I have written several articles previously about veterinary stem cell therapies, which I view as a promising but as yet unproven treatment for a number of medical problems. (e.g. 1, 2, 3, 4, 5) Though not “alternative” in origin, the marketing of these treatments and the arguments used to justify them in advance of adequate scientific data establishing safety and efficacy resembles the promotion of many alternative therapies.
I have received some pretty harsh criticism for suggesting this, so it was satisfying to read a recent editorial in the journal Veterinary Surgery:
Jeffery ND. Is ‘Stem Cell Therapy’ Becoming 21st Century Snake Oil? Veterinary Surgery 41 (2012) 189–19.
The author begins by cautioning us against “a non-critical acceptance of new advances because of a complacent assumption that previous mistakes regarding poor medical regulation will not be repeated in the modern world.” Obviously, this blog exists precisely because such mistakes, and reliance on prescientific methods of evaluating new ideas through personal experience, uncontrolled experimentation, and trust in authority, rather than reliance on rigorous controlled scientific research, are still widespread in our profession. As Dr. Jeffery correctly points out, the majority of veterinarians rightly deride pseudoscientific methods such as homeopathy (though too many still fall for it’s propaganda). And yet the same approaches to justifying other kinds of clinical interventions, both conventional and alternative, are all too common.
He then goes on to remind us that the promising preclinical research involving stem cell therapies does not justify their widespread clinical use without properly designed and conducted clinical trials. Most research on these therapies published so far has been methodologically inadequate to justify the burgeoning market in stem cells. However, the uncritical reports in the media of preclinical research, and the easy availability of testimonials and uncontrolled anecdotes about stem cell treatment, not to mention the aggressive marketing by stem cell therapy companies, make it “easy to sell to owners as a respectable treatment, even in the absence of rigorous proof of efficacy.”
Finally, Dr. Jeffery emphasizes something with which I conclude most of my own articles about unproven therapies, a call for a stricter standard in veterinary medicine for scientific evidence about our interventions.
Whilst stem cell therapy has rapidly achieved high profile in medicine and therefore even misplaced claims for efficacy are noteworthy it is not the only therapy in veterinary medicine or surgery for which there is insufficient evidence of benefit to support widespread implementation. Novel interventions for common conditions are published frequently in veterinary journals, including Veterinary Surgery. Whilst it is undoubtedly important that new interventions are explained through publication, it is essential that they should subsequently be subject to critical testing of their effectiveness before being widely accepted. This is currently not standard practice in veterinary medicine and surgery… Strict testing of novel interventions must become the norm for veterinarians to be able to maintain our view of ourselves as a ‘science-led’ profession.
I couldn’t agree more.
Just for interest, more stem-cell gun-jumping:
http://www.nature.com/nature/journal/v483/n7387/full/483005a.html?WT.ec_id=NATURE-20120301
It is interesting that something so controversial in the human field, with only the “damn the Feds” types promoting it, is so widespread and accepted with so little debate in vet med.
yes, well, a lot of things that go on in various branches of human-nonhuman relations go without the sort of comment they would arouse in human-human behaviour, don’t they?
Quackademic medicine until proven to work.
Art Malernee dvm