MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

conflict of interest

It has been reported that two London councils have written to parents to warn that children who are not vaccinated against measles may need to self-isolate for 21 days if a classmate is infected with the disease. It comes after modelling by the UK Health Security Agency (UKHSA) warned that up to 160,000 cases could occur in the capital alone as a result of low vaccination rates. Just three-quarters of London children have received the two required doses of the MMR jab, which protects against measles. This is 10 per cent lower than the national average.

Barnet Council wrote to parents on July 20 warning that any unvaccinated child identified as a close contact of a measles case could be asked to self-isolate for up to 21 days. “Measles is of serious concern in London due to low childhood vaccination rates. Currently we are seeing an increase in measles cases circulating in neighbouring London boroughs, so now is a good time to check that your child’s MMR vaccination – which not only protects your child against measles but also mumps and rubella – is up to date,” the letter reads. “Children who are vaccinated do not need to be excluded from school or childcare,” the letter added.

Neighbouring Haringey Council also warned that children without both MMR doses may be asked to quarantine for 21 days. Just over two-thirds (67.9 per cent) of children in the area had received both doses by the age of five. The councils stated that they had sent the letters based on guidance by the UKHSA, but the agency said that headteachers should consider “excluding” unvaccinated pupils who become infected with measles rather than instructing them to self-isolate.

Data published by the UKHSA showed that 128 cases of measles were recorded between January 1 and June 30 this year, compared to 54 cases in the whole of 2022. Two-thirds of the cases were detected in London. The agency have said that there is a high risk of cases linked to overseas travel leading to outbreaks in specific population groups such as young people and under-vaccinated communities.

Dr Vanessa Saliba, a consultant epidemiologist at UKHSA, said: “When there are measles cases or outbreaks in nurseries or schools, the UKHSA health protection team will assess the situation, together with the school and other local partners, and provide advice for staff and pupils. “Those who are not up to date with their MMR vaccinations will be asked to catch up urgently to help stop the outbreak and minimise disruption in schools.”

____________________________

Measles is a significant concern with approximately 10 million people infected annually causing over 100,000 deaths worldwide. In the US before use of the measles vaccine, there were estimated to be 3 to 4 million people infected with measles annually, causing 400 to 500 deaths. Complications of measles include otitis media, diarrhea, pneumonia, and acute encephalitis. Measles is a leading cause of blindness in the developing world, especially in those who are vitamin A deficient. Malnourished children with measles are also at higher risk of developing noma (or cancrum oris), a rapidly progressive gangrenous infection of the mouth and face. Most deaths due to measles are caused by pneumonia, diarrhea, or neurological complications in young children, severely malnourished or immunocompromised individuals, and pregnant women. A rare sequela of measles is subacute sclerosing panencephalitis.

Back in 2003, we investigated what advice UK homeopaths, chiropractors and general practitioners give on measles, mumps and rubella vaccination programme (MMR) vaccination via the Internet. Online referral directories listing e-mail addresses of UK homeopaths, chiropractors and general practitioners and private websites were visited. All addresses thus located received a letter of a (fictitious) patient asking for advice about the MMR vaccination. After sending a follow-up letter explaining the nature and aim of this project and offering the option of withdrawal, 26% of all respondents withdrew their answers. Homeopaths yielded a final response rate (53%, n = 77) compared to chiropractors (32%, n = 16). GPs unanimously refused to give advice over the Internet. No homeopath and only one chiropractor advised in favour of the MMR vaccination. Two homeopaths and three chiropractors indirectly advised in favour of MMR. More chiropractors than homeopaths displayed a positive attitude towards the MMR vaccination.  We concluded that some complementary and alternative medicine providers have a negative attitude towards immunisation and means of changing this should be considered.

The problem is by no means confined to the UK. German researchers, for instance, showed that belief in homeopathy and other parental attitudes indicating lack of knowledge about the importance of vaccinations significantly influenced an early immunisation. Moreover, being a German homeopath has been independently associated with lower own vaccination behavior. Data from France paint a similar picture.

Some homeopaths, of course, claim that ‘homeopathic vaccinations’ are effective and preferable. My advice is: DON’T BELIEVE THESE CHARLATANS! A recent study demonstrated that homeopathic vaccines do not evoke antibody responses and produce a response that is similar to placebo. In contrast, conventional vaccines provide a robust antibody response in the majority of those vaccinated.

Homeopathic remedies are highly diluted formulations without proven clinical benefits, traditionally believed not to cause adverse events. Nonetheless, published literature reveals severe local and non–liver-related systemic side effects. Here is the first series on homeopathy-related severe drug-induced liver injury (DILI) from a single center.

A retrospective review of records from January 2019 to February 2022 identified 9 patients with liver injury attributed to homeopathic formulations. Competing causes were comprehensively excluded. Chemical analysis was performed on retrieved formulations using triple quadrupole gas chromatography-mass spectrometry and inductively coupled plasma atomic emission spectroscopy.

