MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

bogus claims

Most pharmacies worldwide sell any bogus treatment to their unsuspecting customers, it seems – as long as it makes a profit, anything goes! Not in New Zealand!

The New Zealand’s Pharmacy Council’s Safe Effective Pharmacy Practice Code of Ethics 2011 section 6.9 requires of pharmacists that:

“YOU MUST… Only purchase, supply or promote any medicine, complementary therapy, herbal remedy or other healthcare product where there is no reason to doubt its quality or safety and when there is credible evidence of efficacy.”

This instruction was the basis for a complaint against a New Zealand pharmacy selling a homeopathic remedy against jet lag called “No-Jet-Lag”. The New Zealand Advertising Standards Authority (ASA) considered the complaint and decided to uphold it. The complaint, which was lodged with the ASA by the Society for Science Based Healthcare in July 2014, alleged that the advertisement’s claims about the product that “It Really Works” for “Homeopathic Jet Lag Prevention” were unsubstantiated and misleading.

In defence of their advertising, the manufacturer of the product, Miers Laboratories, submitted a study they had conducted with their product. However, the Advertising Standards Complaints Board ruled that: “the trial population in the pilot study was small, the methodology was not robust and the results had not been published or peer reviewed. The Complaints Board also noted the study was an in-house trial conducted by the Advertiser rather than independent research…Given the weaknesses in the study, the majority of the Complaints Board said the Advertiser had not satisfactorily substantiated the claim the product “really works” and, as such, the Complaints Board said the advertisement had the potential to mislead consumers. Consequently, the Complaints Board said the advertisement did not observe a high standard of social responsibility required of advertisements of this type.”

However, today I found the following text still on the website of the company: Jet lag is the curse of modern jet travel, but it doesn´t have to spoil your trip. The unique homeopathic remedy No-Jet-Lag helps ensure holiday enjoyment and working efficiency even after long airline flights. No-Jet-Lag is raved about by satisfied travellers globally, including business executives, sports teams, tour operators, and flight crews. It is safe, easy to take, and proven effective in tests.

Are the days of “No-Jet-Lag” counted?

Why do not all countries’ pharmacists have such codes of ethics?

Many experts have warned us that, when we opt for dietary supplements, we might get more than we bargained for. A recent article reminded us that the increased availability and use of botanical dietary supplements and herbal remedies among consumers has been accompanied by an increased frequency of adulteration of these products with synthetic pharmaceuticals. Unscrupulous producers may add drugs and analogues of various classes, such as phosphodiesterase type 5 (PDE-5) inhibitors, weight loss, hypoglycemic, antihypertensive and anti-inflammatory agents, or anabolic steroids, to develop or intensify biological effects of dietary supplements or herbal remedies. The presence of such adulterated products in the marketplace is a worldwide problem and their consumption poses health risks to consumers.

Other authors recently warned that these products are often ineffective, adulterated, mislabeled, or have unclear dosing recommendations, and consumers have suffered injury and death as a consequence. When Congress passed the Dietary Supplement Health and Education Act, it stripped the Food and Drug Administration of its premarket authority, rendering regulatory controls too weak to adequately protect consumers. State government intervention is thus warranted. This article reviews studies reporting on Americans’ use of dietary supplements marketed for weight loss or muscle building, notes the particular dangers these products pose to the youth, and suggests that states can build on their historical enactment of regulatory controls for products with potential health consequences to protect the public and especially young people from unsafe and mislabeled dietary supplements.

A new study has shown that these problems are not just theoretical but are real and common.

Twenty-four products suspected of containing anabolic steroids and sold in fitness equipment shops in the UK were analyzed for their qualitative and semi-quantitative content using full scan gas chromatography-mass spectrometry (GC-MS), accurate mass liquid chromatography-mass spectrometry (LC-MS), high pressure liquid chromatography with diode array detection (HPLC-DAD), UV-Vis, and nuclear magnetic resonance (NMR) spectroscopy. In addition, X-ray crystallography enabled the identification of one of the compounds, where reference standard was not available.

