evidence
This review evaluated the magnitude of the placebo response of sham acupuncture in trials of acupuncture for nonspecific LBP, and assessed whether different types of sham acupuncture are associated with different responses. Four databases including PubMed, EMBASE, MEDLINE, and the Cochrane Library were searched through April 15, 2023, and randomized controlled trials (RCTs) were included if they randomized patients with LBP to receive acupuncture or sham acupuncture intervention. The main outcomes included the placebo response in pain intensity, back-specific function and quality of life. Placebo response was defined as the change in these outcome measures from baseline to the end of treatment. Random-effects models were used to synthesize the results, standardized mean differences (SMDs, Hedges’g) were applied to estimate the effect size.
A total of 18 RCTs with 3,321 patients were included. Sham acupuncture showed a noteworthy pooled placebo response in pain intensity in patients with LBP [SMD −1.43, 95% confidence interval (CI) −1.95 to −0.91, I2=89%]. A significant placebo response was also shown in back-specific functional status (SMD −0.49, 95% CI −0.70 to −0.29, I2=73%), but not in quality of life (SMD 0.34, 95% CI −0.20 to 0.88, I2=84%). Trials in which the sham acupuncture penetrated the skin or performed with regular needles had a significantly higher placebo response in pain intensity reduction, but other factors such as the location of sham acupuncture did not have a significant impact on the placebo response.
The authors concluded that sham acupuncture is associated with a large placebo response in pain intensity among patients with LBP. Researchers should also be aware that the types of sham acupuncture applied may potentially impact the evaluation of the efficacy of acupuncture. Nonetheless, considering the nature of placebo response, the effect of other contextual factors cannot be ruled out in this study.
As the authors stated in their conclusion: the effect of other contextual factors cannot be ruled out. I would go much further and say that the outcomes noted here are mostly due to effects other than placebo. Obvious candidates are:
- regression towards the mean;
- natural history of the condition;
- success of patient blinding;
- social desirability.
To define the placebo effect in acupuncture trials as the change in the outcome measures from baseline to the end of treatment – as the authors of the review do – is not just naive, it is plainly wrong. I would not be surprised, if different sham acupuncture treatments have different effects. To me this would be an expected, plausible finding. But such differences just cannot be estimated in the way the authors suggest. For that, we would need an RCT in which patients are randomized to be treated in the same setting with a range of different types of sham acupuncture. The results of such a study might be revealing but I doubt that many ethics committees would be happy to grant their approval for it.
In the absence of such data, the best we can do is to design trials such that the verum is tested against a credible placebo which, for patients, is indistinguishable from the verum, while demonstrating that blinding is successful.
Guest post by Ken McLeod
Readers will recall that Barbara O’Neill is an Australian health crank, completely unqualified in anything, who is subject of a Permanent Prohibition Order issued by the New South Wales Health Care Complaints Commission, (HCCC),[1] preventing her from engaging in any health-related activity, including ‘health education,’ in Australia. The NSW Public Health Act 2010 provides that it is an offence for a person to provide ‘health education’ in contravention of a prohibition order, with a fine of $60,500 AUD ($38,151 USD, 36251 Euros) for an individual or imprisonment for 3 years, or both, or $121,000 AUD for a corporation.
For jurisdictional reasons that Order does not apply outside Australia and for several years she been touring the world giving health education lectures. The latest was a lecture tour of Ireland.[2] Despite the thorough debunking of her fruitloop beliefs by the HCCC,[3] she has maintained them and continues to give the ‘health education’ that was so dangerous that it led to the Prohibition Order in Australia.
Her Irish ‘health education’ lectures were live-streamed to people in Australia who paid the 20 Euro fee, and one was recorded by us.[4]
A transcript was made and is available online.[5] Her statements were analysed and some comments are made as follows. Alas, we didn’t have time to take a deep dive of her lecture to find the best references, but the following shows that an amateur with limited time and resources can prove that she does not know what she is talking about and that her advice is dangerous, even life-threatening.
It is up to the health regulators and immigration authorities in each country to act on her activities there, but so far none outside Australia have done so.
So a quick analysis of her ‘lecture’ in Dublin on 27 September 2023 shows that O’Neill has learned nothing from her experience with the HCCC. Some comments:
1. O’Neill and her husband, after the Prohibition Order was issued, changed the name of their facility from ‘Misty Mountain Health Retreat’ to ‘Misty Mountain Lifestyle Retreat’ to avoid the jurisdiction of the HCCC. However on four occasions in her lecture O’Neill referred to it as a ‘health retreat.’ 00:07:23 , 00:15:48, 01:30:04, 01:40:16.
2. At 00:12:53 O’Neill claims that the Amish don’t get autism. That is false, as explained by AP Factcheck. [6]
3. At 00:12:54 O’Neill claims that the Amish, ‘They don’t vaccinate their Children. Did you know that they don’t vaccinate their Children and yet they don’t get autism Very rare. Maybe 1%. And often that’s because of chemical exposure. There is always a reason. So why are vaccinations causing autism? Well, it’s neurotoxins, the neurotoxins. ‘
False; Amish do vaccinate their children. [7] However, studies have documented cases of autism, diabetes and cancer among the Amish, albeit at lower rates in some cases than the broader population and for reasons that are unrelated to their vaccination status. These reasons include the cultural norms and customs that may be playing a role in the reporting style of caregivers. [8] O’Neill is engaging in cherry-picking on a grand scale here.
4. At 00:13:37 O’Neill claims that ‘there are still two more neurotoxins’ (In vaccines.) Because children are still autistic. There’s formaldehyde, and there is aluminium, both neurotoxins.’
This is scaremongering disinformation. The CDC says ‘Formaldehyde is diluted during the vaccine manufacturing process, but residual quantities of formaldehyde may be found in some current vaccines. The amount of formaldehyde present in some vaccines is so small compared to the concentration that occurs naturally in the body that it does not pose a safety concern.’ As for aluminium, the CDC says ‘Ingredients like aluminum salt help boost the body’s response to the vaccine.’ The CDC says that both are safe. [9]
5. At 00:15:01 O’Neill claims ‘did you know that the milk in the supermarket if you give that to a newborn baby cow, that cow will die?’
I can find no reference supporting that and I suggest that it is pure fantasy.
6. At 00:18:29 O’Neill claims that ‘parents discover that they put their trust in the princes and vaccinated their child. Now their child has epilepsy. Now their child has autism.’
