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

bias

1 2 3 121

The General Chiropractic Council (GCC) has signed a memorandum of understanding with NHS England, the Crown Prosecution Service and the National Police Chiefs’ Council to collaborate where there is suspected criminal activity on the part of a GCC member in relation to the provision of clinical care or care decision-making.

I find this interesting and most laudable!

But I also have seven questions, e.g.:

  1. Does it amount to criminal activity in relation to the provision of clinical care or care decision-making, if a chiropractor explains that the patient’s problem is caused by a subluxation of the spine, an entity that does not even exist? Apparently this happens every day.
  2. Does it amount to criminal activity in relation to the provision of clinical care or care decision-making, if a chiropractor treats a patient without prior informed consent? Apparently, this happens regularly.
  3. Does it amount to criminal activity in relation to the provision of clinical care or care decision-making, if a chiropractor fails to warn a patient that his/her manipulations can cause harm and even put him/her in a wheelchair? Apparently this (the lack of warning) happens all the time, and some chiropractors even insist that their manipulations are entirely safe.
  4. Does it amount to criminal activity in relation to the provision of clinical care or care decision-making, if a chiropractor claims that spinal manipulations are effective for curing the patient’s problem, while the evidence does not support the claim? Apparently this happens more often than not.
  5. Does it amount to criminal activity in relation to the provision of clinical care or care decision-making, if a chiropractor persuades a patient to have expensive long-term maintenance therapy for preventing health problems, while the evidence for that appoach is less than convincing? Apparently this happens rather frequently.
  6. Does it amount to criminal activity in relation to the provision of clinical care or care decision-making, if the chiropractor issues advice that is both outside his/her competence and detrimental to the health of the patient (for instance, advising parents not to vaccinate their kids)? Apparently this happens a lot.
  7. Does it amount to criminal activity in relation to the provision of clinical care or care decision-making, if a chiropractor advises a patient not to do what a real doctor told him/her to do? Apparently this is far from a rare occurance.

I would be most grateful, if the GCC would take the time to answer the above questions.

Many thanks in advaance.

The objective of this paper, as stated by its authors, was to develop an evidence-based clinical practice guideline (CPG) through a broad-based consensus process on best practices for chiropractic management of patients with chronic musculoskeletal (MSK) pain.

Using systematic reviews identified in an initial literature search, a steering committee of experts in research and management of patients with chronic MSK pain drafted a set of recommendations. Additional supportive literature was identified to supplement gaps in the evidence base. A multidisciplinary panel of experienced practitioners and educators rated the recommendations through a formal Delphi consensus process using the RAND Corporation/University of California, Los Angeles, methodology.

The Delphi process was conducted January–February 2020. The 62-member Delphi panel reached consensus on chiropractic management of five common chronic MSK pain conditions:

  • low-back pain (LBP),
  • neck pain,
  • tension headache,
  • osteoarthritis (knee and hip),
  • fibromyalgia.

Recommendations were made for non-pharmacological treatments, including:

  • acupuncture,
  • spinal manipulation/mobilization,
  • other manual therapy;
  • low-level laser (LLL);
  • interferential current;
  • exercise, including yoga;
  • mind–body interventions, including mindfulness meditation and cognitive behavior therapy (CBT);
  • lifestyle modifications such as diet and tobacco cessation.

Recommendations covered many aspects of the clinical encounter, from informed consent through diagnosis, assessment, treatment planning and implementation, and concurrent management and referral. Appropriate referral and comanagement were emphasized.

Therapeutic recommendations for low back pain:

  • Consider multiple approaches. Both active and passive, and both physical and mind–body interventions should be considered in the management plan. The following are recommended, based on current evidence.
  • Exercise
  • Yoga/qigong (which may also be considered “mind–body” interventions)
  • Lifestyle advice to stay active; avoid sitting; manage weight if obese; and quit smoking
  • Spinal manipulation/mobilization
  • Massage
  • Acupuncture
  • LLL therapy
  • Transcutaneous electrical nerve stimulation (TENS) or interferential current may be beneficial as part of a multimodal approach, at the beginning of treatment to assist the patient in becoming or remaining active.
  • Combined active and passive: multidisciplinary rehabilitation
  • CBT
  • Mindfulness-based stress reduction

Therapeutic recommendations for neck pain:

  • Consider multiple approaches. Both active and passive, and both physical and mind–body interventions should be considered in the management plan for maximum therapeutic effect. The following are recommended, based on current evidence.
  • Exercise (range of motion and strengthening).
  • Exercise combined with manipulation/mobilization.
  • Spinal manipulation and mobilization
  • Massage
  • Low-level laser
  • Acupuncture
  • These modalities may be added as part of a multimodal treatment plan, especially at the beginning, to assist the patient in becoming or remaining active:
  • Transcutaneous nerve stimulation (TENS), traction, ultrasound, and interferential current.
  • Yoga
  • Qigong

Therapeutic recommendations for tension headache:

