Critical Thinking Regarding Purported Dementia Treatments
Brain diseases offer fertile ground for scam artists and snake oil salesmen. Patients and caregivers may be filled with a sense of hopelessness and desperation that drives them to look beyond treatments generally regarded as reasonable. Furthermore, some brain diseases can compromise good judgment. Unscrupulous marketers may therefore view caregivers and dementia patients as “easy targets” or “marks.” While some alternative treatments do have merit, there are countless unproven or even harmful bogus therapies for which, with slick marketing, people will sometimes pay thousands of dollars.
Here are a few guidelines to consider when trying determining if a treatment or therapy learned about in the news or advertising might actually work.
1) If it seems too good to be true… you know the rest. If a story uses the word “breakthrough,” game-changing,” “revolutionary,” or even “cure,” proceed with caution. Science usually proceeds slowly and without such certainty.
2) What other information is provided about what is being sold? Does the research take into account the work of opposing views? Does it recognize work done by other people that supports the conclusions?
3) What was the sample size in the study supporting the claim? Most conclusive studies usually involve hundreds or thousands of people. If there are a dozen people or so involved, that is not enough to be a conclusive study, even if it claims to be. Smaller investigations may be a call for larger studies, but not enough to stand on its own merits.
4) Anecdotes, stories in which someone has said that something works, are really an extreme example of small sample size. Even if there are hundreds of these stories, outside of a well-designed trial such stories cannot be trusted as conclusive. Personal stories and anecdotes can be very persuasive, and are very commonly misleading.
5) Is the research based on studies done in mice or people? Very early studies may be done on mice first, which lays the groundwork for later studies in people. However, this effect may not be found in people.
6) Is a study describing correlation or causation? Correlation means that two things happen together, but this may or may not suggest that one thing causes another. For example, ice cream may be correlated with an increased risk of drowning, but only because people swim and eat ice cream in the summer, not because ice cream causes drowning.
7) Does a story talk about cost or availability of a treatment? Does it talk about both benefits and harm? Do they quantify the effectiveness of the treatment? If side effects or interactions with other drugs aren’t mentioned, be cautious.
8) Beware of thinking that just because something is famous or expensive, it must work. Fame and expense may also be the sign of a really good scam. Good marketing can achieve both fame and fortune for the unscrupulous, even for something that doesn’t have any true benefit.
9) Is this disease mongering? Sometimes a story exaggerates a severity of a condition or medicalizes either normal states of health or tries to explain very common conditions. For example, fatigue, confusion, and aching are all very common conditions caused by a wide variety of things, not just one specific disease, but expensive tests or treatments may capitalize on our tendency to believe a vague description applies specifically to us.
10) Was the article published in a reputable journal? Beware, there are many fake journals, and even reputable journals are sometimes fooled.
11) Follow the money. Who funded the research? Be careful of conflicts of interest, especially if news of a miracle cure or test is followed by a link where you can give your money away.
12) Does the source discredit systems based on critical thinking? For example, some people discredit scientifically based medicine by stating that established medical doctors are merely peddling their own expensive treatments. But most established doctors will give credit to “alternative” treatments that do have some evidence of benefit. For example, there is evidence that melatonin, riboflavin, or magnesium may help some people with headache. This evidence, however, does not exist for a wide number of herbs and supplements that claim to be helpful. Look to the source and examine the evidence yourself before proceeding, remembering the guidelines above.
13) Recognize wolves in sheep’s clothing! Some websites even purport to discount health scams, even as they sell you one at the bottom of the page! Scam artists books sit next to reputable sources in most bookstores.
Below are a few sources to which you can turn for reputable medical knowledge that make use of the principles above.
Beall’s List of Potential Predatory Journals and Publishers
Health News Review – Review Criteria
Quackwatch – Your Guide to Quackery, Health Fraud, and Intelligent Decisions