This is misleading panic-mongering that is a misrepresentation of the science. The Royal Australian College of General Practitioners says ‘Seizures and status epilepticus can occur within 14 days following administration of inactivated and live-attenuated vaccines. These vaccine-proximate seizures can undermine parental confidence in vaccine safety and affect further vaccination decisions. Vaccine-proximate status epilepticus (VP-SE) is uncommon but may be the first manifestation of genetic developmental epileptic encephalopathies, including Dravet syndrome.’ So ‘epilepsy’ may be first encountered [10] following vaccination but the root cause is genetic.
7. At 00:20:27 O’Neill says that she would like to suggest that no child would be vaccinated, because the fact is, our body was designed to heal itself.
This is pure crazy antivax propaganda, unsupported by the facts.
8. At 00:22:01 O’Neill claims ‘skin cancer has only been around in about the last 80 years, and you know what they’re finding today? That vitamin D deficiency is a big contributing back factor to skin cancer’.
The first claim is false; the science shows that skin cancers have been around ‘since the beginning of time.’ [11]
As for the second claim, the research published at the US National Library of Medicine shows that O’Neill’s advice is dangerous. ‘It is, therefore, preferable and safer to obtain adequate levels of vitamin D through diet than through sun exposure. In fact, it is currently accepted that dietary and supplemental vitamin D is functionally identical to that produced after UV exposure, being more reliable and quantifiable (the risks of keeping high levels of vitamin D have not been extensively studied) source of this vitamin.’ And ‘Neither natural nor artificial sun exposure should be encouraged as the main source of vitamin D.’ [12]
9. At 00:23:18 O’Neill disputes claims that ‘cholesterol causes heart disease. Well, it’s been going for 40 years now, and it still hasn’t proven that. But you know what? It has proven that people with high cholesterol levels don’t get Alzheimer’s.’
O’Neill’s first claim points to the conflicting research as revealed by the Cochrane Collaboration. [13] As for her second claim, the research does not justify her claim that it is ’proven.’ The evidence is conflicting and as the Alzheimer’s Society of the UK say, ‘More research is needed to better understand this relationship and what it can tell us.’ [14] O’Neill’s conviction is not based on evidence.
10. At 00:34:41 O’Neill said that at Dublin airport ‘about 10 days ago,’ she was approached by a man who asked ‘Are you the Australian doctor? And I smiled.’
O’Neill did not correct him and allowed him to be duped into believing she is a real doctor. Despite having no qualifications in anything O’Neill has used the honorific title ‘Dr’ many times in social media,[15] so it is no surprise that he assumed she was a doctor. I can’t help but be confused by her use of the ‘Dr.’ Throughout her lectures she denigrates real doctors, and then tries to boost her credibility by adopting the title.
11. At 00:35:21 she claimed that with ‘epigenetics, you can actually turn your genes on or off.’…. ‘So Michael effectively turned those genes off with castor oil. Castor is very effective for for cataracts. Put it in your eye, one lady said. Is it safe? Does anyone ever ask that of the doctor? Is that drug safe? Then the people have been putting cholesterol in their eyes for centuries. It’s safe.’
Bollocks! As Consumer Lab says ‘Although eye drops containing castor oil may help improve symptoms of dry eye and blepharitis, there is currently no compelling evidence that applying castor oil to the eye can diminish cataracts.’ [16] And there is no evidence that Michael turned the genes off.
12. At 00:40:08 she refers to a woman who recently had a stroke. She says
‘… because she had a stroke, she was put on the protocol she was on put on statins. Cholesterol lowering medication with clear arteries. How much sense does that make? You don’t have. You don’t have to be a rocket scientist to work this out. Trust in your gut feeling trust in this incredible body that God has given you. Her blood was no longer thick. Her arteries are open now. And so she came to our retreat and I said, Well, I can’t tell you what to do. And I have no authority over your medication. Only you, and go. You and your doctor do. But this is what I would do. I would stop the blood thinning medication immediately because that aspirin causes brain bleeds, eye bleeds and stomach bleeds. Got that? And I would stop the statin drugs because that the side effect of statin drugs is Alzheimer’s dementia, uh, memory loss, muscle wasting. And they’ve just added another one, which is breast cancer, because all our sex hormones are made from cholesterols.’
O’Neill told a woman who had suffered a stroke to stop taking her life-saving medication! These medications are prescribed by highly qualified medical specialists based on the research. As the UK Stroke Association says, ‘Blood-thinning medications reduce your risk of stroke by helping to prevent blood clots from forming. You might be prescribed them after a transient ischaemic attack (TIA) or a stroke caused by a blockage (an ischaemic stroke, or clot).’[17] It is clear that O’Neill, who has no qualifications in anything, does not know what she is talking about.
As for her claim that the side effects of statins is breast cancer, the research shows the opposite. ‘While statins do not affect the incidence of most cancers, they do exert significant benefits on recurrence and survival in many cancer types, including breast cancer.’ [18]
13. At 42:48 O’Neill claims ‘If you are on cholesterol lowering medication and many have been deceived….’ As above, it is O’Neill who is doing the deceiving.
14. At 45:09 O’Neill claims that ‘If you stop your cholesterol lowering medication, there will be a side effect. Your memory will return. Your muscles will get stronger. Any little appearances of Alzheimer’s will start to ease.’
As above, the available research does not show that.
15. At 48:57 O’Neill claims ‘Why did they put fluoride in water? The claim was to harden the teeth. Has it hardened the teeth? Not at all. Has it reduced tooth decay? Not at all.’ And ‘But that fluoride is very hard on the kidneys, very hard on the liver.’
The research here is overwhelming; as the CDC says: ‘The CDC named community water fluoridation one of 10 great public health achievements of the 20th century.
‘Many research studies have proven the safety and benefits of fluoridated water. For 75 years people in the United States have been drinking water with added fluoride and enjoying the benefits of better dental health.
‘Drinking fluoridated water keeps teeth strong and reduces cavities (also called tooth decay) by about 25% in children and adults.’
As for O’Neill’s claim that fluoride is very hard on the kidneys, very hard on the liver,’ the research is inconclusive, and in fact the reverse may be true. Research shows ‘Fluoride exposure may contribute to complex changes in kidney and liver related parameters among U.S. adolescents. As the study is cross-sectional, reverse causality cannot be ruled out; therefore, altered kidney and/or liver function may impact bodily fluoride absorption and metabolic processes.’ So the science does not support O’Neill’s certainty.
16. At 48:57 O’Neill claims that ‘all body symptoms and body diseases and shows how dehydrating has a huge factor.’ O’Neill gives no evidence to support that huge claim.