Of the 24 products tested, 23 contained steroids including known anabolic agents; 16 of these contained steroids that were different to those indicated on the packaging and one product contained no steroid at all. Overall, 13 different steroids were identified; 12 of these are controlled in the UK under the Misuse of Drugs Act 1971. Several of the products contained steroids that may be considered to have considerable pharmacological activity, based on their chemical structures and the amounts present.

The authors concluded that such adulteration could unwittingly expose users to a significant risk to their health, which is of particular concern for naïve users.

The Internet offers thousands of supplements for sale; specifically for bodybuilders there are hundreds of supplements all claiming things that are untrue or untested. The lax regulations that exist in this area seem to be often ignored completely. I think it is important to inform customers that most supplements are a waste of money and some even a waste of health.

Reflexology? Isn’t that an alternative therapy? And as such, a physiotherapist would not normally use it, most of us might think.

Well, think again! Here is what the UK Chartered Society of Physiotherapists writes about reflexology:

Developed centuries ago in countries such as China, Egypt and India, reflexology is often referred to as a ‘gentle’ and ‘holistic’ therapy that benefits both mind and body. It centres on the feet because these are said by practitioners to be a mirror, or topographical map, for the rest of the body. Manipulation of certain pressure, or reflex, points is claimed to have an effect on corresponding zones in the body. The impact, say reflexologists, extends throughout – to bones, muscles, organs, glands, circulatory and neural pathways. The head and hands can also be massaged in some cases. The treatment is perhaps best known for use in connection with relaxation and relief from stress, anxiety, pain, sleep disorders, headaches, migraine, menstrual and digestive problems. But advocates say it can be used to great effect far more widely, often in conjunction with other treatments.

Reflexology, or Reflex Therapy (RT) as some physiotherapists prefer to call it, clearly is approved by the UK Chartered Society of Physiotherapists. And what evidence do they have for it?

One hundred members of the Association of Chartered Physiotherapists in Reflex Therapy (ACPIRT) participated in an audit to establish a baseline of practice. Findings indicate that experienced therapists use RT in conjunction with their professional skills to induce relaxation (95%) and reduce pain (86%) for patients with conditions including whiplash injury and chronic pain. According to 68% of respondents, RT is “very good,” “good” or “as good as” orthodox physiotherapy practices. Requiring minimal equipment, RT may be as cost effective as orthodox physiotherapy with regards to duration and frequency of treatment.

But that’s not evidence!!! I hear you grumble. No, it isn’t, I agree.

Is there good evidence to show that RT is effective?

I am afraid not!

My own systematic review concluded that the best evidence available to date does not demonstrate convincingly that reflexology is an effective treatment for any medical condition.

Does that mean that the Chartered Society of Physiotherapists promotes quackery?

I let my readers answer that question.

Pranic healing?

What on earth is that?

Whatever it is, it is big; there are more than half a million websites on it, and it seems to me that a lot of dosh is being made with pranic healing.

But what is it?

This website might be as good as any to explain:

Pranic Healing is a form of ancient energy medicine, which utilizes the inherent energy Prana (life force or energy) to balance, and promote the body’s energy and its processes. Prana is a Sanskrit word which actually means, the vital force that keeps us alive and healthy. Pranic healing is a holistic approach as it assumes a person in its complexity and does not separate the body and the mind.

It was developed by Grand Master ChoaKok Sui who founded the World Pranic Healing Foundation. He is a Manila-based businessman of Chinese origin – a spiritual teacher, writer and therapist of Pranic healing system.