  • Consider multiple approaches. Both active and passive, and both physical and mind–body interventions should be considered in the management plan for maximum therapeutic effect. The following are recommended, based on current evidence:
  • Reassurance that TTH does not indicate presence of a disease.
  • Advice to avoid triggers.
  • Exercise (aerobic).
  • Spinal manipulation
  • Acupuncture
  • Cold packs or menthol gels
  • Combined active and passive
  • CBT
  • Relaxation therapy
  • Biofeedback
  • Mindfulness Meditation

Therapeutic recommendations for knee osteoarthritis:

  • Consider multiple approaches. Both active and passive, and both physical and mind–body interventions should be considered in the management plan. The following are recommended, based on current evidence:
  • Exercise
  • Manual therapy
  • Ultrasound
  • Acupuncture, using “high dose” (greater treatment frequency, at least 3 × week)
  • LLL therapy

Therapeutic recommendations for hip osteoarthritis:

  • Consider multiple approaches. Both active and passive, and both physical and mind–body interventions should be considered in the management plan. The following are recommended, based on current evidence
  • Exercise
  • Manual therapy

Therapeutic recommendations for fibromyagia:

  • Consider multiple approaches. Both active and passive, and both physical and mind–body interventions should be considered in the management plan. The following are recommended, based on current evidence:
  • Exercise (aerobic and strengthening)
  • Advice on healthy lifestyle
  • Education on the condition
  • Spinal manipulation
  • Myofascial release
  • Acupuncture
  • LLL therapy
  • multidisciplinary rehabilitation
  • CBT
  • mindfulness meditation
  • yoga
  • Tai chi,
  • Qigong

The authors concluded that these evidence-based recommendations for a variety of conservative treatment approaches to the management of common chronic MSK pain conditions may advance consistency of care, foster collaboration between provider groups, and thereby improve patient outcomes.

This paper is an excellent example of a pseudo-scientific process resulting in unreliable outcomes.

  • The Delphi process was conducted some 4 years ago
  • Because of the truly weird inclusion criteria, the findings are based essentially on just 3 systematic reviews.
  • Anyone who has ever tried to conduct a consensus excercise knows that the outcome will almost entirely depend on who is chosen to sit on the panel. So, all you have to do to obtain pro-chiro recommendations is to select a few pro-chiro ‘experts’ who then write the recommendations!
  • A “best practices for chiropractic management” may sound reasonable but, looking at the therapeutic recommendation, one easily realizes that the authors cast their nets so wide that the result has little to do with what differentiates chiropractic from Physiotherapists or osteopaths.

It is therefore not surprising that the recommendations are laughably unreliable: can, for instance, anyone explain to me why “advice on healthy lifestyle and education on the condition” are recommended for fibromyalgia but not for any other condition?

This paper is, in my view, chiropractic pseudo-science at its most ridiculous!

All it really does is it tries to legitimise all sorts of therapies as part of the chiropractic toolbox. My advice to patients is to:

  • consult a physio if you need exercise therapy or LLL or manual therapy or ultrasound or interferential current or TENS or cold packs or massage;
  • consult a clinical psychologist if you need CBT, or mindfulness, biofeedback;
  • consult a doctor if you want rehab or education or lifestyle advice or reassurance;
  • etc. etc.

And please avoid chiropractors who pretend they can do all of the above, while merely wanting to manipulate your neck.

Crusade Against Naturopathy” (Kreuzzug gegen Naturheilkunde) is the title of a recent article (in German – so, I translated for you) published in ‘MULTIPOLAR‘. It is a defence of – no, not naturopathy – quackery. The authors first defend the indefencible Heilpraktiker. Subsequently, they address what they call ‘The Homeopathy Controversy‘. This is particularly ridiculous because homeopathy is not a form of naturopathy. Yes, it uses some natural materials, but it also employs any synthetic substance that you can think of.

The section on homeopathy contains many more amusing surprises; therefore, I have translated it for you [and added a few numers in square brackets that refer to my brief comments below]:

According to a representative survey conducted by the Allensbach Institute for Public Opinion Research in 2023, 35 per cent of homeopathy users are fully convinced of its effectiveness, while 55 per cent rate it as partially effective. Only nine per cent of respondents described homeopathic medicines as completely ineffective. [1]

Nevertheless, Health Minister Karl Lauterbach announced at the beginning of 2024 that he wanted to abolish homeopathy as a health insurance benefit. Stefan Schmidt-Troschke, paediatrician and managing director of the ‘Gesundheit Aktiv Association’, then launched a petition for the preservation of homeopathic medicines as statutory benefits in statutory health insurance. The petition was signed by more than 200,000 people. In March 2024, the cancellation of homeopathy and anthroposophic medicines as additional statutory benefits was revoked. [2]

Shortly afterwards, in May 2024, the ‘German Medical Assembly’ passed a motion against homeopathy to bring about a total ban for doctors. Dr Marc Hanefeld, official supporter of the ‘Informationsnetzwerk Homöopathie’, was behind the motion. Doctors should be banned from practising homeopathy in future, as well as billing via statutory and private health insurance. [3]

