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

fraud

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This case report aims to describe the effects of craniosacral therapy and acupuncture in a patient with chronic migraine.
A 33-year-old man with chronic migraine was treated with 20 sessions of craniosacral therapy and acupuncture for 8 weeks. The number of migraine and headache days were monitored every month. The pain intensity of headache was measured on the visual analog scale (VAS). Korean Headache Impact Test-6 (HIT-6) and Migraine Specific Quality of Life (MSQoL) were also used.
The number of headache days per month reduced from 28 to 7 after 8 weeks of treatment and to 3 after 3 months of treatment. The pain intensity of headache based on VAS reduced from 7.5 to 3 after 8 weeks and further to < 1 after 3 months of treatment. Furthermore, the patient’s HIT-6 and MSQoL scores improved during the treatment period, which was maintained or further improved at the 3 month follow-up. No side effects were observed during or after the treatment.
The authors concluded that this case indicates that craniosacral therapy and acupuncture could be effective treatments for chronic
migraine. Further studies are required to validate the efficacy of craniosacral therapy for chronic migraine.

So, was the treatment period 8 weeks long or was it 3 months?

No, I am not discussing this article merely for making a fairly petty point. The reason I mention it is diffteren. I think it is time to discuss the relevance of case reports.

What is the purpose of a case report in medicine/healthcare. Here is the abstract of an article entitled “The Importance of Writing and Publishing Case Reports During Medical Training“:

Case reports are valuable resources of unusual information that may lead to new research and advances in clinical practice. Many journals and medical databases recognize the time-honored importance of case reports as a valuable source of new ideas and information in clinical medicine. There are published editorials available on the continued importance of open-access case reports in our modern information-flowing world. Writing case reports is an academic duty with an artistic element.

An article in the BMJ is, I think, more informative:

It is common practice in medicine that when we come across an interesting case with an unusual presentation or a surprise twist, we must tell the rest of the medical world. This is how we continue our lifelong learning and aid faster diagnosis and treatment for patients.

It usually falls to the junior to write up the case, so here are a few simple tips to get you started.

First steps

Begin by sitting down with your medical team to discuss the interesting aspects of the case and the learning points to highlight. Ideally, a registrar or middle grade will mentor you and give you guidance. Another junior doctor or medical student may also be keen to be involved. Allocate jobs to split the workload, set a deadline and work timeframe, and discuss the order in which the authors will be listed. All listed authors should contribute substantially, with the person doing most of the work put first and the guarantor (usually the most senior team member) at the end.

Getting consent

Gain permission and written consent to write up the case from the patient or parents, if your patient is a child, and keep a copy because you will need it later for submission to journals.

Information gathering

Gather all the information from the medical notes and the hospital’s electronic systems, including copies of blood results and imaging, as medical notes often disappear when the patient is discharged and are notoriously difficult to find again. Remember to anonymise the data according to your local hospital policy.

Writing up

Write up the case emphasising the interesting points of the presentation, investigations leading to diagnosis, and management of the disease/pathology. Get input on the case from all members of the team, highlighting their involvement. Also include the prognosis of the patient, if known, as the reader will want to know the outcome.

Coming up with a title

Discuss a title with your supervisor and other members of the team, as this provides the focus for your article. The title should be concise and interesting but should also enable people to find it in medical literature search engines. Also think about how you will present your case study—for example, a poster presentation or scientific paper—and consider potential journals or conferences, as you may need to write in a particular style or format.

Background research

Research the disease/pathology that is the focus of your article and write a background paragraph or two, highlighting the relevance of your case report in relation to this. If you are struggling, seek the opinion of a specialist who may know of relevant articles or texts. Another good resource is your hospital library, where staff are often more than happy to help with literature searches.

How your case is different

Move on to explore how the case presented differently to the admitting team. Alternatively, if your report is focused on management, explore the difficulties the team came across and alternative options for treatment.

Conclusion

Finish by explaining why your case report adds to the medical literature and highlight any learning points.

Writing an abstract

The abstract should be no longer than 100-200 words and should highlight all your key points concisely. This can be harder than writing the full article and needs special care as it will be used to judge whether your case is accepted for presentation or publication.

