MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

satire

Yes, it’s true: we all suffer from potentially poor health due to subluxations of our vertebrae. If they have not yet made us ill, they will do so shortly. But luckily, there is hope: rush to your chiropractor, get adjusted (pay cash) and all will be well.

If you don’t believe me, read what a chiropractor wrote on his website. The message could not be clearer:

Today you are going to learn what it is that causes your spinal misalignments or subluxations. Remember that a subluxation is a partial or incomplete dislocation of a vertebra. And contrary to what you may have been told or think or believe, we all have them. It is virtually impossible for all 24 of your spinal vertebrae to remain in their correct anatomical position because what causes a subluxation is stress. And each and every one of us is affected by stress each and every single day of our lives. The best way for me to explain stress is with the 3 T’s. The 3 T’s are traumas, thoughts and toxins. Traumas are those physical stresses that can affect our body. Examples are the birth process, the falls we have as toddlers as we learn to stand, walk and run, all the bumps, bruises and falls we suffer throughout our childhood, sporting injuries, car accidents, pregnancy, texting on a cell phone and prolonged sitting at a desk (computer). Thoughts are those mental/emotional stresses that can affect our body. Examples are job insecurity, relationship difficulties, being bullied at school and witnessing your parents go through a separation/divorce as a child. Toxins are the chemical stresses that can affect our body. The absolute number 1 chemical stressor is vaccines and immunizations. Other examples of chemical stressors are antibiotics, medications, recreational drugs, tobacco, alcohol and of course a poor diet. As human beings we can never escape the collective effects of stress. Some people have more physical stress, others more mental/emotional and others more chemical stress. But we all are affected by all 3 types of stress which means that we are always at risk of getting subluxations in our spine. What I would like you to do is think what the biggest source of stress is in your life and your children’s lives. Is it traumas, thoughts or toxins?

Yes, yes, yes: ‘The absolute number 1 chemical stressor is vaccines and immunizations.’ And those evil doctors – no, not doctors of chiropractic, doctors of medicine who have managed to steal the title that belongs to chiropractors – are all out to poison us! They are being paid by BIG PHARMA so that our kids are forced to get injected with pure poison.

These so-called doctors also prescribe antibiotics and other medications. As though anyone would ever need them! They are based on what is called the ‘germ theory of disease’. As chiropractors, we have long refuted this ridiculous theory; it is absurd: germs do not cause disease – subluxations are responsible for all that ails humans. But this simple yet important message has been suppressed by the medical mafia since the last 120 years.

So, do yourself a favour and immediately take your entire family to a chiropractor. He is your ideal and only primary care physician. No drugs, no immunizations – just adjustments to benefit your health (and the chiropractor’s cash flow).

PS

In case someone is not quite switched on today: THIS IS A JOKE! DON’T FOLLOW THIS ADVICE, IT MIGHT HARM YOUR HEALTH IRREPARABLY.

The randomized, placebo-controlled, double-blind trial is usually the methodology to test the efficacy of a therapy that carries the least risk of bias. This fact is an obvious annoyance to some alt med enthusiasts, because such trials far too often fail to produce the results they were hoping for.

But there is no need to despair. Here I provide a few simple tips on how to mislead the public with seemingly rigorous trials.

1 FRAUD

The most brutal method for misleading people is simply to cheat. The Germans have a saying, ‘Papier ist geduldig’ (paper is patient), implying that anyone can put anything on paper. Fortunately we currently have plenty of alt med journals which publish any rubbish anyone might dream up. The process of ‘peer-review’ is one of several mechanisms supposed to minimise the risk of scientific fraud. Yet alt med journals are more clever than that! They tend to have a peer-review that rarely involves independent and critical scientists, more often than not you can even ask that you best friend is invited to do the peer-review, and the alt med journal will follow your wish. Consequently the door is wide open to cheating. Once your fraudulent paper has been published, it is almost impossible to tell that something is fundamentally wrong.

But cheating is not confined to original research. You can also apply the method to other types of research, of course. For instance, the authors of the infamous ‘Swiss report’ on homeopathy generated a false positive picture using published systematic reviews of mine by simply changing their conclusions from negative to positive. Simple!

