I've been working up a series of talks on Science 2.0 - what, why, payoffs, etcetera. In an earlier talk on Science Blogs (Staying Current with Science Blogs and Wikis) I had promoted the science blogs community (http://scienceblogs.com/) as a place for faculty to track science innovation and trends, as well as to consider for their own blogging. I did that because of the range of voices represented and the dynamism of the conversation. Right now, I am about to backpedal on that recommendation just a bit, to qualify it as I should have done in the beginning.
Earlier this week I stumbled across an entry in a blogpost at ScienceBlogs that raised red flags for me regarding the actual science in the post.
SciencePunk (Frank Swain): Reiki One-Liners: a daily dose of healing via Twitter: http://scienceblogs.com/sciencepunk/2009/02/reiki_one-liners_a_daily_dose.php
DISCLAIMER: I was initially attracted to reading the article because of seeing it discussed on Twitter, and I must admit that the author of the Reiki One-Liners is one of the roughly 2000 people I follow on Twitter. I also follow a lot of hard care scientists and informaticians, as well as medical and clinical people, social tech geeks, local folk, librarians and friends. I appreciate and enjoy the diversity of the conversations I observe and participate in through Twitter.
One of the sentences that was a warning sign for me was this: "probably the world's laziest form of quackery" as well as the closing sentence, "Given their aversion to actually seeing patients, Reiki practitioners clearly think diagnosis is just some kind of foolish Western misconception anyway." Immediately I wanted to know what made him think this -- where's the evidence, how does he support this statement. So I browsed on to the comments, many of which were overtly insulting to both Reiki (overtly) and the process of intellectual inquiry (covertly). Here is a particularly inflammatory example:
"No, Pamir, Reiki isn't "spiritual teaching". It's nonsense. OK, it's more than nonsense, it's fraud, it's drivel, it's lies, it's trash. It's the way of the idiot.
And a world without idiots feeding idiocy to other idiots would be a better place.
Help your fellow practitioners by suggesting they take up honest work instead of feeding them waffles."
Well, before we get too insulting, let's check the credentials of the person we're bashing, ok? Pamir's work and information is actually affiliated with some hospitals and medical organizations.
South Florida Hospital News: Reiki: The Art of Spiritual Healing: http://www.southfloridahospitalnews.com/specialfocus/default.asp?articleID=492
My response was to dig a bit (not deeply) into the scientific evidence, explore the claims of the original post and the commentor. I already was aware through my work of the National Center for Complementary and Alternative Medicine (NCCAM) from the US government National Institutes of Health. Here is what they have to say about Reiki:
NCCAM: Reiki, an Introduction: http://nccam.nih.gov/health/reiki/
Digging into the evidence more via PubMed, I found little to support the blogpost's assumptions. Basically the evidence seemed to be saying that Reiki might work, we aren't sure yet, but it doesn't seem to hurt as long as you have the money to pay for it. I also had in mind a recent case study we'd been working with in the local medical school focusing on the effects of intercessional prayer, which sounds a little similar to me. I am thinking that reiki is a case of potential good with little risk of overt harm. I responded to the blogpost with a comment focused on the issue of science and evidence and interpretation of the evidence. I'll get to that later. It is what happened next that is interesting.
I received a notice from the system that my comment had been directed to the author for approval before being released to the web page. That is pretty common, and didn't concern me. But that was two days ago, and four more comments have been added to the page without mine being approved for release. I sent a twitter communication to the original author asking why my blog comment had not been approved. OK, Frank is new, still learning how Twitter works, and he doesn't quite get it yet. He tried to reply to my tweet but sent it in a way that I wouldn't see. (Frank, the @pfanderson has to be the first characters of the tweet to show up in my Replies box.) He asked me to email him, but on neither his blog nor his Twitter account was I able to find an email address, not in the profile, the "About", nor in a Google search. I will give him kudos for trying to reach me, but ... did he check the pending comments file at the blog?
Frank is a prominent voice in the science blogging community, having been tapped to write for the Guardian in the UK as well as . Here is a brief bio and a video of his chat about the importance of informing our decisions with evidence:
Why is Science Important?: Frank Swain: evidence to base our decisions: http://whyscience.co.uk/2008/12/frank-swain-evidence-to-base-our-decisions.php
I want to believe that any author at ScienceBlogs would be scientific enough to support the discussion about the evidence that is an essential part of scientific inquiry and progress. I spoke on this as an invited speaker at the Medical Library Association last May, coming from a strong personal conviction that social media has much to contribute to Science through supporting Science as Conversation.
So what does it say about a science blog when inflammatory and insulting comments are part of the comment thread, but a comment about the evidence of the topic is not released to the comments? For me, the most interesting and important part of the conversation is missing, and I must question what was the purpose of the original post if informed dialog is suppressed.
Basically, what it comes down to is a strategy that applies in science at every point from hallway conversations to informal publications such as blogposts all the way through to peer-reviewed publications and systematic reviews -- "Quis custodiet ipsos custodes?" "Who watches the watchers?" (Juvenal, Satire 6.346–348). All of us, in whatever role (scientist, humanist, student, teacher, curious observer) must not assume the reliability of a source, but should take everything with a grain of salt. That's it, that's all I saying -- that we must keep questioning, asking where is the science, where is the evidence, what is the quality of the evidence, what are the trends in the evidence, where is it coming from, who is doing the research, how is it being funded, is there obvious bias ... all those questions. We must keep asking.
So what was my comment that wasn't posted? See below. Please note that at the time of writing it I did not realize that Frank was the author of the post and not Sam, so my own mistake there. I will send Frank a copy of this post, and hope for his response at the original post. Also, here is an example of what sort of content triggered the original SciencePunk blogpost:
http://twitter.com/gassho/status/1174226019
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Sam, I might encourage you to examine some of the recent research evidence on Reiki:
http://tinyurl.com/au9wsn
Within the context of my experience as a consultant working with evidence-based healthcare for the past decade, I would want to mention that insufficient evidence does not always mean that the treatment doesn't work. It means exactly what it says -- that we don't have enough research to make a conclusive decision. The purpose of systematic reviews that identify insufficient evidence is largely to identify flaws and gaps in the research to be addressed in future studies. I have seen a number of drug trials in similar circumstances, who completely turn around the findings by the time of the 5 yr update to the review.
In the case of insufficient evidence, clinicians should look at the BEST AVAILABLE EVIDENCE to support decisions, as well as the balance of potential risk/harm from the treatment. Current clinical trials and systematic reviews of reiki show distinct trends supportive of the effectiveness, and show little or no harm. There just aren't enough of the trials to have reached statistical significance. So, while results are currently inconclusive, they are encouraging of a positive effect.
Please note that in the bulk of the research trials, they are examining the effectiveness of the "healing touch" aspects of reiki. In your post you seem unaware of this aspect of reiki, which you could not have avoided knowing if you read either the Reiki FAQ: http://www.reiki.org/faq/WhatIsReiki.html or even Wikipedia. Perhaps you should research and define your terms, as politely suggested by Pamir.
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