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

Monthly Archives: July 2024

Recently, I heard JD Vance (the would-be Vicepresident of the US) proclaim: THE ENEMY ARE THE PROFESSORS! Unsurprisingly, this remark alarmed me; I had not been previously aware of being an enemy of the people.

Vance stressed that this was a quote by Richard Nixon made some 40/50 years ago. I looked up Nixon’s quote and found that the original is apparently a little different:

Never forget, the press is the enemy. The establishment is the enemy. The professors are the enemy. The professors are the enemy. Write that on a blackboard a hundred times and never forget it.

So, why does Vance quote Nixon (arguably not one of the most honest men in the history of US politics) and insist on THE PROFESSORS ARE THE ENEMY? Why was this puzzling quote followed by plenty of applause from his audience?

The answer must be that it is a populist theme that touches a nerve with right-wing voters. But what does the sentence actually mean?

On Vance’s campaign website, he explains that “hundreds of billions of American tax dollars” get sent to universities that “teach that America is an evil, racist nation.” These universities “then train teachers who bring that indoctrination into our elementary and high schools.” Vance doesn’t want public funds to go to institutions that teach “critical race theory or radical gender ideology.” He rather wants them to deliver “an honest, patriotic account of American history.”

Vance and Nixon are not the first politicians to recently claimed that the enemies are the professors. In 2016, the UK conservative Michael Gove refused to name any economist backing Britain’s exit from the European Union, saying that “people in this country have had enough of experts”.

According to Wikipedia, anti-intellectualism is hostility to and mistrust of intellectintellectuals,  and intellectualism, commonly expressed as deprecation of education and philosophy and the dismissal of artliteraturehistory, and science as impractical, politically motivated, and even contemptible human pursuits. Anti-intellectuals may present themselves and be perceived as champions of common folk—populists against political and academic elitism—and tend to see educated people as a status class that dominates political discourse and higher education while being detached from the concerns of ordinary people. Totalitarian governments have, in the past, manipulated and applied anti-intellectualism to repress political dissent. During the Spanish Civil War (1936–1939) and the following dictatorship (1939–1975) of General Francisco Franco,  the reactionary repression of the White Terror (1936–1945) was notably anti-intellectual, with most of the 200,000 civilians killed being the Spanish intelligentsia, the politically active teachers and academics, artists and writers of the deposed Second Spanish Republic (1931–1939). During the Cambodian Genocide (1975–1979), the totalitarian regime of Cambodia led by Pol Pot nearly destroyed its entire educated population.

Fascist movements are notoriously anti-intellectual and anti-science. Adolf Hitler said he regretted that his regime still had some need for its “intellectual classes,” otherwise, “one day we could, I don’t know, exterminate them or something.” And Joseph Goebbels said this: “There was no point in seeking to convert the intellectuals. For intellectuals would never be converted and would anyway always yield to the stronger, and this will always be the man in the street. Arguments must therefore be crude, clear and forcible, and appeal to emotions and instincts, not the intellect. Truth was unimportant and entirely subordinate to tactics and psychology.” And the ‘bon mot’, “when I hear the word culture, I reach for my gun”, is attributed even to several of the top Nazis of the Third Reich.

And here we might have a reason why a certain type of politician dislikes intellectuals and feels that the enemy are the professors. Professors do science, science is about truth, and the truth is something that politiciance like Vance must fear like the pest. It would disclose their agenda as being fascist.

In conclusion, the claim, “THE PROFESSORS ARE THE ENEMY”, is an argument of polititians who have good reason to fear the truth, and it appeals to voters who are too dim to understand the danger posed by those they wish to elect.

 

 

 

 

What is it about Reiki that fascinates me?

It must be the exemplary poor science that its proponents use trying to convince us that it is valid.

This randomized controlled trial investigated the effect of Reiki on pain, functional status, and holistic well-being in patients with knee osteoarthritis (OA). The sample consisted of 42 patients.

  • The control group received standardized treatment only.
  • The intervention group received face-to-face Reiki (nine positions; 39 minutes) and distance Reiki on two consecutive days in addition to standardized treatment in addition to standard treatment.

The results show that the Reiki group had lower pain scores than the control group as measured by the Visual Analog Scale (p < .001) and the Western Ontario and McMaster Universities Arthritis Index pain score (p < .001). Those participating in the Reiki group had improved holistic well-being scores specifically for the subscales of Sadness, Perception of Sadness, Spiritual Disruption, Cognitive Awareness, and General mood.

