bias
“Dr. Arleen Scholten” – rings a bell?
Yes!
She is the chiropractor who treated John Lawler who then tragically died. Since Scholten was found not guilty of any wrong-doing by the General Chiropractic Council (GCC), she is practising unabated. These days, she seems to be particularly fond of treating children. Here are some excerpts from what she claims on her website:
Subluxations, or misalignments, within the spine can disrupt the vital communication between the brain and the body. These subluxations induce stress on the nervous system, potentially leading to a diminished function in the affected area. Infants, children, and adults can all experience spinal subluxations. Birth trauma, minor or major traumas, and developmental stress can all cause subluxations in infants and children. During the initial five years of life, the body generates more neural pathways than at any other time. It is crucial to optimize this production through pediatric chiropractic care, as these early years are pivotal for each child’s potential…
Chiropractic adjustments are safe for patients of all ages, including newborns… Over time, chiropractic practitioners have received valuable feedback from parents and young patients, highlighting significant and unexpected improvements in various aspects of their lives, including:
- Sleep patterns
- Behavior and attitude
- Immune system functionality
Additionally, patients have reported improvements in conditions such as ADD/ADHD, colic, torticollis, ear infections, bed-wetting, digestive issues, allergies, asthma, seizures, and more.
_________________________
Allow me to add a few comments on these claims:
- Subluxations only exist in the imagination of chiropractors.
- Therefore, they cannot disturb vital communication between the brain and the body.
- Nor can they induce stress on the nervous system.
- Nobody experiences chiropractic subluxations because they are a chiropractic invention to fool patients and take their money.
- Pediatric chiropractic care does not enhance a child’s potential.
- Chiropractic adjustments are not safe; as we have often discussed on this blog, they cause not merely very frequent mild, transient adverse effects but also serious and often permanent complications of unknown frequency.
- Feedback received by chiropractors is a far cry from amounting to reliable evidence.
- Chiropractic does not improve sleep patterns.
- It does not alter behavior and attitude.
- It also does not enhance immune system functionality.
- Nor does it affect ADD/ADHD, colic, torticollis, ear infections, bed-wetting, digestive issues, allergies, asthma, seizures.
Some of these conditions can be potentially serious. Treating them with chiropractic would needlessly prolong the suffering; in a worst case scenarion, it could even cost the life of a child. This, I feel, begs the question: is one death not enough, ‘Dr.’ Scholten?
She has already once been let off the hook by the GCC, I wonder whether the ‘Advertising Standards Authority’ will be as lenient, or whether they could step in and prevent a further tragedy.
Prof Dr Sucharit Bhakdi is one of the most far-reaching disinformation disseminators of the COVID pandemic. He spread numerous bogus claims about the dangers of COVID vaccines and put forward scientifically untenable theories.
- Writing an open Letter in March 2020 to German Chancellor Angela Merkel regarding the “socio-economic consequences of the drastic containment measures which are currently being applied in large parts of Europe”
- Posting videos on YouTube claiming, for example, that the government was overreacting because the virus posed no more threat than influenza, and that any COVID-19 vaccine would be “pointless”.
- Participation in May 2020 in the writing of a “position paper of the BMI” by an employee of the German crisis management department. The Federal Ministry distanced itself from the position, calling the paper a “private opinion” circulating on official letterhead, and released the chief government councilor Stephan Kohn from duty.
- He is the co-author of Corona, False Alarm? Facts and Figures (2020), German: (‘Corona Fehlalarm?’) ISBN 978-3-99060-191-4 and Corona Unmasked. Neue Daten, Zahlen, Hintergründe. (Goldegg, Berlin/Wien 2021, ISBN 978-3-99060-231-7. An earlier book of his was published in 2016, Schreckgespenst Infektionen – Mythen, Wahn und Wirklichkeit (tr. “Bogeyman Infections – Myths, Delusions and Reality”) ISBN 978-3-903090-66-8. He published these books together with his wife, Karina Reiss, a biologist and biochemist at the Quincke Research Center, Christian-Albrechts-Universität zu Kiel.
- Describing Germany in December 2020 as a “health dictatorship”, saying he wanted to emigrate to Thailand because of this.
Now Bhakdi seems to have changed his tune: ‘There were few side effects’ he recently said during an interview. A remarkable admission, considering that Bhakdi had previously warned of literally millions of injured and dead people, destroyed immune systems and a ‘horror without end’ caused by the mRNA vaccines.