According to ancient medicine, the body is composed of several physical elements including skin, bones, muscles, organs and so on which function with the help of Prana.The pranais present in the form of +ve and –ve ions. Pranic therapy or treatment involves the act of manipulating the energy (by experts) to restore the energy of the chakras in the body which is believed to treat the condition. Although it’s difficult to detect and measure life energy, its existence is undoubtedly proved…

Following health issues can be successfully treated with Pranic healing: Sleeping illness (lack of sleep) Mental illnesses including depression, anxiety etc. Stress Sprains and strains Body aches like neck pain, muscle pain, back pain etc. A recent trauma and related inflammation Improve psycho-physical aspects in athletes Improve memory Enhance energy level Treat headache Fight ulcers (intestinal) Heal respiratory illnesses, including sinusitis and asthma Skin diseases, including eczema Improves overall immunity Treat the various causes of infertility Aesthetic treatments such as Pranic face lift, bust lift, hip and tummy tuck etc.

Not only is pranic healing a true panacea, it also includes all the buzz-words any self-respecting charlatan wants to employ these days:

  • energy medicine
  • ancient wisdom
  • life force
  • holism
  • complexity
  • mind-body
  • chakras

But the real beauty is, I think, that the existence of the energy – and by implication pranic healing – is undoubtedly proven!

Should we believe this statement?

Not without some evidence, I suggest.

Medline lists all of 4 articles on the subject of pranic healing – not too difficult a task to summarise them quickly here:

The first paper is entirely evidence-free, but we learn the following interesting thing: “When Pranic healing is applied the molecular structure of liquid and dense states of matter can be altered significantly to create positive outcomes, as revealed through research.”

The second article is not actually on pranic healing and contains no relevant information on it.

The third article is merely a promotional essay for nurses that fails to include anything resembling evidence.

The fourth paper finally is much of the same again.

So where is all this science supporting pranic healing? After all any treatment that can alter the molecular structure of matter must amount to a bit of a scientific sensation! Has the evidence perhaps been published in journals that are not Medline-listed? That I find difficult to imagine after realising that even the AUSTRALIAN JOURNAL OF HOLISTIC NURSING (one of the above 4 publications) is included in this database. And, in any case, such a scientific sensation deserves to be published in one of the leading science-journals!

Could it be that there is not science to pranic healing at all?

Could the whole thing be a hoax?

I sure hope one of my readers can point me to the science thus proving my suspicion to be unfounded!

If you think that homeopathy is risk-free, you should read what this US homeopath proclaims on his website. I have copied several sections from his lengthy article (everything that is in normal print is his writing; mine is in bold). The author first gives a general introduction into homeopathy and why he believes in it; then he continues:

…Now, on the surface, you might think that since there is some common ground between homeopathy and vaccinations, that homeopathic doctors would be, all-in, when it comes to vaccines. The fact is, most homeopaths today are against vaccinations. The main reason for that is not because of the underlying principle, but because the process have been perverted by eugenics. Today, the real purpose of vaccinations is to cause sterilization and early death. Bill Gates spends billions of dollars on global vaccination, admittedly, to reduce the population. All kinds of heavy metals like aluminum, mercury and other poisons and pathogens are put into vaccinations. People, especially children, are given many more times the amount of vaccinations today than they were decades gone by, when it can be argued, vaccinations were effective and were needed.Even cancer viruses have, on record, been put into vaccinations. There is no actual vaccine for cancer. The only reason to put cancer viruses in the mix is to create more cases of cancer. In this day and age, one of the most dangerous things you can do for your health is to get vaccinated…

With homeopathy, you never have to worry about heavy metals, cancer viruses or other poisons being mixed in with the natural ingredients. Even though some of the underlying foundations of homeopathy and vaccinations are similar, there are a number of differences. With vaccinations, the actual disease that they are allegedly trying to build up immunity to is in the injection. In homeopathy, that is not the case, except in rare exception, and due to the dilution process, there is never any risk. Another difference is that homeopathic remedies are taken orally, rather than injected…

Homeopathic remedies have no side effects. That’s a great thing. On the other hand, every drug comes with lots of side effects. And then, you can get in a vicious cycle where you keep taking (or being prescribed) more and more drugs to deal with more and more side effects. In time, this often leads to emergency “live saving” surgery. When they are successful and the patient doesn’t die on the operating table, everyone praises modern medicine for saving those millions of lives, all the while ignoring that the reason those millions of surgeries were needed in the first place, was due to those allegedly wonderful and so-called scientifically proven drugs. Plus, many times, these surgeries aren’t truly needed. If the patient would simply quit taking the drugs, the body could, often, heal itself from life threatening conditions…