The authors concluded that Reiki is a safe, noninvasive, and cost-effective alternative treatment technique that has the potential to reduce symptoms of pain and improve holistic well-being in patients with knee OA.

So many falsehoods in one sentence!

Is this a new record?

Let’s analyse these conclusions a little, shall we?

  • Reiki is safe: this does not follow from the data because the sample was far too small for assessing rare safety issues, safety was not measured, and half of the Reiki group might have dropped dead a week after the study.
  • Reiki is non-invasive: that might be true.
  • Reiki is cost-effective: cost-effectiveness was not an endpoint; the statement is thus not supported by the data.
  • Reiki reduces the symptoms of pain and improve holistic well-being in patients with knee OA: I disagree! The observed outcomes are much more likely caused by the considerable amount of extra attention and treatment time given to the Reiki group, and the results were entirely unrelated to any specific effects of the therapy.

So, I feel the need for re-phrasing the conclusions as follows:

Reiki is an implausible treatment and the outcomes of this study are unrelated to any alleged specific effects of this therapy.

A new market report predicts that the worldwide market for so-called alternative medicine (SCAM) will grow from $100 billion in 2022 to $438 billion by 2032.

According to the report, the SCAM market is expected to see innovation and expansion through mergers, acquisitions, and partnerships among large companies. Companies that are capitalizing on these trends include health supplement companies, companies that specialize in Ayurvedic health, those that offer TCM solutions, and those that offer more general holistic solutions to health. Major supplement brands include Herb Pharm LLC, Gaia Herbs, NOW Foods, Life Extension, Pure Encapsulations, Douglas Laboratories, Nordic Naturals, Nordic Nutraceuticals, Quality of Life Labs, Nature’s Bounty Co., Valensa International, Herbo Nutra, and Emerson Ecologics.

Other major players mentioned in the report are:

  • AYUSH Ayurvedic Pte Ltd, Dabur India Ltd., Himalaya Global Holdings Ltd., Banyan Botanicals, and Arya Vaidya Pharmacy offer Ayurvedic health and wellness products while aiming to advance the science behind Ayurveda.
  • Sheng Chang Pharmaceutical Company produces traditional Chinese medicines and herbal products that is one of the largest TCM pharma companies.
  • All and One Medical provides healthcare solutions that combine conventional medicine with complementary and alternative therapies to promote overall wellness and preventive care.
  • The John Schumacher Unity Woods Yoga Center is another that focuses on enhancing physical and mental well-being through the practice of Iyengar Yoga and offers classes and workshops.
  • New Life Chiropractic aims to improve overall health and well-being by providing comprehensive chiropractic care that focuses on spinal health and preventive wellness.
  • The Chicago Body Works offers a range of therapies and treatments designed to enhance physical and mental well-being, including massage and bodywork services.
  • Weleda AG aims to connect people with nature by producing natural organic products that support health, beauty, and overall wellness while practicing sustainability and social responsibility.
  • Quantum-Touch Inc. teaches energy healing techniques that promote physical, emotional, and spiritual health.
  • Spectrum Chemical Manufacturing Corporation focuses on delivering high-quality chemicals and laboratory supplies to support scientific research and innovation across various industries, including health and wellness.

I must admit, I do like these market reports. They never fail to amuse me – for two main reasons:

  1. They are as reliable as reading tea leafs.
  2. The only reliable info they do provide is that the SCAM proponents’ often-voiced argument, “we are very different from BIG PHARMA” is pure nonsense.

Several years ago, I reported on the range of conditions which, according to homeopaths, “respond best to homeopathic treatment” (basically any condition imaginable). To remind you, here is the list again:

ENT and bronchial problems

  • Ear infections,
  • rhinitis,
  • sinusitis,
  • pharyngitis,
  • tonsillitis,
  • tracheitis,
  • bronchitis,
  • asthma.

Digestive problems

  • Stomach complaints
  • acidity,
  • heartburn,
  • fullness,
  • poor digestion,
  • flatulence,
  • duodenal ulcer,
  • diarrhoea,
  • constipation,
  • nausea,
  • vomiting,
  • canker sores.