17. At 01:00:20 O’Neill claims that a woman told her ‘I had the vaccine. Now I’ve got clots. Barbara, I had the vaccine. I can’t. I cannot even remember all the diseases that are arising. Have you noticed? And so many people were blackmailed into that vaccine.’ And ‘Is that (COVID19) a crisis? it’s not a crisis at all. And yet we’re seeing so many problems arising.’
O’Neill is dreadfully wrong here. COVID 19 was a crisis. How else would we describe a pandemic that is known to have killed at least 6,961,014 deaths, as reported to the WHO? [19] And what are the problems that we are seeing arising? Outside her imagination, that is.
18. At 01:00:20 O’Neill claims that ‘one man said, Show me the safety studies. They gave him three pages of blank paper. No safety studies, no safety studies at all.’ (On vaccines). And ‘drugs never cure disease.’ And a few lines later, again, ‘Drugs never cure disease.’
The allegation that ‘They (doctors) gave him three pages of blank paper’, is just so deranged. No doctor would do that because there are thousands of studies of vaccine safety.
O’Neill’s claim that there are no safety studies on vaccines is hopelessly wrong and dishonest. It’s one of the many anti-vax lies circulating on the internet, so beloved by the gullible. As the Australian Dept of Health and Aged Care say, ‘Research and testing is an essential part of developing safe and effective vaccines. In Australia, every vaccine must pass strict safety testing before the Therapeutic Goods Administration (TGA) will register it for use. Before vaccines become available to the public, they are tested on thousands of people who take part in large clinical trials.’ [20] It took me a few seconds on the internet to find an interesting research paper on HPV vaccines, including a section on safety. [21] O’Neill could do that so the inevitable conclusion is that she set out to deceive. As for ‘drugs never cure disease,’ that is so bizarre, so whacky, so deluded, that it almost not worth challenging. But I will anyway; medical professionals have seen drugs work billions of times, and I can testify that I was saved from a life-threatening illness due to cephalexin.
19. At 01:10:49 O’Neill claims ‘some (medications) can be stopped immediately, like your statin drugs and your blood thinners. Yeah, what do you take instead of statin drugs? Well, there’s no need, because cholesterol is not a problem.’
O’Neill’s advice here is life-threatening rubbish. As the Mayo Clinic says ‘Abruptly stopping an anticoagulant can increase your risk of a stroke.’ [22] As for her advice on cholesterol, see above.
20. At 01:15:39 O’Neill claims that there was ‘No diabetes on the planet til sugar was well established.’ And lack of nose-breathing causes ‘Chronic fatigue syndrome. There’s one cause; it’s lack of oxygen at the cellular level.’
Humans have gathered sugar since we first became homo sapiens and diabetes has always been a problem for us and other animals.
As for her claim that lack of nose-breathing causes ‘Chronic fatigue syndrome;’ the Mayo Clinic says ‘The cause of ME/CFS is unknown, although there are many theories. Experts believe it might be triggered by a combination of factors.’ They go on to list many possible causes but lack of nose-breathing is not one of them.[23]
21. At 01:26:08 O’Neill claims that a researcher ‘…. could turn cancer cells on and off by the amount of animal, pro and animal protein that he was giving’ and liver cancer could be prevented by ‘a simple diet and cancer weights were very low low compared to the city again, with that high meat diet….’ There is some truth in this, but it does not justify O’Neill’s other advice to avoid prescribed medications.
22. At 01:49:26 O’Neill claims ‘if someone has a rash and they put cortisone on it, what happens to the rash? It’s gone, but But it comes back in about another week. Is that right? Twice as bad.’ And ‘No drug can heal cancer. The body and the body alone when it’s given the right conditions can cause cancer to be conquered in the body.’ And ‘A fever is nothing to fear.’
O’Neill’s claim that ‘No drug can heal cancer’ is demonstrably wrong. Life expectancy following cancer treatment has improved vastly over the decades, largely due to better detection and prescribed medications. As the US National Cancer Institute (NCI) estimates, ‘due to improved detection and treatment, deaths have dropped 41 percent from 1989 to 2018, according to the ACS.’ [24]
As for O’Neill’s claim that ‘a fever is nothing to fear,’ the Victorian Dept of Health says ‘High fever (about 41.5°C or more) is extremely dangerous and could trigger convulsions.’ [25]
23. At 01:53:47 O’Neill claims that drug therapy is not working.
What does O’Neill mean by that? Does she mean that prescribed medication does not work? If she is repeating her earlier claim that ‘drugs never cure disease?’ I repeat my earlier rebuttal. That is so bizarre, so whacky, so deluded, that it almost not worth challenging. But I will anyway; medical professionals have seen drugs work billions of times, and I can testify that I was saved from a life-threatening illness due to cephalexin.
I’ll finish the analysis here because you have suffered enough.
Readers everywhere now have rock-solid evidence that should be presented to their national health regulators, showing that O’Neill, as the HCCC put it, ‘poses a risk to the health and safety of members of the public’ and therefore ‘should be permanently prohibited from providing any health services, whether in a paid or voluntary capacity.’ And you have rock-solid evidence that should be presented to venue managers who have allowed O’Neill to present life-threatening ‘education’ to the public on their premises, asking them to cancel the booking. It’s not hard; it was done in Ireland by members of the public. That led to cancellation of the booking, and a rush by O’Neill’s supporters to find a new venue.