The case of the Charité University Hospital in Berlin shows just how much influence opponents of homeopathy have: for years, the hospital’s website stated ‘that homeopathic medicine can cure or improve even the most serious conditions’. After fierce protests – including from the health journalism portal MedWatch – the statement was removed. [4]

My comments:

  1. Effectiveness is not something to be quantified by popular votes. Responsible healthcare professionals employ rigorous clinical trials for that purpose.
  2. Lauterbach caved in because of the pressure from the Green Party and insists that his plans are merely postponed.
  3. The ‘German Medical Assembly’ decided that the use of homoeopathy in diagnostics and therapy does not constitute rational medicine. German doctors continue to be free to practice homeopathy, if they so wish.
  4. The notion that ‘homeopathic medicine can cure or improve even the most serious conditions’ is so obviously and dangerously wrong that it had to be corrected. This has little to do with the influence of opponents but is due to the influence of the evidence.

I feel that, if proponents of homeopathy want to save their beloved quackery from the face of the earth, they could at least get their facts right and think of some agruments that are a little less ridiculous.

 

Homeopathy was founded some two hundred years ago by Dr Samuel Christian Hahnemann. Over time, it has grown to be among the most frequently used forms of alternative medicine in Europe and the USA. It is underpinned by the principle of ‘like cures like’, where highly diluted substances are used for therapeutic purposes, by producing similar symptoms to when the substance is used in healthy people. Many studies have been published on the value of homeopathy in treating diseases such as cancer, depression, psoriasis, allergic rhinitis, asthma, otitis, migraine, neuroses, allergies, joint disease, insomnia, sinusitis, urinary tract infections and acne, to name a few. An international team recently published a “comprehensive review” of the literature on homeopathy and evaluated its effectiveness in clinical practice.

Their conclusions were as follows:

The current evidence supports a positive role for homeopathy in health and wellbeing across a broad range of different diseases in both adult and paediatric populations. However further research to assess its cost-effectiveness and clinical efficacy in larger studies is required. These findings may encourage healthcare providers and policymakers to consider the integration of homeopathic therapies into current medical practice, to provide a greater sense of patient autonomy and improve the consumer experience.

Medicine is dynamic and continues to evolve. Conventional medicine, while backed by the largest body of evidence thus far to support its safety and efficacy, still has its limitations in terms of side effects and subsequent effects on quality of life. This analysis calls for more in-depth assessment of the current research on homeopathy across a larger range of diseases.

And their ‘Key Summary Points’ were:

  • While homeopathy is among the most frequently applied forms of alternative medicine, there is a lack of familiarity with this therapeutic modality within everyday medical practice.
  • This review examines some of the available evidence in relation to the impact of homeopathy on a variety of common chronic diseases.
  • Homeopathy was found to have the potential for symptom improvement in certain diagnoses within the fields of internal medicine, oncology, obstetrics and mental health.
  • Although there is a paucity of studies on homeopathy within the context of standard clinical practice, an opportunity exists for further research into its application by utilising conventional study designs.

To understand how the researchers could arrive at these conclusions, we need to have a look at their methodology. This is their full description:

We conducted a literature review to answer the following research questions:

  • What is the current knowledge on the use of homeopathy in clinical practice?
  • Has the use of homeopathy achieved beneficial results in patients being treated for specific clinical entities?

Results were then appraised in relation to:

  1. Population: patients using homeopathy, physicians and homeopaths who reported using homeopathic agents in the included studies
  2. Intervention: homeopathic remedies
  3. Control: conventional treatment or no treatment
  4. Outcome: improvement in patients’ conditions (or positive results)

Keywords were searched in respect of homeopathy (homeopathy; formulas, homeopathic; pharmacopoeias, homeopathic; materia medica and vitalism) and clinical practice (complementary and alternative medicine, health). The following search terms were used: (“homeopathy” OR “formulas, homeopathic” OR “pharmacopoeias, homeopathic” OR “materia medica” OR “vitalism”) AND (“health” OR “complementary and alternative medicine”).

Two electronic databases were searched using the search terms homeopathycancer therapytype 2 diabetescomplementary and alternative medicineCOVID-19 and SARS-CoV-2. Material retrieved was examined to omit overlapping results or duplicates. Publications in languages other than English, and those without full texts accessible online, were excluded.

This article is based on previously conducted studies and does not contain any new study with human participants or animals performed by any of the authors.

___________________________

Two crucial things are missing here:

  1. An adequate description of which articles were included and which were discarded. A look at the reference list discloses that only articles in favour of homeopathy were considered.
  2. A description of the critical evaluation performed of the included evidence. A look at the text shows that no critical evaluation took place.

Thus this paper turns out to be not a ‘comprehensive review’ but a ‘comprehensive white-wash’ of homeopathy. Using the methodology of the authors it would be easy, for instance, to publish a comprehensive review demonstrating that the earth is flat.

I sugget the journal editors, peer-reviewers and authors of this idiotic paper bow their heads in shame!