Cardiovascular problems

Osteoarticular complaints

All types of muscle and/or joint pain due to arthrosis or arthritis:

  • neck pain,
  • shoulder pain,
  • elbow pain,
  • wrist pain,
  • Back pain,
  • sciatica,
  • knee pain,
  • ankle pain,
  • Sprains,
  • contractures etc.

Traumas

Urological disorders

Gynaecological problems

Dermatological problems

  • Eczema, hives,
  • Acne vulgaris, acne rosacea,
  • Recurrent boils, verucas, plantar warts,
  • Molluscum contagiosum,
  • Herpes simple and zoster
  • Psoriasis

Neurological disorders

  • Headaches and migraines.
  • Eye problems
  • Conjunctivitis,
  • blepharitis,
  • styes, dacryocistitis,
  • uveitis.

Behavioural and psychiatric disorders

  • Anxiety,
  • depression,
  • stress,
  • mental fatigue,
  • Pediatric problems,
  • Ear infections,
  • tonsillitis,
  • bronchitis,
  • asthma,
  • diarrhoea,
  • vomiting,
  • skin complaints,
  • canker sores,
  • teething problems,
  • sleep disorders,
  • educational attainment issues,
  • behavioural issues.

Endocrine disorders

  • Obesity,
  • hypothyroidism,
  • hyperthyroidism,
  • Depleted immune defences,
  • Recurrent infections affecting the throat,
  • sinuses, nose, ears,
  • connective tissue, larynx,
  • bronchial tubes,
  • lungs,
  • skin,
  • bladder etc.

Palliative care

For the treatment of the diverse symptoms that appear over the course of the illness. Homeopathy can improve the patient’s general wellbeing and counteract the side effects of other treatments.

These are just a few examples, but the list could be endless – it is important to stress that homeopathy is very effective in pathologies that are difficult to establish or those with contradictory or paradoxical symptoms.

In recurrent illnesses, homeopathic medicines can boost the defences and help to regulate the sufferer’s body in order to prevent further relapses.

Homeopathy is an excellent preventive medicine.

_______________________

You will notice that SCIATICA is on the list.

Would they really be as daft as to use homeopathy for sciatica?

Not only that, they would even conduct a study on the subject. Here is this recently published trial:

Objectives: Sciatica is a debilitating condition that causes pain in its distribution or in the lumbosacral nerve root that is connected to it. Although there are claims that homeopathy can reduce sciatica pain, systematic scientific proof is currently lacking. The objective of the trial was to determine whether individualized homeopathic medicines (IHMs) were as effective as identical-looking placebos in treating sciatica pain. Design: This is a double-blind, randomized (1:1), two parallel arms, placebo-controlled trial. Setting: The study was conducted at Mahesh Bhattacharyya Homoeopathic Medical College and Hospital, Howrah, West Bengal, India. Subjects: Sixty participants with sciatica pain were included in this study. Interventions: Verum (n = 30; IHMs plus concomitant care) versus control (n = 30; placebos plus concomitant care). Outcome measures: Primary-Sciatica Bothersome Index (SBI) and Sciatica Frequency Index (SFI) scores and secondary-Roland Morris Pain and Disability Questionnaire (RMPDQ), Short Form McGill Pain Questionnaire (SF-MPQ), and Oswestry Low Back Pain Questionnaire (OLBPQ) scores: all of them were measured at baseline, and every month, up to 3 months. Results: Intention-to-treat sample (n = 60) was analyzed. Group differences were examined by two-way (split-half) repeated measure analysis of variance, primarily accounting for between groups and time interactions, and additionally, by unpaired t tests comparing the estimates obtained individually every month. The level of significance was set at p < 0.025 and <0.05 two tailed for the primary and secondary outcomes, respectively. Group differences could not achieve significance in SBI (p = 0.044), SFI (p = 0.080), and RMPDQ scores (p = 0.134), but were significant for SF-MPQ (p = 0.007) and OLBPQ (p = 0.036). Gnaphalium polycephalum (n = 6; 10%) was the most frequently prescribed medicine. No harm, serious adverse events, or intercurrent illnesses were recorded in either of the groups. Conclusions: The primary outcome failed to demonstrate evidently that homeopathy was effective beyond placebo, and the trial remained inconclusive. Independent replications are warranted to confirm the findings.

So, homeopathy does not work for sciatica.