References
1 https://www.hccc.nsw.gov.au/decisions-orders/public-statements-and-warnings/public-statement-and-statement-of-decision-in-relation-to-in-relation-to-mrs-barbara-o-neill
2 https://www.independent.ie/irish-news/controversial-wellness-coach-barbara-oneill-set-to-host-talk-in-ireland-this-month/a1781099169.html
3 https://www.hccc.nsw.gov.au/ArticleDocuments/216/Statement%20of%20Decision%20-%20Mrs%20Barbara%20ONeill.pdf.aspx
4 The video is available at https://rumble.com/v3lt611-barbara-oneill-positive-life-event-27th-september.html and a backup is available at https://www.dropbox.com/scl/fi/vqe9plhgjijunvl22kvb6/Barbara-ONeill-Positive-Life-Event-27th-September.mp4?rlkey=1kjyi9jdl8kfdp8kcdf1p4xba&dl=0
5 https://www.dropbox.com/scl/fi/csl95hg7gomr318nygotx/TRANSCRIPT-BARBARA-O-NEILL-POSITIVE-LIFE-EVENT-DUBLIN-27-SEPT-2023.pdf?rlkey=z2d5uh59fwagzdfdk30hvpauy&dl=0
6 https://apnews.com/article/fact-check-amish-covid-vaccines-cancer-diabetes-autism-356029928165
7 https://apnews.com/article/fact-check-amish-covid-vaccines-cancer-diabetes-autism-356029928165
8https://www.researchgate.net/publication/268144514_Prevalence_Rates_of_Autism_Spectrum_Disorders_Among_the_Old_Order_Amish
9 https://www.cdc.gov/vaccines/vac-gen/additives.htm
10 https://www1.racgp.org.au/ajgp/2020/october/seizures-following-vaccination-in-children
11 https://www.usatoday.com/story/news/factcheck/2023/08/03/false-claim-skin-cancer-has-only-been-around-for-60-years-fact-check/70515019007/
12 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8709188/
13 https://s4be.cochrane.org/blog/2018/07/02/cholesterol-and-heart-disease-whats-the-evidence/
14 https://www.alzheimers.org.uk/about-dementia/risk-factors-and-prevention/cholesterol-and-dementia
15 https://www.facebook.com/people/Dr-Barbara-ONeill/100093111507726/
16 https://www.consumerlab.com/answers/castor-oil-eye-drops-for-cataracts/castor-oil-cataracts/
17 https://www.stroke.org.uk/resources/blood-thinning-medication-and-stroke
18 https://breast-cancer-research.biomedcentral.com/articles/10.1186/s13058-018-1066-z#author-information
19 https://covid19.who.int/
20 https://www.health.gov.au/are-vaccines-safe
21 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7565290/
22 https://connect.mayoclinic.org/blog/take-charge-healthy-aging/newsfeed-post/know-the-warning-signs-of-blood-thinner-complications/
23 https://www.mayoclinic.org/diseases-conditions/chronic-fatigue-syndrome/symptoms-causes/syc-20360490
24 https://www.healthline.com/health/breast-cancer/survival-facts-statistics#breast-cancer-stages
25 https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/fever#bhc-content
Vaccine hesitancy has become a threat to public health, especially as it is a phenomenon that has also been observed among healthcare professionals.
In this study, an international team of researchers analyzed the relationship between endorsement of so-called alternative medicine (SCAM) and vaccination attitudes and behaviors among healthcare professionals, using a cross-sectional sample of physicians with vaccination responsibilities from four European countries:
- Germany,
- Finland,
- Portugal,
- France.
In total the sample amounted to 2,787 physicians.
The results suggest that, in all the participating countries, SCAM endorsement is associated with lower frequency of vaccine recommendation, lower self-vaccination rates, and being more open to patients delaying vaccination, with these relationships being mediated by distrust in vaccines. A latent profile analysis revealed that a profile characterized by higher-than-average SCAM endorsement and lower-than-average confidence and recommendation of vaccines occurs, to some degree, among 19% of the total sample, although these percentages varied from one country to another:
- 24% in Germany,
- 18% in France,
- 10% in Finland,
- 6% in Portugal.
These results constitute a call to consider health care professionals’ attitudes toward SCAM as a factor that could hinder the implementation of immunization campaigns.
The authors also point out that the link between SCAM endorsement and negative attitudes toward vaccines has been documented in previous research among the general public. A systematic review, which categorized arguments against vaccines retrieved from peer-reviewed articles and debunking texts published by international fact checking agencies, identified a category of arguments largely based on alternative health beliefs related to SCAM. This category was the third most common in the scientific and fact-checking literature. Furthermore, in a British study, anti-vaccination arguments related to SCAM were also among the most endorsed arguments by individuals. These results suggest that SCAM beliefs play an important role in individuals’ justification of their hesitant attitudes toward vaccines for both adults and children. Analyses of samples from the Australian, Finnish, American, and Spanish general populations found that positive attitudes toward SCAM were related to negative attitudes toward vaccines. In a recent large-scale study in 18 European countries, parental consultation with homeopaths was associated with higher vaccine hesitancy than consultation with pediatricians or nurses. Moreover, a systematic review found that SCAM use tended to be positively associated with lower childhood immunization. Similar findings were reported also from the US and Australia.
There are several potential causes for the observed relationship between vaccine hesitancy and SCAM. Since SCAM use occurs more frequently at the poles of the disease spectrum (i.e., in cases of minor or life-threatening illness), SCAM use has been identified as a marker of both misperception of risk and frustration with regular healthcare (e.g., negative prognosis or lack of remission of symptoms). Accordingly, SCAM-related health conceptions could be motivating healthcare practitioners (HCPs) to be more reluctant to recommend and receive vaccinations both for illnesses that are perceived as minor and in cases of severe clinical pictures. There are also reasons related to the potential alignment between SCAM and the ideology or worldview of the HCP, such as their distrust in “Big Pharma” or a general disregard for scientific knowledge. Along the same lines, it has been shown that the main reasons for their preference for SCAM included a greater affinity between SCAM, their do-it-yourself approach to health care, and their sympathy for natural and allegedly harm-free products in contrast to medications marketed by pharmaceutical companies, which were perceived as ineffective, “toxic” and “adulterating.”
Besides these implicit reasons, some SCAM traditions are theoretically incompatible with vaccination and portrayed as a valid, or even superior, alternative to scientific knowledge. A quantitative study found that pro-SCAM and anti-vaccination attitudes both reflect beliefs contrary to basic scientific knowledge, such as “an imbalance between energy currents lies behind many illnesses” and “an illness should be treated with a medicine that has properties similar to those of the illness.” An example of these SCAM-related beliefs that contradict the theoretical basis of vaccinations is “homeopathic immunization” through so-called “nosodes” – orally administered extreme dilutions of infectious agents. Similarly, Rudolf Steiner and Ryke Geerd Hamer, promoters of anthroposophic medicine and ‘German New Medicine’, respectively, have sown doubts about vaccinations based on their conceptions of the etiology and treatment of diseases. Consequently, strong science denial and vaccine hesitancy can be found within these communities, and outbreaks of vaccine-preventable diseases, such as measles and whooping cough, have been reported in educational centers linked to anthroposophy.
PS
This project has received funding from the European Union’s Horizon 2020 research and innovation programme.
Many people believe in and use so-called alternative medicine (SCAM) to address health issues or prevent diseases. Empirical evidence for those treatments is either lacking or controversial due to methodological weaknesses. Thus, practitioners and patients primarily rely on subjective references rather than credible empirical evidence from systematic research.
This study investigated whether cognitive and personality factors explain differences in belief in SCAM and homeopathy. The researchers, German psychologists, investigated the robustness of 21 predictors when examined together to obtain insights into key determinants of such beliefs in a sample of 599 participants (60% female, 18-81 years). A combination of predictors explained 20% of the variance in SCAM belief:
- ontological confusions,
- spiritual epistemology,
- agreeableness,
- death anxiety,
- gender.