2 PRETTIFICATION

Obviously, outright cheating is not always as simple as that. Even in alt med, you cannot easily claim to have conducted a clinical trial without a complex infrastructure which invariably involves other people. And they are likely to want to have some control over what is happening. This means that complete fabrication of an entire data set may not always be possible. What might still be feasible, however, is the ‘prettification’ of the results. By just ‘re-adjusting’ a few data points that failed to live up to your expectations, you might be able to turn a negative into a positive trial. Proper governance is aimed at preventing his type of ‘mini-fraud’ but fortunately you work in alt med where such mechanisms are rarely adequately implemented.

3 OMISSION

Another very handy method is the omission of aspects of your trial which regrettably turned out to be in disagreement with the desired overall result. In most studies, one has a myriad of endpoints. Once the statistics of your trial have been calculated, it is likely that some of them yield the wanted positive results, while others do not. By simply omitting any mention of the embarrassingly negative results, you can easily turn a largely negative study into a seemingly positive one. Normally, researchers have to rely on a pre-specified protocol which defines a primary outcome measure. Thankfully, in the absence of proper governance, it usually is possible to publish a report which obscures such detail and thus mislead the public (I even think there has been an example of such an omission on this very blog).

4 STATISTICS

Yes – lies, dam lies, and statistics! A gifted statistician can easily find ways to ‘torture the data until they confess’. One only has to run statistical test after statistical test, and BINGO one will eventually yield something that can be marketed as the longed-for positive result. Normally, researchers must have a protocol that pre-specifies all the methodologies used in a trial, including the statistical analyses. But, in alt med, we certainly do not want things to function normally, do we?

5 TRIAL DESIGNS THAT CANNOT GENERATE A NEGATIVE RESULT

All the above tricks are a bit fraudulent, of course. Unfortunately, fraud is not well-seen by everyone. Therefore, a more legitimate means of misleading the public would be highly desirable for those aspiring alt med researchers who do not want to tarnish their record to their disadvantage. No worries guys, help is on the way!

The fool-proof trial design is obviously the often-mentioned ‘A+B versus B’ design. In such a study, patients are randomized to receive an alt med treatment (A) together with usual care (B) or usual care (B) alone. This looks rigorous, can be sold as a ‘pragmatic’ trial addressing a real-fife problem, and has the enormous advantage of never failing to produce a positive result: A+B is always more than B alone, even if A is a pure placebo. Such trials are akin to going into a hamburger joint for measuring the calories of a Big Mac without chips and comparing them to the calories of a Big Mac with chips. We know the result before the research has started; in alt med, that’s how it should be!

I have been banging on about the ‘A+B versus B’ design often enough, but recently I came across a new study design used in alt med which is just as elegantly misleading. The trial in question has a promising title: Quality-of-life outcomes in patients with gynecologic cancer referred to integrative oncology treatment during chemotherapy. Here is the unabbreviated abstract:

OBJECTIVE:

Integrative oncology incorporates complementary medicine (CM) therapies in patients with cancer. We explored the impact of an integrative oncology therapeutic regimen on quality-of-life (QOL) outcomes in women with gynecological cancer undergoing chemotherapy.

PATIENTS AND METHODS:

A prospective preference study examined patients referred by oncology health care practitioners (HCPs) to an integrative physician (IP) consultation and CM treatments. QOL and chemotherapy-related toxicities were evaluated using the Edmonton Symptom Assessment Scale (ESAS) and Measure Yourself Concerns and Wellbeing (MYCAW) questionnaire, at baseline and at a 6-12-week follow-up assessment. Adherence to the integrative care (AIC) program was defined as ≥4 CM treatments, with ≤30 days between each session.

RESULTS:

Of 128 patients referred by their HCP, 102 underwent IP consultation and subsequent CM treatments. The main concerns expressed by patients were fatigue (79.8 %), gastrointestinal symptoms (64.6 %), pain and neuropathy (54.5 %), and emotional distress (45.5 %). Patients in both AIC (n = 68) and non-AIC (n = 28) groups shared similar demographic, treatment, and cancer-related characteristics. ESAS fatigue scores improved by a mean of 1.97 points in the AIC group on a scale of 0-10 and worsened by a mean of 0.27 points in the non-AIC group (p = 0.033). In the AIC group, MYCAW scores improved significantly (p < 0.0001) for each of the leading concerns as well as for well-being, a finding which was not apparent in the non-AIC group.