Surprise, surprise!

Why not?

Simple: because homeopathy does not work for any condition.

Some papers on homeopathy are bad, others are very bad and others again create a new dimension of bad. Here is an example of the latter category (Research, Society and Development, v. 13, n. 7, e1413746050, 2024
(CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v13i7.46050 ):

Objective: To research, through literature review, the use of homeopathy as an alternative treatment for many pathologies involved in dentistry field. Methodology: online searches using databases available at PUBMED Central and VHL/BIREME. Other platforms such as Web of Science, Science Direct and Google Academy. Results: Our search resulted in 25 articles. Conclusion: Despite the mysticism that surrounds it, the use of homeopathic medicines in dental treatments is, in fact, a scientifically proven alternative treatment, which helps in various pre and post surgical procedures, which has a low financial cost and great effectiveness, enabling a contribution to dental care. Scientific study in this area requires more research and clinical evidence, so that this practice is more widespread and used by dental surgeons, in addition to the application of homeopathy as a discipline in dentistry.

But that’s merely the abstract. Perhaps the article itself offers some convincing evidence. See for yourself; here is the only section of the paper that provides something akin to evidence:

In dentistry, homeopathic remedies have been proposed for a variety of conditions including oral ulcers, sialorrhea (excessive salivation), neuralgia, temporomandibular joint disorders (TMJ), xerostomia (dry mouth), lichen planus, bruxism (teeth grinding), minor acute illnesses, chronic pathologies, atypical facial pain, burning mouth syndrome, postoperative osteitis, and anxiety related to dental treatment (Steinchler, 2015; Fischer, 2005). They are often used as adjuncts to conventional treatments, especially in cases where traditional approaches have failed or are contraindicated (Amaral, 2021).

Homeopathic medicines for these conditions come in various forms such as tablets, pills, drops, liquids, granules, and creams (Darby, 2011). Some are designed to dissolve on or under the tongue for quick absorption. The instructions typically advise placing the medicine directly in the mouth, where it can be sucked or chewed to facilitate absorption (Darby, 2011).

The use of homeopathic remedies in dentistry offers several potential benefits, including cost-effectiveness, versatility across different dental specialties (such as orthodontics, stomatology, endodontics, pediatric dentistry, periodontics, and surgery), relative efficacy, safety, and ease of use (Eleutério, 2011; Mendonça, 2022; Almeida et al., 2023). This makes them a valuable option in integrative dental care, where they can complement conventional treatments and provide additional therapeutic options for patients.

______________________

As the Brazilian authors of the article fail to say it, allow me to do so:

The place of homeopathy in dentistry is nowhere! There is no reliable evidence that homeopathy is effective for any of the conditions listed above.

PS

This paper is nonetheless notable: it is certainly amongst the worst I have seen for a very long time.

Project 2025 is a set of proposals from the US Heritage Foundation to reform the US according to right-wing ideology and to consolidate executive power shouldTrump win the 2024 presidential election. The project is a most frightening blueprint for fascism in the US and would have serious implications for the rest of the world. It would also profoundly impact on healthcare (my expertise) in multiple ways.

Here are some of them:

According to Project 2025, the federal government should prohibit Medicare from negotiating drug prices and promote the Medicare Advantage program, which consists of private insurance plans. Federal healthcare providers should deny gender-affirming care to transgender people and eliminate insurance coverage of the morning-after-pill Ella. Project 2025 also suggests a number of ways to cut funding for Medicaid, such as caps on federal funding, limits on lifetime benefits per capita, and letting state governments impose stricter work requirements for beneficiaries of this program. Other proposals include limiting state use of provider taxes, eliminating preexisting federal beneficiary protections and requirements, increasing eligibility determinations and asset test determinations to make it harder to enroll in, apply for and renew Medicaid, providing an option to turn Medicaid into a voucher program, and eliminating federal oversight of state medicaid programs.

Project 2025 insists that life begins at conception. The Mandate says that the Department of Health and Human Services (HHS) should “return to being known as the Department of Life”. Project 2025 says it would reposition department policies “by explicitly rejecting the notion that abortion is health care and by restoring its mission statement under to include furthering the health and well-being of all Americans ‘from conception to natural death’.”