Males predominated with a median age of 54 years. The most typical clinical presentation was acute hepatitis, followed by acute or chronic liver failure. All patients developed jaundice, and ascites were notable in one-third of the patients. Five patients had underlying chronic liver disease. COVID-19 prevention was the most common indication for homeopathic use. Probable DILI was seen in 77.8%, and hepatocellular injury predominated (66.7%). Four (44.4%) patients died (3 with chronic liver disease) at a median follow-up of 194 days. Liver histopathology showed necrosis, portal and lobular neutrophilic inflammation, and eosinophilic infiltration with cholestasis. A total of 29 remedies were consumed between 9 patients, and 15 formulations were analyzed. Toxicology revealed industrial solvents, corticosteroids, antibiotics, sedatives, synthetic opioids, heavy metals, and toxic phyto-compounds, even in ‘supposed’ ultra-dilute formulations.

The authors concluded that homeopathic remedies potentially result in severe liver injury, leading to death in those with underlying liver disease. The use of mother tinctures, insufficient dilution, poor manufacturing practices, adulteration and contamination, and the presence of direct hepatotoxic herbals were the reasons for toxicity. Physicians, the public, and patients must realize that Homeopathic drugs are not ‘gentle placebos.’

The authors also cite our own work on this subject:

A detailed systematic review of homeopathic remedies-induced adverse events from published case reports and case series by Posadzski and colleagues showed that severe side effects, some leading to fatality, are possible with classic and unspecified homeopathic formulations. The total number of patients included was 1159, of which 1142 suffered adverse events directly related to homeopathy. The direct adverse events had acute pancreatitis, severe allergic reactions, arsenical keratosis, bullous pemphigoid, neurocognitive disorders, sudden cardiac arrest and coma, severe dyselectrolytemia, interstitial nephritis, kidney injury, thallium poisoning, syncopal attacks, and focal neurological deficits as well as movement disorders. Fatal events involved advanced renal failure requiring dialysis, toxic polyneuropathy, and quadriparesis. The duration of adverse events ranged from a few hours to 7 months, and 4 patients died. The authors state that in most cases, the mechanism of action for side effects of homeopathy involved allergic reactions or the presence of toxic substances—the use of strong mother tinctures, drug contaminants, adulterants, or poor manufacturing (incorrect dilutions).

When we published our paper back in 2012, it led to a seies of angry responses from defenders of homeopathy who claimed that one cannot ‘have the cake and eat it’; either homeopathic remedies are placebos and thus harmless, or they have effects and thus also side-effects, they claimed. As the new publication by Indian researchers yet again shows, they were mistaken. In fact, homeopathy is dangerous in more than one way:

  • the homeopathic remedies can do harm if not diluted or wrongly manufactured;
  • the homeopaths can do harm through their often wrong advice in health matters;
  • homeopathy erodes rational thinking (as, for instance, the resopnses to our 2012 paper demonstrated).

Many community pharmacies in Switzerland provide so-called alternative medicine (SCAM) approaches in addition to providing biomedical services, and a few pharmacies specialise in SCAM. A common perception is that SCAM providers are sceptical towards, or opposed to, vaccination.

The key  objectives of this study were to examine the potential roles of biomedically oriented and SCAM-specialised pharmacists regarding vaccine counselling and to better understand the association between vaccine hesitancy and SCAM. The researchers thus conducted semistructured, qualitative interviews. Transcripts were coded and analysed using thematic analysis. Interview questions were related to:

  • type of pharmaceutical care practised,
  • views on SCAM and biomedicine,
  • perspectives on vaccination,
  • descriptions of vaccination consultations in community pharmacies,
  • and views on vaccination rates.

Qualitative interviews in three language regions of Switzerland (German, French and Italian). A total of 18 pharmacists (N=11 biomedically oriented, N=7  SCAM specialised) were invited.

Pharmacist participants expressed generally positive attitudes towards vaccination. Biomedically oriented pharmacists mainly advised customers to follow official vaccination recommendations but rarely counselled vaccine-hesitant customers. SCAM-specialised pharmacists were not as enthusiastic advocates of the Swiss vaccination recommendations as the biomedically oriented pharmacists. Rather, they considered that each customer should receive individualised, nuanced vaccination advice so that customers can reach their own decisions. SCAM-specialised pharmacists described how mothers in particular preferred getting a second opinion when they felt insufficiently advised by biomedically oriented paediatricians.

The authors concluded that vaccination counselling in community pharmacies represents an additional option to customers who have unmet vaccination consultation needs and who seek reassurance from healthcare professionals (HCPs) other than physicians. By providing individualised vaccination counselling to vaccine-hesitant customers, SCAM-specialised pharmacists are likely meeting specific needs of vaccine-hesitant customers. As such, research and implementation efforts should more systematically involve pharmacists as important actors in vaccination provision. SCAM-specialised pharmacists particularly should not be neglected as they are important HCPs who counsel vaccine-hesitant customers.