Approximately 21% of the variance in belief in homeopathy was explained by the following predictors:
- ontological confusions,
- illusory pattern perception,
- need for cognitive closure,
- need for cognition,
- honesty-humility,
- death anxiety,
- gender,
- age.
The autors concluded that individuals believing in SCAM and homeopathy have cognitive biases and certain individual differences which make them perceive the world differently.
The authors argue that a key characteristic of many SCAM treatments is the spiritual orientation to knowledge and decision-making. For medical decisions, individuals who agree that important knowledge results from religious or spiritual experiences might not rely on evidence as a proof of efficiency but rather explain it in terms of personal experiences. One primary reason for the use of homeopathy is having had good experiences in the past. Own experiences have a high value and persuasive power but are meaningless from a scientific point of view.
Paranormal beliefs and SCAM belief do not only share ontological confusions as a predictor, paranormal beliefs are typically the best predictor of CAM belief. However, comparing those belief forms, it becomes clear that they share many concepts and approaches to explain reality in an unscientific way. Therefore, both belief forms, paranormal beliefs and SCAM beliefs, could also be seen as a result of a world view in which scientific evidence is valued less and, instead, emotional and spiritual explanations are consulted.
I think that anyone who has followed the discussions on this blog must agree wholeheartedly.
Since 1997, several meta-analyses (MAs) of placebo-controlled randomised efficacy trials of homoeopathy for any indication (PRETHAIs) have been published with different methods, results and conclusions. To date, a formal assessment of these MAs has not been performed. The main objective of this systematic review of MAs of PRETHAIs was to evaluate the efficacy of homoeopathic treatment.
The inclusion criteria were as follows: MAs of PRETHAIs in humans; all ages, countries, settings, publication languages; and MAs published from 1 Jan. 1990 to 30 Apr. 2023. The exclusion criteria were as follows: systematic reviews without MAs; MAs restricted to age or gender groups, specific indications, or specific homoeopathic treatments; and MAs that did not assess efficacy. We searched 8 electronic databases up to 14 Dec. 2020, with an update search in 6 databases up to 30 April 2023.
The primary outcome was the effect estimate for all included trials in each MA and after restricting the sample to trials with high methodological quality, according to predefined criteria. The risk of bias for each MA was assessed by the ROBIS (Risk Of Bias In Systematic reviews) tool. The quality of evidence was assessed by the GRADE framework. Statistical analyses were performed to determine the proportion of MAs showing a significant positive effect of homoeopathy vs. no significant difference.
Six MAs were included, covering individualised homoeopathy (I-HOM, n = 2), nonindividualised homoeopathy (NI-HOM, n = 1) and all homoeopathy types (ALL-HOM = I-HOM + NI-HOM, n = 3). The MAs comprised between 16 and 110 trials, and the included trials were published from 1943–2014. The median trial sample size ranged from 45 to 97 patients. The risk of bias (low/unclear/high) was rated as low for three MAs and high for three MAs.
Effect estimates for all trials in each MA showed a significant positive effect of homoeopathy compared to placebo (5 of 5 MAs, no data in 1 MA). Sensitivity analyses with sample restriction to high-quality trials were available from 4 MAs; the effect remained significant in 3 of the MAs (2 MAs assessed ALL-HOM, 1 MA assessed I-HOM) and was no longer significant in 1 MA (which assessed NI-HOM).
The authors concluded that the quality of evidence for positive effects of homoeopathy beyond placebo (high/moderate/low/very low) was high for I-HOM and moderate for ALL-HOM and NI-HOM. There was no support for the alternative hypothesis of no outcome difference between homoeopathy and placebo. The available MAs of PRETHAIs reveal significant positive effects of homoeopathy beyond placebo. This is in accordance with laboratory experiments showing partially replicable effects of homoeopathically potentised preparations in physico-chemical, in vitro, plant-based and animal-based test systems.
Reading this SR, I got the impression that it was designed to generate a positive result. The 6 included MAs are marginally positive (mainly due to publication bias and other artefacts) and thus very well known to fans of homeopathy. The authors of this paper must therefore have expected that combining them in a review would generate an overall positive finding.
The first question I asked myself while studying this paper was: who would want to do an SR of MAs (a most peculiar exercise); why not at least an SR of SRs which is already an unusual project but would make at least some sense. (An SR is a review that includes all studies that match a set of pre-definied criteria. A MA is a special form of SR where statistical pooling was possible.) The answer is, I fear, simple: this would not have generated a positive result: here are now dozens of SRs of homeopathy and most are not positive (as discussed regularly on this blog)
The authors themselves provide no real justification for their bizarre approach. All they tell us about it is this:
One approach is to focus on a specifc indication (e.g., depression [4], acute respiratory tract infections in children [5]) while often including open-label trials and observational studies. In this approach, data synthesis is grouped by design, thus yielding information about homoeopathy in patient care. Te opposite approach is to include all indications while restricting study designs to placebo-controlled trials and aggregating results in an MAs, thus yielding information about the specifc efects of homoeopathy beyond those of placebo. A major reason for using this approach has been the claim that ‘homoeopathy violates natural laws and thus any efect must be a placebo efect’ [6].
Since 1997, at least six MAs of placebo-controlled homoeopathy trials for any condition have been published [6–11]. These MAs have difered in their methods for trial inclusion, data synthesis and assessment of risk of bias; furthermore, their results and conclusions have been inconsistent. During this period, there have been substantial advancements in methodology and quality standards for MAs and other SRs [12–15], including SRs of SRs (also called overviews or umbrella reviews) [16–18]. To our knowledge, a formal SR of MAs of randomised placebo-controlled homoeopathy trials for any condition has not been performed. Herein, we report such an SR.
What the authors actually did is this: they knew of the 6 MA; they also knew that they arrived at cautiously positive conclusions; finally they also were aware of the fact that, obviously, the 6 MA included more or less almost the same primary studies. So, by pooling the MAs, they generated a positive result which was no longer marginally positive but strongly. Anyone looking through this strategy (which in effect multiplies the results of many primary studies by factor 6) must realize that this methods creates a false-positive impression.
My suspicion that this paper is a deliberate attempt at misleading us about the ‘efficacy’ (actually it should be effectiveness) is strengthened by further facts:
- One of the two MAs by Mathie et al excluded primary studies that reported positive findings (i.e. mine and the one by Walach et al)
- Funding: Open Access funding enabled and organized by Projekt DEAL. Funding specifcally for this SR was provided by Christophorus-Stiftung (No. 393 CST), Stiftung Marion Meyenburg (Date 24.09.2020), Dr. Hauschka Stiftung (Date 16.11.2020) and Gesellschaft für Pluralität im Gesundheitswesen (Dates 11.06.2021, 22.06.2021). General funding for IFAEMM was provided by the Software-AG Stiftung (SE-P 13544). The funders had no infuence on the writing of the protocol or on the planning, conduct and publication of this SR.