The project opposes any initiatives that, in its view, subsidize single parenthood. Project 2025 encourages the next administration to rescind some of the provisions of the Family Planning Services and Population Research Act of 1970, which offers reproductive healthcare services, and to require participating clinics to emphasize the importance of marriage to potential parents.

According to Project 2025, the Food and Drug Administration is “ethically and legally obliged to revisit and withdraw its initial approval” of the abortion pills mifepristone and misoprostol. It recommends that the Centers for Disease Control and Prevention “update its public messaging about the unsurpassed effectiveness of modern fertility awareness-based methods” of contraception, such as smartphone applications that track a woman’s menstrual cycle. The project also seeks to restore Trump-era “religious and moral exemptions” to contraceptive requirements under the Affordable Care Act, including emergency contraception, which it deems an abortifacient, to defund Planned Parenthood, and to remove protection of medical records involving abortions from criminal investigations if the owners of said records cross state lines.

Project 2025 aims to prohibit sending abortion pills and medical equipment used for abortions through the mail; the plan would allow criminal prosecution for senders and receivers of abortion pills. Project 2025 does not explicitly promote the prohibition of abortion, but some legal experts and abortion rights advocates said adopting the Project’s plan would cut off access to medical equipment used in surgical abortions to create a de facto national abortion ban.

Project 2025 advises the federal government to deprecate what it considers promotion of abortion and high-risk sexual behaviors among adolescents. It also seeks to remove the role of the Department of Health and Human Services in shaping sex education in the United States, arguing that this is tantamount to creating a monopoly.

__________________________

If you think this part on healthcare (within my area of expertise) is crazy or dangerous, you should see the rest of the document (not my area of expertise)!

Donald Trump tried hard to deny that he has anything to do with the project. But this as been largely in vain. However, the Democratic National Committee is rolling out a media blitz connecting him to it. This campaign will erect splashy billboards in major cities throughout the battleground states including Atlanta, Las Vegas, Raleigh, Charlotte, Philadelphia, Detroit, Lansing, Grand Rapids, Green Bay, and Phoenix.

Project 2025 is being staffed with countless members of Trump’s administration as well as close advisers. “I know nothing about Project 2025. I have not seen it, have no idea who is in charge of it, and, unlike our very well received Republican Platform, had nothing to do with it,” “Trump’s Plan to be a dictator day one: Project 2025. Google it,” reads one billboard. Another explains how Project 2025 will eviscerate our checks and balances, enable a Trump revenge tour, and ban abortion nationally. It is, in the truest sense, a blueprint for a fascist America.

It has been announced that advertisements for three supplement brands claiming to treat a range of medical conditions, including autism and ADHD, have been banned in the UK.

A paid-for Facebook advert for Aspire Nutrition in April said: “The secret weapon parents of ASD kids swear by”, while text in the form of a review attributed to “Tara K. Verified Buyer”, read: “This has helped my five-year-old with level two autism so much. “Within the first week his meltdowns decreased by 80%. He is communicating so much better… he is starting to show kindness and empathy to his little sister.” Further text read: “As parents of children with autism, we all share the same dream: to see our children thrive in school.”

Another paid-for Facebook ad in January, for Drop Supplements, stated: “For people with stress, anxiety, brain fog, ADHD … Happy Mind Drops – your new secret adaptogen against stress! Prepare yourself to unleash your true potential and banish your mental barriers.”

A third paid-for Facebook ad for Spectrum Awakening stated: “My five-year-old son Scout is diagnosed with receptive expressive language disorder and sensory disorder. Until I found Spectrum Awakening he could barely put a sentence together with very limited speech and words and lots of jargon.” It went on: “The first supplement we tried was Power and Focus and within the first three days he started using way more words. Within a week he was speaking sentences. I’m absolutely amazed that I can’t wait to order more.”

The Advertising Standards Authority (ASA) found that the claims that each supplement, or substances in them, could help to prevent, treat or cure autism breached regulations after investigations.

Aspire Nutrition said they had stopped sending adverts to UK residents who visited their website and had withdrawn the ad entirely for all audiences after being informed of the complaint. Drop Supplements said their adverts featuring Happy Mind made no direct or implied statements about curing, treating or preventing ailments or diseases. However, the ASA said the advert’s claims would be understood by most consumers as implied claims that the product could prevent, treat or cure human disease. Spectrum Awakening did not respond to the ASA’s inquiries.