CONCLUSIONS:

An IP-guided CM treatment regimen provided to patients with gynecological cancer during chemotherapy may reduce cancer-related fatigue and improve other QOL outcomes.

A ‘prospective preference study’ – this is the design the world of alt med has been yearning for! Its principle is beautiful in its simplicity. One merely administers a treatment or treatment package to a group of patients; inevitably some patients take it, while others don’t. The reasons for not taking it could range from lack of perceived effectiveness to experience of side-effects. But never mind, the fact that some do not want your treatment provides you with two groups of patients: those who comply and those who do not comply. With a bit of skill, you can now make the non-compliers appear like a proper control group. Now you only need to compare the outcomes and BOB IS YOUR UNCLE!

Brilliant! Absolutely brilliant!

I cannot think of a more deceptive trial-design than this one; it will make any treatment look good, even one that is a mere placebo. Alright, it is not randomized, and it does not even have a proper control group. But it sure looks rigorous and meaningful, this ‘prospective preference study’!

It is Christmas time – one cannot possibly fail to realise it, if only by listening to the perennial reports about our hospitals and GP surgeries being over-stretched to breaking point.

Will we cope?

Sure we will – after all, we can rely on our homeopaths! Yet again, they are at the ready to help out and prevent a disaster.

What, you don’t believe me? But it must be true, just look at this tiny selection of what homeopaths currently say on the internet:

Where to begin… Let’s start with my favorite holiday event: Eating-To-Excess.  From there we slide over to the Too-Much-Drinking Marathon, the Suicidal Depression Derby, the Slipping On Ice, Falling Off Ladders and Sleep Deprivation Triathlon… the World Series of Overwork, Tension Headaches, Anxiety About Seeing Your Relatives and… maybe we should just cancel this holiday altogether! Fortunately, homeopathy can help. 

Stressed before Christmas?  Well the good news is that many of these emotions can quickly be tackled with Homeopathy, helping you relax and get back into the swing of the festive season…

Here’s how homeopathy can help make your Christmas a happy one…Consultation fees vary from homeopath to homeopath – please ring us for details and to book an appointment.

Give the gift of health this Christmas with our Homeopathy Gift Sets. These sets have been carefully put together by registered homeopathy Jenny Livingstone M.A., R.S.Hom. There are three kits to choose from: the first aid kit for those little emergencies, the travellers kit for those on the road and for our mums to be – the birthing kit. The kits are priced at £45…

THE HOMEOPATHIC CHRISTMAS SURVIVAL KIT: Christmas is a great time for catching up with friends and family, taking time out to enjoy the festive season and of course partying! It can also be a time of stress physically and emotionally as we rally hard to create the perfect day and cope with situations outside our comfort zone. There is the pressure of shopping, dealing with relatives and in laws, coping with the cold weather conditions, worrying about finances, perhaps coping with feelings of sadness or loneliness and over indulging in food and wine which wreaks havoc on our digestive system. For these type of situations Homeopathy can help bring relief on a number of levels whether for acute periods of physical or emotional stress, or longer term it can be a great support for those grieving or suffering from depression or confidence issues.

Homeopathy can be very helpful and healing during this time of the year. I have heard some homeopaths talk about their practice being quite busy during the holiday months, November thru January. Issues, emotions, situations, responses, reactions, and physical complaints and concerns may come more to the surface than at other times of the year. Because they are more accessible and right there on the surface, it may be a good time to come for homeopathic care.

And whatever you do, don’t forget your pet: With Christmas time just around the corner, I thought it may be worthwhile to draw attention to some of the hazards that can face our pets during this festive season.

END OF QUOTES

Convinced? Well, I am!

It’s Christmas – so, let’s not be cynical!

If our health care does not break down completely this time, it surely is due to the altruistic sacrifice of the nation’s homeopath.

(My only worry is: how will we cope next year when those awful, nasty sceptics, scientist and rational thinkers will no doubt have succeeded in insisting that even homeopaths need evidence for their claims?)

HAPPY, HEALTHY HOLIDAYS EVERYONE!!!

(And don’t forget your Nux Vomica for the detox next week)

The US homeopath Alan V Schmukler has been the subject of one post on this blog already. Here, to remind everyone, is his fascinating background again:

He attended Temple University, where he added humanistic psychology to his passions. After graduating Summa Cum Laude, Phi Beta Kappa and President’s Scholar, he spent several years doing workshops in human relations. Alan also studied respiratory therapy and worked for three years at Einstein Hospital in Philadelphia. Those thousands of hours in the intensive care and emergency rooms taught him both the strengths and limitations of conventional medicine.

