Edzard Ernst

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

Brillia for Children is probably the most amazing homeopathic quackery I have ever encountered:

Uses: Enhance clarity, improve concentration of attention, reduce feelings of anxiety & stress, excitability, irritability and hyperactivity to improve attention, focus and mood regulation.

Active Ingredient: Lapine S-100 immune globulin mixture of homeopathic dilutions 12C, 30C and 50C.

Brillia is a unique combination of antibody science and homeopathic formulation. The active ingredient of Brillia is antibodies to the brain-specific S100 protein (S100B). This protein is an important regulator of many different intracellular and extracellular brain processes, e.g. various enzymes activities, calcium homeostasis, communication between neurons, etc. Since almost all mental and neurological diseases as well as temporal stress-induced conditions are accompanied by disturbance of the above-mentioned processes, especially communication between neurons, the normalization of these processes is considered to be a prospective way to treat people with such undesirable conditions. Brillia is an antibody conjugated to the S100B protein and does not alter the concentration of the S100B protein in the bloodstream. Brillia’s efficacy stems from its ability to regulate the activity of the S100B protein and does not alter its concentration. In order for a protein to have an effect in the body, it needs to bind to its target, such as an enzyme. Proteins have very specific conformations that ensure that only the correct protein binds to the correct target molecule. Once the protein correctly orients itself into the active site of the target molecule, this is when the protein causes an effect in the body. When Brillia binds to the S100B protein, the overall shape of the protein is altered, hindering its ability to bind to its target molecule and thereby controlling its activity in the body. In short, Brillia stops the S100B protein from acting in the body by changing its shape, consequently regulating levels of anxiety and hyperactivity.

PARENT TOOL | WATCH: DISCOVER BRILLIA

WATCH: WHY & HOW BRILLIA WORKS

Inactive Ingredients: Lactose monohydrate, magnesium stearate, microcrystalline cellulose. Does not contain artificial colors or artificial flavors.

Food Allergy Warning: This product contains lactose. Brillia is gluten free and nut free.

About active ingredients, the website tells us this:

Let’s start off with the active ingredient, registered with the FDA as Lapine S-100B immune globulin. Now we know this name can be intimidating, so we are going to break it down for you. Working backwards, “immune globulin” is just the “sciency” way of saying “antibody”, and don’t worry, we will get into what an antibody actually is in just a second. Next, “S-100B” is the name of the protein the antibody is designed to recognize in the body. Lastly, “Lapine” is just a descriptor of the origin of the antibody, just like the millions of other antibodies used each and every day in laboratories all across the world.

So, what exactly is an antibody? Antibodies are a naturally occurring protein and component of our immune system that are individually programmed to target a very specific protein, in the case of Brillia, the S-100B protein. It is important to understand that antibodies are one of the most specific and targeted molecules in our bodies, resulting in zero off-target effects — meaning that antibodies specifically look for and attach to their target only. This is why Brillia has no harmful side effects, because it only interacts with the S-100B protein. Not only does Brillia have absolutely zero side effects, it also has no contraindications with any other medications or supplements your child may be taking. This is due to Brillia’s extremely high level of target specificity, meaning that Brillia is so well targeted to the S-100B protein, it won’t even think about touching anything else in the body, including any other drugs or supplements.

Now that we know more about the active ingredient, let’s talk about its target, the S-100B protein.

The S-100B protein is a naturally occurring protein and is most prevalent in the brain. It is an important regulator of many processes such as regulating calcium levels and helping neurons communicate, but in our case, we care about how it influences the symptoms we mentioned earlier, such as anxiety and hyperactivity.

Given that S-100B protein influences these symptoms, it is quite intuitive that when the S-100B protein doesn’t do its job properly, these symptoms become more prevalent, and this is exactly what happens in those who suffer from anxiety, hyperactivity, stress and lack of focus.

So, what makes the S-100B protein, for a lack of a better term, mess up? The answer is quite simple, when the S-100B protein is overproduced or overactive, its activity becomes unnecessarily high, making it capable of causing these symptoms.

The firm even has something vaguely resembling evidence: a study that “shows that over the course of 12 weeks, Brillia had a significantly better effect on the severity of anxiety over those that did not take Brillia, therefore proving Brillia’s efficacy.” They show some actual results but the methods or source of the study are not disclosed. On Medline, I could not find it either. Therefore, I asked the firm to send it to me. This is the answer I got:

“Our studies were conducted in Europe and then published on our website. Please click here to view the full details found on our site.”

