MD, PhD, FMedSci, FSB, FRCP, FRCPEd

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    by chris - Tuesday 22 August 2017 12:34
    I know , I know....there are a few gaps here and there. But such strong evidence should at least warrant a signed copy of cliff notes : ?

    by Richard Rawlins - Tuesday 22 August 2017 07:27
    As a surgeon who has done countless arthroscopies, as a founder member of the management board of the National Centre for Clinical Audit (now superceeded by NICE), as the former chairman of the BMA's Clinical Audit Committee, and as a magician, I am bound to say I endorse pretty well everything this article says. But Harris's comment: “Once you accept that some or all of the effect of the surgery you are doing is down to placebo, but you carry on doing it anyway, you have removed the only barrier between mainstream medicine and alternative medicine,” says Ian Harris, a professor of surgery at the University of New South Wales in Sydney.“You can no longer say, as a doctor, that homeopathy is rubbish because you’re doing the same thing.” - is barmy! 'Tu quoque' - "You're just as bad" is a fallacy, unworthy of a professor of surgery. We doctors are trying to audit responsibly, and change our practice when indicated (based on evidence). That is why folks who do not change are 'alternative'. And destined ever to reman so.

    by Edzard - Tuesday 22 August 2017 06:40
    what a barmy comment!!!

    by GibleyGibley - Tuesday 22 August 2017 01:20
    https://www.theguardian.com/science/2017/aug/20/when-surgery-is-just-a-stitch-up-placebo-effect Prof. Ernst, you forgot to include this article. Shame on you!!!!

    by James - Monday 21 August 2017 21:21
    Most of the quotations are irrelevant and at high-risk of bias (did anyone expect that homeopathicvet.org would be an unbiased critic of homeopathy?). However, one catches the eye: “Systematic review counters argument of ‘no reliable evidence’ in veterinary homeopathy 21st October 2014” I looked into it. It is a systematic review (http://veterinaryrecord.bmj.com/content/175/15/373) from R. T. Mathie and J. Clausen. I have a few comments with respect to that: -First of all, the reported result was that only two out of 18 eligible RCTs were deemed to contain reliable evidence, while not being at significant risk of bias (including funding). This is a preliminary indication that most homeopathy trials have significant sources of bias. -The two reliable and relatively unbiased trials referenced are one negative and one positive. Especially regarding the "positive" one, it is mentioned as: "homeopathic Coli had a prophylactic effect on porcine diarrhoea (odds ratio 3.89, 95 per cent confidence interval [CI], 1.19 to 12.68, P=0.02)". That's right. The sample sizes were small enough and P=0.02 is not very convincing. Not-very-convincing is also the habit of looking into implausible treatments, but this is another issue. This is a weak positive in my opinion, especially considering diarrhoea, which is a strongly self-limiting condition. -Actually, it was THREE reliable trials. One of them was dismissed because it was funded by the HPC (whatever that means... inside the study, as I checked, the authors state HomeoPet as their funding source). Among many other trials, this is also presented as having an effect "towards homeopathy". I couldn't resist checking into it. This can be found here: https://www.ncbi.nlm.nih.gov/pubmed/17572119. I looked INTO the text, and I find it very convincing and extremely clear and honest, even though it was funded by HomeoPet. Apart from certain conspicuous absurdities, e.g. treating the condition "fear of fireworks", recruiting dogs according to some homeopathic criteria (quote: "Dog’s diet excludes coffee, garlic, mint and sweets – homeopathic provision") etc, the authors reached a WIDELY negative conclusion: "No evidence for the specific efficacy of homeopathy for the treatment of fear of noises was found in this study.". This is because improvement was observed in both the verum and the placebo groups. HOWEVER, R. T. Mathie and friends created a study protocol (and referenced it in the above systematic review as if it were a published paper) that I was only able to locate in homeopathy associations' webpages (e.g. https://www.hri-research.org/wp-content/uploads/2016/09/Mathie-et-al-Systematic-review-and-meta-analysis-of-randomised-OTP-controlled-trials-of-IHT-Study-protocol-2016.pdf). According to this study protocol, they use their own effect measures, one of which is the Odds Ratio. According to the authors of the paper with the dog study, improvement was found in 26/40 from placebo, and 25/35 of Verum group. However, the authors state: "One owner from each treatment group used dog appeasing pheromone (DAP, Ceva Sante´ Animale) during at least one firework exposure, and one dog in the placebo group was exposed to a strong odour in the home (air freshener). These subjects were excluded from analysis". So this is reworked to 26/38 and 25/34, as is indeed reported in Mathie and Clausen (2014). Guess what the odds ratio is from these numbers... 1.28 (effect towards homeopathy). However, they found p = 0.63 for this. The trial funded by HomeoPet was negative, but a weak apparent effect towards homeopathy could be worked out if the Odds Ratio were used. The trial was excluded anyway from the review. -Of the two reliable trials and not excluded for reasons of funding, one of them did not state any funding, whereas the other one was funded by the government (as stated by Mathie and Clausen). So, all in all, if we are to follow the conclusions of the systematic review, in NO WAY does it "counter[s] argument of ‘no reliable evidence’ in veterinary homeopathy" as stated in homeopathicvet.org. The authors found 2 out of 18 trials to be reliable, according to their criteria. This is very close to no reliable evidence. And even those 2 trials produce conflicting results. A very interesting piece of this systematic review is a small excerpt from the introduction, which states: "Nevertheless, many homeopathic medicines are not in this ‘ultra-molecular’ range (Rutten and others 2013), and the plausibility argument is being approached directly in new research on nanoparticles (Bell and Schwartz 2013) and other physicochemical properties of dilutions (see Hill and others 2009)". When this stuff shows up, bias bells start ringing. Many of the studies, indeed, used remedies that were not in the ultra-molecular range. Not pure homeopathy, right? At least not very potent... But new research on nanoparticles and physicochemical properties of dilutions? Yet again? The abstract of "Bell and Schwartz, 2013" contains the following sentence: "Recent studies reveal that homeopathic remedies contain nanoparticles (NPs) of source materials formed by "top-down" mechanical grinding in lactose and/or succussion (forceful agitation) in ethanolic solutions". Nice! And, EVEN SO, this proves what exactly? The abstract concludes: "Updating terminology from "homeopathy" to "adaptive network nanomedicine" reflects the integration of this historical but controversial medical system with modern scientific findings". I see! So... What's in a name? (poor Juliet... poor Shakespeare).