What next

Discuss with your supervisor or team about options for presenting or publishing your case report. At the very least, you should present your article locally within a departmental or team meeting or at a hospital grand round. Well done!

Both papers agree that case reports can be important. They may provide valuable resources of unusual information that may lead to new research and advances in clinical practice and should offer an interesting case with an unusual presentation or a surprise twist.

I agree!

But perhaps it is more constructive to consider what a case report cannot do.

It cannot provide evidence about the effectiveness of a therapy. To publish something like:

  • I had a patient with the common condition xy;
  • I treated her with therapy yz;
  • this was followed by patient feeling better;

is totally bonkers – even more so if the outcome was subjective and the therapy consisted of more than one intervention, as in the article above. We have no means of telling whether it was treatment A, or treatment B, or a placebo effect, or the regression towards the mean, or the natural history of the condition that caused the outcome. The authors might just as well just have reported:

WE RECENTLY TREATED A PATIENT WHO GOT BETTER

full stop.

Sadly – and this is the reason why I spend some time on this subject – this sort of thing happens very often in the realm of SCAM.

Case reports are particularly valuable if they enable and stimulate others to do more research on a defined and under-researched issue (e.g. an adverse effect of a therapy). Case reports like the one above do not do this. They are a waste of space and tend to be abused as some sort of indication that the treatments in question might be valuable.

 

The current BMJ has an article entitled UK could have averted 240 000 deaths in 2010s if it matched other European nations. Here is its staring passage:

The UK has fallen far behind its international peers on a range of health outcomes and major policy reforms are required to reverse this, a report1 has concluded.

Analysts from the Institute for Public Policy Research (IPPR) calculated that there would have been 240 000 fewer deaths in the UK between 2010 and 2020 if the UK matched average avoidable mortality in comparable European nations.

The report says the UK’s poor outcomes are partly down to people’s inability to access healthcare in a timely manner, a problem that has intensified since the pandemic.

To tackle this, the progressive think tank has put forward a 10 point plan to shift the NHS from a sickness service to a prevention service. It says primary care should be placed at the heart of a “prevention first” NHS with a nationwide rollout of neighbourhood health hubs to deliver integrated health and care services in every local area…

INTEGRATED HEALTH?

Isn’t that the nonsense Charles III, Michael Dixon, THE COLLEGE OF MEDICINE AND INTEGRATED HEALTH and many others promote? The integrated health we discussed so often before, e.g.:

The UK ‘Integrated Medicine Alliance’ offers information sheets on all of the following treatments: AcupunctureAlexander TechniqueAromatherapyHerbal MedicineHomeopathyHypnotherapyMassage, ,NaturopathyReflexologyReikiTai ChiYoga Therapy. The one on homeopathy, for example, tells us that “homeopathy … can be used for almost any condition either alone or in a complementary manner.” Is the BMJ thus promoting homeopathy and similar dubious treatments?

The answer is, of course, NO!

The BMJ supports INTEGRATED HEALTH as defined not by quacks but by real experts: “Integrated care, also known as integrated health, coordinated care, comprehensive care, seamless care, or transmural care, is a worldwide trend in health care reforms and new organizational arrangements focusing on more coordinated and integrated forms of care provision. Integrated care may be seen as a response to the fragmented delivery of health and social services being an acknowledged problem in many health systems.”

I have often wondered why quacks use established terms, give it a different meaning and use it for confusing the public. I suppose the answer is embarrassingly simple: they thrive on confusion, want to hide the fact that they have no convincing arguments of their own, and like to use the established terminology of others in order to push their agenda and maximize their benefits.

The US ‘Public Citizen‘ is an American non-profit, progressive consumer rights advocacy group, and think tank based in Washington, D.C. They recently published an article entitled “FDA Guidance on Homeopathic Drugs: An Ongoing Public Health Failure“. Here are a few excerpts:

In December 2022, the U.S. Food and Drug Administration (FDA) issued new guidance on homeopathic drug products. The guidance states that the agency now “intends to apply a risk-based enforcement approach to the manufacturing, distribution and marketing of homeopathic drug products.”

