Monday, April 13, 2009

The CAM Donut

Clerk: Would you like a donut?

Person: What do you have?

Clerk: Let me show you some donut-holes.

Person: Mmm tasty! (reaches toward display)

Clerk: (slaps hand) No! We don't sell these. We sell the part that is not a donut hole.

Person: So a donut is...

Clerk: Everything else, yes.

Person: Gosh. How big are your donuts?

Clerk: We don't get into that.

From NCCAM: CAM is a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine.

Here's my question for you, NCCAM: What defines the outside edge of the CAM donut? Do CAM proponents have any rational method for rejecting therapies from their set?

If Oedipus recommends tearing out one's eyes as a means of treating overwhelming feelings of guilt and despair, might that be included in the CAM set?

How about ground up rhinocerous horn for male impotence?

How about faith healing for children with menningitis?

Exorcism for epilepsy?

"CAM" as a concept is meaningless without a rational method for rejecting some proposed therapies from the set.

Wow! I think we just wound our way back to science-based medicine. For science is the method for sorting plausible from implausible claims.


  1. Ah, Dr. Benway, you have come so close to the mystery but have veered off at the last moment!

    If "CAM" is defined as:

    "... health care systems, practices, and products that are not presently considered to be part of conventional medicine."

    and if "conventional" (real) medicine is defined as:

    "Diagnostic and therapeutic modalities that have been tested and found to be effective and safe."

    then, using set theory, "health care" can be seen as the union of the sets "CAM" and "conventional medicine".

    Since "CAM" does not have defined bounds (it can, and does, include anything that hasn't been tested and found effective and safe), the set "health care" also is unbounded (infinite).

    The only bounded set in this system is "conventional (real) medicine", which is bounded by the limits "tested", "effective" and "safe".

    As a result, we can conclude that the set "CAM" - which is unbounded (infinite) - contains all "health care systems, practices and products" which DO NOT fall withing the limits of "tested" AND "effective" AND "safe".

    Thus, "CAM" is "untested" OR "ineffective" OR "unsafe". Combinations are also allowed.


  2. Yes, I once thought of CAM v medicine as unproven v proven. But that's an inadequate razor for dividing the two sets.

    Words like "integrative" and "CAM" are the invention of marketers --people who need not think deeply about logic or set theory. Marketing is pre-rational and associative. In marketing, ideas group by family resemblance rather than explicit rules. Translating these ideas into a rational system takes a bit of fudging.

    An oncologist develops a novel chemotherapy approach and has some success in two patients. Is that approach "CAM" because it hasn't yet been proven in controlled trials? No, it is not.

    The razor as I understand it now: prior plausibility based on science verses prior plausibility based on politics or collective desire.