I recently published an article in the German newspaper ‘DIE WELT‘ about the Bavarian Homeopathy trial. My comments did not go down well with the German Association of Homeopathic Doctors (DZVhÄ). Here is their ‘OPEN LETTER’ (my translation) in response to my article (the numbers [in bold brackets refer to my comments below):

Berlin, 11 December 2024: Open letter to Ulf Poschardt, editor-in-chief of the daily newspaper Die Welt, asking whether Prof. Edzard Ernst is really still acceptable as a WELT author. This letter refers to E. Ernst’s article ‘Why a globule study was discontinued’ (DIE WELT, Tuesday, 3 December 2024).

Edzard Ernst is a member of the GWUP (Gesellschaft zur Wissenschaftlichen Untersuchung von Parawissenschaften). (1) This organisation within the so-called sceptic movement has set itself the task of pointing out in the health sector that belief in alternative medicine (‘pseudoscience’) prevents more effective therapies from being used. (2) From this point of view alone, Ernst’s polemic against the iHOM study by the Technical University of Munich[1] misses the mark by a mile, as the study design explicitly does not envisage treating patients with recurrent cystitis ‘either with individually selected homeopathic remedies or a placebo’. On the contrary, it provides for all patients to be treated strictly in accordance with the rules of evidence-based medicine if necessary and if the findings are clear, but also to investigate whether concomitant homeopathic treatment could lead to a reduction in the frequency of antibiotic use. It must be assumed that Ernst has read the study design, but either he is deliberately omitting the true aim of the study or he is simply unable to recognise the difference between a study and his personal fight against homeopathy (3). In both cases, he cannot be taken seriously (!) as an expert on scientific issues in the field of medicine, and certainly not in a serious print medium such as WELT.

Health services research shows: Homeopathy can save antibiotics

The members of the Bavarian state parliament, some of whom were cross-party supporters of this study, were clearly aware of the results of healthcare research, according to which homeopathy can help to reduce the use of antibiotics in defined clinical pictures. In France, for example, a large survey (EPI3-MSD cohort study[2]) came to the conclusion that GPs who use homeopathy for respiratory diseases only use around half as many antibiotics as their conventionally working colleagues. (4) To date, however, there have been no studies that have investigated this at the highest scientific level (randomised, double-blind, placebo-controlled). Against the background of increasing antibiotic resistance worldwide, it was therefore neither ‘ignorance on the part of the Bavarian state government’ nor a foreseeable ‘waste of money’ to investigate this option.(5) If you add to this the fact that panel doctors with an additional qualification in ‘homeopathy’ can even get confirmation in black and white from their panel doctors’ association that their antibiotic consumption is below the average for their respective specialist group, then it would be “unethical” – in complete contrast to Ernst’s assessment – not to have attempted this study. (6)

The article shows the ideological ‘blinding’ of Edzard Ernst
It is clear that Mr (7) Ernst’s ideological ‘blinding’ as an exponent of the sceptic movement (8) leads him, consciously or unconsciously, to draw conclusions that are contrary to open-ended science (9). Reducing the use of antibiotics in the fight against the increasing development of resistance is simply a medical necessity, and those who do not or do not want to face up to this task are manoeuvring themselves into scientific obscurity with flimsy interpretations. (10) The fact that there are individual cases (Italy, child, middle ear infection, globules, dead) in which a method was not applied with sufficient care or expertise does not change this. It should be added at this point that there are always examples in the field of conventional medicine where misdiagnoses can lead to complications or even death. In addition, the RKI (Robert Koch Institute) estimates 9,700 deaths[3] due to antimicrobial resistance, and the trend is rising! Against this dramatic backdrop, Mr Ernst’s polemic should actually be out of the question. (11)

One must come to the same conclusion if one scrutinises the meaning of the reference to a ‘series of experiments in the Third Reich’ and a ‘Homeopathy World Congress’ under Nazi rule. The attempt to discredit homeopathy by pointing out the involvement of homeopathically orientated doctors in the Third Reich is well known. (12) Of course, this usually ignores the fact that the doctors convicted of crimes against humanity at the Nuremberg medical trial were exclusively representatives of the scientific medicine of the time. (13)

However, Ernst’s references to the ‘Third Reich’ conceal something else: the ‘Society of Truth-Loving Men’, which studied the effectiveness of homeopathy in 1835, was a Masonic lodge, and although it was a ‘double-blind trial’, it was of course not ‘the first randomised, placebo-controlled double-blind trial in the history of medicine’, as it is accepted and applied today as a scientific experiment with strict ethical and legal regulations. The first such study worthy of its name was not conducted until 1947 (treatment of tuberculosis with streptomycin). (14)

And of course there was the so-called ‘Donner Report’ (after Dr Fritz Donner), which Ernst indirectly refers to and which summarises the results of drug trials in the ‘Third Reich’. The result was indeed not convincing in favour of homeopathy (15), but this report had a not inconsiderable ‘flaw’: it is extremely problematic in terms of source criticism because it was not written until around two decades after the end of the Second World War, and the original documents Donner referred to have not reappeared and must therefore be considered lost. (16)