Under this new risk-based approach, the agency plans to target its enforcement actions against homeopathic drug products marketed without FDA approval that fall within the following limited categories:

  • products with reports of injury that, after evaluation, raise potential safety concerns
  • products containing or purportedly containing ingredients associated with potentially significant safety concerns (for example, infectious agents or controlled substances)
  • products that are not administered orally or topically (for example, injectable drug products and ophthalmic drug products)
  • products intended to be used to prevent or treat serious or life-threatening diseases
  • products for vulnerable populations, such as immunocompromised individuals, infants and the elderly
  • products with significant quality issues (for example, products that are contaminated with foreign materials or objectionable microorganisms)

But this new FDA guidance fails to adequately address the public health threat posed by the agency’s decades-long permissive approach to these illegal drug products.

Under FDA regulations, prescription and over-the-counter (OTC) homeopathic products are considered drugs and are supposed to be subject to the same review and approval requirements as all other prescription and OTC medications. However, under a flawed enforcement policy issued in 1988, the FDA has allowed these drug products to be marketed in the U.S. without agency review or approval. Thus, all products labeled as homeopathic are being marketed without the FDA having evaluated their safety, effectiveness or quality…

… there is no plausible physiologic or medical basis to support the theory underlying homeopathy, nor is there evidence from well-designed, rigorous clinical trials showing that homeopathic drugs are safe and effective.

The FDA should declare unequivocally that all unapproved homeopathic drug products are illegal and direct all manufacturers to immediately remove such products from the market. In the meantime, as we have recommended for many years, consumers should not use homeopathic products. At best, the products are a waste of money, given the lack of any evidence that they are effective. At worst, they could cause serious harm because of the lack of FDA oversight to ensure safety.

_____________________

I fully agree with these sentiments. The harm caused by homeopathy is considerable and multi-facetted. Many previous posts have discudded these problems, e.g.:

Having warned about the dangers of homeopathy for decades, I feel it is high time for regulators across the world to take appropriate action.

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).

Swedish researchers examined the relationship between cognitive ability and prompt COVID-19 vaccination using individual-level data on more than 700,000 individuals in Sweden.

The analyses were based on individual-level data from several administrative registers in Sweden. The study population consisted of all men and women who enlisted for military service in Sweden between 1979 and 1997. During this period, enlistment was mandatory for men the year they turned 18 or 19. Women could not enlist for military service before 1980 but were then allowed to do so on a voluntary basis.

The study population thus covered almost the entire population of Swedish men born between 1962 and 1979, in total 750,381, as well as the sample of women who enlisted during the period of 1980–1997, in total 2703. In addressing the role of confounders, the researchers analyzed the sub-sample of 6750 twin brothers (3375 twin-pairs) in the enlistment records (identified by shared biological mother and year and month of birth).

The results show a strong positive association between cognitive ability and swift vaccination, which remained even after controlling for confounding variables with a twin-design. Consistent with this, the researchers showed that simplifying the vaccination decision through pre-booked vaccination appointments alleviates almost all of the inequality in vaccination behavior.

The authors concluded that the complexity of the vaccination decision may make it difficult for individuals with lower cognitive abilities to understand the benefits of vaccination.

On this blog, we have repeatedly discussed similar or related findings, e.g.:

I know, it would be politically incorrect, unkind, unhelpful, etc. but is anyone not tempted to simplify the issue by assuming that people who are against (COVID) vaccinations are intellectually challenged?

The American Chiropractic Association Council on Chiropractic Pediatrics (CCP) announced a new diplomate education program focused on pediatric care. The program will include 300 hours of education covering topics such as pediatric development from birth to age 16, adjusting techniques, working diagnosis, clinical application, integrated care and more…

Development of the diplomate education program has been in the works for several years, with contributions from many members of the CCP, including council president Jennifer Brocker, DC, DICCP. At the helm of course development for this education program are Mary Beth Minser, DC, CACCP, and Kris Tohtz, DC, LAc, educational coordinators for CCP. They agreed that the goal of the new program is to provide education that furthers knowledge of chiropractic pediatrics in an evidence-based, integrative way. “We wanted to make sure that we had something that aligned with ACA’s core principles,” Dr. Tohtz said. “Chiropractic-forward, yes, but scientifically focused.”