Schmukler eventually learned about homeopathy in 1991 when he felt he had been cured of an infection with Hepar sulphur, his very own ‘homeopathic epiphany’, it seems. He then founded the Homeopathic Study Group of Metropolitan Philadelphia and helped found and edit Homeopathy News and Views, a popular newsletter. He taught homeopathy for Temple University’s Adult Programs, and has been either studying, writing, lecturing or consulting on homeopathy since 1991. Today, he is Chief Editor of Hpathy.com and of Homeopathy4Everyone and says that his work as Editor is one of his most rewarding experiences.

Schmukler is clearly well-placed to comment on all aspects of homeopathy competently and with great vision. What he says must be taken seriously. And that includes his profound and well-researched opinions regarding homeopathy’s critics. The most recent article by Schmukler is entitled ‘WHEN THE GAME IS OVER’ and it discloses the truth and nothing but the truth about these critics and the worldwide conspiracy against homeopathy. Here is an excerpt from his revelations:

…we still find homeopathy being attacked as placebo, mostly by government officials, academics and the press. There are essentially two categories of critics. The first category consists of individuals who are totally ignorant of homeopathy and just repeating propaganda they’ve been exposed to. The second category is people who know that homeopathy works, but have a vested financial interest in destroying it. When you read about attacks on homeopathy, you have to ask yourself whether you are dealing with pure ignorance, or deceit. Those who deny homeopathy from deceit use the same tactics as those who deny global warming. Just as global warming deniers are financed by the petroleum industry, homeopathy deniers are financed by the pharmaceutical industry. They engage in the same tactics of misinformation using surrogates in academia, in the media and in government.

So here we have it!

Two categories of critics!!!

THE IGNORANT and THE CORRUPT!

I am so glad Schmukler did find this out through his research and said it with such clarity. It needed to se said! And I am surprised how simple it all becomes, once one has the guidance from someone in the know.

The opposition to homeopathy has nothing to do with evidence (and as evidence does not come into it, there is also no need to supply evidence for Schmukler’s statements, of course), as some might have speculated. Instead, it all is a huge conspiracy. Makes sense! Why did we not think of this myself?

I applaud Schmukler for putting the defence of homeopathy to a level which must be a new low.

If the Flat Earth Society (FES) really exists at all, I must confess I know nothing about it. Here I use the term ‘FES’ merely as an analogy; you might replace FES with SoH or BHA or BAA or BCA or with most of the other acronyms used in my field of inquiry.

What I do know about is alternative medicine, particularly publications in this area, and the authors of such papers. As it happens, the members of my imaginary FES have a lot in common with the authors of articles on alternative medicine. Their publication policy, for instance, is remarkably simple yet astonishingly effective. Its aim is straight forward: mislead the public. As far as I can see, it is being pursued by just two main strategies.

1 SWAMP THE MARKET WITH TRASH

This is a simple and most successful strategy. It consists of publishing an ever-growing mountain of utter nonsense. Anyone who is  interested in alternative medicine and conducts a search would thus find tons of articles listed in Medline or other databases. This will instantly generate the impression that Flat Earth research is highly active. Those who can bear the pain might even try to read a few of these papers; they will soon give up in despair. Too many are hardly understandable; they are often badly written, lack essential methodological detail, and invariably arrive at positive conclusions.

The strategy can only work, if there are journals who publish such rubbish. I am glad to say, there is no shortage of them! To attain a veneer of credibility, the journals need to be peer-reviewed, of course. This is no real problem, as long as the peer-reviewers are carefully chosen to be ‘cooperative’. The trick is to make sure to ask the authors submitting articles to name two or three uncritical friends who might, one day, be happy to act as peer-reviewers for their own papers. This works very smoothly indeed: one pseudo-scientist is sure to help another in their desire to publish some pseudo-science in a ‘peer-reviewed’ journal.

To oil the system well, we need money, of course. Again, no problem: most of these journals ask for a hefty publication fee.

The result is as obvious as it is satisfying. The journal earns well, the pseudo-researchers can publish their pseudo-research at will, and the peer-reviewers know precisely where to go for a favour when they need one. Crucially, the first hurdle to misleading the public is taken with bravura.