If, like Mr Ernst, one sets out in search of arguments against homeopathy and goes back more than half a century (17), then it would also be fair and obvious to mention that the homeopathic medical profession commissioned the Institute for the History of Medicine of the Robert Bosch Foundation years ago to scientifically investigate the role of homeopathic doctors during National Socialism (Mildenberger 2016[4]). The result: to quote Mr Ernst from a different context, there is no more ‘dirt on their sleeves’ than with other professional and socially relevant groups. (18)

Edzard Ernst ignores the current state of homeopathic research

‘Sugar pellets are the basis of many homeopathic treatments. However, all previous research (19) has shown that their effect does not exist.’ This statement by Edzard Ernst is simply wrong! The current state of research is described by the University of Bern as follows: ‘Summarising the current state of preclinical and clinical research, it can be concluded that homeopathic preparations show specific effects that differ from placebo when they are used appropriately…’[5]. (20)

But Ernst could have come up with the idea of comparing the quality of old studies with the current meta-analyses up to a systematic review of six such meta-analyses (Hamre and Kiene, 2023[6]). But he didn’t! If he had, he would have had to admit that the quality and rigour of the latest scientific homeopathy research need not shy away from comparison with studies in conventional medicine. (21)

Based on positive study results, additional homeopathic treatment was included as a treatment option in the medical S3 guideline ‘Complementary medicine in the treatment of oncological patients’[7] in 2021. Ernst also deliberately ignores this treatment recommendation from scientific medical societies. (22)

Edzard Ernst is part of a sceptic association and not the international research community
As an activist of the GWUP (23), Ernst is known for the fact that he has not been scientifically active for a long time (24), but regularly tries to discredit those scientists who conduct research into complementary medical procedures. (25) This uncollegial behaviour has meant that Ernst has not been invited to speak at international scientific research congresses on integrative and complementary medicine for a long time. (26) Agitation, however, is no substitute for a fact-based exchange, but prevents dialogue, in this specific case about the meaning of the Bavarian state government’s commitment. Furthermore, polemics do not contribute in the slightest to coming even a small step closer to a solution to the obvious problem of increasing antibiotic resistance (27). As a reputable print medium, WELT is therefore advised to distance itself from Mr Ernst and his comments or to dismiss him.

[1] https://www.ihom.nephrologie.med/de#iHOM-Studie

[2] https://www.dzvhae.de/homoeopathische-arzneimittel-antibiotika-notstand/epi3laser_study_de-18/

[3] https://www.rki.de/DE/Content/Service/Presse/Pressemitteilungen/2022/06_2022.html

[4] https://www.wallstein-verlag.de/9783835318793-der-deutsche-zentralverein-homoeopathischer-aerzte-im-nationalsozialismus.html

[5] https://www.ikim.unibe.ch/forschung/uebersichten_zum_stand_der_forschung/homoeopathie/index_ger.html

[6] https://pubmed.ncbi.nlm.nih.gov/37805577/

[7] https://register.awmf.org/de/leitlinien/detail/032-055OL

_____________________________________

  1. If you want to demonstrate how well informed you are, it is always a good idea to start with a falsehood: I left the GWUP about a year ago, a move that created considerable huhah in Germany.
  2. Wrong again: “The GWUP has set itself the task of promoting science and scientific thinking.”
  3. My description of the study did not mention that homeopathy was to be used as an add-on. I thought this was obvious (not least because otherwise the study would have not been ethical) but I gladly admit it was my mistake to not spell this out for those who are slow on the uptake.
  4. These studies merely show that homeopaths tend to prescribe less antiiotics, and the quoted French study was so convincing that the French government promptly ceased the reimbursement of homeopathy.
  5. I would still argue that my comment is entirely correct here.
  6. The notion that it might be unethical not to study homeopathy in expensive clinical trials flies in the face of medical ethics.
  7. Have I been demoted?
  8. I probably should be flattered to be called an ‘exponend for the skeptic movement’; however, this is far from what I am. I am simply a scientist trying his best to inform the public responsibly.
  9. In my WELT article, I point out that virtually every respectable panel worldwide looking at the evidence has concluded that homeopathy is a dangerous nonsense. Does that not suggest that my conclusions might be more accurate than those of homeopaths?
  10. I am all for rigorous research into the over-prescribing of antibiotics, antibiotic resistance, etc. – so much so that I would have used the Euro 800 000 not for the nonsensical homeopathy study but for that purpose.
  11. Do I detect a bit of the ‘Tu quoque’ fallacy here?
  12. I mentioned the project not primarily because I wanted to discredit homeopathy, but mostly because it was the largest research project ever conducted in homeopathy. Omitting it in a review of the history would have been wrong.
  13. The Nuremberg Doctors Tribunal tried barely more than a handfull of physicians, while, in total, hundreds had committed crimes agaimst humanity.
  14. The 1835 study was a placebo-controlled, randomised study; the streptomycin trial was the first to be generally aknowledged.
  15. From all we know, the results were devastatingly negative, not just “not convincingly in favour”.
  16. The original files of the project disappeared in the hands of homeopaths after WWII.
  17. No, I did a review of the history, for which puropose it is inevitable to go back in time.
  18. Do I detect more ‘Tu quoque’ fallacy here?
  19. Mea culpa: I should have written: “all previous credible research”.
  20. Yes, we recently discussed the current state of research on my blog.
  21. And we also discussed this review; in neither instance were we impressed!
  22. The guidelines had to rely on the Frass study which has since been disclosed as fraudulent.
  23. When you issue a falsehood, it is best to repeat it; only then you can make sure to discredit yourself completely.
  24. And when you tell one lie, you might as well tell a few more (a simple Medline search would have told them that I am ‘research-active’ to the present day!)
  25. I have often noticed that homeopaths find it tough to accept or even deal with criticism; they thus often prefer to interpret it as a personal attack and discreditation.
  26. Yes, why not? It’s fun to add yet another falsehood to the hilarious mix of lies and ad hominem attacks!
  27. A comment in  a newspaper cannot possibly find “a solution to the obvious problem of increasing antibiotic resistance”. This has to be found with rigorous research – something homeopaths would not recognise if it bit them in their behinds.