I must say that I find these conclusions odd, perhaps even wrong. Here are my reasons:

  • Pharmacists are well-trained healthcare professionals.
  • As such, they have ethical obligations towards their customers.
  • These obligations include behaving in a way that is optimal for the health of their customers and follows the rules of evidence-based practice.
  • This includes explaining to vaccine-hesitant customers why the recommended vaccinations make sense and advising them to follow the official vaccination guidelines.
  • SCAM-specialised pharmacist should ask themselves whether offering SCAM is in line with their ethical obligation to provide optimal care and advice to their customers.

I fear that this paper suggests that SCAM-specialised pharmacists might be a danger to the health of their customers. If that is confirmed, they should consider re-training, in my view.

This randomised, double blind controlled trial compared the efficacy of curcumin versus omeprazole in improving patient reported outcomes in people with dyspepsia.

The interventions were:

  • curcumin alone (C),
  • omeprazole alone (O),
  • curcumin plus omeprazole (C+O).

Patients in the combination group received two capsules of 250 mg curcumin, four times daily, and one capsule of 20 mg omeprazole once daily for 28 days.

Main outcome measure was unctional dyspepsia symptoms on days 28 and 56, assessed using the Severity of Dyspepsia Assessment (SODA) score. Secondary outcomes were the occurrence of adverse events and serious adverse events.

A total of 206 patients were enrolled in the study and randomly assigned to one of the three groups; 151 patients completed the study. Demographic data (age 49.7±11.9 years; women 73.4%), clinical characteristics and baseline dyspepsia scores were comparable between the three groups. Significant improvements were observed in SODA scores on day 28 in the pain (−4.83, –5.46 and −6.22), non-pain (−2.22, –2.32 and −2.31) and satisfaction (0.39, 0.79 and 0.60) categories for the C+O, C, and O groups, respectively. These improvements were enhanced on day 56 in the pain (−7.19, –8.07 and −8.85), non-pain (−4.09, –4.12 and −3.71) and satisfaction (0.78, 1.07, and 0.81) categories in the C+O, C, and O groups, respectively. No significant differences were observed among the three groups and no serious adverse events occurred.

The authors concluded that curcumin and omeprazole had comparable efficacy for functional dyspepsia with no obvious synergistic effect.

This study, which was funded by the Thai Traditional and Alternative Medicine Fund, has been picked up by the press and is being lauded as a solid proof of efficacy. Its authors too are not half proud of their splendid trial:

This multicentre randomised controlled trial provides highly reliable evidence for the treatment of functional dyspepsia. PPIs, widely used and approved for over-the-counter use, were compared with curcumin, a popular herbal remedy. The study design, including double blind randomisation, minimised biases. Participants met strict criteria, underwent endoscopy and were tested for H pylori infection. Furthermore, we implemented measures to minimise biases by ensuring that the individuals administering the drugs, participants receiving the drugs and individuals conducting the assessment remained blinded to the type of medications administered to the participants. The trial was carried out in hospitals, and certified individuals used standardised questionnaires for assessments. Statistical methods were appropriate and followed accepted principles.

Two follow-up appointments were scheduled, and blood tests showed no abnormal symptoms or liver function abnormalities. However, participants with high body mass index indicated a trend towards liver function impairment in the curcumin group, suggesting the need for larger studies. Some participants did not provide follow-up information, which is a study weakness. However, the number of participants who provided this information was sufficient for statistical analysis and the majority of the participants attended the follow-up visit. Therefore, it can be deduced from the results that even if the number of participants followed after drug administration increased, the study findings would not be significantly different. Another limitation of this study was the absence of long term follow-up data for all patients after treatment. This is a question that will require further investigation.

The strength of the study lies in its relevance to daily clinical practice, providing additional drug options in addition to PPIs alone, without added side effects. The study was unbiased, partially funded by government organisations and the first well designed trial comparing curcumin with PPI for functional dyspepsia, with confirmation through endoscopy and ruling out H pylori infection. Limitations of this study included the small number of patients who were lost to follow-up and the lack of long term follow-up data.

However, I am far less impressed.

Why?

Curcumin is bright yellow and has a very distinct taste/smell. Even though curumin was given in capsules, patients can easily tell what they are taking. I therefore doubt that they were adequately blinded. In fact, the authors seem to agree when they state the following:

We observed that despite improvements in pain and non-pain scores, there was no significant improvement in the SODA satisfaction scores in the O and C+O groups (table 3). A possible explanation for this observation could be related to the taste and/or smell of curcumin, which might have caused reduced pleasantness for the participants while ingesting it. This potential discomfort could offset the improvements in pain and non-pain symptoms, leading to the non-significant change in satisfaction score. Further studies may be needed to explore this hypothesis as well as to improve the palatability of curcumin.

