MD, PhD, FMedSci, FSB, FRCP, FRCPEd

‘Alternative truth’ is a term that I used first in 2013 . Since then I had to employ it with increasing frequency. Disturbingly, since then similar terms, such as ‘alternative facts’, ‘alternative science’ etc., have become ‘en vogue’. In an NEJM-editorial on the subject, Alta Caro from the University of Wisconsin Law School, Madison, US recently concluded: Reasonable people may disagree about how to interpret data, but they do not ignore scientific method by giving credence to flawed, fraudulent, or misrepresented studies … Whether in the debates regarding climate change, evolutionary theory, or human reproduction, alternative facts are just fiction, and alternative science is just bad policy.

I am tempted to add AND ALTERNATIVE TRUTHS ARE JUST LIES!!!

On this blog, we are confronted with so many lies that it would be only normal, if we gradually got used to them.

  • I think we must resist this temptation.
  • I think we should expose those who tell untruths again and again.
  • I think it is our moral and ethical duty.
  • I think the truth is far too precious to allow it to be eroded by anyone.

Because I feel strongly about this issue, I would like to use this post to give two of my former colleagues the opportunity to correct the untruths they have published about me and my actions.

The 1st is Prof Harald Walach;

as I pointed out in a previous post, he stated the following untruth (his remarks were in German, and this is my translation):

“My friend and colleague George Lewith from Southampton gave a keynote lecture on his review of chiropractic interventions for infant colic. This was prompted by the claim, made by Singh and Ernst a few years ago, that chiropractic was dangerous, that no data existed showing its effectiveness, and that it had dangerous side-effects, particularly for children. The chiropractors had sued the science journalist Singh for libel and won the case. George Lewith had provided the expert report for the court and has now extended his analysis on children.

To put it briefly: the intervention is even very effective; the effect-size is about one standard deviation. The children cry less long and more rarely. And the search of the literature for dangerous side-effects resulted in no – literally: not one – case of side-effects, not to mention dangerous ones. The fuzz had started back then because an unqualified person had walked over the back of a thin woman and had thus broken her neck. The press had subsequently hyped the whole thing to a “deadly side-effect of a chiropractic intervention”. 

The 2nd is Dr Peter Fisher;

as I pointed out in another post, he too published an untruth about me:

In this article which he published as Dr. Peter Fisher, Homeopath to Her Majesty, the Queen, he wrote: “There is a serious threat to the future of the Royal London Homoeopathic Hospital (RLHH), and we need your help…Lurking behind all this is an orchestrated campaign, including the ’13 doctors letter’, the front page lead in The Times of 23 May 2006, Ernst’s leak of the Smallwood report (also front page lead in The Times, August 2005), and the deeply flawed, but much publicised Lancet meta-analysis of Shang et al…”

And why bring this up again?

For the reasons mentioned above.

And for giving Walach and Fisher the opportunity to correct their errors. If they don’t, their untruths will be henceforth called lies.

21 Responses to It would be wrong to get used to the untruths told by proponents of alternative medicine or anybody else

  • I imagine that all sensible- and indeed stupid- people here will know of the Cancer Tutor site, and similar.
    A horrible example of grotesque lies being endlessly repeated, and eventually taken as fact.
    I’m regularly accused on there of being a troll( usual reason- politely asking for evidence), and have recently added two ‘assholes’ to my earlier ‘twat’. But I’m still envious of Edzard being called a ‘wanker’ by a qualified doctor.

  • There are some others also:

    “In Ernst’s latest review of homeopathy, which was published in December 2012 and is entitled Adverse Effects of Homeopathy: A Systematic Review of Published Case Reports and Case Series, he reported 1,140 cases having had “adverse events directly related to homeopathy.”(18) A careful review of the original references of the cases he reported revealed that not a single one of these cases that had received genuine homeopathic treatment had also experienced “adverse events directly related to homeopathy.” In fact, it is totally astonishing to find out that the great majority of these cases, 1,070 or 94% of them, were actually phone inquiries about accidental ingestion of supposedly homeopathic remedies. 37 of the other 70 cases were related to ingestion of crude doses of mother tinctures, eardrops, ointments, or complex remedies.(19)

    To leave no doubt regarding the great travesty of this paper, one of the cases reported to have had experienced “adverse events directly related to homeopathy” had originally been published in the New England Journal of Medicine in 1986 and was about a man who had taken 100 “Regeneration Tablets” containing “a mixture of 19 ingredients.”(20) The fact that the authors and reviewers of this article, and the editors of one of the most prestigious peer-reviewed journals associated this case with homeopathy is another evidence of the great confusion and ignorance existing in academic circles about homeopathy. Quite a long stretch of imagination was needed to associate this case with homeopathy.