I am, of course, not surprised that the German homeopath did not like my article. Yet, I am truly amazed by their emarrassingly poor (but highly amusing) arguments against me and my comments. I had hoestly thought they had more sense.

Homeopathy is ‘First-Line-Medicine’ – at least this is what a German pro-homeopathy website recently proclaimed. The notion, it informs us, is based on EU law.

But is that true?

Does the ‘Regulation (EU) 2018/848 of the European Parliament and of the Council on organic production (…)’ really recommend homeopathy for treating animals?

This is what the EU law states (my translation from a German original):

‘Diseases shall be treated immediately to avoid animal suffering; chemically-synthesised allopathic veterinary medicinal products, including antibiotics, may be administered, if necessary, under strict conditions and under the responsibility of a veterinarian, when treatment with phytotherapeutic, homeopathic and other remedies is inappropriate … phytotherapeutic and homeopathic preparations are preferable to chemically synthesised allopathic veterinary medicinal products, including antibiotics, provided that their therapeutic effect is guaranteed for the species concerned and the disease to be treated’.

Let’s analyse the text and find out what it really means. It states that:

  1. Vets should treat suffering animal without delay.
  2. They should use conventional therapies when homeopathy is inappropriate.
  3. Homeopathics are preferable, if their therapeutic effect is guaranteed for the species concerned and the disease to be treated.

So, homeopathy is recommended under two important and well-defined conditions:

  1. They have to be appropriate.
  2. They have to be proven to be effective.

It is amply clear that homeopathy has not been proven to be effective in any condition that afflicts animals. As this is so, homeopathics are evidently inappropriate.

But why, does the EU make it so complicated?

I don’t know the answer to this question but suspect that there was plenty of lobbying going on, and they had to find a phraseology that apeases the homeopaths and their industry.

 

 

It has been reported that Kash Patel, Donald Trump’s pick to lead the FBI. Patel seems to be a scary man. During 2023 appearance on Steve Bannon‘s “War Room” podcast, Patel agreed that Trump is “dead serious” about his intent to seek revenge against his political enemies should he be elected in 2024. Patel stated:

“We will go out and find the conspirators — not just in government, but in the media … we’re going to come after the people in the media who lied about American citizens, who helped Joe Biden rig presidential elections … We’re going to come after you. Whether it’s criminally or civilly, we’ll figure that out. But yeah, we’re putting you all on notice, and Steve, this is why they hate us. This is why we’re tyrannical. This is why we’re dictators … Because we’re actually going to use the Constitution to prosecute them for crimes they said we have always been guilty of but never have.”

Meanwhile, Patel has been flogging a range of very odd products aimed at the MAGA crowd, making hundreds of thousands of dollars from Trump-aligned businesses. In particular, Patel promoted pills that claim to reverse the effects of the Covid-19 vaccine. Marketed under the trademark “Nocovidium,” the pills from a company called ‘Warrior Essentials’ contain a range of ‘natural ingredients none of which has been shown to do anything significant in relation to Covid-19 or vaccines:

“Spike the Vax, order this homerun kit to rid your body of the harms of the vax,” Patel said in a Truth Social post promoting the SCAM remedy. Another advert stated: “You were immune to the propaganda, but are you immune to the shedders.”

The website explains:

“The ingredients are listed above, but they break down into a few distinct categories.  Polyamines are the driving force that helps to push the body into autophagy. These are found in many foods and are also in all living organisms.  Our formula is designed to give a boost of externally supplied polyamines, while also working to turn your body into a polyamine producing gigafactory.  This is done by providing the body the precursors, activators, and synthesizers to ramp up production.  The third goal is to inhibit pathogens, including the spike protein, from interfering with the process. It’s a 1-2-3 patent-pending punch.  Every ingredient was specifically chosen and balanced for its ability to promote autophagy, polyamine production, the inhibition of factors that can stop the process, or a combination of all three.”