Bhakdi’s statement about the paucity of adverse effects is, of course, right – in fact, it might be one of the very few of his statements that are correct. Current figures from the Paul Ehrlich Institute confirm the safety of the COVID vaccines: with 65 million people vaccinated and around 182 million vaccine doses administered in Germany, only 573 vaccine injuries were noted. This corresponds to an incidence of around 0.00088 %. In contrast, it has been calculated that COVID vaccinations have saved about 166,000 lives in Germany alone.
So, how does Bhakdi explain the contradiction of first insisting on the danger of the vaccinations and now admitting that “there were few side-effects”? In the interview, he claims that the vast majority of doses administered had no effect whatsoever because they had rapidly lost their activity. He explains that, in most cases, the mRNA in the vaccines did not enter the body due to unstable packaging. Therefore the expected side effects did not materialise. An obviously fictitious explanation that is scientifically untenable and clearly a desperate excuse. When asked how someone can tell that she received an inactive vaccine, he replied that, if you did not fall ill after the vaccination, the dose you received was inactive.
I think Bhakdi deserves all the high honors that were bestowed on him. He deserves them not because he ever was right or truthful or honest about the danger of COVID vaccination. No! He deserves them for his ingenuity in finding yet another lie that enables him to bring all his previous lies (COVID vaccinations are frightfully dangerous) in line with reality (COVID vaccinations harmed almost nobody).
Yes, sometimes two lies can result in the truth:
there were indeed few side-effects!
This paper explored the intersection of science and pseudoscience in online discourse about detoxification, investigating how and to what extent they coexist on the web. Drawing on previous studies of internet health scams, it examines the discursive strategies used to either validate or refute alternative detox treatments. Using a corpus-assisted discourse studies approach, the present study analyses a corpus of texts (167,177 tokens) about detoxification randomly collected from the web.
The results show that corrective messages debunking the detox myth make up less than 10% of the corpus. Furthermore, many keywords in the corpus, such as “toxin(s),” are subject to constant renegotiation. Advocates of so-called alternative medicine (SCAM) use the term “toxin(s)” to justify detox treatments, while scientists criticize it as pseudoscientific.
The authors conclude thaat their study highlights how terminological ambiguity facilitates the mixing of science and pseudoscience, confusing readers. It also highlights the role of language in health-related misinformation and calls for interdisciplinary research to develop educational tools for health professionals.
Corpus-assisted discourse studies (CADSs) are related historically and methodologically to the discipline of corpus linguistics. Their principal endeavor is the investigation and comparison of features of particular discourse types, integrating into the analysis the techniques and tools developed within corpus linguistics. These include the compilation of specialised corpora and analyses of word and word-cluster frequency lists, comparative keyword lists and, above all, concordances. A broader conceptualisation of corpus-assisted discourse studies would include any study that aims to bring together corpus linguistics and discourse analysis.
The findings of this CADS can hardly surprise anyone who has been following this blog. We have often discussed the problem of pseudo-scientific language and the confusion it creates. Likewise, we have repeatedly dealt with the ‘detox myth’ and how it is being used by advocates of SCAM.
What is new is the finding that only 10% of of the discourse seems to come from people who debunk the ‘detox myth’. This is, of course, disappointing but not really surprising considering how much virtually the entire SCAM business relies on it.
So, to make it clear yet again:
- A toxin is a substance that is poisonous to our body.
- No ‘detox’ method from the realm of SCAM has been shown to remove a toxin from the human body.
As always, I would be delighted to learn more and to correct these statements, provided someone shows me good evidence to the contrary.
Robert F Kennedy Jr. (RFKJr.)recently said that he’s aiming to know the cause of the “autism epidemic” by September, and will be able to “eliminate those exposures” that he says are behind the condition. This and other statements lay bare the embarrassing ignorance of RFKJr. as it contains a surprising number of errors:
- There is no epidemic of autism. The figures he likes to quote are hugely inflated. According to a meta-analysis, 0.77% of children globally are diagnosed with ASD, with boys comprising 1.14% of this group. Notably, Australia showed the highest prevalence rate, with an effect size of 2.18, highlighting it as a critical area for public health focus. The increase observed by many is largely due to a widening of diagnostic criteria.
- He presupposes that autism is due to some type of exposure (he claimed: “We know it’s an environmental exposure.”). However, this is far from proven and several other possibilities exist; most experts think that a genetic predisposition is the most important factor.