    Likely the only patient, who had been treated with genuine homeopathy in these 1,140 cases reported by Ernst et al. as having experienced “adverse events directly related to homeopathy,” was a 62 year-old man with angina. He was a smoker and drinker who, five years earlier, had been successfully treated with homeopathy for epilepsy, and began experiencing chest pain while under stress. An EKG showed signs of ST ischemia. He then resumed homeopathic treatment and his angina disappeared. Eight years later, he returned to his homeopathic physician with blood in his urine. He was then referred to a urologist for a complete urologic diagnostic work-up, and was soon diagnosed with cancer of the bladder. On the one hand, he received radiotherapy, and on the other hand, he responded well to homeopathy for the alleviation of the side effects of radiotherapy.(21) However to ascribe the development first, of angina and second, of cancer of the bladder to having received prior homeopathic treatment is a complete aberration, and is another example of the extremely bad science that circulates in academic circles about homeopathy and can even find its way not only into prestigious peer-reviewed journals, but can be repeatedly quoted by other researchers, peer reviewers, editors and the Cochrane Collaboration without ever being recognized as flawed and or of being retracted.

    The fact that the peer reviewers and editors of the International Journal of Clinical Practice didn’t recognize such basic flaws contained in Ernst’s last review is again another blatant example of how ignorant the academic community is about genuine homeopathy. To add insult to injury, one of the editors commented, “We published a thoroughly peer-reviewed article on adverse effects of homeopathy,” and that it must be difficult to keep critical comments factual about Ernst et al.’s article “as homeopathy is scientifically imprecise.”(22)”
    http://homeopathy.ca/debates_2013-03-22Q1ns.shtml

    • is anyone surprised that the ‘Canadian Academy of Homeopathy’ does not like our paper?

      • Or Dr. R HAHN

        Edzard Ernst

        Since 1997, attempts to invalidate Linde et al.’s [2,3,4] results have followed the path of excluding most of the clinical trials or, for various reasons, focused on smaller subgroups of studies. The first claim was made by the German-British physician Edzard Ernst, a former professor of complementary medicine in UK. In 1998, he selected 5 studies using highly diluted remedies from the original 89 and concluded that homeopathy has no effect [5].

        In 2000, Ernst and Pittler [6] sought to invalidate the statistically significant superiority of homeopathy over placebo in the 10 studies with the highest Jadad score. The odds ratio, as presented by Linde et al. in 1999 [3], was 2.00 (1.37-2.91). The new argument was that the Jadad score and odds ratio in favor of homeopathy seemed to follow a straight line (in fact, it is asymptotic at both ends). Hence, Ernst and Pittler [6] claimed that the highest Jadad scores should theoretically show zero effect. This reasoning argued that the assumed data are more correct than the real data.

        Two years later, Ernst [7] summarized the systematic reviews of homeopathy published in the wake of Linde’s first meta-analysis [2]. To support the view that homeopathy lacks effect, Ernst cited his own publications from 1998 and 2000 [5,6]. He also presented Linde’s 2 follow-up reports [3,4] as being further evidence that homeopathy equals placebo. Moreover, Ernst cited a book chapter [8] that will be commented upon later.

        Continue reading:

        A fourth point spread to newspapers by a professional academic was that the analyses by Ernst [7] and Shang et al. [10] demonstrate beyond a doubt that homeopathy is fraud and humbug. As we have seen, these publications represent a biased selection of the literature.

        The reader of this literature must be aware that ideology plays a part in these meta-analyses. For example, Ernst [ makes conclusions based on assumed data when the true data are at hand . Ernst invalidates a study by Jonas et al. that shows an odds ratio of 2.19 (1.55-3.11) in favor of homeopathy for rheumatic conditions, using the notion that there are not sufficient data for the treatment of any specific condition . However, his review deals with the overall efficacy of homeopathy and not with specific conditions. Ernst still adds this statistically significant result in favor of homeopathy over placebo to his list of arguments of why homeopathy does not work. Such argumentation must be reviewed carefully before being accepted by the reader.

        https://www.karger.com/Article/FullText/355916

          • Your post against Dr. Hahn is an Big Ad-hominem.