Sadly, the success of blinding (which under such circumstances should always be tested) was not reported and probably not even quantified. If many patients were de-blinded, it seems inevitable that their expectation influenced the results. In other words, the much-lauded effect of curcumin might just be due to placebo and curcumin might be entirely useless. Or, to put it bluntly, the trial was not nearly as good as many made it out to be.

PS

Sad to see that the reviewers of a reputable journal failed to pick up on this significant flaw.

The aim of this systematic review was to update the current level of evidence for spinal manipulation in influencing various biochemical markers in healthy and/or symptomatic population.

Various databases were searched (inception till May 2023) and fifteen trials (737 participants) that met the inclusion criteria were included in the review. Two authors independently screened, extracted and assessed the risk of bias in included studies. Outcome measure data were synthesized using standard mean differences and meta-analysis for the primary outcome (biochemical markers). The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was used for assessing the quality of the body of evidence for each outcome of interest.

There was low-quality evidence that spinal manipulation influenced various biochemical markers (not pooled). There was low-quality evidence of significant difference that spinal manipulation is better (SMD -0.42, 95% CI – 0.74 to -0.1) than control in eliciting changes in cortisol levels immediately after intervention. Low-quality evidence further indicated (not pooled) that spinal manipulation can influence inflammatory markers such as interleukins levels post-intervention. There was also very low-quality evidence that spinal manipulation does not influence substance-P, neurotensin, oxytocin, orexin-A, testosterone and epinephrine/nor-epinephrine.

The authors concluded that spinal manipulation may influence inflammatory and cortisol post-intervention. However, the wider prediction intervals in most outcome measures point to the need for future research to clarify and establish the clinical relevance of these changes.

The majority of the studies were of low or very low quality. This means that the collective evidence is less than reliable. In turn, this means, I think, that the conclusions are misleading. A more honest conclusion would be this:

There is no reliable evidence that spinal manipulation influences inflammatory and cortisol levels.

As for the clinical relevance, I would like to point out that it would not be surprising if chiropractors could one day convincingly show that spinal manipulation do influence various biochemical markers. Many things do! If you fall down a staircase, for instance, plenty of biochemical markers will be affected. This, however, does not mean that throwing our patients down the stairs is of therapeutic value.

This study aimed to evaluate whether individualized homeopathic medicines have a greater adjunctive effect than adjunctive placebos in the treatment of moderate and severe cases of coronavirus disease 2019 (COVID-19). It was designed as a randomized, single-blind, placebo-controlled trial set in the clinical context of standard care. Patients admitted in a tertiary care hospital, suffering from moderate or severe COVID-19 and above 18 years of age were included. In total, 150 patients were randomly divided into two groups to receive either:

  • individualized homeopathic medicines
  • or placebos.

Both options were administered in addition to the standard treatment of COVID-19.

The primary outcome was time taken to achieve RT-PCR-confirmed virus clearance for COVID-19. Secondary outcomes were changes in the Clinical Ordinal Outcomes Scale (COOS) of the World Health Organization, the patient-reported MYMOP2 scale, and several biochemical parameters. Parametric data were analyzed using unpaired t-test. Non-parametric data were analyzed using the Wilcoxon signed rank test. Categorical data were analyzed using Chi-square test.

In total, 72 participants of the add-on homeopathy (AoH) group showed conversion of RT-PCR status to negative, in an average time of 7.53 ± 4.76 days (mean ± SD), as compared with 11.65 ± 9.54 days in the add-on placebo (AoP) group (p = 0.001). The mean COOS score decreased from 4.26 ± 0.44 to 3.64 ± 1.50 and from 4.3 ± 0.46 to 4.07 ± 1.8 in the AoH and AoP groups respectively (p = 0.130). The mortality rate for the AoH group was 9.7% compared with 17.3% in the AoP group. The MYMOP2 scores between the two groups differed significantly (p = 0.001), in favor of AoH. Inter-group differences in the pre- and post- mean values of C-reactive protein, fibrinogen, total leukocyte count, platelet count and alkaline phosphatase were each found to be statistically significant (p <0.05), favoring AoH; six other biochemical parameters showed no statistically significant differences.

The authors concluded that the study suggests homeopathy may be an effective adjunct to standard care for treating moderate and severe COVID-19 patients. More rigorous, including double-blinded, studies should be performed to confirm or refute these initial findings.