- Even if he can identify an exposure, it is unclear that and how he might eliminate it.
- To do the necessary research by September is not realistic.
RFKJr. has hired another pseudo-scientist, David Geier, to conduct the research. If they approached the subject rationally, they would start by looking what research has already been done. Few areas of inquiry are more active that research into autism (Medline currently lists ~ 84 ooo papers on the subject).
Here are some examples of conclusions from recent meta-analyses showing subject areas where research might yield relevant findings and those that are likely to be dead ends:
Probable dead ends
- For children, strength of evidence was high for no increased risk of autism following measles, mumps, and rubella (MMR) vaccine.
- Our study provides evidence that in utero exposure to ADHD medications does not increase the risk of long-term neurodevelopmental disorders in offspring. This study replicates safety data for methylphenidate and extends it with new safety data on amphetamines and atomoxetine. These findings are crucial for informing clinical guidelines and helping healthcare providers and expectant mothers make informed decisions.
- This study indicates that individuals with Kawasaki disease have a higher risk for ADHD but not for Autism Spectrum Disorder (ASD).
- Results found no evidence to support a link between genetically predicted Human Herpesviruses infection and the risk of NDDs based on existing datasets.
- These findings indicate that prenatal painkiller exposure is unlikely to be a major determinant of the severity of neurodevelopmental outcomes in autistic children.
Possibly relevant
- Our study summarized research evidence on the genetic variants of ASD and provides a broad and detailed overview of ASD risk genes.
- Maternal diabetes is associated with an increased risk of neurodevelopmental disorders and impaired neurodevelopmental performance in children. Further high-quality research is needed to establish causality and clarify the associations between specific types of diabetes and the full spectrum of neurodevelopmental disorders.
- Suggestive evidence included the associations between pregnancy O3 exposure and autism spectrum disorder.
- Gestational exposure to valproate was associated with an increased risk of autism spectrum disorder.
- This study indicated that Bisphenol A (BPA) exposure was associated with an increased risk of neurodevelopmental disorders and problems (NDPs) in children, particularly in boys, underscoring the importance of considering BPA exposure as a potential risk factor for children’s brain health.
- Our study found a significant difference in dental caries severity between children and adolescents with Autism Spectrum Disorder (ASD) and those without ASD.
- The development of childhood ASD may be associated with screen exposure.
- The total number of cannabis exposed pregnancies (with ASD and ADHD as the outcomes) in world literature is small. However, cannabis use during pregnancy is, at the very least, a clear marker for adverse neurodevelopmental outcomes
- In this meta-analysis, the relationships between air pollutants and ASD risk revealed significant associations, particularly for PM2.5 and NO2. Exposure during preconception exhibited a protective trend, while postnatal exposure, particularly during the second year of life uncovered substantially higher ASD risk.
- While there was weak evidence for associations between antibiotic use in early-life and later neurodevelopmental outcomes, these were attenuated in sibling-controlled subgroup analyses. Thus, associations may be explained by genetic and familial confounding, and studies failing to utilise sibling-control groups must be interpreted with caution.
- The current findings suggest that Anorexia Nervosa (AN) frequently overlaps with both autistic traits and autistic symptomatology. Therefore, it is essential to evaluate autism and autistic traits in individuals with AN to tailor individualized treatment plans.
- Increased risk of autism in children is significantly associated with greater parents’ ages.
- Parental PMADs are significantly associated with an increased risk of NDDs in children.
Above, I wrote that rational scientists would approach the subject by evaluating the research that has already been done. So, why will Kennedy, Geier et al not do that?
Simple!
The very first meta-analysis cited above (confirmed by multiple further reviews) firmly establishes that the pursuit of RFKJr.’s obsession (vaccines cause autism) is a dead end! The issue has been researched, re-researched ad nauseam and laid to bed.
So, in order to confirm his belief, RFKJr. needs to spend all this money in order to find (or manipulate) some evidence that questions a rock-solid consensus. Once he has succeeded in this task, he will to do what all pseudo-scientists do best: he will pretend that correlations are prove of causation.
In the end, this will amount to a spectecular waste of money. Because some people will nevertheless believe RFKJr., it will also strengthen the anti-vax movement and thus further endanger public health.
WATCH THIS SPACE!