So, they have a study that they commissioned in Europe; it was done by researchers unnamed. The firm then put some data of it on their website. In other words:

  • we don’t know who was responsible for the study;
  • we cannot evaluate how rigorous it was;
  • it has never been peer-reviewed;
  • it is now being used for promotional purposes.

Personally, I don’t find this acceptable. In my view, this does not provide a legitimation to make far-reaching claims about the remedy. Until I have evidence to the contrary, I thus deem it safe to conclude that Brillia has no effect other than enriching the manufacturer.

In case you have categorized Harry Windsor as an ungrateful brat, you are entirely wrong! He did thank a lot of people – Ophra and Gwyneth Paltrow, for instance. No, I did not read Harry’s bestseller ‘SPARE’. But I did, of course, read the odd report about it simply because it is almost impossible to escape the current press hoo-ha about it.

Most of what I learned is of no interest to me. Some of it, I have to admit, made me concerned about Hary’s wellbeing – after all, we know that chronic drug-taking can severely affect one’s mental health! However, one recent article in Newsweek managed to reassure me on that score:

Among the “professionals, medical experts, and coaches” thanked by the prince for “keeping me physically and mentally strong over the years,” is John Amaral, a Los Angeles-based chiropractor, energy practitioner, author and educator. Amaral is known for his self-developed “energy flow formula,” which combines body and energy work to include mindfulness, meditation and breathing.

This sounded sufficiently relevant for me to look up Amaral. This is what we learn from one website:

Dr. John Amaral is a holistic chiropractor that practices Network Spinal (NSA). This technique helps people release stored tension in their muscles and joints through gentle force adjustments, also known as entrainments. Instead of the traditional cracking or popping of bones that you’re used to seeing at chiropractic offices, John Amaral leverages different energetic intelligences to help people heal physically and emotionally.

Another source tells us the following:

John Amaral is a chiropractor, energy healer and educator who works behind the scenes helping celebrities, entrepreneurs, pro athletes and influencers elevate their energy so they feel and perform their best. John has worked with thousands of people from over 50 countries. He is the Founder of Body Centered Leadership… How much do his sessions cost? According to the Wall Street Journal, a healing session with Amaral will run you $2,500.

And a third website informs us that:

Amaral works with what he calls the “subtle energy body”, which is the energy field around the body that can extend around 3 to 8 feet from the physical body. His work is primarily focused on shifting the tension state of the body and help in freeing up bound-up energy that’s held in different parts of the body. He accesses the energy around the body to achieve this.

In case you have not yet got the drift, take a look at this video; impressive isn’t it?

Yes, Amaral is not cheap but he must be worth it! And because he is such a genial healer, I am confident that we can all relax now knowing that Harry’s health is in such good hands. Personally, I am thrilled by Harry’s hint that there might be a second book in the offing – one with the really dirty linen. I think I might actually buy that one, now that I know how badly he needs the money for keeping healthy.

Yesterday, Harriet’s many friends received the sad news of her unexpected death on 11 January. Harriet was not just a good and loyal friend, she was a tirelessly working, determined, and effective skeptic. Her work focussed on so-called alternative medicine (SCAM), and thus the two of us were on the same wavelength.

Harriet’s husband, Kirk, posted this short note about her death on social media:

I know Harriet’s work was followed and admired by many of you. It is with great sadness that I must tell you my beloved wife passed away quietly and unexpectedly in her sleep last night. At this moment, she would probably simply ask you to have a kind thought for her, be kind to each other and continue to support her belief in the truth.

I feel that, without intending to, Kirk described Harriet’s character very well. She was a quiet and kind person. Yet she inspired many, and her influence was considerable. Harriet Hall had been the founding member of skeptic organizations, author of books and countless articles, recipient of awards, author of many brilliant lectures, and much more.

Harriet and I have met in person only 2 or 3 times. But we did keep in contact and exchanged many emails. Most generously, she published reviews of most of my books and was often immeasurably supportive of my work.

Harriet Hall will be remembered by skeptics around the world for her quiet enthusiasm, her kindness, and her honesty. I will always remember her for coining an absolutely perfect term for the pseudo-research that plagues the field of SCAM:

TOOTH FAIRY SCIENCE

I lost a friend; the world lost a great skeptic.

We will all miss you, Harriet!