Homeopathy is much more well known in Europe and various other nations than it is known in the United States. There is a huge medical conspiracy against the use of homeopathy and other medical modalities that threaten the financial dominance of the current medical industry. The conspiracy extends world-wide, but it is strongest in the USA…This conspiracy is being perpetrated on a conscious level, for going on 200 years. Then, on the heels of that, there is a massive amount of ignorance from ironically, highly educated people, who have been influenced by the conspirators. (Most of these people you might not be able to classify as conspirators, because they believe what they are saying.) Doctors who have never even tried a homeopathic remedy on themselves, or their patients, often say that there is no evidence that homeopathy works. When you point to the innumerable raving fans of homeopathy around the world, each of whom have testimonies of homeopathic remedies working extremely well, the detractors simply call those, anecdotal evidence, not worthy of consideration. When you point out some of the clinical case histories of undeniable healings that have come to patients of homeopathic doctors, the opponents of homeopathy chalk it all up to the placebo effect. They say they want scientific proof and that none exists, but the truth is, numerous studies have shown very positive results, and have outperformed drugs and/or placebo. There are more than 150 placebo controlled clinical studies, most of which have shown positive results, either compared with a placebo or compared with a conventional drug. Moreover, they did so with zero side effects, (unlike drugs, which often have that little side effect known as, death.) And yet, the detractors always have a Rolodex of never ending excuses, why those studies, “don’t count.” They range from, the studies are too small; they are conducted by people who believe in homeopathy – (I’m serious!); the doctors aren’t well known enough; there must have been some breakdown of the scientific procedure that has yet to come out, etc. These people are unable to deal with the conundrum, that homeopathic remedies become more potent, with dilution, instead of less potent, like you would assume. From there, they assume that it can’t work, and no matter how much healing is done with homeopathic remedies, it’s nothing more than mind of matter, (placebo effect.) …The evidence is overwhelming to anyone with an open mind that homeopathy is for real. Does everyone magically become well? Will you not have to die? You know the answers to that, and nobody is suggesting it.

What is undeniable is that the pharmaceutical industry peddles toxic drugs that do more harm than good, by far. Big pharma corporations get caught faking studies, bribing doctors and all kinds of dirty, illegal activity, for which they are fined billions of dollars. To call them purveyors of science is laughable. There are drugs like Vioxx, that have killed anywhere from tens of thousands to more than a million people (depending on whether you go by Merck and the FDA statistics, or outside investigators), which, shockingly, aren’t even pulled from the market by the government. The company finally quits peddling them once the lawsuits make it unprofitable…

I’ve finally come to the conclusion that these people aren’t interested in finding the truth. They only want to protect their status quo, and well as their paradigms of how the world works. They don’t have room for experiential evidence. When these type of people write research papers smearing homeopathy, they are being intellectually dishonest. They consciously obfuscate facts and mold findings to seem to conform to their beliefs – let the evidence be damned…

These medical mafia type of people, don’t even care about logic. They stopped making sense a long, long time ago. When you are done reading these two articles, if you have a modicum of an open mind, you will at the very least, not be able to deny that there really is a very genuine conspiracy against homeopathy…

Such utter nonsense speaks, I think, for itself. Therefore perhaps just this as my comment. 

I have said and written it often: the homeopathic remedy might be harmless, however, many homeopaths are clearly not.

In a way, I should be thankful to the author of this truly amazing article enforcing my point.

 

As a pharmacy professional, you must:

1. Make patients your first concern
2. Use your professional judgement in the interests of patients and the public
3. Show respect for others
4. Encourage patients and the public to participate in decisions about their care
5. Develop your professional knowledge and competence
6. Be honest and trustworthy
7. Take responsibility for your working practices.