Yes, this was the (rather sensationalist) headline of a recent article in the Daily Mail that I allegedly wrote. Its unusual genesis might interest some of you.
I was contacted by a journalist who asked for a telephone interview on the subject of chiropractic as well as my recent book. I agreed under the condition that we do this not over the phone but in writing via email. So, he sent me his questions and I supplied the responses; here they are:
· What’s the absolute worst case scenario of seeing a chiropractor?
The worst that can happen is that you die. Certain manipulations that chiropractors regularly do can injure an artery that supplies part of the brain. This would then result in a stroke; and a stroke can of course be fatal. This is what happened, for example, to the American model Katie May. She had pinched a nerve in her neck on a photoshoot and consulted a chiropractor who manipulated her neck. This caused a tear to an artery in her upper spine. The result was a massive stroke of which she died a few days later.
· How did you first become interested in the topic?
I learned hands on spinal manipulation as a junior doctor. Later, as the head of the department of Physical Medicine and Rehabilitation at the University of Vienna, we used such techniques routinely. In 1993, I became chair of Complementary Medicine in Exeter, and my task was to scientifically investigate alternative therapies such as chiropractic. Recently, I decided to summarize all our research in a book.
· What did you learn from your research?
In essence, our investigations found that almost all the claims that chiropractors make are unsubstantiated. Their manipulations are not nearly as effective as they claim. More worryingly, they are also not free of risks. About 50% of patients who see a chiropractor suffer from side effects after spinal manipulation. These are usually not severe and disappear after 2 or 3 days. But, in addition, very serious complications like stroke, death, bone fractures, paralysis can also occur. Chiropractors say that these are rare, and I hope they are right, but the truth is that nobody knows because there is no system of monitoring such events. We once asked British neurologists to report cases of neurological complications occurring within 24 hours of cervical spine manipulation over a 12-month period. This unearthed a total of 35 cases. Particularly striking was the fact that none of these cases had previously been reported anywhere. So, the underreporting was exactly 100%. This tells me that, when chiropractors claim there are just a few such incidents, in truth there might be a few hundred or even thousand.
· Is there an especially shocking finding?
What I find particularly unnerving is the way chiropractors regularly disregard medical ethics. Take the issue of informed consent, for example. It means that we all have to fully inform patients about the treatment we plan to give. In the case of chiropractic spinal manipulation, it would need to include that the therapy is of doubtful effectiveness, that other options are more likely to help, and that the treatment carries very frequent minor as well as probably rare major risks. I do understand why chiropractors do often not provide this information – it would chase away most patients and thus impact of their income. At the same time, I feel that chiropractors should not be allowed to violate fundamental principles of medical ethics. This is not in the interest of patients!!!
· Why do you think patients are so keen on chiropractors?
I am not sure that they really are so keen; some are but the vast majority are not. Our own research suggests that, depending on the country, between 7 and 33% of the population see chiropractors. This means that between 93 and 67% have enough sense to avoid chiropractors.
· But what does the evidence actually show about the efficacy of chiropractic?
As it happens our most recent summary has just been published. It concluded that “it is uncertain if chiropractic spinal manipulation is more effective than sham, control, or deep friction massage interventions for patients with headaches” [Is chiropractic spinal manipulation effective for the treatment of cervicogenic, tension-type, or migraine headaches? A systematic review – ScienceDirect]. For other conditions the evidence tends to be even less convincing. The only exception might be chronic low back pain, according to another recent summary [Analgesic effects of non-surgical and non-interventional treatments for low back pain: a systematic review and meta-analysis of placebo-controlled randomised trials | BMJ Evidence-Based Medicine]. But here too, I would argue that other treatments are safer and cheaper.
· Are some chiropractors worse than others?
The profession is divided into 2 groups, the ‘straights’ and the ‘mixers’. The former believe in all the nonsense their founding father, DD Palmer, proclaimed 120 years ago, including that spinal manipulation is the only treatment for virtually all our ailments, and that vaccinations must be avoided at all cost. The mixers have realized that Palmer was a charlatan of the worst kind, focus on musculoskeletal conditions and use treatments borrowed from physiotherapy. Needless to say that the mixers might be bad, but the straights are even worse.
· What can patients do to keep safe?
Avoid chiropractors, go to a library and read my book.
· If you have backpain or joint pain what can you do instead?