We have discussed the UK conservative MP and arch-Brexiteer, Andrew Bridgen, and his anti-vax stance before. Yesterday, it has been reported that he lost the Tory whip, i.e. he was expelled from the Tory party. The reason for this step is that he had taken to social media and claimed the Covid vaccine to be the “biggest crime against humanity since the holocaust”.

The North West Leicestershire MP has been vocal in remarks questioning the coronavirus vaccine.

On Wednesday he shared an article on vaccines on Twitter, adding: “As one consultant cardiologist said to me, this is the biggest crime against humanity since the Holocaust.”

Renouncing Bridgen’s right to sit as a Tory MP in Parliament, Conservative chief whip Simon Hart said: “Andrew Bridgen has crossed a line, causing great offence in the process. “As a nation, we should be very proud of what has been achieved through the vaccine programme. The vaccine is the best defence against Covid that we have. “Misinformation about the vaccine causes harm and costs lives. I am therefore removing the whip from Andrew Bridgen with immediate effect, pending a formal investigation.”

Earlier, former Cabinet minister Simon Clarke had condemned his colleague’s tweet referencing the Holocaust, calling it “disgraceful”.

Bridgen is currently already suspended from the Commons after he was found to have displayed a “very cavalier” attitude to the rules in a series of lobbying breaches. MPs agreed on Monday to suspend the North West Leicestershire MP for five sitting days from Tuesday.

Comments from different sources are not flattering for Bridgen:

  • Karen Pollock, the chief executive of the Holocaust Educational Trust, said Bridgen’s tweet was “highly irresponsible, wholly inappropriate and an elected politician should know better”.
  • Anneliese Dodds, the Labour chair, said: “Andrew Bridgen has been spreading dangerous misinformation on Covid vaccines for some time now. He could have been disciplined weeks ago. “To invoke the Holocaust, as he did today, is utterly shameful, but it should never have reached this point.”
  • Andrew Percy, the Conservative MP who is vice-chair of the all-party group against antisemitism, called the comment “disgusting”. Asked by Times Radio if Bridgen should be allowed to stand again, Percy said: “I don’t think anybody who believes this kind of crap should, but that’s a matter for the whips not for me.”
  • John Mann, the former Labour MP who is now a non-affiliated peer and the government’s independent adviser on antisemitism, said Bridgen should not be allowed to stand again as a Tory. “There is no possibility that Bridgen can be allowed to stand at the next election,” he said. “He cannot claim that he didn’t realise the level of offence that his remarks cause.”

____________________________

To the best of my knowledge, this is the first time that a UK politician has been punished in this way. But it may well be also the first time that a sitting UK politician has uttered such insane stupidity. Bridgen’s chronic ineptitude is all the more significant as he really should know better. He studied genetics and behaviour at the University of Nottingham and graduated with a degree in biological sciences!

Here are some reactions from people commenting on Twitter about the twit:

  • Tory MP, Andrew Bridgen highlights… – Lies in court over family dispute and ordered by judge to pay £800k – Suspended for breaching MP lobbying rules – Thought all Brits entitled to Irish passport after Brexit – Likens vaccines to holocaust What a guy.
  • Spreads a dangerous, baseless smear his party colluded in a vaccine Holocaust and at the same time manages to insults victims of a grotesque wartime Holocaust. Conspiracy theorist Andrew Bridgen’s lost the plot. See no way back for the Tory MP now.
  • Grubby and despicable: Tory MP Andrew Bridgen loses whip over ‘dangerous’ Covid vaccine claims
  • To be fair, Bridgen kept the whip after saying the MI5 knew about the pandemic six months early, then colluded with shadowy elites to impose needless restrictions for their own nefarious ends. So the bar is high.
  • Politicians like Andrew Bridgen have succeeded in bringing conspiracy theories into the mainstream. They need to be called out, their arguments dismantled and their political influence cast out to the fringes where it belongs.
  • A Holocaust survivor has condemned a Tory MP’s “mind-boggling ignorance” after he compared the mass genocide of Jewish people during World War II to the COVID vaccine rollout
  • Many congratulations to Andrew Bridgen on his imminent selection as the Reform Party candidate for North West Leicestershire in the 2024 election
  • Andrew Bridgen. Perjury, bullying, misuse of money, months of anti-vaccine garbage, finally loses whip after comparing vaccination to the Holocaust. Scum.
  • Six million Jews were murdered in the Holocaust. COVID vaccines have saved millions. The false and outrageous comparisons must end.
  • Andrew Bridgen suspended as Tory MP he said: “As one consultant cardiologist said to me, this is the biggest crime against humanity since the Holocaust.” Crucially a cardiologist saying this too. Who are they? Should GMC act in same way as Whips Office?