The ASA told each firm to ensure their future advertising did not claim that food – in these cases in the form of a supplement – could prevent, treat or cure human disease.

____________________

Such work by the ASA is most laudable, in my view. Misleading advertising is endangering the health of consumers thousands of times every day. However, the firms affected by the ASA reprimands are probably not all that worried. In fact, I imagine that they are laughing their heads off:

  • The chances of getting caught for misleading advertising are truly minimal.
  • If they are unlucky and do get caught the punishment is negligible.
  • There is little to stop them re-offending.

It is time that the ASA (and the equivalent organisations in other countries) get more power, more support and more money to effectively go after offenders in such a way that others think twice before breaking advertising rules.

International guidelines have recommended cognitive behavioural therapy, including acceptance and commitment therapy (ACT), as it offers validated benefits for managing fibromyalgia; however, it is inaccessible to most patients.  This study aimed to evaluate the effect of a 12-week, self-guided, smartphone-delivered digital ACT programme on fibromyalgia management.

In the PROSPER-FM randomised clinical trial conducted at 25 US community sites, adult participants aged 22–75 years with fibromyalgia were recruited and randomly assigned (1:1) to the digital ACT group or an active control group that offered daily symptom tracking and monitoring and access to health-related and fibromyalgia-related educational materials. Randomisation was done with a web-based system in permuted blocks of four at the site level. We used a blind-to-hypothesis approach in which participants were informed they would be randomly assigned to one of two potentially effective therapies under evaluation. Research staff were not masked to group allocation, with the exception of a masked statistics group while preparing statistical programming for the interim analysis. The primary endpoint was patient global impression of change (PGIC) response rate at week 12. Analyses were by intention to treat. The trial was registered with ClinicalTrials.govNCT05243511 (now fully closed).

Between Feb 8, 2022, and Feb 2, 2023, 590 individuals were screened, of whom 275 (257 women and 18 men) were randomly assigned to the digital ACT group (n=140) and the active control group (n=135). At 12 weeks, 99 (71%) of 140 ACT participants reported improvement on PGIC versus 30 (22%) of 135 active control participants, corresponding to a difference in proportions of 48·4% (95% CI 37·9–58·9; p<0·0001). No device-related safety events were reported.

The authors concluded that digital ACT was safe and efficacious compared with digital symptom tracking in managing fibromyalgia in adult patients.

___________________

These conclusions might well be valid – but then again, they might not!

Here is why I have my doubts:

  • The patients treated with digital ACT knew that they were getting a novel and thus exciting treatment.
  • The patients randomised to the control group, on the other hand, would most likely be disappointed not to receive this therapy. In other words, there were high expectations in the experimental group and disappointment in the control group.
  • In addition, the unmasked researchers would have had the ambition that their innovation would be successful. Thus they would have used verbal and non-verbal communications with the ACT patients to bring about the desired result.

It is therefore conceivable – I think even likely – that these factors would add up to generate a false-positive finding, particularly since the endpoint was entirely subjective.
In view of all this, I am surprised that a journal like THE LANCET has published such a flimsy study with such a over-optimistic conclusion, and I suggest re-phrasing the conclusions as follows:

Digital ACT seemed safe and effective compared with digital symptom tracking in managing fibromyalgia in adult patients. However, due to the design of the study, it is possible that digital ACT is entirely ineffective and the positive outcome is caused by a number of context effects.

To accuse anyone of an abuse of science is a hefty charge, I know. In the case of proponents of so-called alternative medicine (SCAM) doing science, it is, however, often justified. Let me explain this by using the example of chiropractors (I could have chosen homeopathy, faith heaalers, acupuncturists or almost any other type of SCAM professional, but in recent times it was the chiros who provided the clearest examples of abuse).

Science can be seen as a set of tools that is used to estabish the truth. In therapeutics, science is employed foremost to answer three questions:

  1. Is the therapy plausible?
  2. Is the therapy effective?
  3. Is the therapy safe?

The way to answer them is to falsify the underlying hypotheses, i.e. to demonstrate that:

  1. The therapy is not plausible.
  2. The therapy is not effective.
  3. The therapy is not safe.

Only if rigorous attempts at falsifying these hypotheses have falied can we conclude that:

  1. The therapy is plausible.
  2. The therapy is effective.
  3. The therapy is safe.

I know, this is rather elementary stuff. It is taught during the first lessons of any decent science course. Yet, proponents of SCAM are either not being properly taught or they are immune to even the most basic facts about science. On this blog, we regularly have the opportunity to observe exactly that when we read and are bewildered by the comments made by SCAM proponents. This is often clearest in the case of chiropractors.