There is lots people can do but advice has to be individualized. By far the best is to prevent back pain from happening. Here advice might include more exercise, loosing weight, changing your mattress, avoiding certain things like heavy lifting, etc. If you are acutely suffering, see a physio or a doctor, keep moving and be aware that over 90% of back pain disappears within a few days regardless of what you do.
________________________
I had insisted that I see his edits before this gets published, and a little while later I received the edited version. To my big surprise, the journalist had transformed the interview into an article allegedly authored by me. I told him that I was uncomfortable with this solution, and we agreed that he would make it clear that the article was merely based on an interview with me. I then revised the article in question and the result was the mentioned article published still naming me as its author but with a footnote: “As told in an interview with Ethan Ennals”
Never a dull day when you research so-called alternative medicine!
Dr. Stephan Baumgartner, Deputy Director of the “Institute of Complementary and Integrative Medicine” in Bern, Switzerland, and Dr. Alexander Tournier, Research Associate at the same institution are well known defenders of homeopathy. They just published a paper entitled SCIENTIFIC EVIDENCE ON HOMEOPATHY. Needless to say that such an article is relevant for my blog and attracted my interest.
In their abstract, they claim that “the most recent meta-analyses of RCTs across all indications concluded that there is evidence for specific effects of homeopathic remedies superior to placebo when prescribed by a qualified homeopath. Furthermore, there are several meta-analyses on specific indications (e.g. allergic complaints, childhood diarrhoea) which provide evidence for specific effects of homeopathic preparations superior to placebo.”
As I have published several such papers, I had a look at which of them – if any – they quoted. It turns out they only cited the one entitled “Homeopathy for postoperative ileus? A meta-analysis“. Here is its abstract:
Homeopathic remedies are advocated for the treatment of postoperative ileus, yet data from clinical trials are inconclusive. We therefore performed meta-analyses of existing clinical trials to determine whether homeopathic treatment has any greater effect than placebo administration on the restoration of intestinal peristalsis in patients after abdominal or gynecologic surgery. We conducted systematic literature searches to identify relevant clinical trials. Meta-analyses were conducted using RevMan software. Separate meta-analyses were conducted for any homeopathic treatment versus placebo; homeopathic remedies of < 12C potency versus placebo; homeopathic remedies of > or = 12C potency versus placebo. A “sensitivity analysis” was performed to test the effect of excluding studies of low methodologic quality. Our endpoint was time to first flatus. Meta-analyses indicated a statistically significant (p < 0.05) weighted mean difference (WMD) in favor of homeopathy (compared with placebo) on the time to first flatus. Meta-analyses of the three studies that compared homeopathic remedies > or = 12C versus placebo showed no significant difference (p > 0.05). Meta-analyses of studies comparing homeopathic remedies < 12C with placebo indicated a statistically significant (p < 0.05) WMD in favor of homeopathy on the time to first flatus. Excluding methodologically weak trials did not substantially change any of the results. There is evidence that homeopathic treatment can reduce the duration of ileus after abdominal or gynecologic surgery. However, several caveats preclude a definitive judgment. These results should form the basis of a randomized controlled trial to resolve the issue.
And here is the paragraph from the article by Baumgartner and Tournier citing our paper:
Barnes et al. (1997) performed a systematic review and meta-analysis of controlled clinical
trials investigating the effects of a homeopathic treatment of postoperative ileus. Meta
analysis yielded a statistically significant (p < 0.05) weighted mean difference (WMD) in favour
of homeopathy (compared with placebo) on the time to first flatus. The exclusion of
methodologically weak trials did not substantially alter the results. The authors concluded
that “our analyses suggest that homeopathic treatment administered immediately after
abdominal surgery may reduce the time to first flatus when compared with placebo
administration”.
(The bits that I have put in bold print are the ones that appear in this paragraph.)
Are you puzzled?
Me too!
What they also forgot to mention is the fact that, in our paper, we explained that the partly positive outcome was produced by several small and flawed trials. They were the reason why eventulally a large and rigorous study was conducted. Its results showed homeopathy to be no better than placebo. Yet, in the meta-analysis this study was not large enough to out-weigh the rigorous trial (this is a well-known weakness of meta-analyses and requires carefull attention when interpreting the findings).
It seems important to note that after the rigorous trial, no further studies of homeopathy for post-operative ileus have emerged. The reason, it seems, is that this trial was conclusive and thus put the notion to rest that homeopathy might work for this highly prevalent condition.