The prime candidate for the cardiologist in question must, of course, be Aseem Malhotra who also appeared on September 27, 2022, in a press conference with the World Council for Health — a group that has previously spread vaccine misinformation — to call for the “immediate and complete suspension of Covid-19 vaccine.”

Who was it that coined the bon mot: We were all born ignorant but to remain so requires hard work

It is hardly surprising that I receive plenty of complaints about the things I publish. After all, so-called alternative medicine (SCAM) is dominated by emotions and not by rationality. When I was still in post at Exeter, my peers received complaints about me all the time. Now that I write articles for several newspapers and journals (not to mention this blog), the flow of complaints to the editors is continuing nicely. Consequently, I am in a good position to offer a beginner’s guide to complaining to everyone who is fed up with me and my work.

Foremost, such a complaint must have a clear structure. Here is one that I advise considering:

  1. Introduction
  2. Self-aggrandizement
  3. Your objection
  4. Ad hominem
  5. Generalizations
  6. Threats

Allow me to take you through these headings one by one.

Introduction

The recipient of your complaint (e.g. a newspaper editor) needs to know why you are addressing him or her. This means you ought to clearly state your aim at the outset. Something like “I am writing to you to complain about an article recently published in your paper” would probably suffice. But you probably find it hard to be concise – and who could blame you: you are fuming with anger and overflowing with emotion.

I am sure the recipient of your complaint will understand that you have to use a few colorful sentences to introduce the subject properly. If you feel like elaborating that you have been a reader of the paper since 1972, or that you slept badly last night, or that your last dinner was indigestible, or why you are opposed to COVID vaccinations – by all means, please go ahead. The editor will be delighted to receive a little background and can thus empathize with your concerns.

Self-aggrandizement

Despite these efforts, there is always the danger that the editor reading your complaint does not take you seriously. This must be avoided at all costs. Therefore, you must make sure he/she understands how important you truly are. As your complaint is healthcare-related, it is helpful to stress your unique standing in this area. Do not worry if you have not studied medicine, are not a scientist, or understand buggar all about anything. The least you must do is to state that you have years of experience in health. Such phraseology is non-commital – after all, you probably have been ill once or twice – and it makes it clear that you know what you are talking about.

Your objection

Now it is time to state what you actually object to and why. This might not be as easy as it sounds. Most people who complain about my work are unable to pinpoint what exactly it is that they don’t like. They never dispute a concrete fact or finding I presented but they disagree with my stance in general terms. Therefore, they cannot define a precise error or misinterpretation in my text. In such cases, it might be best to claim that you have read several or all of my articles and you are scandalized by my general attitude, ignorance, or malice. You might add that my articles systematically defame SCAMs that:

  • have clearly stood the test of time,
  • are used by millions,
  • are holistic,
  • have cured your goldfish, etc.

Do never include any actual data in your complaint. This can only expose you to criticism; and that’s the last thing you want to achieve.

Ad hominem

The less specific material you complain about, the more important it is to display true conviction by going on a personal attack. I can highly recommend the ad hominem principle for this purpose. Go for it!

In a previous post, I listed some ideas that might help you here. You could claim that:

  • I am not qualified
  • I only speak tosh
  • I do not understand science
  • I never did any ‘real’ research
  • Exeter Uni fired me
  • I have been caught red-handed (not quite sure at what)
  • I am on BIG PHARMA’s payroll
  • I faked my research papers

Feel free to come up with your own ideas; use your imagination. I am sure the editor who reads your inspired lines will thank you for it.

Generalizations

Now that you have thoroughly dealt with me (Prof Ernst) as a person, you need to generalize in order to lend more relevance and impact to your complaint. You could point out, for example, that not just I but all scientists or skeptics are corrupt, ignorant, etc. Or you might explain that, in any case, science is over-rated and cannot be trusted. Such enlightened remarks are important because they put things into perspective and show that you are well-informed.

Threats

To end your letter, it is advisable to ensure that the editor who is trying to make sense of your complaint cannot dismiss it easily. For this purpose, I find it helpful to add a few actual threats. The editor needs to know that he would disregard your concerns at his own peril.