  1. They cherry-pick the evidence to persuade us that their hallmark intervention, spinal manipulation, is plausible.
  2. They cherry-pick the evidence to persuade us that their hallmark intervention, spinal manipulation, is effective.
  3. They cherry-pick the evidence to persuade us that their hallmark intervention, spinal manipulation, is safe.

If they conduct research, they set up their investigations in such a way that they confirm their beliefs:

  1. Spinal manipulations are plausible.
  2. Spinal manipulations are effective.
  3. Spinal manipulations are safe.

In other words, they do not try to falsify hypotheses, but they do their very best to confirm them. And this, I am afraid, is nothing other than an abuse of science.

QED

And how can the average consumer (who may not always be in a position to realize whether a study is reliable or not) tell when such abuse of science is occurring? How can he or she decide who to trust and who not?

A simplest but sadly not fool-proof advice might consist in 2 main points:

  1. Never rely on a single study.
  2. Check whether there is a discrepancy in the results and views of SCAM proponents and independent experts; e.g.:
    • Chiropractors claim one thing, while independent scientists disagree or are unconvinced.
    • Homeopath claim one thing, while independent scientists disagree or are unconvinced.
    • Acupuncturists claim one thing, while independent scientists disagree or are unconvinced.
    • Energy healers claim one thing, while independent scientists disagree or are unconvinced.
    • Naturopaths claim one thing, while independent scientists disagree or are unconvinced.
    • Etc., etc.

In all of those cases, your alarm bells should ring and it might be wise to be cautious and avoid the treatment in question.

Yesterday, I stumbled across this remarkable notice. As it is in German, I took the libery of translating it for you:

Am 6. April 2024 war es wieder soweit: Die ÖGHM und die Schwabe Austria GmbH luden zur Verleihung des mit 4.000,- Euro dotierten Dr. Peithner Preises ein.

Dieses Mal wurde der Forschungspreis für die zwei eingereichte Arbeiten „Recommendations in the design and conduction of randomized controlled trials in human and veterinary homoeopathic medicine“ und „Recommendations for Designing, Conducting and Reporting Clinical Observational Studies in Homeopathic Veterinary Medicine“ an Katharina Gaertner, Klaus von Ammon, Philippa Fibert, Michael Frass, Martin Frei-Erb, Christien Klein-Laansma, Susanne Ulbrich-Zuerni und Petra Weiermayer vergeben.

Wir freuen uns sehr und gratulieren den Preisträger:innen zum verdienten Erfolg. Ein herzliches Dankeschön geht auch an die ÖGHM und die Schwabe Austria, die nicht nur mit diesem traditionellen Forschungspreis die Wissenschaft unterstützt.

Here is my translation:

On 6 April 2024, the time had come again: the ‘Austrian Society for Homeopathic Medicine’ (ÖGHM) and Schwabe Austria GmbH hosted the award ceremony for the Dr Peithner Prize, which is endowed with 4,000 euros.

This time, the research prize was awarded to Katharina Gaertner, Klaus von Ammon, Philippa Fibert, Michael Frass, Martin Frei-Erb, Christien Klein-Laansma, Susanne Ulbrich-Zuerni and Petra Weiermayer for the two submitted papers “Recommendations in the design and conduction of randomised controlled trials in human and veterinary homoeopathic medicine” and “Recommendations for Designing, Conducting and Reporting Clinical Observational Studies in Homeopathic Veterinary Medicine”.

We are delighted and congratulate the prizewinners on their well-deserved success. A big thank you also goes to the ÖGHM and Schwabe Austria, who support science with this traditional research prize.

______________________________

And where is the irony?

Firstly, homeopaths are not exactly the experts on how to conduct research.

Secondly, there are recommendations and guidelines for conducting clinical research (e.g. here), and there is no reason for homeopathy to not to adopt those.

Thirdly, and most importantly, to award a prize to Michael Frass for telling us how to do research is more than a little ironic. If anything, Frass could teach us a thing or two about how to falsify, fabricate and manipulate research results!

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