The website even explains how the supplement works: “With regards to the spike protein, the body identifies this as a foreign object, and the autophagy process is designed to help protect your body by completely eliminating items like the spike.  Many indicators show that the spike’s ability to block this process may be why the spikes are lasting far longer in the body than anybody ever expected.  Our formula was developed to counter these measures allowing the process to complete and the objects, including the spike, identified by the body for removal, to be eliminated.”

Is there any evidence?

One should not ask such probing questions!

Why not?

The answer is as simple as it is scary: “We’re going to come after you!”

This paper examined the state of homeopathic clinical research by critically assessing the overall quality of peer-reviewed, recently published, English-language, homeopathic clinical research in terms of internal, external, and model validity using standard and homeopathic-specific instruments. Further, an international panel of nine experts in research methods and homeopathy to identifed gaps in homeopathic research and prioritize areas for future study.
The team reviewed 99 clinical research studies targeting a wide range of populations and conditions. Studies were conducted in Western and Asian countries, with the largest number (30 percent) conducted in India. Of the 99 studies reviewed,
  • 85 were controlled trials;
  • 79 of these were randomized.

There were many areas where the quality of the studies could be improved. About two-thirds of the 85 controlled trials had either high (42 percent) or unclear (24 percent) risk of bias according to internationally recognized standards for internal validity.

Of the 14 observational (cohort) studies, over one-third did not control for important confounders in the outcome analyses. Regarding external validity, adherence was reported in less than a third of studies (n=31). Forty percent of studies (79% of observational studies) did not report on safety. Regarding model validity, fewer than two-thirds of the studies were consistent with homeopathic principles.

The expert panel’s opinion was mixed on whether the homeopathic research literature was missing important populations and/or conditions, and they suggested a variety of priority areas. Panelists also expressed a variety of opinions about the types of homeopathy that should be prioritized for future study but also noted that since homeopathic practice differs by country, each country may have different priorities.
Panelists agreed with the findings of the literature review that the research literature was at least somewhat deficient in all three types of validity. Although the assessment of validity was [by necessity] based only on what was reported, it suggests the need for both better reporting and higher quality research. They recommended the use of reporting guidelines to improve all types of validity, the identification of exemplar studies to help guide researchers to improve internal validity, and, given the limitations of the instruments available to measure external and model validity, that these instruments be validated and configured to provide summary scores.
Finally, substantial discussion addressed the need to bring more research expertise into homeopathic studies. This could be done both by better training homeopathic researchers and by collaborating with experienced conventional medicine research groups.
The authors concluded that the state of homeopathic research could be substantially improved in terms of internal, external, and model validity. Strict adherence to reporting guidelines, with attention to quality criteria during study design, would likely result in most of the needed improvement. However, there is also a need for the homeopathic community to decide where to focus future research in terms of conditions, populations, and types of homeopathy studied. These focus areas could take many forms and should align with the community’s research goals.
One of the fascinating aspects here is that the panel was not asked to deliberate whether – in view of homeopathy’s implausibility and the largely negative clinical evidence – further reseach into the subject is meaningful or desirable.
But by now you probably ask yourself: who are the members of the expert panel? Here they are:
  1. Iris Bell, M.D., Ph.D., University of Arizona College of Medicine (Retired) and Sonoran University of Health Sciences;
  2. Dan Cherkin, Ph.D., Osher Center for Integrative Health, Department of Family Medicine, University of Washington;
  3. Roger Chou, M.D., Department of Medical Informatics & Clinical Epidemiology and Department of Medicine, Oregon Health & Science University;
  4. Katharina Gaertner, MBBS, Research Faculty of Health, University Witten/Herdecke;
  5. Klaus Linde, M.D., Ph.D., Scientific Coordinator, Technische Universität München, Institute of General Practice and Health Services Research;
  6. Alexander Tournier, Ph.D., Homeopathy Research Institute and Institute of Complementary and Integrative Medicine, University of Bern;
  7. Esther van der Werf, M.Sc., Ph.D., Clinical Research Lead, Homeopathy Research Institute, and Honorary Senior Lecturer, Primary Care Infection, Bristol Medical School, University of Bristol;
  8. Harald Walach, Ph.D., CHSInstitute.

Two very obvious things should be noted about this panel:

  • There are not 9 but only 8 members.
  • Almost all are individuals who are pro-homeopathy, and no informed critic of homeopathy was invited.

The latter fact seems important. Anyone who has worked with panels knowns that one can pre-determine the outcome of the deliberations by the choice of the members.

The panel essentially concluded that homeopathic research could be substantially improved. Considering its highly biased composition, this is remarkable. It means that, in fact,

HOMEOPATHIC RESEARCH IS DISMAL.

Being a dedicated crook and a liar himself, Donald Trump has long had an inclination to surround himself with crooks and liars. As discussed repeatedly, this preferance naturally extends into the realm of healthcare, Some time ago, he sought the advice of Andrew Wakefield, the man who published the fraudulent research that started the myth about a causal link between MMR-vaccinations and autism.