For instance, you could state that, if this paper/journal in question should dare to ever again publish a single line of Ernst’s writings, you will never again buy this publication. If you want to sound alarmingly dangerous, add that you will tell all your friends to do likewise. And if you wish to scare the hell out of the poor editor, tell him/her that you will file a report with the ombudsman.

______________________________

 GOOD LUCK

 

The objective of this cross-sectional survey was to evaluate the beliefs about and attitudes toward cancer prevention of people professing vaccination skepticism or conspiracy theories. Data were collected mainly from a well-known Spanish forum and other platforms, including Reddit (English), 4Chan (English), HispaChan (Spanish), and a Spanish-language website for cancer prevention (mejorsincancer.org) from January to March 2022.

Among 1494 responders, 209 were unvaccinated against covid-19, 112 preferred so-called alternative rather than conventional medicine, and 62 reported flat earth or reptilian beliefs. Cancer beliefs were assessed using the Cancer Awareness Measure (CAM) and Cancer Awareness Measure Mythical Causes Scale (CAM-MYCS), both validated tools.

Awareness of the actual causes of cancer was greater (median CAM score 63.6%) than that of mythical causes (41.7%). The most endorsed mythical causes of cancer were:

  • eating food containing additives or sweeteners,
  • feeling stressed,
  • eating genetically modified food.

Awareness of the actual and mythical causes of cancer among the unvaccinated, alternative medicine, and conspiracy groups was lower than among their counterparts. A median of 54.5% of the actual causes was accurately identified among each of the unvaccinated, alternative medicine, and conspiracy groups, and a median of 63.6% was identified in each of the three corresponding counterparts (P=0.13, 0.04, and 0.003, respectively). For mythical causes, medians of 25.0%, 16.7%, and 16.7% were accurately identified in the unvaccinated, alternative medicine, and conspiracy groups, respectively; a median of 41.7% was identified in each of the three corresponding counterparts (P<0.001 in adjusted models for all comparisons).

In total, 673 (45.0%) participants agreed with the statement “It seems like everything causes cancer.” No significant differences were observed among the unvaccinated (44.0%), conspiracist (41.9%), or alternative medicine groups (35.7%), compared with their counterparts (45.2%, 45.7%, and 45.8%, respectively).

The authors’ conclusions were as follows: we evaluated the patterns of beliefs about cancer among people who believed in conspiracies, rejected the covid-19 vaccine, or preferred alternative medicine. We observed that the participants who belonged to these groups were more likely to endorse mythical causes of cancer than were their counterparts but were less likely to endorse the actual causes of cancer. Almost half of the participants, whether
conspiracists or not, agreed with the statement “It seems like everything causes cancer,” which highlights the difficulty that society encounters in differentiating actual causes of cancer from mythical causes owing to mass (veridical or not) information. This suggests a direct connection between digital misinformation and consequent potential erroneous health decisions, which may represent a further preventable fraction of cancer. Cultivating oriented medical education and scientific literacy, improving online ranking algorithms, building trust, and using effective health communication and social marketing campaigns may be possible ways to tackle this complex public health threat.

This is yet another study showing that so-called alternative medicine (SCAM) usage is linked to misinformation and conspiratorial thinking in other areas. We have discussed similar findings all too often. They are hardly surprising, in my view. As I have repeatedly been trying to point out:

The best way to prevent harm must therefore be to educate the public responsibly (which, of course, is one of the main aims of this blog.

I have tried!

Honestly!

But at present, it is simply not possible to escape the revelations and accusations by Harry Windsor.

So, eventually, I gave in and had a look at the therapy he often refers to. He claims that he is deeply traumatized by what he had to go through and, to help him survive the ordeal, Harry has been reported to use EMDR.

Eye Movement Desensitization and Reprocessing (EMDR) is a fringe psychotherapy that was developed to alleviate the distress associated with traumatic memories. It is supposed to facilitate the accessing and processing of traumatic memories and other adverse life experiences with a view of bringing these to an adaptive resolution. The claim is that, after successful treatment with EMDR therapy, affective distress is relieved, negative beliefs are reformulated, and physiological arousal is reduced.

During EMDR therapy the patient must attend to emotionally disturbing material in brief sequential doses while simultaneously focusing on an external stimulus. Therapist-directed lateral eye movements are commonly used as external stimulus but a variety of other stimuli including hand-tapping and audio stimulation can also be employed.