I do agree with the authors that more rigorous studies are needed before we can accept these findings. As it stands, this study seems to have multiple flaws:

  • I fail to understand why they did not design their trial as a double-blind study. The reason given by the authors makes little sense to me.
  • I also have my doubts that the study was even single-blind. If I understand it correctly, the placebo group was did not benefit from the detailed homeopathic history taking that is necessary to find the optimal homeopathic remedy. If that is so, unblinding of patients is inevitable.
  • The authors themselves point out that the relevance of many outcome measures is questionable

Generally speaking, I find the results suspicious, implausible, and frankly too good to be true. I might also point out that the authors’ afilitation do not inspire much trust in their objectivity:

  • 1Central Council for Research in Homoeopathy, New Delhi, India.
  • 2Central Council for Research in Homoeopathy, Ministry of AYUSH, Govt. of India, New Delhi, India.
  • 3Rejoice Health Foundation, New Delhi, India.
  • 4Department of Onco-Anaesthesia and Palliative Medicine, Dr. B.R. Ambedkar Institute Rotary Cancer Hospital and National Cancer Institute, All India Institute of Medical Sciences, Ministry of Health and Family Welfare, New Delhi, India.
  • 5Department of Onco-Anaesthesia and Palliative Medicine, All India Institute of Medical Sciences, Ministry of Health and Family Welfare, New Delhi, India.

Neither do these statements:

Funding
The study was funded by the Central Council for Research in Homoeopathy, Ministry of AYUSH, Government of India. The funder approved the study through its review committees, delegated/recruited staff for conducting the study, and facilitated all collaborative procedures.

Conflict of Interest
None declared.

Lastly, I do wonder why the authors published their study in the 3rd class journal ‘Homeopathy’. Surely, such findings – if true – deserve to be published in a journal of a decent reputation!

King Charles III is an enthusiastic, albeit uncritical proponent of so-called alternative medicine (SCAM). Does that boost his popularity in the general population? Or does it have the opposite effect? I am not aware of reliable data on this issue, yet I suspect it is neither here nor there. So, his waning popularity is probably caused by other factors.

A survey of more than 2,000 adult Brits found that overall, 62% want to keep the monarchy and 59% of people thought Charles was “personally doing a good job”.. At first glance, this looks not too bad for Charles and William but a more detailed analysis is far less optimistic: among 18 to 24-year-olds, only 30% say the monarchy is “good for Britain”. This “remarkable difference between generations”, demonstrates that younger people are much less supportive on remaining a monarchy and more sceptical about the Royal Family representing good value for money.

A decade ago, the same YouGov tracking survey found 17% preferred an elected head of state, which in this latest survey has risen to 26%. On the question whether Britain should continue to be a monarchy or be replaced with an elected head of state, the poll found:

  • 62% wish no change,
  • 26% want an elected head of state,
  • 11% don’t know.

On the question whether the Royal Family is good value for money, 75% of the over-65s believe they are, but only 34% of 18 to 24-year-olds feel the same. And while 80% of the over-65s want Britain to stay as a monarchy, that figure falls to 37% for the 18 to 24-year-olds. There is also less support for the royals in Scotland or Wales than in England, where London has higher levels of people against the monarchy than elsewhere in the country.

Historian and royal commentator Ed Owens says the lack of support among the young should “certainly be of concern” to the Royal Family. But he says it will be difficult for the royals to turn this around, when many of the factors are outside their control. Dr Owens says opposition to the monarchy is part of a wider sense of “disenchantment” for younger generations about issues such as unaffordable housing, stagnant wages and student debt. “The system doesn’t seem to be working for them, so why should they celebrate an institution that seems to be at the heart of that system?” says Dr Owens.

Graham Smith, chief executive of the anti-monarchy campaign Republic, said the survey showed a “general trend of falling support, and that younger people will not be won back to the monarchist cause. Sooner rather than later we’ll see support for the monarchy fall below 50%.”

When the 1st edition of my book about about Charles’ (at the time, he was still ‘Prince of Wales’) love affair with SCAM came out, it was reviewd by the Daily Mail.  They courageously asked Charles’ press office for a comment on it. A Clarence House spokesperson then told the journalist: ‘The Prince of Wales believes in combining the best of evidence based, conventional medicine with an holistic approach to healthcare – treating the whole person rather than just the symptoms of disease and taking into account the effects on health of factors such as lifestyle, the environment and emotional well-being.’  I know this is not all that meaningful and just a (fairly daft and uninformed) formular for getting rid of a tedious request, yet – for what it’s worth – it does not indicate that, in the realm of SCAM, Charles is all that open to change. More recent activities of King Charles seem to support this impression.

With regards to his overall popularitiy in the UK, this might mean that Charles will continue to lose the support of skeptics, while gaining the one of SCAM enthusiasts.

And the net result of this?

I fear it will almost be negligible.

The ‘ALTERNATIVE MEDICINE HALL OF FAME’ is my creation amd is meant to honour reserchers who have dedicated much of their professional career to investigating a form of so-called alternative medicine (SCAM) without ever publishing negative conclusions about it. Obviously, if anyone studies any therapy, he/she will occasionally produce a negative finding. This would be the case, even if he/she tests an effective treatment. However, if the treatment in question comes from the realm of SCAM, one would expect negative results fairly regularly. No therapy works well under all conditions, and to the best of my knowledge, no SCAM is a panacea!