Dr. Brocker added, “There was a need for more evidence-informed education [in pediatrics]. I felt like the Council was well positioned to take this on because we had the opportunity to build it from scratch, making it what students and practicing doctors need.” …

Drs. Minser and Tohtz are excited that the diplomate program will also include a research component. “There is some lacking information when it comes to pediatric chiropractic,” Dr. Minser explained. She recently participated in the COURSE Study, an international study seeking to fill knowledge gaps in research relating to pediatric chiropractic treatment. “It was a very easy project to do, and pretty exciting to be involved,” she said. “But you have to know how to treat pediatric patients in order to be involved in those research projects. We want doctors and students [in this program] to be able to go through a case study, to be able to extract information for their clinical application from that case study or from research, or, if they would like, to write up case studies so we can get more published.”

“We feel we could really push pediatric chiropractic to a whole new level having doctors that have this type of knowledge base,” Dr. Minser said. “We just want to be the best pediatric chiropractors that we can be, and this diplomate [education] program helps [us] do that.”

____________________________________

“There is some lacking information when it comes to pediatric chiropractic.”

Really?

I think the evidence is quite clear: chiropractic has nothing to offer for ill children that other, properly trained healthcare professionals would not do better.

“We feel we could really push pediatric chiropractic to a whole new level.”

Why?

“We just want to be the best pediatric chiropractors that we can be.”

In this case, please study the evidence and you will inevitably arrive at the following conclusion:

THE BEST A CHIROPRACTOR CAN DO FOR A SICK CHILD IS TO REFER IT TO A COMPETENT DOCTOR  – A DOCTOR OF MEDICINE, NOT CHIROPRACTIC!

 

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!

As I mentioned before: it’s the season for awards and prizes:

It goes all the way back to 1982 when the Australian Skeptics instituted an award to be presented annually at the National Convention to individuals or organisations who made the most outrageous claim of a paranormal or pseudoscientific nature in the preceding year. After conferring with leading American Skeptic and illusionist, James Randi, who had earlier instituted a Bent Spoon award, it was decided that the Australian version would also commemorate one of the less useful, though widely acclaimed, alleged paranormal claims; the psychic ability to distort items of cutlery. So was born the Australian Bent Spoon Award. Some years later, in a masterpiece of alliteration, it was decided that the preamble to the award should read “presented to the perpetrator of the most preposterous piece of paranormal or pseudoscientific piffle”.

For a nomination to be accepted it should include the following details:The Bent Spoon Award on its Plinth

  • The name and contact details of the nominator (only the name will be listed on the website)
  • The name of the person or organisation being nominated
  • The reason for the nomination, including a clear explanation of the link to the paranormal or to pseudo-science

The ‘Bent Spoon’ is reserved for people who do their woo in Australia. The organisers also reserve the right to reject nominations that are deemed inappropriate. In particular, defamatory or frivolous nominations will not be accepted.

If you feel like nominating you favourite Australian anti-hero, use this link to email your nomination for 2023.

Click here to see the list of all current nominations.

And here is the fascinating list of former winners that reads like a ‘WHO IS WHO IN AUSTRALIAN QUACKERY’:

  • 2022: Maria Carmela Pau, for selling useless COVID vaccination exemption certificates, and claiming medical qualifications she did not have.
  • 2021: Craig Kelly MP, for spreading misinformation about COVID and vaccinations, and offering dubious cures and conspiracy theories.
  • 2020: Pete Evans for the promotion of the pseudoscientific non-medical BioCharger and continuing his anti-vaccination position.
  • 2019: SBS-TV program “Medicine or Myth” for promoting certain alternative medical treatments as if they had scientific credibility as opposed to placebo effectiveness.
  • 2018: Sarah Stevenson/Sarah’s Day for the promotion of questionable natural health remedies via her vast network of followers.
  • 2017: National Institute of Complementary Medicine and the University of Western Sydney for the continued promotion of disproved and unproved alternative medicine practices.
  • 2016: Judy Wilyman, Brian Martin, and the University of Wollongong for awarding Wilyman a doctorate on the basis of a PhD thesis riddled with errors, misstatements, poor and unsupported ‘evidence’ and conspiratorial thinking.
  • 2015: Pete Evans, chef, for his diet promotions, campaigns against fluoridation and support of anti-vaccinationists.
  • 2014: Dr Larry Marshall, Chief Executive, CSIRO for his support of water divining.
  • 2013: Chiropractors’ Association of Australia and the Chiropractic Board of Australia for failing to ensure their own members – including some committee members – adhere to their policy announcements.
  • 2012: Fran Sheffield of Homeopathy Plus! for advocating the use of magical sugar and water in place of tried and true vaccination for many deadly diseases, most notably Whooping Cough.
  • 2011: RMIT University “for having a fundamentalist chiropractic education program – if the word education can be used in this way – and for endorsing the practice by targeting children and infants in their on-campus paediatric chiropractic clinics”
  • 2010: the Australian Curriculum and Reporting Authority (ACARA) for its draft science curriculum.
  • 2009: Meryl Dorey and the deceptively named Australian Vaccination Network, who spread fear and misinformation about vaccines
  • 2008: Prof Kerryn Phelps
  • 2007: Marena Manzoufas, Head of Programming at the ABC for her sterling work in authorising the television show Psychic Investigators, made worse by putting it to air in the Catalyst timeslot
  • 2006: The pharmacists of Australia, who manage to forget their scientific training long enough to sell quackery and snake oil (such as Homoeopathy and ear candles) in places where consumers should expect to get real medical supplies and advice. Video of award here.
  • 2005: The ABC television program Second Opinion for the uncritical presentation of many forms of quackery.
  • 2004: The producers of the ABC television show The New Inventors, principally for giving consideration to an obvious piece of pseudoscience, the AntiBio water water conditioning system
  • 2003: The Complementary Healthcare Council
  • 2002: Gentle Heal Pty Ltd for the selling of fake (Homoeopathic) vaccine.
  • 2001: The Lutec “Free Energy Generator”
  • 2000: Jasmuheen who claims one can live without food and water.
  • 1999: Mike Willesee for the ‘documentary’ Signs From God.
  • 1998: Southern Cross University for offering a degree course in naturopathy, while also claiming to be conducting research into whether there was actually any validity to naturopathy.
  • 1997: Dr. Viera Scheibner – Anti-immunisation advocate
  • 1996: Marlo Morgan – American new age author who claimed in her book Mutant Message Downunder, that Australian Aborigines could levitate.
  • 1995: Tim McCartney-Snape for his promotion of the Foundation for the Adulthood of Mankind.
  • 1994: Commonwealth Attorney General for an enterprise agreement with its 2,400 employees that included a clause so any employee, who had taken sick leave, need not provide a medical certificate signed by a medical practitioner, but could provide one signed by a naturopath, herbalist, iridologist, chiropractor or one of assorted other “alternative” practitioners.
  • 1993: Steve Vizard’s Tonight Live programme (Channel 7).
  • 1992: Allen S Roberts, archaeological research consultant for a search for Noah’s Ark.
  • 1991: Woman’s Day magazine for its coverage and support of the paranormal, in particular astrology.
  • 1990: Mafu, multilifed entity, channelled by Penny Torres Rubin and who, despite millennia of experience, was remarkable for the banality of his/her pronouncements.
  • 1989: Diane McCann who wrote that Adelaide was built on one of the temples of Atlantis.
  • 1988: None
  • 1987: Anne Dankbaar, Adelaide “psychic”, whose discovery of the Colossus of Rhodes created something of a media stir until it was shown to be modern builders rubble.
  • 1986: Peter Brock, prominent racing driver, whose highly touted “energy polariser” generated more heat in the motoring media than it did energy in his car.
  • 1985: The Findhorn Festival Group, which sponsored the visit to Australia of American “psychic dentist” Willard Fuller. “Brother” Willard left town just ahead of some injunctions from real dentists.
  • 1984: Melbourne Metropolitan Board of Works for its payment of $1,823 to US “psychic archaeologist” Karen Hunt to use divining rods to detect an alleged “Electromagnetic Photo Field”
  • 1983: Dennis Hassel, “medium” whose chief trick was to make his hand disappear.
  • 1982: Tom Wards, self proclaimed “psychic”, whose predictions in the popular press were renowned for their inaccuracy.

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.

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