Francine Shapiro, the psychologist who invented EMDR claims to have serendipitously discovered this technique by experiencing spontaneous saccadic eye movements in response to disturbing thoughts during a walk in the woods. Yet, as GM Rosen explains, this explanation is difficult to accept because normal saccadic eye movements appear to be physiologically undetectable and are typically triggered by external stimuli.

Shapiro hypothesizes that EMDR therapy facilitates the access to the traumatic memory network, so that information processing is enhanced, with new associations forged between the traumatic memory and more adaptive memories or information. These new associations are alleged to result in complete information processing, new learning, elimination of emotional distress, and development of cognitive insights.

EMDR therapy uses a three-pronged protocol:

  • (1) the past events that have laid the groundwork for dysfunction are processed, forging new associative links with adaptive information;
  • (2) the current circumstances that elicit distress are targeted, and internal and external triggers are desensitized;
  • (3) imaginal templates of future events are incorporated, to assist the client in acquiring the skills needed for adaptive functioning.

The question I ask myself is, of course: Does EMDR work?

The evidence is mixed and generally flimsy. A systematic review showed that “limitations to the current evidence exist, and much current evidence relies on small sample sizes and provides limited follow-up data”.

What might be particularly interesting in relation to Harry Windsor is that EMDR techniques have been associated with memory-undermining effects and may undermine the accuracy of memory, which can be risky if patients, later on, serve as witnesses in legal proceedings.

Personally, I think that Harry’s outbursts lend support to the hypothesis that EMDR is not effective. In the interest of the royal family, we should perhaps see whether so-called alternative medicine (SCAM) does offer an effective treatment against navel gazing?

It has been reported that a German consumer association, the ‘Verbraucherzentrale NRW’, has first cautioned the manufacturer MEDICE Arzneimittel Pütter GmbH & Co. and then sued them for misleading advertising statements. The advertisement in question gave the wrong impression that their homeopathic remedy MEDITONSIN would:

  1. for certain generate a health improvement,
  2. have no side effects,
  3. be superior to “chemical-synthetic drugs”.

The study used by the manufacturer in support of such claims was not convincing according to the Regional Court of Dortmund. The results of a “large-scale study with more than 1,000 patients” presented a pie chart indicating that 90% of the patients were satisfied or very satisfied with the effect of Meditonsin. However, this was only based on a “pharmacy-based observational study” with little scientific validity, as pointed out by the consumer association. Despite the lack of evidence, the manufacturer claimed that their study “once again impressively confirms the good efficacy and tolerability of Meditonsin® Drops”. The Regional Court of Dortmund disagreed with the manufacturer and agreed with the reasoning of the consumer association.

“It is not permitted to advertise with statements that give the false impression that a successful treatment can be expected with certainty, as suggested by the advertising for Meditonsin Drops,” emphasizes Gesa Schölgens, head of “Faktencheck Gesundheitswerbung,” a joint project of the consumer centers of North Rhine-Westphalia and Rhineland-Palatinate. According to German law, this is prohibited. In addition, the Regional Court of Dortmund considered consumers to be misled by the advertising because the false impression was created that no harmful side effects are to be expected when Meditonsin Drops are taken. The package insert of the drug lists several side effects, according to which there could even be an initial worsening of symptoms after taking the drug.

The claim of advantages of the “natural remedy” represented by the manufacturer in comparison with “chemical-synthetic medicaments, which merely suppress the symptoms”, was also deemed to be inadmissible. Such comparative advertising is inadmissible.

__________________________________

This ruling is, I think, interesting in several ways. The marketing claims of so-called alternative medicine (SCAM) products seem all too often not within the limits of the laws. One can therefore hope that this case might inspire many more legal cases against the inadmissible advertising of SCAMs.

 

You, the readers of this blog, have spoken!

The WORST PAPER OF 2022 competition has concluded with a fairly clear winner.

To fill in those new to all this: over the last year, I selected articles that struck me as being of particularly poor quality. I then published them with my comments on this blog. In this way, we ended up with 10 papers, and you had the chance to nominate the one that, in your view, stood out as the worst. Votes came in via comments to my last post about the competition and via emails directly to me. A simple count identified the winner.