Even though these 7 main principles were laid down by the UK General Pharmaceutical Council, they are pretty much universal and apply to pharmacists the world over.

On this blog, I have repeatedly criticised community pharmacists (here I am only discussing this branch of pharmacists) for selling remedies which are not just of debatable efficacy but which fly in the face of science and have been all but disproven. Recently, I came across this website of a working group of the Austrian Society of Pharmacists. It is in German, so I will translate a few sections for you.

They say that it is their aim to find “explanatory models for the mechanisms of action of homeopathy”. This is a strange aim, in my view, not least because there is no proven efficacy; why then search for a mechanism?

Things go from bad to worse when we consider the ‘Notfallapotheke’, the emergency kit which they recommend to consumers who might find themselves in desperate need for emergency care. It includes the following remedies, doses and indications:

Aconitum C 30 2 x 5 Glob, first remedy in cases of fever
Allium cepa C 12 3 x 5 Glob, hayfever or cold
Anamirta cocculusLM 12 : 2 x 5, travel sickness
Apis mellifica C 200 2 x 5 Glob, insect bites
Arnica C 200 1 x 5 Glob, injuries
Acidum arsenicosum C 12 3 – 5 x 5, food poisoning
Atropa belladonna C 30 2 x 5 Glob, high fever
Cephaelis ipecacuahna C 12 2 x 5 Glob, nausea and vomiting
Coffea arabica C 12 2 x 5 Glob, insomnia and restlessness
Euphrasia officinalis C 12 3 x 5 Glob, eye problems
Ferrum phosphoricum C 12 2 x 5 Glob, nose bleed
Lachesis muta C 30 1 x 5 Glob, infected wounds
Lytta vesicatoria C 200 1 – 2 x 5, burns,
Matricaria chamomilla C 30 1 x 3 Glob, toothache
Mercurius LM 12 2 x 5 Glob ear ache, weakness
Pulsatilla LM 12 2 x 5 Glob, ear ache, indigestion
Solanum dulcamara C12 3 x 5 Glob, cystitis
Strychnos nux vomica LM 12 2 x 5 Glob, hangover
Rhus toxicodendron C 200 2 x 5 Glob, rheumatic pain
Veratrum album C12, 3-5 x 3, watery diarrhoea, nausea, vomiting, circulatory problems, collapse.

I can well imagine that, after reading this, some of my readers are in need of some Veratrum album because of near collapse with laughter (or fury?).

We all know that most pharmacists sell such useless remedies; and we might pity them for such behaviour, as they claim they have no choice. But if pharmacists’ professional organisations put themselves so very clearly behind quackery thereby violating all ethical rules in the book, one is truly speechless.

Do I hear someone mutter “what has Austria to do with us?”?

Not a lot, perhaps – but have a look at the range of similar ‘homeopathic emergency kits’ sold outside Austria. Or be stunned by the plethora of homeopathic pharmacies across the globe here and UK-wide here. Or consider the fact that most non-homeopathic pharmacies in the world sell homeopathic remedies. Or let me remind you that a snapshot investigation into UK pharmacies revealed that 13 out of 20 pharmacisits failed to explain that there’s no clinical evidence that homeopathy works. Or be once again reminded that it is “the ethical role of the pharmacist is to give accurate, impartial information regarding the homeopathic therapy, the current scientific proof on their therapeutic effects, including the placebo effect.”

And what is the current scientific proof?

The most reliable verdict that I am aware of comes from the Australian ‘NATIONAL HEALTH AND MEDICAL RESEARCH COUNCIL’ (NHMRC) who have assessed the effectiveness of homeopathy. The evaluation concluded that “the evidence from research in humans does not show that homeopathy is effective for treating the range of health conditions considered.”

I rest my case.

Many proponents of alternative medicine seem somewhat suspicious of research; they have obviously understood that it might not produce the positive result they had hoped for; after all, good research tests hypotheses and does not necessarily confirm beliefs. At the same time, they are often tempted to conduct research: this is perceived as being good for the image and, provided the findings are positive, also good for business.