Finally, as I merely looked at one single aspect, I wonder whether there are further misrepresentations in the Baumgartner/Tournier paper.
Here is my question to my readers: does the behavior of Baumgartner and Tournier amount to
- honest error,
- sloppiness,
- wishful thinking,
- dishonesty,
- fraud,
- scientific misconduct?
PLEASE, DO LET ME KNOW WHAT YOU THINK
Homeopathy is harmless – except when it kills you!
Death by homeopathy has been a theme that occurred with depressing regularity on my blog, e.g.:
- Death by homeopathy
- Another death by homeopathy
- Death by homeopathy?
- The case of a boy tortured to death with homeopathy
- Homeopathy is the death of the patient suffering from gangrene
Now, there is yet another sad fatality that must be added to the list. This case report presents a 61-year-old woman with metastatic breast cancer who opted for homeopathic treatments instead of standard oncological care. She presented to the Emergency Department with bilateral necrotic breasts, lymphedema, and widespread metastatic disease. Imaging revealed extensive lytic and sclerotic lesions, as well as pulmonary emboli. Laboratory results showed leukocytosis, lactic acidosis, and hypercalcemia of malignancy.
During hospitalization, patient was managed with anticoagulation and broad-spectrum antibiotics. Despite disease progression, patient declined systemic oncological treatments, leading to a complicated disease trajectory marked by frailty, sarcopenia, and functional quadriplegia, ultimately, a palliative care approach was initiated, and she was discharged to hospice and died.
This case highlights the complex challenges in managing advanced cancer when patients choose alternative therapies over evidence-based treatments. The role of homeopathy in cancer care is controversial, as it lacks robust clinical evidence for managing malignancies, especially metastatic disease.
Although respecting patient autonomy is essential, this case underscores the need for healthcare providers to ensure patients are fully informed about the limitations of alternative therapies. While homeopathy may offer emotional comfort, it is not a substitute for effective cancer treatments. Earlier intervention with conventional oncology might have altered the disease course and improved outcomes. The eventual transition to hospice care focused on maintaining the quality of life and dignity at the end-of-life, emphasizing the importance of integrating palliative care early in the management of advanced cancer to enhance patient and family satisfaction.
Even though such awful stories are far from rare, reports of this nature rarely get published. Clinicians are simply too busy to write up case histories that show merely what sadly must be expected, if a patient refuses effective therapy for a serious condition and prefers to use homeopathy as an “alternative”. Yet, the rather obvious truth is that homeopathy is no alternative. I have pointed it out many times before: if a treatment does not work, it is dangerously misleading to call it alternative medicine – one of the reasons why I nowadays prefer the term so-called alternative medicine (SCAM).
But what about homeopathy as an adjunctive cancer therapy?
In 2011, Walach et al published a prospective observational study with cancer patients in two differently treated cohorts: one cohort with patients under complementary homeopathic treatment (HG; n = 259), and one cohort with conventionally treated cancer patients (CG; n = 380). The authors observed an improvement of quality of life as well as a tendency of fatigue symptoms to decrease in cancer patients under complementary homeopathic treatment.
Walach and other equally deluded defenders of homeopathy (such as Wurster or Frass) tend to interpret these findings as being caused by homeopathy. Yet, this does not seem to be the case, as they regularly forget about the possibility of other, more plausible explanations for their results (e.g. placebo or selection bias). I am not aware of a rigorous trial showing that adjunctive homeopathy has specific effects when used by cancer patients (if a reader knows more, please let me know; I am always keen to learn).
So, is there a role for homeopathy in the fight against cancer?
My short answer:
No!
Robert F. Kennedy Jr. is coming out with so much stupidity, ignorance and quackery that it is getting difficult to keep up. A recent article reported that he touted two particular medications that have not been shown to work as first-line treatments for measles:
- the steroid budesonide,
- the antibiotic clarithromycin.
Kennedy claimed on X that the medications had been instrumental in treating around 300 children in Texas, and told Fox News that doctors prescribing them had seen “very, very good results.”
Consequently, families in Texas have turned to questionable remedies — in some cases, also prompted by the recommendation of two Texas doctors, Dr. Ben Edwards and Dr. Richard Bartlett. Kennedy called Edwards and Bartlett “extraordinary healers” who have “treated and healed” hundreds of children with budesonide and clarithromycin, sharing a photo of himself and the doctors with three Mennonite families whose children had become ill. Two of the families had each recently lost a daughter to measles: 6-year-old Kayley Fehr died in February and 8-year-old Daisy Hildebrand died last week. Neither child was vaccinated.