2. REFUTE ANY EVIDENCE THAT IS UNFAVOURABLE

There are, of course, journals which refuse to play along. Annoyingly, they adhere to such old-fashioned things like standards and ethics; they have a peer-review system that is critical and independent; and they don’t rely on pseudo-scientists for their income. Every now and then, such a journal publishes an article on alternative medicine. It goes without saying that, in all likelihood, such an article is of high quality and therefore would not be in favour of Flat Earth assumptions.

This is a serious threat to the aim of the FES. What can be done?

No panic, the solution is simple!

An article is urgently needed to criticise the paper with the unfavourable evidence – never mind that it is of much better quality than the average paper in the Flat Earth-journals. If one looks hard enough, one can find a flaw in almost every article. And if there is none, the FES can always invent one. And if the proper science journal refuses to publish the pseudo-criticism as a comment, there are always enough pseudo-journals that are only too keen to oblige.

The important thing is to get something that vaguely looks like a rebuttal in print (the public will not realise that it is phony!).

Once this aim is achieved, the world is back in order again. As soon as someone dares to cite the high quality, negative evidence, the FES members can all shout with one voice: BUT THIS PAPER HAS BEEN HEAVILY CRITICISED; IT IS NOT RELIABLE! WHOEVER CITED THE PAPER IS ILL-INFORMED AND THEREFORE NOT CREDIBLE.

3. MISSION ACCOMPLISHED

The overall effect is clear. The public, journalists, politicians etc. get the impression that the earth is indeed flat – or, at the very minimum, they are convinced that there is a real scientific debate about the question.

A ‘RAZOR’ is an argument for “shaving off” unlikely or implausible explanations or arguments. Who would, in this context, not think of alternative therapies and the explanations provided for them? And who could deny that homeopathy, in particular, is crying out for its very own razor?

I am, of course, inspired by 4 existing razors:

Occam’s Razor: Among competing hypotheses, the one with the fewest assumptions is likely to be the correct one.

Hitchens’s Razor: What can be asserted without evidence can be dismissed without evidence.

Hanlon’s Razor: Never attribute to malice what can adequately explained by stupidity.

Alder’s Razor: What cannot be settled by experiment is not worth debating.

To those of my readers who fail to see the relationship to homeopathy, I offer the following explanations:

OCCAM

Homeopaths claim that the explanation for homeopathy’s mode of action is the ‘memory of water’ theory which is now supported, they say, by all sorts of basic science from water structure to nano-particles. Even if true [which it is not], this explanation relies on a whole series of further assumptions, for instance, about how nano-particles bring about any clinical outcome. The competing hypothesis is that the benefit experienced by patients after homeopathy is due to non-specific or context effects such as the placebo effect, the empathetic consultation etc. We have therefore one single hypothesis (i. e. homeopathy works via non-specific effects which is even supported by experimental data) against a myriad of postulates which are largely speculative. Occam’s Razor holds that the explanation with the least assumptions is likely to be correct.

HITCHENS

Homeopaths claim that their remedies are more than a placebo. To support their claim, they have no good evidence but rely on cherry-picking and misrepresenting the available data. Hitchen’s Razor suggests that, as long as they don’t come up with evidence, we can dismiss these claims without even attempting to prove the cherry-pickers wrong.

HANLON

Homeopaths have given us plenty of evidence (for instance, on this blog) for the fact that they often have a somewhat disturbed relationship with the truth. One might think that this is because they are maliciously trying to mislead us. According to Halon’s Razor, it is more likely that they are just stupid.

ALDER

Homeopaths regularly claim that, as long as there is no proof that homeopathy does not work, there must be an open debate about the issues involved and, as long as there are genuine debates and doubts, we must continue to make homeopathy available to all. Alder’ s Razor, however, suggests otherwise: there have been many tests of homeopathy; their results have failed to settle the matter in favour of homeopathy; therefore we can forget about the whole thing, stop debating it, and close the issue.

So, what about the razor promised in the title of this post? Here it comes; it is an attempt to synthesize the 4 razors above and apply them to homeopathy. I will call it (somewhat pompously) ‘Ernst’s Razor’ and I have tried to formulate it such that it can be applied to most other bogus treatments simply by exchanging one single word:

INSTEAD OF RELYING ON EVIDENCE, HOMEOPATHY’S SURVIVAL DEPENDS ON MULTIPLE ASSUMPTIONS, LIES, IGNORANCE AND STUPIDITY.