Therefore they seem to be tirelessly looking for a study design that cannot ‘fail’, i.e. one that avoids the risk of negative results but looks respectable enough to be accepted by ‘the establishment’. For these enthusiasts, I have good news: here is the study design that cannot fail.

It is perhaps best outlined as a concrete example; for reasons that will become clear very shortly, I have chosen reflexology as a treatment of diabetic neuropathy, but you can, of course, replace both the treatment and the condition as it suits your needs. Here is the outline:

  • recruit a group of patients suffering from diabetic neuropathy – say 58, that will do nicely,
  • randomly allocate them to two groups,
  • the experimental group receives regular treatments by a motivated reflexologist,
  • the controls get no such therapy,
  • both groups also receive conventional treatments for their neuropathy,
  • the follow-up is 6 months,
  • the following outcome measures are used: pain reduction, glycemic control, nerve conductivity, and thermal and vibration sensitivities,
  • the results show that the reflexology group experience more improvements in all outcome measures than those of control subjects,
  • your conclusion: This study exhibited the efficient utility of reflexology therapy integrated with conventional medicines in managing diabetic neuropathy.

Mission accomplished!

This method is fool-proof, trust me, I have seen it often enough being tested, and never has it generated disappointment. It cannot fail because it follows the notorious A+B versus B design (I know, I have mentioned this several times before on this blog, but it is really important, I think): both patient groups receive the essential mainstream treatment, and the experimental group receives a useless but pleasant alternative treatment in addition. The alternative treatment involves touch, time, compassion, empathy, expectations, etc. All of these elements will inevitably have positive effects, and they can even be used to increase the patients’ compliance with the conventional treatments that is being applied in parallel. Thus all outcome measures will be better in the experimental compared to the control group.

The overall effect is pure magic: even an utterly ineffective treatment will appear as being effective – the perfect method for producing false-positive results.

And now we hopefully all understand why this study design is so very popular in alternative medicine. It looks solid – after all, it’s an RCT!!! – and it thus convinces even mildly critical experts of the notion that the useless treatment is something worth while. Consequently the useless treatment will become accepted as ‘evidence-based’, will be used more widely and perhaps even reimbursed from the public purse. Business will be thriving!

And why did I employ reflexology for diabetic neuropathy? Is that example not a far-fetched? Not a bit! I used it because it describes precisely a study that has just been published. Of course, I could also have taken the chiropractic trial from my last post, or dozens of other studies following the A+B versus B design – it is so brilliantly suited for misleading us all.

A recent article by Frank King (DC, ND) caught my eye. In it, he praises homeopathy in glowing terms. First I was not sure whether he is pulling my leg; then I decided he was entirely serious. Am I mistaken?

Here is the crucial passage for you to decide:

Even though the founder of homeopathy lived more than 200 years ago, he wrote about genetics. Samuel Hahnemann, MD, not only emphasized the importance of natural healing methods, he also recognized the influence of genetics in some types of illnesses.

Hahnemann used the term miasm to refer to the source of chronic diseases. He recognized several miasms, such as psora (meaning “itch”), syphilis, tuberculosis, gonorrhea, and cancer. In addition to recognizing and naming these miasms, he developed homeopathic remedies to address and correct them.

When your patient treatment protocols reach a plateau with chiropractic and nutritional support, consider turning to the constitutional homeopathic remedies, miasms, and detoxification formulas. Toxins inhibit the body’s ability to heal by interfering with the normal nerve pathways.

For example: Due to the steady growth in heavy-metal exposure modern civilization has experienced since the Industrial Revolution, mercury could be considered a modern miasm. Animal studies indicate that mercury’s negative effects can carry through to future generations, just as some of the other miasms do.

Mercurius is homeopathically prepared mercury to help address the symptoms of mercury toxicity, which can manifest as slow thought processes, chilliness, weak digestion, sore throat, and night sweats.

This is just one of the more than 1,300 Homeopathic Pharmacopoeia of the United States ingredients recognized by the FDA.