Edwards, a conventionally trained doctor who has shifted to promoting natural remedies and prayer, has been operating a makeshift clinic in Seminole, offering children these unproven treatments — including, according to a video posted by an anti-vaccine group, while he said he was sick with measles. Edwards has allied himself with the anti-vaccine movement in recent months, hosting influencers and activists on his podcast, including Andrew Wakefield.
“There is no evidence to support the use of either aerosolized budesonide or clarithromycin for treatment of children with measles,” said Dr. Adam Ratner, a spokesman for the American Academy of Pediatrics. Prescribing treatments that have not been vetted in clinical trials amounts to experimenting on patients, added Dr. Susan McLellan, a professor in the infectious diseases division at the University of Texas Medical Branch.
During the measles outbreak, both Edwards and Bartlett have each warned of risks associated with the MMR vaccine: Edwards claimed, falsely, that it causes “potentially” hundreds of deaths a year and Bartlett has said that the complications caused by measles, including brain swelling and pneumonia, can also be caused by the vaccine. In reality, the MMR vaccine, which is only given to children with healthy immune systems, has been overwhelmingly safe since its approval more than five decades ago, and has saved an estimated 94 million lives worldwide.
Public health experts said touting these medications as first-line treatments sends the wrong message. “By mentioning such treatments without that context, RFK Jr. continues to distract away from the prevention measure that incontrovertibly works — the vaccine,” said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security
A national public health organization is calling for RFK Jr. to resign citing “implicit and explicit bias and complete disregard for science.” Georges Benjamin, executive director of the American Public Health Association, said in a statement that concerns raised during Kennedy’s confirmation hearing last month have been realized, followed by massive reductions in staff at key health agencies.
What’s next? I aslk myself.
Perhaps homeopathy as a savior of the US healthcare system?
Watch this space.
Patients with headaches often seek so-called alternative medicine (SCAM), including chiropractic care. Chiropractic spinal manipulation is one of the most commonly used techniques for these patients; however, its effectiveness remains unclear. This systematic review aimed to evaluate the effectiveness of chiropractic spinal manipulation in reducing headache days, episode duration, episode intensity, and medication intake in patients with headaches.
MEDLINE (Pubmed), PEDro, SCOPUS, Cochrane Library and Web of Science databases were searched from inception to April 2024. PICO search strategy was used to identify randomized controlled trials applying chiropractic spinal manipulations versus sham manipulation, no additional intervention, or other conservative non-pharmacological interventions in patients with headaches. Eligible studies and data extraction were conducted independently by two reviewers. Quality of the studies was assessed with Physiotherapy Evidence Database scale, and risk of bias with Cochrane Collaboration tool. Certainty of the evidence was evaluated using GRADE approach.
Eight studies ranging from low to high methodological quality were included. The results were categorized into three subgroups: chiropractic manipulation versus sham, chiropractic manipulation versus control, and chiropractic manipulation versus deep friction massage. Among the five studies comparing chiropractic manipulation to sham, two found a significant reduction in the number of headache days. Of the three studies comparing chiropractic manipulation to another control, one reported a decrease in headache episode duration. No significant differences were observed for any other variable across the subgroups. The certainty of evidence was downgraded to very low.
We concluded that it is uncertain if chiropractic spinal manipulation is more effective than sham, control, or deep friction massage interventions for patients with headaches.
These conclusions might not surprise many readers. Yet, in at least one way, they are quite surprising: the version of the article we submitted to the ‘European Journal of Integrative Medicine’ had a substantially different conclusion; it was as follows:
What happened?
You may well ask!
The journal wanted us to change our conclusion! Because the main authors of our paper needed, for academic reasons, to publish without any further delay, they agreed to the demand. As far as I remember, such a thing is unprecedented in my ~50 years of publishing research in medical journals.
PS
It is also the last time I will have any dealings with the European Journal of Integrative Medicine
World Homeopathy Day is celebrated on April 10 every year. It aims at marking the importance of homeopathy and its contributions to medicine. It also honors the memory of Dr. Christian Friedrich Samuel Hahnemann — the founder of homeopathy.