- Competing interests: In the past 3 years, HJH has received research grants from two manufacturers of anthroposophic medicinal products (Wala Heilmittel GmbH, Bad Boll/ Eckwälden, Germany; Weleda AG, Arlesheim Switzerland). Anthroposophic medicine is not based on the homoeopathic simile principle or on drug provings, but some anthroposophic medicinal products are potentized. The two manufacturers had no involvement with the present SR. Anthroposophic medicinal products were not part of the intervention in any of the trials evaluated in the MAs of this SR (Suppl. Table 15). DSR has received a development grant from Heel GmbH (manufacturer of homoeopathic products) for online training in case report writing. AG, KvA and HK declare that they have no competing interests.
- Author details: 1) Institute for Applied Epistemology and Medical Methodology at Witten/ Herdecke University (IFAEMM), Freiburg, Germany. 2) Faculty of Health, Department of Medicine, Chair of Medical Theory, Integrative and Anthroposophic Medicine, Witten/Herdecke University, Witten, Germany. 3) Maryland University of Integrative Health (MUIH), Laurel, MD, USA. 4) Homeopathic Pharmacopoeia Convention of the United States (HPCUS), Southeastern, PA, USA.
Personally, I do not find it surprising that these authors bend over backwards to publish something positive about homeopathy (such things happen in homeopathy all the time). However, I do find it astonishing that an allegedly decent journal passes such pseudoscience for publication as though it is serious science.
Guest post by Richard Rawlins,
Consultant Orthopaedic Surgeon and member of the Magic Circle.
Aka Professor Riccardo, Consultant Charlatan and Specialist in the Care of the Gullible.
Many readers of this blog will be delighted that in September 2024, the University of Exeter will offer a degree in ‘magic’. An MA in ‘Magic and Occult Science’ has been created following a “recent surge in interest in magic”, the course leader said. Exeter University officials advise the course will offer “an opportunity to study the history and impact of witchcraft and magic around the world on society and science”. And they should know.
Exeter was the first (and so far, only) university to establish a department to conduct coherent research into ‘complementary and alternative medicine’. No plausible evidence was found to support any of the many ‘therapies’ investigated in Exeter, but publication of this research was particularly disagreeable to the Fellow of the Royal Society who was patron of the Prince’s Foundation for Integrated Health. The department was closed, with the dismissal of the eminent professor who wrote to the Times “the majority of alternative therapies appear to be clinically ineffective, and many are downright dangerous.”
Today, the university says its planned course is “one of the only postgraduate courses of its kind in the UK to combine the study of the history of magic with such a wide range of subjects taught by academics with expertise in history, literature, philosophy, archaeology, sociology, psychology, drama, and religion.” It is expected “to show the role of magic on the West and the East.”
The course leader Prof Emily Selove, claimed “A recent surge in interest in magic and the occult inside and outside of academia lies at the heart of the most urgent questions of our society.” Here the professor is using hyperbole which is also common amongst the camists who promote so-called ‘complementary and alternative medicine’.
‘Modern magic’ is found in two dimensions: the skills of deceit, deception and delusion created by such as Paul Daniels, Tommy Cooper, Luke Jermay, and Derren Brown, and used for entertainment; and the esoteric philosophical domain which this course will consider – and which is often spelt ‘Magick’. This spelling was introduced by Aleister Crowley to afford some differentiation, though context usually makes it clear whether a double lift and Elmsley count is being discussed, or metaphysics. Crowley was largely associated with other founders of ‘religions’ such as Wicca’s Gerald Gardner and Scientology’s L. Ron Hubbard. A six-letter word has special significance for many occultists.
The study of religions and the sociology of the occult are worthy objectives of an academic department, but Emily Selove (an aptronym surely), not only uses hyperbole, but personal predilection to establish that “decolonisation, the exploration of alternative epistemologies, feminism and anti-racism are at the core of this programme.” She ventures even further off piste when declaring “this MA will allow people to re-examine the assumption that the West is the place of rationalism and science, while the rest of the world is a place of magic and superstition.”
Assumptions indeed, which Prof Selove has conjured for herself. Speculative opinion with no evidence whatsoever, and seemingly oblivious of the fact that all reputable Western scholars throughout history have been aware of science’s development in the ‘rest of the world’, albeit slowly. Astronomy, gunpowder, papermaking, the use of zero as a number, Musa al-Khwarizmi’s Al-jabr, every branch of science imaginable. There is no ‘Western science’, just ‘science’. (Latin: scientia, knowledge, understanding.)
Interestingly, the course on Magic will be offered in the Institute of Arab and Islamic Studies. The university said the course “could prepare students for careers in teaching, counselling, mentoring, heritage and museum work, work in libraries, tourism, arts organisations or the publishing industry, among other areas of work.” Given students will be able to choose modules on ‘Dragons in western literature and art’, ‘the legend of King Arthur’, and the ‘depiction of women in the Middle Ages’, they should have satisfying careers ahead.
Good luck, and may the Wu be with them all (Chinese, wu: nothingness.)
The ‘University College of Osteopathy’ announced a proposal to merge with the AECC University College (AECC UC). Both institutions will seek to bring together the two specialist providers to offer a “unique inter-disciplinary environment for education, clinical practice and research in osteopathy, chiropractic, and across a wide range of allied health and related disciplines”.
The partnership is allegedly set to unlock significant opportunities for growth and development by bringing together the two specialist institutions’ expertise and resources across two locations – in Dorset and central London.
As a joint statement, Chair of the Board of Governors at AECC UC, Jeni Bremner and Chair of the Board of Governors at UCO, Professor Jo Price commented:
“We believe the proposed merger would further the institutional ambitions for both of our organisations and the related professional groups, by allowing us to expand our educational offering, grow student numbers and provide a unique inter-disciplinary training environment, providing students the opportunity to be immersed in multi-professional practice and research, with exposure to and participation in multi-disciplinary teams.
“There is also an exciting and compelling opportunity to expedite the development of a nationally unique, and internationally-leading MSK Centre of Excellence for Education and Research, developed and delivered across our two sites.”