Homeopathy can be the perfect complement to chiropractic care. It can correct the energetics (including the genetics) of the deepest areas of the body, mind, and emotions, where the hands of the chiropractor can’t reach.

In case you don’t know much about homeopathy, it is true that Hahnemann believed in ‘miasms’, i.e. noxious vapours as the cause of a disposition to certain diseases. Even by Hahnemann’s standards, it turned out to be one of his more crazy ideas. To claim that, by believing in miasms, he foresaw the science of genetics is more than a little far-fetched.

In case you are not sure what toxins do in our body, rest assured that only chiropractors believe they inhibit the body’s ability to heal by interfering with the normal nerve pathways.

And in case you think you suffer from slow thought processes, chilliness, weak digestion, sore throat, and night sweats and thus feel like rushing to the next pharmacy to buy some Mercurius, don’t! This would not eliminate any mercury from your body, it would just eliminate cash from your pocket (in that sense, homeopathy might indeed occasionally reach where the hands of the chiropractor can’t reach).

One can say a lot about alternative medicine, I think, but nobody can deny that it regularly provides us with perfect (unintentional) comedy.

Kinesiology tape is all the rage. Its proponents claim that it increases cutaneous stimulation, which facilitates motor unit firing, and consequently improves functional performance. But is this just clever marketing, wishful thinking or is it true? To find out, we need reliable data.

The current trial results are sparse, confusing and contradictory. A recent systematic review indicated that kinesiology tape may have limited potential to reduce pain in individuals with musculoskeletal injury; however, depending on the conditions, the reduction in pain may not be clinically meaningful. Kinesiology tape application did not reduce specific pain measures related to musculoskeletal injury above and beyond other modalities compared in the context of included articles. 

The authors concluded that kinesiology tape may be used in conjunction with or in place of more traditional therapies, and further research that employs controlled measures compared with kinesiology tape is needed to evaluate efficacy.

This need for further research has just been met by Korean investigators who conducted a study testing the true effects of KinTape by a deceptive, randomized, clinical trial.

Thirty healthy participants performed isokinetic testing of three taping conditions: true facilitative KinTape, sham KinTape, and no KinTape. The participants were blindfolded during the evaluation. Under the pretense of applying adhesive muscle sensors, KinTape was applied to their quadriceps in the first two conditions. Normalized peak torque, normalized total work, and time to peak torque were measured at two angular speeds (60°/s and 180°/s) and analyzed with one-way repeated measures ANOVA.

Participants were successfully deceived and they were ignorant about KinTape. No significant differences were found between normalized peak torque, normalized total work, and time to peak torque at 60°/s or 180°/s (p = 0.31-0.99) between three taping conditions. The results showed that KinTape did not facilitate muscle performance in generating higher peak torque, yielding a greater total work, or inducing an earlier onset of peak torque.

The authors concluded that previously reported muscle facilitatory effects using KinTape may be attributed to placebo effects.

The claims that are being made for kinesiology taping are truly extraordinary; just consider what this website is trying to tell us:

Kinesiology tape is a breakthrough new method for treating athletic sprains, strains and sports injuries. You may have seen Olympic and celebrity athletes wearing multicolored tape on their arms, legs, shoulders and back. This type of athletic tape is a revolutionary therapeutic elastic style of support that works in multiple ways to improve health and circulation in ways that traditional athletic tapes can’t compare. Not only does this new type of athletic tape help support and heal muscles, but it also provides faster, more thorough healing by aiding with blood circulation throughout the body.

Many athletes who have switched to using this new type of athletic tape report a wide variety of benefits including improved neuromuscular movement and circulation, pain relief and more. In addition to its many medical uses, Kinesiology tape is also used to help prevent injuries and manage pain and swelling, such as from edema. Unlike regular athletic taping, using elastic tape allows you the freedom of motion without restricting muscles or blood flow. By allowing the muscles a larger degree of movement, the body is able to heal itself more quickly and fully than before.