We have heard often, here and elsewhere, that chiropractic is neither effective nor safe. But now I found that it is not useless after all!!! It is an effective preventative measure against infections like the common cold and the flu.

You find this hard to believe? But it must be true!

It is the message given to chiropractors on this website:

Chiropractic care raises your body’s natural resistance to disease by removing serious interference to its proper function, vertebral subluxations. For that reason, it’s important to explain to clients that their lymphatic system is basically their body’s drainage system. Lymph is a clear fluid composed of immune cells and the greater lymphatic system is made up of a network of ducts and lymph nodes that help filter out viruses, bacteria, and other harmful elements. Remind your patients that when they go to a medical doctor and complain of a cold or the flu, the first thing he or she checks is their lymph glands, feeling for enlarged lymph nodes on the neck under the jaw. Enlarged nodes, or swollen glands as we often call them, are a sign that the lymphatic system is actively fighting an infection or imbalance.
 
Here’s where chiropractic care comes in: when the body is healthy and working correctly, the bad things your lymph nodes collects drains out through the lymph ducts, some of which are located along the spine and in the neck. But when the neck and spine are out of alignment from muscle tension, a musculoskeletal condition or other injury, those lymph ducts can become blocked and congested. Fortunately, chiropractic adjustments restore the neck and spine to proper alignment, taking pressure off of the congested lymph ducts. That allows the lymphatic system to start flowing and working correctly again, naturally decongesting and helping your body’s immune system to work properly in the fight against colds, flu, and illness.
 
It’s hard to quantify the health benefits of a strong immune system, but one recent study found that patients who had chiropractic adjustments had a 200-400% stronger immune system than those who weren’t adjusted. Another study published in the Journal of Vertebral Subluxation Research showed that regular chiropractic care resulted in a 15% average decrease in the incidence of colds and the flu. For that reason, regular chiropractic adjustment and lymphatic massage will help keep a patient’s immune system strong and functioning optimally, and even will help minimize the symptoms and speed recovery once a patient already comes down with the flu.

And you thought that chiropractors had all but given up the notion of ‘subluxation’? No, they haven’t!

Subluxations are real, alive and kicking!

The germ theory of disease is false!

Chiropractic adjustments are the only cure and prevention!

Immunisations are just poison in your body!

What, I have not convinced you? Then you are not a chiropractor, perhaps?

You say they make numerous such claims because it keeps them in clover? Oh, you are cynical – shame on you!

When the British Medical Journal (BMJ) asked me for an interview, I felt very honoured and obliged with great pleasure. The result was published in the BMJ earlier this year. I take the liberty of re-publishing it here on my blog because many of my readers do not see the BMJ, and I think it’s rather fun. Moreover, I hope it might provide my critics with more diverse material for ad hominem attacks – the constant allegations that I am in the pocket of ‘Big Pharma’, that I have never done any original research etc. etc. are getting just too boring.

HERE IT IS

Edzard Ernst is a champion of clear thinking in the often murky waters of alternative medicine. As Britain’s first professor of the subject at Exeter, he investigated claims made by its practitioners and found many to be devoid of supporting evidence. He was productive and highly visible and became a bit of an embarrassment to a craven university administration when he took on the Prince of Wales. He was frozen out, as he explains in his book A Scientist in Wonderland (subtitled A Memoir of Searching for Truth and Finding Trouble). Despite it all he, a German by birth, remains a phlegmatic Anglophile.

What was your earliest ambition?

As a young man I wanted to become a jazz musician. I practised enthusiastically—first on the clarinet, then on the drums—and if it had not been for my mother I might have ended up as a (not all that brilliant) drummer.

Who has been your biggest inspiration?

Hans and Sophie Scholl, two Munich University students and members of the White Rose resistance group who opposed Hitler by distributing leaflets at the university. On 23 February 1943, only five days after their arrest, they were executed.

What was the worst mistake in your career?

Most of my friends thought that leaving my chair in Vienna to become a researcher of alternative medicine was a grave error.

What was your best career move?

Leaving Vienna and becoming a researcher of alternative medicine.

Bevan or Lansley? Who has been the best and the worst health secretary in your lifetime?