    by Kevin - Monday 21 August 2017 19:33
    I tracked down one of the pictures on the net (the one showing a lot of white pills and the caption 'acute rescue'), because my brother is a paramedic and I thought he ought to be carrying some of these homeopathic pills for acute emergencies 😉 Anyway clicking on it took me to a homeopathy site featuring a video titled 'Homeopathic cure of paralysed rottweiler'. Ludicrous claptrap!

by Edzard - Tuesday 22 August 2017 08:42
I have always been intolerant of extreme stupidity

by Greg - Tuesday 22 August 2017 07:32
Edzard, how come you and James have to write comments on Bjorn's behalf? In my view, Bjorn has subjected many people on this site to questioning of their background and 'sarcastically heckled' them, now he is not providing a simple answer. So why are you jumping in here? Also, who is WE? (you and James?), and what is THIS that you have FIGURED OUT?

by Edzard - Tuesday 22 August 2017 07:14
we have all figured this out - it has nothing to do with Bjorn; the answer lies in your state of mind.

by Greg - Tuesday 22 August 2017 07:10
Barrie Dr Rawlins is a doctor of medicine - from 1969 and on the GMC register (although now retired) as a specialist - from 1996 (trauma and orthopaedic surgery). Bjorn refers me to his 'profile' link and James gives a long statement regarding Bjorn not answering straightforward questions. Bjorn has stated his credentials before, what I am asking is for substantiation. Why? You can figure that one out Barrie.