The announcement is accompanied by further uncritical and promotional language:
Established as the first chiropractic training provider in Europe, AECC UC has been at the forefront of evidence-based chiropractic education, practice and research for more than 50 years. The institution is on an exciting journey of growth and development, having expanded and diversified its academic portfolio and activity beyond its traditional core offering of chiropractic across a broad range of allied health courses and apprenticeships, working closely with NHS, local authority and other system partners across Dorset and the south-west. The proposed merger with UCO would allow AECC UC to enhance the breadth and depth of its offer to support the expansion and development of the health and care workforce across a wider range of partners.
Now in its 106th year, UCO is one of the UK’s leading providers of osteopathic education and research with an established reputation for creating highly-skilled, evidence-informed graduates. UCO research is recognised as world-leading, delivering value to the osteopathic and wider health care community.
Sharon Potter, Acting Vice-Chancellor of UCO, said:
“As an institution that has long been at the forefront of osteopathic education and research, we are committed to ensuring further growth and development of the osteopathic profession.
“UCO has been proactively considering options to future-proof the institution. Following a review of strategic options, UCO is delighted by the proposed merger, working closely with AECC UC to ensure that UCO and osteopathy thrives as part of the inter-professional health sciences landscape, both academically and clinically. There is significant congruence between UCO and AECC UC in our strong aligned values, commitment to and delivery of excellent osteopathic education, clinical care and research, and opinion leadership.
“AECC UC has a strong track record of respecting the differences in professions, evidenced by the autonomy across the 10 different professional groups supported by the institution. The merger will not only mean we are protecting UCO through preserving its osteopathic heritage and creating a sustainable future, but that our staff and students can collaborate with other professional groups such as physiotherapy, chiropractic, sport rehabilitation, podiatry and diagnostic imaging, in a multidisciplinary MSK and rehabilitation environment unlike anywhere else in the UK.”
Professor Lesley Haig, Vice-Chancellor of AECC UC, commented:
“Preserving the heritage of UCO and safeguarding its future status as the flagship osteopathy training provider in the UK will be critical, just as it has been to protect the chiropractic heritage of the AECC brand. UCO is seen as synonymous with, and reflective of, the success of the osteopathy profession and we fully recognise and respect the important role that UCO plays not only as a sector-leading provider of osteopathic education, research and clinical care, but as the UK’s flagship osteopathy educational provider.
“Overall it is clear that UCO and AECC UC already have a common values base, similar understanding of approaches to academic and clinical delivery, and positive relationships upon which a future organisational structure and opportunities can be developed. It’s an exciting time for both institutions as we move forward in partnership to create something unique and become recognised nationally and internationally as a centre of excellence.”
The proposed merger would continue the already founded positive relations between the institutions, where regular visits, sharing of good practice, and collaborative research work are already taking place. Heads of terms for the potential merger have now been agreed and both institutions are entering into the next phase of discussions, which will include wide consultation with staff, students and other stakeholders to produce a comprehensive implementation plan.
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In case this bonanza of platitudes and half-truths has not yet overwhelmed you, I might be so bold as to ask 10 critical questions:
- What is an “evidence-based chiropractic education”? Does it include the messages that 1) subluxation is nonsense, 2) chiropractic manipulations can cause harm, 3) there is little evidence that they do more good than harm?
- How an an “expansion and development of the health and care workforce” be anticipated on the basis of the 3 points I just made?
- What does the term “evidence-informed graduates” mean? Does it mean they are informed that you teach them nonsense but instruct them to practice this nonsense anyway?
- Do “options to future-proof the institution” include the continuation of misleading the public about the value of chiropractic/osteopathy?
- Does the”delivery of excellent osteopathic education, clinical care and research, and opinion leadership” account for the fact that the evidence for osteopathy is weak at best and for most conditions negative?
- By “preserving its osteopathic heritage”, do you intend to preserve also the reputation of your founding father, Andrew Taylor Still, who did many dubious things. In 1874, for instance, he was excommunicated by the Methodist Church because of his “laying on of hands”; specifically, he was accused of trying to emulate Jesus Christ, labelled an agent of the Devil, and condemned as practicing voodoo. Or do you prefer to white-wash the osteopathic heritage?
- You also want “to protect the chiropractic heritage”; does that mean you aim at white-washing the juicy biography of the charlatan who created chiropractic, DD Palmer, as well?
- “UCO and AECC UC already have a common values base” – what are they? As far as I can see, they mainly consist in hiding the truth about the uselessness of your activities from the public.
- How do you want to “recognised nationally and internationally as a centre of excellence”? Might it be a good idea to begin by critically assessing your interventions and ask whether they do more good than harm?
- Crucially, what is really behing the merger that you are trying to sell us with such concentrated BS?
Yes, that would be nice!
You want to lose weight?
Just take a few pills an Bob’s your uncle!
There is, of course no shortage of such pills – but do they work?
This study aimed at quantifying and ranking the effects of different nutraceuticals on weight loss. PubMed, Scopus, and Web of Science to November 2022 were searched and all randomized trials (RCTs) evaluating the comparative effects of two or more nutraceuticals, or comparing a nutraceutical against a placebo for weight loss in adults with overweight or obesity were included. A random-effects network meta-analysis was conducted with a Frequentist framework to estimate mean difference [MD] and 95% confidence interval [CI] of the effect of nutraceuticals on weight loss.
One hundred and eleven RCTs with 6171 participants that investigated the effects of 18 nutraceuticals on body weight were eligible. In the main analysis incorporating all trials, there was high certainty of evidence for supplementation of spirulina (MD: -1.77 kg, 95% CI: -2.77, -0.78) and moderate certainty of evidence that supplementation of curcumin (MD: -0.82 kg, 95% CI: -1.33, -0.30), psyllium (MD: -3.70 kg, 95% CI: -5.18, -2.22), chitosan (MD: -1.70 kg, 95% CI: -2.62, -0.78), and Nigella sativa (MD: -2.09 kg, 95%CI: -2.92, -1.26) could result in a small improvement in body weight. Supplementations with green tea (MD: -1.25 kg, 95%CI: -1.68, -0.82) and glucomannan (MD: -1.36 kg, 95%CI: -2.17, -0.54) demonstrated small weight loss, also the certainty of evidence was rated low.
The authors concluded that supplementations with nutraceuticals can result in a small weight loss in adults with overweight or obesity.
The authors tell us little about the methodological quality of the studies. All they did report was this:
Among trials with a low risk of bias, only chitosan (mean difference: −1.72 kg, 95%CI: −3.37, −0.06) and green tea (mean difference: −1.61 kg, 95%CI: −3.14, −0.09) were effective for weight loss compared with placebo. There was no significant weight loss following increased consumption of other nutraceuticals in trials with a low risk of bias.