This is why researchers who defy this inevitability must be remarkable. If someone tests a treatment that is at best dubious and at worst bogus, we are bound to see some studies that are not positive. He/she would thus have a high or norma ‘TRUSTWORTHINESS INDEX‘ (another creation of mine which, I think, is fairly self-explanatory). Conversely, any researcher who does manage to publish nothing but positive results of a SCAM is bound to have a very low ‘TRUSTWORTHINESS INDEX‘. In other words, these people are special, so much so that  I decided to honour such ‘geniuses’ by admitting them to my ALTERNATIVE MEDICINE OF FAME.

So far, this elite group of people comprises the following individuals:

  1. Tery Oleson (acupressure , US)
  2. Jorge Vas (acupuncture, Spain)
  3. Wane Jonas (homeopathy, US)
  4. Harald Walach (various SCAMs, Germany)
  5. Andreas Michalsen ( various SCAMs, Germany)
  6. Jennifer Jacobs (homeopath, US)
  7. Jenise Pellow (homeopath, South Africa)
  8. Adrian White (acupuncturist, UK)
  9. Michael Frass (homeopath, Austria)
  10. Jens Behnke (research officer, Germany)
  11. John Weeks (editor of JCAM, US)
  12. Deepak Chopra (entrepreneur, US)
  13. Cheryl Hawk (chiropractor, US)
  14. David Peters (osteopathy, homeopathy, UK)
  15. Nicola Robinson (TCM, UK)
  16. Peter Fisher (homeopathy, UK)
  17. Simon Mills (herbal medicine, UK)
  18. Gustav Dobos (various SCAMs, Germany)
  19. Claudia Witt (homeopathy, Germany/Switzerland)
  20. George Lewith (acupuncture, UK)
  21. John Licciardone (osteopathy, US)

Today, it is my great pleasure to admit another osteopath to the HALL OF FAME:

Helge Franke

Helge is a German Heilpraktiker and Osteopath. On his website, he lists his publications (kindly saving me the effort of doing a Medline search):

  1. Osteopathic manipulative treatment for nonspecific low back pain: a systematic review and meta-analysis. BMC Muskuloskeletal Disorders, 2014
  2. Effectiveness of osteopathc manipulative therapy for managing symptoms of irritable bowel syndrome: a systematic review. Journal of the American Osteopathic Association, 2014
  3. Why reservations remain: A critical reflection about the systematic review and meta-analysis “Osteopathic manipulative treatment for low back pain” by Licciardone et al. Journal of Bodywork & Movement Therapies, 2012, Elsevier
  4. Osteopathic Manipulative Treatment (OMT) for Lower Urinary Tract Symptoms (LUTS) in Women. A Systematic Review and Meta-analyses. Journal of Bodywork & Movement Therapies, 2012, Elsevier
  5. Comment: Is a postural-structural-biomechanical model, within manual therapy, viable? A JBMT debate. Journal of Bodywork & Movement Therapies (2011) 15, 259-261, Elsevier
  6. Die manuelle Behandlung des Kniegelenks – veraltetes Verfahren oder alternative Option? Naturheilpraxis mit Naturmedizin 9-2010, 1019-1026, Pflaum Verlag
  7. CRPS und Osteopathie – Grenzen und Möglichkeiten DO – Deutsche Zeitschrift für Osteopathie 3-2010, 6-8, Hippokrates Verlag
  8. Research and osteopathy: An interview with Dr Gary Fryer by Journal of Bodywork & Movement Therapies. 14, 304-308, Elsevier
  9. „…there is not much we can say without any doubt“ DO Life about Gary Fryer DO – Deutsche Zeitschrift für Osteopathie 1-2010, 4-5, Hippokrates Verlag
  10. Fred Mitchell und die Entwicklung der Muskel-Energie-Techniken DO – Deutsche Zeitschrift für Osteopathie 2-2009, 4-5, Hippokrates Verlag
  11. A randomized trial of arthroscopic surgery for osteoarthritis of the knee. Commentary Forschende Komplementärmedizin 2008 Dec 15(6), 354-5, Karger
  12. Evidence-informed management of chronic low back pain with spinal manipulation and mobilization. Commentary Forschende Komplementärmedizin 2008 Dec 15(6), 353-4, Karger
  13. Interview mit Prof. Eyal Lederman Teil 1 Osteopathische Medizin, 2/2007, S.15-21, Elsevier
  14. Interview mit Prof. Eyal Lederman Teil 2 Osteopathische Medizin, 3/2007, S.22-27, Elsevier
  15. Artikel über das 3. Internationale Symposium über die Fortschritte in der osteopathischen Forschung. Osteopathische Medizin, 1-2007, S.23-24, Elsevier
  16. Die richtige Haltung des Behandlers Osteopathische Medizin, 4-2006, S.8-10, Elsevier
  17. Interview mit Laurie Hartman Osteopathische Medizin, 4-2006, S. 11-16, Elsevier
  18. Herausgeber des Sonderheftes „Functional Technique” Osteopathische Medizin, 2-2006, Elsevier
  19. Harold Hoover, Charles Bowles, William Johnston und die Geschichte der Funktionellen Technik Osteopathische Medizin, 2-2006, S.4-12, Elsevier
  20. Interview mit Harry Friedman Osteopathische Medizin, 2-2006, S.25-30, Elsevier
  21. Funktionelle Technik – Praxis Osteopathische Medizin, 2-2006, S.17-23, Elsevier
  22. Osteopathische Diagnose und Behandlung des Hüftgelenks Naturheilpraxis mit Naturmedizin, 10-2006, S.1383-1393, Pflaum-Verlag
  23. Bericht über das 2-Tage Seminar von Prof. Laurie Hartman in München Naturheilpraxis mit Naturmedizin, 5-2006, S.754-755, Pflaum Verlag
  24. Bewusstsein für Bewegung. Die minimale Hebeltechnik und das Behandlungskonzept von Laurie Hartman Osteopathische Medizin, 4-2006, S.4-7, Elsevier
  25. ICAOR 6 / Interview mit Florian Schwerla Osteopathische Medizin, 3-2006, S.15-17, Elsevier
  26. Muscle Energy Technique – Geschichte, Modell und Wirksamkeit Teil 1 Geschichte Osteopathische Medizin 2-2005, S.4-10, Elsevier
  27. Muscle Energy Technique – Geschichte, Modell und Wirksamkeit Teil 2 Modell Osteopathische Medizin 3-2005, S.4-10, Elsevier
  28. Muscle Energy Technique – Geschichte, Modell und Wirksamkeit Teil 3 Wirksamkeit Osteopathische Medizin 4-2005, S.4-10, Elsevier
  29. Die Behandlung der Rippen mit Muskel-Energie-Techniken Naturheilpraxis mit Naturmedizin, 10-2005, S. 1353-1359, Pflaum Verlag