Samuel Hahnemann (1755-1843) was born in Meissen, Germany. He studied medicine in Germany and Austria and received his doctorate in 1779 from the university of Erlangen. He practised as a physician but soon became disenchanted with the medicine of his time which he felt was neither effective nor safe. Eventually, he stopped practising and lived from translating medical texts. In the course of this work, he came across a remark about the action of Cinchona bark which prompted him to do experiments on himself. These experiments eventually led to the creation of homeopathy. Hahnemann’s new therapy was controversial but soon became a worldwide success. When Hahnemann was about to retire at the age of 75, he was visited by a young women from Paris. The two were soon married and Hahnemann started a new career in the French metropole where he died in 1843.
Hahnemann’s followers have suffered one defeat after the next, in recent years. More and more countries have stopped reimbursing homeopathy, and the fact that homeopathics are pure placebo has become undeniable. For some of them, this is reason to retreat into their traditional position claiming that homeopathy is, in this or that way, so special that it cannot be squeezed into the straight jacket of science. Here is a very recent article that might serve as an apt example of this notion:
Integrating homeopathy into mainstream medical practice requires a thorough understanding of how the medicine works and what it involves. However, homeopathy, a highly individualized and philosophically alternative medicine, may not be accurately captured by the existing EBM hierarchy. Despite the utility EBM may have as a systematic tool for recognizing evidence-laden treatment options, it overlooks the relevant complexities related to homeopathy. The EBM hierarchy’s narrow focus on statistical significance and empirical data may not be sufficient to capture the complexities and unique principles of homeopathic medicine. A more inclusive, unbiased, and flexible approach that values individualization, mechanistic reasoning, as well as historical and traditional evidence within homeopathy, is needed to develop a nuanced understanding of this alternative medical practice. To bridge this gap, it is crucial to develop an alternative epistemic framework that is consistent with the underlying principles of homeopathy. Such a framework should envelope a more diverse range of data such as mechanistic and experiential evidence. Collaboration between homeopathic practitioners, researchers, and experts in evidence-based methodology could help establish a more comprehensive and inclusive approach to evaluating the evidence for homeopathic treatments.
The article itself explains it as follows:
An appropriate design for assessing homeopathy would consider its unique healing philosophy, thus accurately reflecting the practice under study. To achieve this, we must assess the mechanistic underpinnings that contribute to the treatment’s effectiveness. Homeopathy’s healing philosophy emphasizes individualization and potentization. These practices rely on the practitioner’s assessment of the individual and the resulting design of the medicine prescribed. Furthermore, such a study would not conflate different homeopathic medicines; instead, it would elucidate the effectiveness of the mechanisms giving rise to homeopathy’s healing capacity. For instance, if a certain potency of Ignatia works for one individual, it may be ineffective if prescribed to another without considering their constitution. This relationship regarding the efficiency of homeopathy is backed by the treatment’s medical philosophy. Therefore, it is unfair to reject homeopathy as a medical treatment in its entirety based on a few cases of ineffectiveness, especially when the source of the ineffectiveness can’t be pinpointed.
These arguments sum up the somewhat delusional feelings of many homeopaths. These defenders of the indefensible seem to live on a different planet than the rest of us. Here on planet earth, we have many rational, fair, independent and thus reliable assessments of homeopathy – let me remind you of some of their conclusion:
• “The principles of homeopathy contradict known chemical, physical and biological laws and persuasive scientific trials proving its effectiveness are not available” (Russian Academy of Sciences, Russia)
• “Homeopathy should not be used to treat health conditions that are chronic, serious, or could become serious. People who choose homeopathy may put their health at risk if they reject or delay treatments for which there is good evidence for safety and effectiveness.” (National Health and Medical Research Council, Australia)
• “Homeopathic remedies don’t meet the criteria of evidence-based medicine.” (Hungarian Academy of Sciences, Hungary)
• “The incorporation of anthroposophical and homeopathic products in the Swedish directive on medicinal products would run counter to several of the fundamental principles regarding medicinal products and evidence-based medicine.” (Swedish Academy of Sciences, Sweden)
• “There is no good-quality evidence that homeopathy is effective as a treatment for any health condition” (National Health Service, England)
So, on the occasion of World Homeopathy Day, rational thinkers might conclude that:
- there is a wide consensus stating that homeopathy is a placebo therapy;
- only homeopaths do not agree with this consensus;
- those homeopaths who disagree use transparently bogus arguments in defence of their trade;
- closer inspection reveals that they are, in fact, members of a cult.