It is PAUL VARNAS, DC, a graduate of the National College of Chiropractic, US. He is the author of several books and has taught nutrition at the National University of Health Sciences. His award-winning paper is entitled “What is the goal of science? ‘Scientific’ has been co-opted, but science is on the side of chiropractic“. In my view, it is a worthy winner of the award (the runner-up was entry No 10). Here are a few memorable quotes directly from Paul’s article:

  • Most of what chiropractors do in natural health care is scientific; it just has not been proven in a laboratory at the level we would like.
  • In many ways we are more scientific than traditional medicine because we keep an open mind and study our observations.
  • Traditional medicine fails to be scientific because it ignores clinical observations out of hand.
  • When you think about it, in natural health care we are much better at utilizing the scientific process than traditional medicine.

But I am surely doing Paul an injustice. To appreciate his article, please read his article in full.

I am especially pleased that this award goes to a chiropractor who informs us about the value of science and research. The two research questions that undoubtedly need answering more urgently than any other in the realm of chiropractic relate to the therapeutic effectiveness and risks of chiropractic. I just had a quick look in Medline and found an almost complete absence of research from 2022 into these two issues. This, I believe, makes the award for the WORST PAPER OF 2022 all the more meaningful.

 

PS

Yesterday, I wrote to Paul informing him about the good news (as yet, no reply). Once he provides me with a postal address, I will send him a copy of my recent book on chiropractic as his well-earned prize. I have also invited him to contribute a guest post to this blog. Watch this space!

This meta-analysis of randomized clinical trials (RCTs) was aimed at evaluating the effects of massage therapy in the treatment of postoperative pain.

Three databases (PubMed, Embase, and Cochrane Central Register of Controlled Trials) were searched for RCTs published from database inception through January 26, 2021. The primary outcome was pain relief. The quality of RCTs was appraised with the Cochrane Collaboration risk of bias tool. The random-effect model was used to calculate the effect sizes and standardized mean difference (SMD) with 95% confidential intervals (CIs) as a summary effect. The heterogeneity test was conducted through I2. Subgroup and sensitivity analyses were used to explore the source of heterogeneity. Possible publication bias was assessed using visual inspection of funnel plot asymmetry.

The analysis included 33 RCTs and showed that MT is effective in reducing postoperative pain (SMD, -1.32; 95% CI, −2.01 to −0.63; p = 0.0002; I2 = 98.67%). A similarly positive effect was found for both short (immediate assessment) and long terms (assessment performed 4 to 6 weeks after the MT). Neither the duration per session nor the dose had a significant impact on the effect of MT, and there was no difference in the effects of different MT types. In addition, MT seemed to be more effective for adults. Furthermore, MT had better analgesic effects on cesarean section and heart surgery than orthopedic surgery.

The authors concluded that MT may be effective for postoperative pain relief. We also found a high level of heterogeneity among existing studies, most of which were compromised in the methodological quality. Thus, more high-quality RCTs with a low risk of bias, longer follow-up, and a sufficient sample size are needed to demonstrate the true usefulness of MT.

The authors discuss that publication bias might be possible due to the exclusion of all studies not published in English. Additionally, the included RCTs were extremely heterogeneous. None of the included studies was double-blind (which is, of course, not easy to do for MT). There was evidence of publication bias in the included data. In addition, there is no uniform evaluation standard for the operation level of massage practitioners, which may lead to research implementation bias.

Patients who have just had an operation and are in pain are usually thankful for the attention provided by carers. It might thus not matter whether it is provided by a massage or other therapist. The question is: does it matter? For the patient, it probably doesn’t; However, for making progress, it does, in my view.

In the end, we have to realize that, with clinical trials of certain treatments, scientific rigor can reach its limits. It is not possible to conduct double-blind, placebo-controlled studies of MT. Thus we can only conclude that, for some indications, massage seems to be helpful (and almost free of adverse effects).

This is also the conclusion that has been drawn long ago in some countries. In Germany, for instance, where I trained and practiced in my younger years, Swedish massage therapy has always been an accepted, conventional form of treatment (while exotic or alternative versions of massage therapy had no place in routine care). And in Vienna where I was chair of rehab medicine I employed about 8 massage therapists in my department.

Subscribe via email

Enter your email address to receive notifications of new blog posts by email.

Recent Comments

Note that comments can be edited for up to five minutes after they are first submitted but you must tick the box: “Save my name, email, and website in this browser for the next time I comment.”

The most recent comments from all posts can be seen here.

Archives

Categories