Yes, I agree! The list is confusing because it contains all sorts of papers, including even interviews. Let’s do a Medline search after all and find the actual studies published by Franke:

  1. Osteopathic manipulative treatment (OMT) for lower urinary tract symptoms (LUTS) in women. Franke H, Hoesele K.J Bodyw Mov Ther. 2013 Jan;17(1):11-8. doi: 10.1016/j.jbmt.2012.05.001. Epub 2012 Jun 17.
  2. Effectiveness of osteopathic manipulative treatment for pediatric conditions: A systematic review. Franke H, Franke JD, Fryer G.J Bodyw Mov Ther. 2022 Jul;31:113-133. doi: 10.1016/j.jbmt.2022.03.013. Epub 2022 Mar 24.
  3. Muscle energy technique for non-specific low-back pain. Franke H, Fryer G, Ostelo RW, Kamper SJ. Cochrane Database Syst Rev. 2015 Feb 27;(2):CD009852. doi: 10.1002/14651858.CD009852.pub2.
  4. Osteopathic manipulative treatment for nonspecific low back pain: a systematic review and meta-analysis. Franke H, Franke JD, Fryer G.BMC Musculoskelet Disord. 2014 Aug 30;15:286. doi: 10.1186/1471-2474-15-286.
    Effectiveness of osteopathic manipulative therapy for managing symptoms of irritable bowel syndrome: a systematic review. Müller A, Franke H, Resch KL, Fryer G.J Am Osteopath Assoc. 2014 Jun;114(6):470-9. doi: 10.7556/jaoa.2014.098.
  5. Osteopathic manipulative treatment for low back and pelvic girdle pain during and after pregnancy: A systematic review and meta-analysis. Franke H, Franke JD, Belz S, Fryer G.J Bodyw Mov Ther. 2017 Oct;21(4):752-762. doi: 10.1016/j.jbmt.2017.05.014. Epub 2017 May 31.
  6. Evidence-informed management of chronic low back pain with spinal manipulation and mobilization Franke H.Forsch Komplementmed. 2008 Dec;15(6):353-4
  7. Osteopathic manipulative treatment for chronic nonspecific neck pain: A systematic review and meta-analysis Helge Franke, Jan-David Franke, Gary Fryer, 2015 Int J Osteop Med.

Not a huge list, I agree. Yet it is respectable, particularly if we consider that Franke managed to squeeze out a little positive message even from cases where the data are fairly clearly negative. Another thing that I find noteworthy is the fact that Franke, as far as I can see, never published a clinical trial. He seems to specialize in reviews – and perhaps that is understandable: if one is compelled to spinning the message from fairly negative evidence to a positive conclusion, reviews might be better suited.

Altogether, I think Helge Franke deserves his place in the ALTERNATIVE MEDICINE HALL OF FAME!

