Friday, April 9, 2021

#2461: David Alimi & Jacques Chelly

Alimi
David Alimi
David Alimi (MD) and Jacques E. Chelly (MD, PhD, MBA) are both apparently (nominally) respectable medical doctors associated with the University of Pittsburgh. Despite possessing credentials that are impressive enough, Alimi and Chelly are also two of the most central defenders of the woo known as auricular acupuncture, or auriculotherapy. Acupuncture, of course, is theatrical placebo. Auricular acupuncture, however, is sillier by another order of magnitude. The fundamental idea behind auricular acupuncture is, apparently, that there is a homunculus of the human body on the ear (usually with the head near the earlobe and the feet near the upper part of the ear), and when the practitioner sticks needles into the ear, the locations of needles are determined in line with the homunculus to target the organ or body part that they wish to treat. It is an idea as silly and pseudoscientific as it sounds, vaguely corresponding to medieval superstitions and definitely rooted in medieval vitalism. Nevertheless, studies are being published by people like Alimi and Chelly, and those studies are textbook cases of tooth fairy science, painstakingly recording properties associated with a phenomenon they haven’t established actually exists, according to a protocol carefully designed to avoid having to take a stance on the latter, and sort of crucial question. Their article “A New Universal Nomenclature of Auriculotherapy” is a splendid example, discussed in detail here.
 
 
Alimi & Chelly even claim to have studied brain dissections and “proved the neurophysiological correlations existing between auricular displays and their brain correspondences”; indeed, they claim to have found that the middle of the corpus callosum is the “epicenter of the somatotopic organization of the brain homunculus.” We suppose real neuroscientists must be in some sort of conspiracy to hide those facts, though we suspect that Alimi & Chelly made the discovery based on loose association and poetic and metaphorical license. They do, admittedly, provide a new nomenclature for auriculotherapy, which is almost as impressive as providing a new nomenclature for a Dungeon & Dragons stats sheets. 
  
Apparently Chelly even has a clinical trial going, officially motivated by (piggybacking on) the currently popular movement to explore non-pharmacological techniques to treat post-operative pain in light of the opioid crisis. In the study, Chelly will be using a cryopuntor device, “which has been shown to produce the same effect as needles”. Of course, needles have no effect beyond placebo either, so showing that a technique has “the same effect as needles” would be textbook tooth fairy. Chelly is apparently into aromatherapy, too, which is arguably even more ridiculous than auriculotherapy.  
 
Despite (or rather: due to) it being what it is, Alimi’s and Chelly’s research has apparently managed to acquire a certain amount of influence among woo practitioners and pseudoscientists.  
 
Diagnosis: More nonsense from people who possess real credentials and, on the surface, look respectable enough (Chelly even has a Wikipedia article, which fails to mention his forays into pseudoscience), and who should really know better. The real tragedy, of course, is the massive amount of resources used to add to the pile of pseudoscientific junk instead of being used on projects that have at least some chance of providing real benefits to real people.  
 

6 comments:

  1. Funny that acupuncture, after only a couple of treatments made my 14 year old dog walk better than he had in a long time. He also returned to his lifetime weight of 72-75 pounds with a major increase in appetite. By the third treatment, he was dragging me into the vet's office, and would fall hard asleep as soon as the needles went in. I don't think he was smart enough to go for a placebo effect, LOL. I don't know why it works, but I'm seen it work on other dogs and people too.

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    1. So basically, you are going for an it worked for me gambit.

      You see, if your dog was suffering enough for you to bring him to the vet, then you probably did a lot of other things, too - and those things might have a beneficial effect. I doubt that your vet only did acupuncture. Did you control for those other factors?

      You see, we can be pretty confident that it wasn't the acupuncture. Acupuncture has been extensively studied, in situations where those other factors (including *your* bias when assessing the dog's improvement) have been controlled for, and it probably doesn't do shit. Plenty of other things probably do have beneficial effects, however.

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    2. He was on no meds at all, nothing else was being done, as he had negative reactions to every med that we tried on him. He was almost 14, and the improvement was dramatic. He turned around in the back seat of the car after the first treatment, which he really hated, that honestly shocked us when we saw him doing it. By the 3rd time, he was jumping up on the couch and bed with ease and that continued until the end. He had been using a ramp I made for the couch and steps up to the bed for almost a year. After the third treatment, he never used them again. He was put down due to cancer at 14.5 years. Less than 24 hours before the end, he went for his usual 3 mile walk. Believe it or not, no big deal to me, but after seeing his huge improvement, it's not "theatre".

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  3. This sort of commentary is not new. In an age-old custom, if something is not understood, disparage it. Can the brain affect a point on the ear? Is the reverse true? Turn the clock back a bit: can a diseased internal organ cause a skin lesion? Can the location of such lesions be predictable between indivduals suffering from the same disease? If you believe the answer is 'no', then you have a gap in your knowledge. Dr. Henry Head published detailed findings related to these phenomena in 1893, with a follow-up in 1895, in the English journal "Brain". Over the years his research and practice was of sufficient renown that he was knighted, Sir Henry Head. Acquiring copies of those articles in Brain is possible, but reading them is fairly tedious for the casual investigator. I suggest instead an article by Florian Beissner, et al, entitled "Forgotten Features of Head Zones and Their Relation to Diagnostically Relevant Acupuncture Points", published in 2011. It's quite easy to find via a Google search. Anyone who approaches it with a closed mind will learn very little, but others will ask (among other things) "why aren't these facts more widely known?" Better yet, why is the name Henry Head so little known? Perhaps the same reason that Nikola Tesla's name suffered the same fate for decades. Whatever that reason is, it's tesitmony to how ignorant we can be of important facts.

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    1. Sigh. More of the same, right?

      "If something is not understood, disparage it"

      But the issue here isn't that something is not *understood*. It's that Alimi & Chelly has not the faintest shred of quality evidence for their claims and plenty of evidence against them. Mangling a fake Schopenhauer quote and appealing to ignorance isn't going to change that. The rest of us meet new hypotheses with an open mind, but the onus is on the person promoting it to provide the evidence, and when they can't do that, we reject the hypothesis. And when evidence is stacked against the hypotheses, continuing to stick to it isn't cute.

      What you should have meant to say is: "when someone is promoting something false, disparage it" or "when someone is promoting something they can't back up, point it out and ask for evidence."

      I don't know where you want to to go with Henry Head. He is certainly not forgotten - his impact on neurology is well known. But his writings are a century old, and things have moved on. Head's understanding of the brain seems kind of quaint by modern standards and lots of it is speculative (much of it was recognized as ... doubtful ... even in his own day). It's got shit to do with acupuncture, as far as I can see.

      And Beissner's article is a silly example of tooth fairy science. They *presume* that acupuncture points are something real (they aren't), and then they try, laughably, to shoehorn Head's century old writings onto their modern pseudoscientific maps (which is not too hard since there is no rigor involved). Importantly: there is not a *shred* of evidence that any of it connects to reality in any conceivable way in Beissner et al.'s article. It's just an exercise in New Age theology.

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