Early November this year, Trump stated that, if he wins the election, he’ll “make a decision” about whether to outlaw some vaccines based on the recommendation of Robert F. Kennedy Jr., a notorious vaccine critic without any medical training. The president doesn’t have authority to ban vaccines but he can influence public health with appointments to federal agencies that can change recommendations or potentially revoke approvals.

Now that he did win the election, Trump suggested that Robert F. Kennedy Jr., his pick to run Health and Human Services, will investigate supposed links between autism and childhood vaccines, a discredited connection that has eroded trust in the lifesaving inoculations.

“I think somebody has to find out,” Trump said in an exclusive interview with “Meet the Press” moderator Kristen Welker. Welker noted in a back-and-forth that studies have shown childhood vaccines prevent about 4 million deaths worldwide every year, have found no connection between vaccines and autism, and that rises in autism diagnoses are attributable to increased screening and awareness.

Trump, too stupid to know the difference between correlation and causation, replied: “If you go back 25 years ago, you had very little autism. Now you have it.” “Something is going on,” Trump added. “I don’t know if it’s vaccines. Maybe it’s chlorine in the water, right? You know, people are looking at a lot of different things.” It was unclear whether Trump was referring to opposition by Kennedy and others to fluoride being added to drinking water.

Kennedy, the onetime independent presidential candidate who backed Trump after leaving the race, generated a large following through his widespread skepticism of the American health care and food system. A major component of that has been his false claims linking autism to childhood vaccinations. Kennedy is the founder of a prominent anti-vaccine activist group, Children’s Health Defense. The agency Trump has tasked him with running supports and funds research into autism, as well as possible new vaccines.

The debunked link between autism and childhood vaccines, particularly the inoculation against mumps, measles and rubella, was first claimed in 1998 by Andrew Wakefield who was later banned from practicing medicine in the UK. His research was found to be fraudulent and was subsequently retracted. Hundreds of studies have found childhood vaccines to be safe.

Autism diagnoses have risen from about 1 in 150 children in 2000 to 1 in 36 today. This rise has been shown to be due to increased screening and changing definitions of the condition. Strong genetic links exist to autism, and many risk factors occurring before birth or during delivery have been identified.

If Trump does, in fact, ‘outlaw’ certain vaccinations, he would endanger the health of the US as well as the rest of the world. Will he really be that stupid?

In this case study, the authors describe an adult patient who struggled with persistent warts on the plantar surface of the foot for several years. All medical therapies were exhausted, so the patient turned to medical hypnosis as a last resort.

The patient experienced complete resolution of all his warts after three sessions of medical hypnosis. The suggestions used in the treatment included:

  • strengthening the immune system,
  • increasing blood flow in the foot,
  • visualizing immune mechanisms destroying infected cells,
  • the regrowth of healthy tissue.

After 3 years, the authors are still in contact with the patient, and he reports no recurrence of the disease.

The authors concluded that this case report adds to the existing body of the literature supporting the use of medical hypnosis in the treatment of warts. It demonstrates that medical hypnosis can be a valuable complementary or alternative treatment option for patients with persistent warts who have not responded to conventional therapies. It also highlights the need for further research to better understand the mechanisms by which hypnosis influences the resolution of warts and to identify the most effective types of suggestions for treatment.

Oh, dear!

Warts are viral infections. They can persist for months and years and disappear suddenly without apparent reason. What the authors of this case report observed is exactly this phenomenon of spontaneous recovery. There is no sound evidence that hypnotherapy or any similar treatment will speed up the disappearance of warts.

Many years ago, we did a trial of ‘distant healing’ for warts. It confirmed the ineffectiveness of this approach:

Purpose: Distant healing, a treatment that is transmitted by a healer to a patient at another location, is widely used, although good scientific evidence of its efficacy is sparse. This trial was aimed at assessing the efficacy of one form of distant healing on common skin warts.

Subjects and methods: A total of 84 patients with warts were randomly assigned either to a group that received 6 weeks of distant healing by one of 10 experienced healers or to a control group that received a similar preliminary assessment but no distant healing. The primary outcomes were the number of warts and their mean size at the end of the treatment period. Secondary outcomes were the change in Hospital Anxiety and Depression Scale and patients’ subjective experiences. Both the patients and the evaluator were blinded to group assignment.

Results: The baseline characteristics of the patients were similar in the distant healing (n = 41) and control groups (n = 43). The mean number and size of warts per person did not change significantly during the study. The number of warts increased by 0.2 in the healing group and decreased by 1.1 in the control group (difference [healing to control] = -1.3; 95% confidence interval = -1.0 to 3.6, P = 0.25). Six patients in the distant healing group and 8 in the control group reported a subjective improvement (P = 0.63). There were no significant between-group differences in the depression and anxiety scores.

Conclusion: Distant healing from experienced healers had no effect on the number or size of patients’ warts.

My conclusion of the above case study is therefore very different from that of the original authors:

This case report adds nothing to the existing body of the literature on medical hypnosis or on the treatment of warts other than misleading the public.

1 2 3 121
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