by James - Monday 21 August 2017 23:47
Oh, yes. How come it wasn't obvious earlier... C'mon, spill it out... You like JAQing off right? (JAQ is short for Just-Asking-Questions)? You discovered this technique of rhetoric the other day and you are here to practice, huh? So, the simple reason that he won't answer to you (apart from the fact that it is utterly needless, as the stuff is available online), is that it is COMPLETELY out of the matter at hand. What is the reason you request it so persistently? Will it change your life? What is your course of reasoning on that matter? You are trying to make a point? You think that by not getting a direct answer, you will somehow prove that he has some special reason for not providing a straight answer? You believe he does not have medical qualifications? You believe you can trick people in here? Your tactic is that of question-flooding? You think you can fool anyone into believing that there might be something fishy or catchy behind the fact that Björn does not answer straight away? Who are you? What are YOUR scientific qualifications? Did you finish high school? Where is your high school certificate? It is a straightforward and easy question. I will ask it for twenty consecutive posts, yet you will not be able to procure all the data I am requesting. This constitutes reasonable doubt that you have any credentials, doesn't it? Do you get +1 point for evoking every additional comment here responding to one of your answers? Do you make money out of this? Is there a bet we should be aware of? Are you intentionally getting on peoples' nerves? You already can find the data you are asking for. Why do you want them here posted by Björn? To be able to quote them afterwards as having been mentioned by Björn himself, so that you can keep trying to make void points? And, after that, what? You are going to find a different question, and keep posting that a million times? If you want to flood the comments section, be clear about it. What was that again? "It is the 2nd time that I have asked the same questions and you are refusing to answer. Answer the questions Bjorn." Who are you Greg? The Grand Jury? The Inquisition? A stooge for homeopathy? A shill for alternative medicine? An expert in anything, maybe? Where are your qualifications? "Dr. Ernst: Considering your background, and averring for several years to be ‘expert’ in all sorts of health practices that you are not qualified in is funny. Have you forgotten that you were fired from your post http://edzardernst.com/2013/03/ive-been-fired/) and that you were terminated in your post as ‘Professor of Complementary Medicine’?" Do you know of any job position that lasts forever? Who are you Greg? When was the last time you held any post? What post was that? Wow, now you are going to accuse me of "ad hominem" attacks (how typical)? Not too complicated...this is just you looking in the Internet mirror. Welcome! Let me end with your trademark signature... ... You guys are so much fun.

by Barrie Lee 'Wellness' Thorpe - Monday 21 August 2017 23:06
Greg There was a fashion among reggae singers a few years ago for calling themselves whatever they felt like sand so for a while there was a black Clint Eastwood and indeed a similarly tinted'Lautel and Hardy'. 'Dr' Gillian McKeith didn't go quite so well however. at least among the more questioning.

by UK Homeopathy Regulation - Monday 21 August 2017 19:34
I thought he was a hobo.

by Barrie Lee 'Wellness' Thorpe - Monday 21 August 2017 13:18
When I typed a spoof Trump email a couple of days ago, Spellcheck changed 'bigly" to 'bigot'.

by compandalt - Monday 21 August 2017 09:17
When I type "larry malerba" into google, the next word it suggests is "quack". Enough said.

by Norbert Aust - Sunday 20 August 2017 13:07
Oh you lucky skeptical bastards in the US! Over here in Germany we critics of homeopathy are in trouble: Big Pharma won't pay us! The two major societies of "Big Pharma" in Germany, the BPI ("Bundesverband der Pharmazeutischen Industrie") and BAH (Bundesverband der Arzneimittelhersteller") expressed their opposition to dropping the law that requires homeopathic remedies to be sold in pharmacies only. Furthermore they insist on public health to cover homeopathic treatments. See here: http://www.pharma-relations.de/news/bpi-und-bah-aeussern-sich-pro-homoeopathie https://www.deutsche-apotheker-zeitung.de/news/artikel/2017/06/20/pharmaverband-verteidigt-homoeopathie (both in German)

by Richard Rawlins - Sunday 20 August 2017 10:25
Larry Malerba is an osteopath, not a doctor of medicine.

by Richard Rawlins - Monday 21 August 2017 18:02
If only...but, never was, never will be. Those who want to join the medical profession should do so, or one of the other much respected health care professions, or accept they are 'alternative'. That is how standards are maintained and improved.

by Michael Kenny - Monday 21 August 2017 16:43
The notion of a "critical Chiro" is enigmatic to me....like a critical Christian or Muslim. By 'adopting' a set of standards which are by design NOT based in deducing critical-assessment of reality you are not eligible for the title critical. A critical chiropractor is NOT a Chiropractor, why (except your financial stability) do you persist in trying to have scientific standards envelope 'Chiropractic' and still maintain the name?? IF Chiropractic adopts comprehensively-critical standards it would become NOT-Chiropractic....not "science-based Chiropractic". I've been to 12 DCs and excepting they were adept showman and salesmen (and had excellent personalities to hook patients) they ALL were nuts. If I could have infiltrated their brains I know they were simply trying to bullshit me with nonsense....at root they had no more idea than I did as to what was wrong, and what to do. Some were "specific", some not, some used adjuncts some not....all had posters about the "root of my problem": some form of subluxation. They all shared a basic paradigm: perpetuating a parsimonious solution to a chimerical problem, i.e. a religious core disguised as science. I ceased going and my pain(s) always go away anyway....just like they did with the 'treatments'.