The KFF provides reliable, accurate, and non-partisan information to help inform health policy in the US. The KFF has just released its ‘Health Misinformation Tracking Poll Pilot‘ examining the public’s media use and trust in sources of health information and measuring the reach of specific false and inaccurate claims surrounding three health-related topics: COVID-19 and vaccines, reproductive health, and gun violence. It makes grimm reading indeed. Here are but a few excerpts pertaining to health/vaccination:

Health misinformation is widespread in the US with 96% of adults saying they have heard at least one of the ten items of health-related misinformation asked about in the survey. The most widespread misinformation items included in the survey were related to COVID-19 and vaccines, including that the COVID-19 vaccines have caused thousands of deaths in otherwise healthy people (65% say they have heard or read this) and that the MMR vaccines have been proven to cause autism in children (65%).

Regardless of whether they have heard or read specific items of misinformation, the survey also asked people whether they think each claim is definitely true, probably true, probably false, or definitely false. For most of the misinformation items included in the survey, between one-fifth and one-third of the public say they are “definitely” or “probably true.” The most frequently heard claims are related to COVID-19 and vaccines.

Uncertainty is high when it comes to health misinformation. While fewer than one in five adults say each of the misinformation claims examined in the survey are “definitely true,” larger shares are open to believing them, saying they are “probably true.” Many lean towards the correct answer but also express uncertainty, saying each claim is “probably false.” Fewer tend to be certain that each claim is false, with the exception of the claim that more people have died from the COVID-19 vaccines than from the virus itself, which nearly half the public (47%) recognizes as definitely false.

Across the five COVID-19 and vaccine related misinformation items, adults without a college degree are more likely than college graduates to say these claims are definitely or probably true. Notably, Black adults are at least ten percentage points more likely than White adults to believe some items of vaccine misinformation, including that the COVID-19 vaccines have caused thousands of sudden deaths in otherwise healthy people, and that the MMR vaccines have been proven to cause autism in children. Black (29%) and Hispanic (24%) adults are both more likely than White adults (17%) to say that the false claim that “more people have died from the COVID-19 vaccine than have died from the COVID-19 virus” is definitely or probably true. Those who identify as Republicans or lean towards the Republican Party and pure independents stand out as being more likely than Democratic leaning adults to say each of these items is probably or definitely true. Across community types, rural residents are more likely than their urban and suburban counterparts to say that some false claims related to COVID vaccines are probably or definitely true, including that the vaccines have been proven to cause infertility and that more people have died from the vaccine than from the virus.

Educational attainment appears to play a particularly important role when it comes to susceptibility to COVID-19 and vaccine misinformation. Six in ten adults with college degrees say none of the five false COVID-19 and vaccine claims are probably or definitely true, compared to less than four in ten adults without a degree. Concerningly, about one in five rural residents (19%), adults with a high school education or less (18%), Black adults (18%), Republicans (20%), and independents (18%) say four or five of the false COVID-19 and vaccine misinformation items included in the survey are probably or definitely true.

________________________________

If you have followed some of the comments on this blog, you might find it hard to be surprised!

I do encourage you to read the full article.

For about 40 years, the RMIT University in Australia had a Bachelor of Health Science/Bachelor of Applied Science (Chiropractic), probably the first official course of its kind in Australia. “Get qualified with a chiropractic degree: a solid grounding in anatomy, physiology and pathology and practise at the RMIT Health Clinic” was how the RMIT advertised it. But now the website states this: “from 2023, this degree is no longer offered.”

The Australian Chiropractors Association (ACA) is appalled!!!

What is more, they claim that this decision was made without consultation with staff, students (Australian or international) or other relevant stakeholders such as the chiropractic professional bodies. A publicly funded university acting in this manner appears to fly in the face of the Albanese government’s positive philosophy around educational access, particularly for those in the regions.
What the ACA omits to mention is that the chiro-unit at the RMIT has a dismal research output and hardly ever tackled relevant research questions such as effectiveness and safety of spinal manipulations. The ACA have even posted a video and believe a public institution that selectively closes a program which serves the public health interest and is economically viable, requires scrutiny. Given the role chiropractors play in serving the ageing population, together with the fact that low back pain is the number one disability worldwide, this decision is contrary to future community needs and industry demands.
Really?
The role chiros play in terms of public health, serving the elderly, alleviating back pain, reducing disability is close to zero. The fact that it is not nothing at all is due to the fact that, arguably, it is a detrimental role. As we have discussed ad nauseam on this blog:
  • the main contribution of chiros to public health is that many of them advise AGAINST immunizations;
  • a significant contribution by chiropractors to the health of the elderly is that they have put many of them in wheelchairs.
The ACA state that they believe an institution funded by government must be accountable to its stakeholders both within and without.
Exactly!
I suspect and hope that this is precisely the reason why they closed the course.
Well dome RMIT!
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