          • You did not answer the points raised.

            All that you did was tell everyone the kind of person Dr. Hahn is in your understanding. You rebut nothing of the errors in your analysis stated by him. This you continue to avoid.

            ” Hence, Ernst and Pittler [6] claimed that the highest Jadad scores should theoretically show zero effect. This reasoning argued that the assumed data are more correct than the real data.”

            “For example, Ernst [ makes conclusions based on assumed data when the true data are at hand .”

            “Ernst invalidates a study by Jonas et al. that shows an odds ratio of 2.19 (1.55-3.11) in favor of homeopathy for rheumatic conditions, using the notion that there are not sufficient data for the treatment of any specific condition . However, his review deals with the overall efficacy of homeopathy and not with specific conditions. Ernst still adds this statistically significant result in favor of homeopathy over placebo to his list of arguments of why homeopathy does not work”

            And off course: Andre Saine:
            “In Ernst’s latest review of homeopathy, which was published in December 2012 and is entitled Adverse Effects of Homeopathy: A Systematic Review of Published Case Reports and Case Series, he reported 1,140 cases having had “adverse events directly related to homeopathy.”(18) A careful review of the original references of the cases he reported revealed that not a single one of these cases that had received genuine homeopathic treatment had also experienced “adverse events directly related to homeopathy.” In fact, it is totally astonishing to find out that the great majority of these cases, 1,070 or 94% of them, were actually phone inquiries about accidental ingestion of supposedly homeopathic remedies. 37 of the other 70 cases were related to ingestion of crude doses of mother tinctures, eardrops, ointments, or complex remedies.(19)”

        • Iqbal, it is amazing how thick you are. Hahn does not get two things. First, prior probability, second, that data calculated by extrapolation are often far more robust than data not using extrapolation. Ernst with his approach does *not* rely on hypothetical data, but uses *all* data to estimatet what would happen if something that is not yet done (studies with optimal jaddard score) is done. This approach is very well known and very successfully applied throughout biology (Enzyme kinetics for instance). By fitting models to data, these approaches are usually very robust.

          Hahn is a clinician and not a statistician which is very evident in his criticism that Ernst uses hypothetical data. The only problem in Ernsts paper is that he did not validate this approach using studies of a drug that works. Also, Hahn does not understand prior probability. The prior probability that homeopathy works is so low that the probability of observing 10 false positives is *still* higher.

          Iqbal, you are thivk as a brick.

      • It is no like or dislike: it is discussing your providing false information.

        • Flying over to: http://www.bmj.com/content/351/bmj.h3735 … my eye is caught by a sentence used EVERY NOW AND THEN from homeopathy advocates, practitioners, defenders, apologists etc:

          “But similar ideas are found in the Hippocratic Corpus”… WHAT? Has anyone ever really TAKEN THE TIME to read pieces of that Corpus? Or has Hahnemann’s Organon completely overtaken its significance in terms of philosophy (and history) of medicine for those people?

          I am utterly grieved to see this VERY VERY VERY VERY VERY bad interpretation of an extremely elevated, intellectually, piece of work such as that of Hippocrates (always considering the contemporary context). Unfortunately (for homeopathy advocates), I happen to have a relatively fair grasp of Ancient Greek, and that is why it is a SORE to my eyes to see, YET AGAIN, this kind of misrepresentation. Let me explain…

          The most typical position misused by Hahnemann is a small excerpt from “Peri topon, ton kata anthropon” (About the places within human –> referring to a description of what is inside a person, i.e. organs etc. it is like an Anatomy and Pathology textbook). The main excerpt, from which everyone alludes (and Hahnemann quotes) is this one (though he quotes from various other pieces apparently):
          https://skepsis.nl/mainsite/inhoud/uploads/2016/01/citaat1hippocrates-768×348.jpg

          Let me type an as precise translation as possible, from Ancient Greek:
          PRECISE TRANSLATION FROM ANCIENT GREEK:
          the pains manifest; the pains become healthy by things that are opposite; this is characteristic of every disease; what is naturally warm, and diseased by cold, is to be rewarmed and the rest goes as such. Another way is this; by similar things a disease comes to be, and by similar things given [the diseased] are healed; what itself makes stranguria to come forth, when it is not there (stranguria), this itself makes it stop; and cough in the same way, as stranguria, by the same things comes to be and is ceased. Another way is this; fever that by inflammation (=phlegmasia) comes to be, then it, sometimes, by the same things comes to be and is ceased, and other times by those opposite to what caused it (the inflammation).

