Pathological Science in Laser Medicine

“Most alternative laser medicine is not supported by basic physics, and cannot be reproduced by mainstream researchers.  If it were reproducible it would not be called alternative medicine, and it would not require a belief system for it to work.”

 

lowlevelasertherapyThe increased interest in Alternative Laser Medicine (ALM), predominately Low Level Laser Therapy (LLLT), and its applications is mostly a product of pathological science, and partly due to a financial incentive to sell easy solutions for difficult problems.  

ALM is well established in the veterinary field where patients cannot describe their experience, and the level of scientific rigor is less then in the medical community. There are also fewer constraints from the FDA regarding labeling the devices. The published articles supporting these ALM procedures, however, seem to fall short of the scientific rigor necessary to establish reproducible results.  Typical issues involve conflicted researchers, lack of proper controls, a misapplication of statistics, and a lack of analysis of experimental fluctuations. Most involve subjective analysis by the authors evaluating their own ideas, or businesses whose income depends on positive results.

The most common problem is that negative studies by proponents rarely get published.  As a result, there is a bias towards publishing mostly positive claims. As an example if we compared an ineffective treatment to a placebo then we would expect half to do better with new treatment and half to do better with the placebo treatment.  Comparing all these studies we would find, with a high level of confidence, that there would be no significant difference between the treatment and the placebo. If authors are more inclined to submit publications that show something new and positive then failed studies, then there will be  more studies published favoring the treatment and a review of such publications will find that there is an indications that these treatments might work, even though the statistics of individual studies are uncertain. I believe this is the situation we see today with LLLT.  

The internet and media have many anecdotal reports of individuals who believe ALM treatments worked for them. This is not science, it is not reproducible, and is a belief system. We are all free to believe what we want, and should be encourage to do so.  The fact is that with thousands of treatments being performed daily we expect that there will be many false positive results. Companies selling these devices heavily promote these anecdotal claims and rely on people who believe in alternative medicine to support them. The authors of the positive studies are mostly  owners of the devices who make money from the treatments or providers of the equipment and are financially conflicted with regard to the study results. LLLT, like most alternative laser medicine is not supported by rigorous science, and cannot be reproduced by mainstream independent researchers.  If it were reproducible it would not be called alternative medicine, and it would not require a belief system for it to work. 

Promoting a technology with the goal of converting others to your own belief system is not science, and it hampers technological progress towards real solutions to the problems these treatments attempt to address. You may argue these treatments do no harm, but they misinform individuals about the possible solutions to medical problems they may have.  In some cases it may be dangerous

It is interesting to note some of the third party research that has not been able to reproduce any of the claims of LLLT. See some of the links below for reference. Some of this research was sponsored by insurance companies, who had a lot to gain by approving lower cost treatments, though still did not support the claim that ALM treatments with LLLT devices were effective.

There will be a market for these treatments as long as they are promoted by companies that have a financial incentive to mislead consumers desiring  easy remedies to difficult problems, or for use on our animal friends who cannot  complain about the lack of results. 

 Other resources:

Quackwatch Your Guide to Quackery, Health Fraud, and Intelligent Decisions. Operated by Stephen Barrett, M.D see his article on LLLT.

Cochrane Collaboration The largest collection of records of randomised controlled trials in the world, called CENTRAL, published as part of The Cochrane Library. Internationally recognised as the benchmark for high quality information about the effectiveness of health care. Check out the articles on Low Level Laser Therapy.

Science-Based Medicine This site dedicate to exploring the issues of science and medicine has a nice blog on LLLT

Skeptivet A resource for reliable, independent information about complementary and alternative medical treatments (CAM) used for companion animals with a good article on laser therapy.

Pathological Science by Henry Bauer, International Journal for Philosophy of Chemistry, Vol. 8, No.1 (2002), pp. 5-20
 

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