Whenever I read such over-enthusiastic promotion that is not based on evidence but on keen salesmanship, my alarm-bells start ringing and I see parallels to the worst type of alternative medicine hype. In fact, kinesiology tapes have all the hallmarks of alternative medicine and its promoters have, as far as I can see, all the characteristics of quacks. The motto seems to be: LET’S EARN SOME MONEY FAST AND IGNORE THE SCIENCE WHILE WE CAN.

Most of the underlying assumptions of alternative medicine (AM) lack plausibility. Whenever this is the case, so the argument put forward by an international team of researchers in a recent paper, there are difficulties involved in obtaining a valid statistical significance in clinical studies.

Using a mostly statistical approach, they argue that, since the prior probability of a research hypothesis is directly related to its scientific plausibility, the commonly used frequentist statistics, which do not account for this probability, are unsuitable for studies exploring matters in various degree disconnected from science. Any statistical significance obtained in this field should be considered with great caution and may be better applied to more plausible hypotheses (like placebo effect) than the specific efficacy of the intervention.

The researchers conclude that, since achieving meaningful statistical significance is an essential step in the validation of medical interventions, AM practices, producing only outcomes inherently resistant to statistical validation, appear not to belong to modern evidence-based medicine.

To emphasize their arguments, the researchers make the following additional points:

  • It is often forgotten that frequentist statistics, commonly used in clinical trials, provides only indirect evidence in support of the hypothesis examined.
  • The p-value inherently tends to exaggerate the support for the hypothesis tested, especially if the scientific plausibility of the hypothesis is low.
  • When the rationale for a clinical intervention is disconnected from the basic principles of science, as in case of complementary alternative medicines, any positive result obtained in clinical studies is more reasonably ascribable to hypotheses (generally to placebo effect) other than the hypothesis on trial, which commonly is the specific efficacy of the intervention.
  • Since meaningful statistical significance as a rule is an essential step to validation of a medical intervention, complementary alternative medicine cannot be considered evidence-based.

Further explanations can be found in the discussion of the article where the authors argue that the quality of the hypothesis tested should be consistent with sound logic and science and therefore have a reasonable prior probability of being correct. As a rule of thumb, assuming a “neutral” attitude towards the null hypothesis (odds = 1:1), a p-value of 0.01 or, better, 0.001 should suffice to give a satisfactory posterior probability of 0.035 and 0.005 respectively.

In the area of AM, hypotheses often are entirely inconsistent with logic and frequently fly in the face of science. Four examples can demonstrate this instantly and sufficiently, I think:

  • Homeopathic remedies which contain not a single ‘active’ molecule are not likely to generate biological effects.
  • Healing ‘energy’ of Reiki masters has no basis in science.
  • Meridians of acupuncture are pure imagination.
  • Chiropractic subluxation have never been shown to exist.

Positive results from clinical trials of implausible forms of AM are thus either due to chance, bias or must be attributed to more credible causes such as the placebo effect. Since the achievement of meaningful statistical significance is an essential step in the validation of medical interventions, unless some authentic scientific support to AM is provided, one has to conclude that AM cannot be considered as evidence-based.

Such arguments are by no means new; they have been voiced over and over again. Essentially, they amount to the old adage: IF YOU CLAIM THAT YOU HAVE A CAT IN YOUR GARDEN, A SIMPLE PICTURE MAY SUFFICE. IF YOU CLAIM THERE IS A UNICORN IN YOUR GARDEN, YOU NEED SOMETHING MORE CONVINCING. An extraordinary claim requires an extraordinary proof! Put into the context of the current discussion about AM, this means that the usual level of clinical evidence is likely to be very misleading as long as it totally neglects the biological plausibility of the prior hypothesis.

Proponents of AM do not like to hear such arguments. They usually insist on what we might call a ‘level playing field’ and fail to see why their assumptions require not only a higher level of evidence but also a reasonable scientific hypothesis. They forget that the playing field is not even to start with; to understand the situation better, they should read this excellent article. Perhaps its elegant statistical approach will convince them – but I would not hold my breath.

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