          *stranguria comes from what is Greek for “drain” + “urine”, i.e. urination as if draining, drop by drop, by squeezing, accompanied by great pain of course!

          **it –> the inflammation, as I parenthesize in the end, means that, unlike English, in Ancient Greek, inflammation is a feminine noun and the “it” in the original text refers to that one, and not the fever. Not too important, but just for the sake of accuracy…

          For whomever not in a position to readily understand by the above passage that “similia similibus curentur” is NOT at the heart of the Hippocratic rationale, I will also provide a small analysis:

          Three “ways” or “theses” are posited in the text:
          The first concept developed is that, usually, when conditions appear to go out of balance, COUNTERBALANCING (as in “opposites”) is needed to restore balance (cf. what is naturally warm and ill-posed by cold, needs rewarming, the OPPOSITE of cold).

          The second way is that: whatever causes something, it might make it stop too when it is already there.

          The third concept is: when some symptomatic manifestation (e.g. fever) is caused by something (e.g. inflammation), then it can be healed by EITHER the same things that cause it, OR by opposite things to it.

          As is made CRYSTAL CLEAR, Hippocrates simply presents the various alternative possibilities, to the extent of his own contemporary grasp of the evidence. I.E. when some disease exists, it may go away by either things that cause it, or by opposites, or by BOTH. This is a fairly valid way of saying, things can take ONE turn, or ANOTHER.

          By omitting the parts regarding “OPPOSITES” in the original Ancient Greek text, the case was FRAUDULENTLY made that like-cures-like can be found in the heart of the Hippocratic Corpus.

          The truth is, given the grasp of medical matters back then, Hippocrates demonstrates an extremely rational and open-minded view, recording all different potential ways of action for the various treatment protocols. He also proactively despised superstition, as can be seen in “Peri hierees nousou” (about the sacred disease), where he dismisses supernatural causes, as was frequently the idea back then, but this is a lesson for some other time.

          This is a JACK-POT for anyone advocating homeopathy on the basis of it being a core idea of Hippocratic Practice:
          4 MALUS points at once, for a fallacious appeal to antiquity, a misrepresentation of the truth, a generalization of, LITERALLY, a couple of words in a small sentence within a very large piece of work, AND an out-of-context quote-mining, in order to support …SOME view.

          What I am trying to say is that anyone could JUST as easily have stuck to the “opposites” part, and make an Antithetopathy cult (antitheta = opposites), proclaiming that “opposite cures opposite”!

          What I must make as a closing comment, is that all of the above is precisely the state-of-affairs with respect to the Hippocratic text. There can be no denying that Hippocrates wrote the text, and it was CHAINSAWN appropriately to fit to SOME interpretation. I cannot help but take WHOMEVER appeals to Hippocrates in THAT respect (ascribing to him a “like cures like” idea just because it helps them), with a great deal of reservations with respect to their ideas about science and medicine in general. If someone is willing to misrepresent anything so fundamental, they are BOUND to lose their good-faith level of credibility and inspire GREAT CAUTION to whomever is exposed to their opinions and interpretations.

          Could it be that they are simply misinformed? No, because if one is a faithful researcher and devoted scientist, they are expected to exhibit a constantly strengthening NEGATIVE correlation between the level of devotion to truth, reality, science and precision, and the level of willingness to relay unverified information, or wield unsubstantiated claims.

    • Have you spotted the essential differences between Ernst’s work and that of the homeopathasists? Here are three for starters:

      1. Ernst’s work is peer reviewed, the homeopathists’ is not.
      2. Ernst’s criteria are stated, and not dependent on subjective analysis, for example of what is “genuine” homeopathy
      3. Ernst has no financial stake in homeopathy.

  • Is it possible then that we may see Ernst v Fisher, and Ernst v Walach?

  • The FACT that the British Chiropractic Association withdrew its case against Simon Singh means they did not ‘win’ as Walach claims.
    And whatever it was that Lewith was doing in court, he could not have given evidence as an expert in chiropractic.
    His expertise was in (dare I say it), alternative medicine.Or false medicine as some would have it.

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