In view of the lack of reliability of the primary studies, I feel that the conclusions drawn by the authors are not justified. Even though far from recent, I much prefer our own conclusion of a similar data set:
The evidence for most dietary supplements as aids in reducing body weight is not convincing. None of the reviewed dietary supplements can be recommended for over-the-counter use.
In other words, if you want to lose weight, don’t rely on dietary supplements!
The history of so-called alternative medicine (SCAM) is rich with ‘discoveries’ that are widely believed to be true events but that, in fact, never happened. Here are 10 examples:
- DD Palmer is believed to have cured the deafness of a janitor by manipulating his neck. This, many claim, was the birth of chiropractic. BUT IT NEVER HAPPENED! How can I be so sure? Because the nerve responsible for hearing does not run through the neck.
- Samuel Hahnemann swallowed some Cinchona officinalis, a quinine-containing treatment for malaria, and experienced the symptoms of malaria. This was the discovery of the ‘like cures like’ assumption that forms the basis of homeopathy. BUT IT NEVER HAPPENED! How can I be so sure? Because Hahnemann merely had an intolerance to quinine, and like does certainly not cure like.
- Edward Bach, for the discovery of each of his flower remedies, suffered from the state of mind for which a particular remedy was required; according to his companion, Nora Weeks, he suffered it “to such an intensified degree that those with him marvelled that it was possible for a human being to suffer so and retain his sanity.” This is how Bach discovered the ‘Bach Flower Remedies‘. BUT IT NEVER HAPPENED! How can I be so sure? His experience was not caused by by the remedy, which contain no active ingredients, but by his imagination.
- William Fitzgerald found that pressure on specific areas on the soles of a patient’s feet would positively affect a specific organ of that patient. This was the birth of reflexology. BUT IT NEVER HAPPENED! How can I be so sure? Because there are no nerve connections from the sole of our feet to our inner organs.
- Max Gerson observed that his special diet with added liver juice, vitamin B3, coffee enemas, etc. cures cancer. This is how Gerson found the Gerson therapy. BUT IT NEVER HAPPENED! How can I be so sure? Because he never could demonstrate this effect and others never were able to replicate his alleged finfings.
- George Goodheart was convinced that the strength of a muscle group provides information about the health of inner organs. This formed the basis for applied kinesiology. BUT IT NEVER HAPPENED! How can I be so sure? Because applied kinesiology has been disclosed as a simple party trick.
- Paul Nogier thought that the function of inner organs can be influenced by stimulating points on the outer ear. This was the discovery that became auricular therapy. BUT IT NEVER HAPPENED! How can I be so sure? Because Nogier’s assumptions fly in the face of anatomy and physiology.
- Antom Mesmer discovered that by moving a magnet over a patient, he would move her vital fluid and affect her health. This discovery became the basis for Mesmer’s ‘animal magnetism‘. BUT IT NEVER HAPPENED! How can I be so sure? Because there is no vital fluid and neither real nor animal magnetism have specific therapeutic effects.
- Reinhold Voll observed that the electric resistance over acupuncture points provides diagnostic information about the function of the corresponding organs. He thus invented his ‘electroacupuncture according to Voll‘ (EAV). BUT IT NEVER HAPPENED! How can I be so sure? Because EAV and the various methods derived from it are not valid and fail to produce reproducible results.
- Ignatz von Peczely discovered that discolorations on the iris provide valuable information about the health of inner organs. This was the birth of iridology. BUT IT NEVER HAPPENED! How can I be so sure? Because discolorations develop spontaneously and Peczely’s assumptions about nerval connections between the iris and the organs of the body are pure fantasy.
I hope that you can think of further SCAM discoveries that never happened. If so, please elaborate in the comments section below; you will see, it is good fun!
PS
By sating ‘IT NEVER HAPPENED’, I mean to say that it never happened as reported/imagined by the inventor of the respective SCAM and that the explanations perpetuated by the enthusiasts of the SCAM regarding cause and effect are based on misunderstandings.
We have repeatedly discussed the fact that so-called alternative medicine (SCAM) is related to magical health and pseudoscientific assumptions. Now new evidence has emerged on this subject. This study (Alternative Medicine, COVID-19 Conspiracies, and Other Health-Related Unfounded Beliefs: The Role of Scientific Literacy, Analytical Thinking, and Importance of Epistemic Rationality | Studia Psychologica (savba.sk)) examined how scientific literacy (scientific reasoning, scientific knowledge, and trust in science), analytical thinking and the importance of epistemic rationality relate to the belief in the efficacy of so-called alternative medicine (SCAM) and other health-related unfounded beliefs (COVID-19 conspiracies, pseudoscientific and magical beliefs, and cancer myths).
A representative sample of 1038 Slovaks (age = 42.08, SD = 13.99) participated in the study. While SCAM belief correlated with COVID-19 conspiracy theories, pseudoscientific beliefs, magical health-related beliefs, and cancer myths, it appeared that belief in SCAM was primarily driven by lower trust in science, lower analytical thinking, and, interestingly, a higher need to be epistemically rational. Other components of scientific literacy did not significantly predict SCAM belief but they did predict other health-related unfounded beliefs, which may suggest that a more fine-tuned approach to studying SCAM beliefs is needed.
The authors commented that SCAM is moderately related to magical health beliefs and pseudoscientific beliefs and only weakly related to COVID-19 conspiracy theories. However, the weak association between SCAM and conspiracy beliefs is in line with previous findings (Mijatović et al., 2022; Vujić et al., 2022). Similar to previous studies (Fasce & Picó, 2019; Lobato et al., 2014), we found that different unfounded beliefs tend to correlate with each other. However, it appears that COVID-19 conspiracy beliefs are distinct from magical and pseudoscientific beliefs (as evidenced by weaker correlations), whereas SCAM beliefs overlap more with magical health and pseudoscientific beliefs. SCAM beliefs correlated positively with all types of unfounded beliefs, from low to moderate levels (r values between -.16 and -.50) but did not have the same predictors. Contrary to previous findings about the stronger predictive power of scientific reasoning compared to analytical thinking in unfounded beliefs (Čavojová et al., 2020; 2022), our results point to more balanced strengths, except for belief in SCAM, which was not predicted by scientific reasoning. One of the possible explanations lies in the very low reliability of the Scientific Reasoning Scale in this study. On the other hand, other studies using the same scale showed only slightly higher reliability (e.g., Bašnáková et al., 2021, Čavojová et al., 2020; 2023; Čavojová & Ersoy, 2020) and it predicted both COVID-19 conspiracy theories, as well as pseudoscientific/magical component, similarly to the results of previous studies.