by Alan Henness - Monday 21 August 2017 15:53
If only chiropractic was a medical profession...

by Bilal - Monday 21 August 2017 14:04
First of all Thank you for your input. Sure. In any profession there are abusers. Chiropractors for endless follow-up, MDs involved in the Opioid epidemic in the US which is probably was worst than endless adjustments..... and the list goes on... All i'm saying and maybe this is wishful thinking that all medical professions needs to work together with patient as the end game...

by Richard Rawlins - Monday 21 August 2017 10:48
When you finish reforming you will be a doctor, physiotherapist, nurse, biomedical scientist - depending on your inclination and ability and effort you put in to your studies. Good luck. Welcome to the 21st century.

by Critical_Chiro - Monday 21 August 2017 04:45
How many times have I said over the years that criticism both within and without the profession is absolutely necessary for reform. But it needs to be balanced with SUPPORT FOR REFORM otherwise reform and the reformers become unacceptable collateral damage. Does this sound familiar. How many times have I said: Step 1. Point out the BS and criticize it. Step 2. Support reform and the reformers. Classic example is your post on Charlotte LeBoeuf-Yde earlier in the year. I have cited her along with other key researchers many times and it has been met with silence. Then you write: "I have always thought highly of Charlotte’s work, however, her conclusion made me doubt whether my high opinion of her reasoning was justified." Really, so you think highly her work but have remained silent then take offense at one sentence she wrote so: "Charlotte Leboeuf-Yde, DC,MPH,PhD, may be a professor in Clinical Biomechanics etc., etc., however, logical and critical thinking do not seem to be her forte." Cherry pick one sentence to support your bias, discount everything else and Carpet Bomb. "I do not see them complying with all my criteria." The subluxationists, yes I agree. The reformers are compliant and actively pushing all these criteria. Unfortunately you think all chiropractors are the same.

by AN Other - Sunday 20 August 2017 18:47
@ Richard What would you have done if it had got worse or if the conditon didn't improve? Also, what would you define as the condition getting worse i.e. signs and symptoms

by jm - Sunday 20 August 2017 17:44
I think you understand perfectly fine, Bjorn. You could say I'm speaking your language :). But, that's dodge #9. Shall we go for 10, or wait until next time?

by Björn Geir - Sunday 20 August 2017 10:39
@Pete Strangely, "jm" seems to read your comment as you answering my questions (See jm on Sunday 20 August 2017 at 08:56). Of course this thread is getting far to complex but the "jm" person seems increasingly incoherent. I hope it's nothing serious? Maybe we should stop playing cat with this mouse?

by jm - Sunday 20 August 2017 10:09
James, The whole "massage is medicine...", definitely not an attempt at humor. Bjorn wanted proof of gua sha benefits. I would hope that what I answered will be plenty fine. As to the rest of your comment - gua sha is a massage technique...just leave it at that. It's good for massage. We've talked about child services, hospitals, etc looking into gua sha. They didn't find any evidence of injury. If you disagree with their assessment, prove it. Show some evidence. And definitely let them know :).

by jm - Sunday 20 August 2017 08:56
Wow Bjorn - that was weird. Pete just posted a bunch of my answers to your questions. Odd timing, eh? Oh, and it's on the new thread you started, right after the comment where I answer your question. You know, the latest question you're using to dodge my question :). So far, I asked you 8 times (in this latest round anyway) about evidence for willful injury, bodily assault, and all of your other dramatic claims. Got any? Or should I wait for dodge #9?

by Björn Geir - Sunday 20 August 2017 00:38
"jm"never answers questions, doesn't seem to know the answers or understand the difficult words so ignores them and repeats its own inanities 🙂 390 comments and counting. Let's get this silly thread over 400. Would that be a record?

by Osteopathie Praxis im Klinikum Karlsruhe - Sunday 20 August 2017 14:44
There is no evidence at all for Osteopathic Manipulative Medicine for children or babies or for Cranio Sacral Therapy or for Osteopathy in the Cranial Field https://www.kinderaerzte-im-netz.de/media/53ec90b733af614b730028c3/source/20061222174343_kranisakraltherapie.pdf

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