, Canada | Jul 11, 2010
Trick or Treatment didn't have to carry me very far, I was already severely dubious of any from of alternative medicine, and it may in fact have made me reconsider my own point of view on a number of the treatments that apparently have some claim to efficacy, despite the authors' overwhelmingly negative conclusions with regards to the efficacy of alternative treatments.
However, I don't know whether I really appreciated its overall tone, which, while informative, struck me as too impassioned to be as neutral as they claimed to be. I agreed with their arguments, and I too was shocked and outraged when they presented the evidence and theory behind some of these treatments, homeopathy in particular. Unfortunately I don't think their arguments will be nearly as convincing when faced with someone who has a vested interested, or even a strong belief, in the treatments they describe. A lighter touch would probably be more convincing, and might have made it a slightly easier read.
That said, I came out of this book feeling significantly more knowledgable on the subject than I was when I started. The references that I followed up on proved solid and intriguing, which leads me to believe that the authors' position is both well researched and dependable. I thought it was interesting that one of the authors, Edzard Ernst, is an expert in the field of Complementary and Alternative medecine, and has even practiced homeopathy.
I should note that the book is written from a British perspective, and that all of the references to healthcare, costs, etc... are in pounds and the context of the NHS. I didn't mind this, as Canada's healthcare system seems fairly close to the UK system, and the majority of the information the book provides is location agnostic.
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3 out of 5
by
Harry
from
London, The United Kingdom | Jan 17, 2010
This book reviews the evidence for the various main forms of alternative medicine. The take-home message, for me, was that most of these treatments are completely ineffective but harmless, with two major exceptions.
First is herbal medicines, which are largely untested but some of which work. Of course they can also have just as bad side-effects as anything your doctor will prescribe for you, and there's no guarantee of the quality of the product. So that's a bit of a crap-shoot.
And the surprisingly scary one is chiropractic. It turns out your chiropractor can kill you! Who knew.
A study found that 'patients under forty-five years of age who had suffered torn arteries [in their neck:] were five times more likely to have visited a chiropractor in the week prior to the damage being recognised than healthy individuals of a similar age.' And the torn artery then gives you a stroke.
Anyway, it's interesting stuff, if occasionally bit dry, since inevitably a lot of the time it is reporting data from studies.
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4 out of 5
by
Mike
from
Oakland, CA | Dec 14, 2009
So a while back a friend of mine used acupuncture to help with some nausea issues. I teased her about it and said it was just the placebo effect. Then I heard that some studies indicated that acupuncture may truly be useful for certain kinds of pain and nausea. In order to confirm this, I wanted to find a trusted source. I'm rather new to the skeptical community, but I have already heard much about Simon Singh and his battles with British libel laws to tell the truth about chiropractics. So I thought he would be a good person to trust.
I was very happy with my choice. The book is quite well written. It's not just a dry account of peer-reviewed studies. It tells the stories of how various forms of alternative medicine became so popular, some of which are very strange and interesting. The book also weaves in stories of how evidence-based medicine came to take hold in Western society. It's amazing how far medicine has come in just a couple centuries. So many people contributing in small ways that add up to change the world. And Florence Nightingale is so much cooler than they bothered to teach me in high school.
As for my friend's acupuncture, well I guess it's still unclear whether or not acupuncture works beyond placebo for nausea. Further evidence may well show that it's useless, but at the time of her treatment, there was some apparently legitimate positive evidence. So it was a legitimate choice and I should probably go apologize.
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4 out of 5
by
Elaine
from
Olympia, WA | Jun 8, 2009
My tongue-in-cheek instinct is to say that I'm posting spoilers, but not really: acupuncture might work for nausea & pain; homeopathy is BS; chiropractic might work for lower back pain; and herbal remedies are a mixed bag, some quite effective, others not so much.
More seriously, I like the detailed approach to these fairly common "alternative" techniques. The authors start with a history of evidence-based medicine and the application of the scientific method to human health, before going on to each of the modalities in particular. And throughout they introduce and reinforce scientific techniques for evaluating proposed remedies. Plus they personalize science by describing how the techniques evolved and the people involved. (It had never occurred to me, btw, that placebo also boosts the benefits provided by truly effective techniques.)
I've not been much for alternative medicine, but even I was surprised at the evidence in some aspects. (Except for homeopathy. The whole idea of it makes me giggle.) Chiropractic in particular -- some years back I saw a chiropractor for overpoweringly bad and frequent headaches. My regular doctor hadn't been a lot of help: I had some medication that provided symptom relief, but whacked me out and didn't reduce either the severity or the frequency.
To his credit, the chiropractor suggested massage (which I think gave genuine relief) and didn't encourage me to keep going after the headaches started to trail off. But after reading this, I have to wonder about my crazy popping neck, which didn't used to do that at all. Ultimately, it's my take that the headaches were somewhat psychosomatic, and were eventually "cured" with therapy and later antidepressants. (But anecdote != data and all that.)
In any case, very engaging and thought-provoking. Includes an appendix with quick reviews of a couple dozen other modalities.
Caveats: I'm not sure how effective this would be with someone who was really into alternative medicine, except that one of the authors is a former homeopath. The tone occasionally tips into LOLcrackpots! territory. For US readers, a lot of the data is UK-centered, although I didn't find that to be a huge barrier.