Bevan is an undisputed hero who, in my view, cannot possibly be surpassed by the Lansleys of this world. The worst heath secretary will be the one who finally completes the Tory sell off of the NHS.

Who is the person you would most like to thank and why?

My mother for bringing me into this world and for steering me in the right direction with love and determination.

To whom would you most like to apologise?

To all the patients who, day in, day out, become victims of some form of quackery. It should have been my job to warn them and to point them towards treatments that actually work.

If you were given £1m what would you spend it on?

I might start a charity dedicated to counterbalance the overwhelming amount of misinformation about alternative medicine that consumers constantly have to endure.

When are you happiest?

When I manage to give to others in a way that is truly appreciated.

What single unheralded change has made the most difference in your field in your lifetime?

The intervention of the self proclaimed “enemy of the enlightenment” who advocates “integrated medicine” for the NHS that, for the most part, is unmitigated quackery. Prince Charles certainly made a difference in my field, albeit not in a positive way.

Do you support doctor assisted suicide?

Doctors should be able (but not obliged) to assist their patients in this way.

What book should every doctor read?

My memoir, A Scientist In Wonderland, of course. But not really—I find the idea of one book for all doctors a little bizarre.

What poem, song, or passage of prose would you like mourners at your funeral to hear?

When they are about to go home I’d like them to listen to the Bonzo Dog Doo-Dah Band performing “I’m Going to Bring a Watermelon to My Girl Tonight.”

What is your guiltiest pleasure?

Research! During the past 20 years pen pushers of various kinds have managed to make it feel like a guilty pleasure.

If you could be invisible for a day what would you do?

I would try to do some mischief that benefits all of us, such as transferring all bankers’ bonuses to the NHS or vaccinating the children of “anti-vaxxers.”

Clarkson or Clark? Would you rather watch Top Gear or Civilisation? What television programmes do you like?

I have to admit that I do sometimes watch Clarkson, mostly to learn how to avoid coming across like a middle aged chauvinist. If, however, I want to have a good time in front of my TV I watch a Bond film, only to doze off after the opening sequence.

What is your most treasured possession?

My memories of friends and family, of good times and tears of laughter.

What, if anything, are you doing to reduce your carbon footprint?

Wearing one or, if necessary, two extra layers (sometimes even thermal skiing underwear) when an icy wind makes our Suffolk home too cold for comfort.

What personal ambition do you still have?

To be on the BBC Radio 4 programme Desert Island Discs. It would be such a fun way to link life, medicine, and music.

Summarise your personality in three words

Stubborn, compassionate, rational.

Where does alcohol fit into your life?

As a collector of fine Bordeaux wines, I can hardly deny that it often fits very well indeed.

What is your pet hate?

Administrators who seem to think that the prime role of everyone else is to accommodate their whims.

What would be on the menu for your last supper?

As long as the wine for the main course is a Chateau Latour from a good year, I don’t mind.

Do you have any regrets about becoming a doctor and academic?

None whatsoever.

If you weren’t in your present position, what would you be doing instead?

I would probably be sitting behind a drum kit making even more disturbing noises.

Homeopathy has its fair share of lunes who are unable to make a reasonable case for it without telling overt falsehoods; we have seen some of then on this blog, for sure. Therefore I was encouraged to finally find a well-argued, rational defence of homeopathy. It comes from an unlikely source – Christian Boiron (CB) is the General Manager of the world’s largest manufacturer of homeopathics ‘BOIRON’ with a turn-over of more than 600 million Euros annually. Some would have thought he could be a trifle biased, but no – judge for yourself.

In a recent, short interview (unfortunately it is in French, so you have to trust my translations) CB rightly pointed out that “Il y a un Ku Klux Klan contre l’homéopathie” THERE IS A KU KLUX KLAN AGAINST HOMEOPATHY. About time that someone calls a spade a spade, I’d say. I think others have previously called those who doubt the miracle of homeopathy ‘fascists’ – but ‘KKK’ is much better, more to the point. Sceptics have indeed a long and infamous habit of stringing everyone who disagrees with their views up on a tree.

The interview refers to the report from the Australian NHMRC which showed that homeopathy is not effective and can even be dangerous. How can this be? Fortunately CB knows the answer: “…personne ne comprend rien”. The panel members were all ignorant! Thanks for clearing that up CB; were they also members of the KKK?

After all, homeopathy is 200 years old, it is now well-grounded in science and accepted throughout the world (“L’homéopathie, qui a 200 ans, évolue avec les connaissances de la science. La France l’a relancée dans un axe totalement scientifique et lui a donné une reconnaissance mondiale”) That surely needed to be said, and don’t you KKK members dare pointing out the occasional fallacy here! Because CB is the first to be critical (“Je suis le premier à être le plus critique”).

What about studies of homeopathy that fail to be as convincingly positive as CB might have hoped? “Quand on dit qu’il faut démontrer en médecine et que la médecine est une pratique scientifique ce sont deux idioties.” Yes, well said CB, the assumption that medicine should become scientific is indeed idiotic. Medicine is about individuals, not statistics; Hahnemann realised this, of course, and thus showed us the way to the future in health care.

And to finish this elating encounter with one of the brightest buttons in any homeopathic drawer: “On croit savoir énormément de choses alors qu’il y a beaucoup qu’on méconnait”. ONE THINKS ONE KNOWS A LOT BUT THERE IS PLENTY ONE MISUNDERSTANDS”

I think even those terrible KKK members amongst my readers might agree with CB here, particularly if this remark introspectively refers to himself.

***a note to homeopaths and their libel lawyers: this post is SATIRE

No, I kid you not!

This abstract was actually published in the leading chiro-journal. The authors include three professors from the Canadian Memorial Chiropractic College, Research, Toronto, Canada. Its title is impressive but made my alarm bells ring a bit:

A Randomized Pragmatic Clinical Trial of Chiropractic Care for Headaches With and Without a Self-Acupressure Pillow.

And the actual texts does not disappoint those looking for of pure pseudo-science:

The purpose of this study was to determine if the addition of a self-acupressure pillow (SAP) to typical chiropractic treatment results in significantly greater improvement in tension-type and cervicogenic headache sufferers.

METHODS:

A pragmatic randomized clinical trial was conducted in a chiropractic college teaching clinic. Thirty-four subjects, including tension-type and cervicogenic headache sufferers, 21 to 60 years of age, male or female, completed the study. Group A (n = 15) received typical chiropractic care only (manual therapy and exercises), and group B (n = 19) received typical chiropractic care with daily home use of the SAP. The intervention period was 4 weeks. The main outcome measure was headache frequency. Satisfaction and relief scores were obtained from subjects in the SAP group. Analysis of variance was used to analyze the intergroup comparisons.

RESULTS:

Owing to failure of randomization to produce group equivalence on weekly headache frequency, analysis of covariance was performed showing a trend (P = .07) favoring the chiropractic-only group; however, this was not statistically significant. Group A obtained a 46% reduction of weekly headache frequency (t = 3.1, P = .002; d = 1.22). The number of subjects in group A achieving a reduction in headaches greater than 40% was 71%, while for group B, this was 28%. The mean benefit score (0-3) in group B of the use of the SAP was 1.2 (.86). The mean satisfaction rating of users of the SAP was 10.4 (2.7) out of 15 (63%).

CONCLUSION:

This study suggests that chiropractic care may reduce frequency of headaches in patients with chronic tension-type and cervicogenic headache. The use of a self-acupressure pillow (Dr Zaxx device) may help those with headache and headache pain relief as well as producing moderately high satisfaction with use.

Where to begin?

Perhaps it is best, if I simply concentrated on the bizarre research question: is chiropractic care plus the largely uncontrolled use of an ‘acupressure cushion’ better than chiropractic care alone? To savour the lunacy of it, we need to consider that:

  • chiropractic is not plausible;
  • chiropractic care is not proven to be effective for headaches;
  • acupressure is not plausible;
  • acupressure is not proven to be effective;
  • a self-administered acupressure cushion is also unproven and even less plausible;

This, I fear, renders the study one of the most nonsensical trials I have seen for a very long time. To make the bonanza in pseudo-science complete, the article is supplemented with a most bizarre conclusion about the effectiveness of chiropractic (which, of cause, cannot be examined in a trial of chiro vs chiro).

All this leads me to fear that:

  • the best journal of chiropractic is rubbish;
  • a professorship in a chiro school may not mean that the professor has the slightest idea about research methodology;
  • chiropractors will try to squeeze a conclusion that is favourable for their trade even out of a dead horse.
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