bias
Recently, there has been a flurry of research interest in mindfulness – one could almost call it hype! Not that this is reflected in loads of rigorous trials, rather it manifests itself by an unprecedented amount of systematic reviews on mindfulness being published.
I conducted a Medline search on 8/2/2022 for meta-analyses of mindfulness. It resulted in no less than 9 such papers. Here are their conclusions:
- This meta-analysis suggests that SOF is a moderately effective evidence-based practice for reducing disruptive behavior.
- In conclusion, both mindfulness interventions showed robust evidence on anxiety symptoms in pretest-posttest periods compared to control groups. Few studies and lack of evidence of follow-up periods were the main limitations found.
- Memory specificity did not significantly differ from baseline to post-treatment for either MBCT and Control interventions.
- Although this review was limited by search strategies and most of the included studies were of low quality, it still provided some tentative support for PSIs for the treatment of TOPFA women.
- Meta-regression results showed that some heterogeneity in effect size could be accounted for by intervention dosage, study population, and study design. Our findings quantify MBIs’ potential for improving immune function and thus impacting somatic disorders.
- Mindfulness interventions somewhat improved depression in emerging adults. Because primary researchers did not report the adverse effects, mindfulness interventions should be used with caution. Future researchers might study the adverse effects of mindfulness interventions as well as the long-term effects.
- The effect of MBIs on pain in cancer patients was demonstrated in our analysis, albeit with small effect sizes. High-quality RCTs are needed to verify the efficacy of MBIs on cancer patients or survivors with pain complaints. Future trials should take into account the specific pain outcome measures (pain intensity or pain interference), the approach of intervention provision (clinic-based or remote MBI, group or individual practice), the duration and frequency of interventions and the comparators (passive or active control arms).
- This meta-analysis found that MBIs had beneficial effects on mental health such as psychological distress and wellbeing in nurses.
- Because MBIs show promise across some PICOS, future RCTs and meta-analyses should build on identified strengths and limitations of this literature.
This amounts to about two systematic reviews/meta-analyses per week!
And what do these papers tell us?
If you are an advocate of mindfulness, you probably conclude that your pet therapy is supported by reasonably sound evidence. If, however, you think a little more critically, you would probably see that the evidence is far from strong. The effect size is usually small and of doubtful clinical relevance. This is, I think, important because clinical trials of mindfulness cannot easily control for placebo effects (there is no adequate placebo that would allow patients to be blinded). Therefore, the small effects that do emerge in systematic reviews/meta-analyses are most likely the result of a placebo response and not due to mindfulness per se.
My conclusion is therefore not nearly as positive as that of fans of mindfulness: the collective evidence suggests to me that the success of mindfulness relies mostly or even entirely on the placebo effect. And this means that even dozens of further systematic reviews are not going to advance our knowledge significantly. What is needed, I think, is a few truly rigorous studies aimed at determining whether the effects of mindfulness are specific or non-specific in nature. My prediction is that, once we have this evidence, the current hype around mindfulness will calm down.
The purpose of this recent investigation was to evaluate the association between chiropractic utilization and use of prescription opioids among older adults with spinal pain … at least this is what the abstract says. The actual paper tells us something a little different: The objective of this investigation was to evaluate the impact of chiropractic utilization upon the use of prescription opioids among Medicare beneficiaries aged 65 plus. That sounds to me much more like trying to find a CAUSAL relationship than an association.
Anyway, the authors conducted a retrospective observational study in which they examined a nationally representative multi-year sample of Medicare claims data, 2012–2016. The study sample included 55,949 Medicare beneficiaries diagnosed with spinal pain, of whom 9,356 were recipients of chiropractic care and 46,593 were non-recipients. They measured the adjusted risk of filling a prescription for an opioid analgesic for up to 365 days following the diagnosis of spinal pain. Using Cox proportional hazards modeling and inverse weighted propensity scoring to account for selection bias, they compared recipients of both primary care and chiropractic to recipients of primary care alone regarding the risk of filling a prescription.
The adjusted risk of filling an opioid prescription within 365 days of initial visit was 56% lower among recipients of chiropractic care as compared to non-recipients (hazard ratio 0.44; 95% confidence interval 0.40–0.49).
The authors concluded that, among older Medicare beneficiaries with spinal pain, use of chiropractic care is associated with significantly lower risk of filling an opioid prescription.
The way this conclusion is formulated is well in accordance with the data. However, throughout the paper, the authors imply that chiropractic care is the cause of fewer opioid prescriptions. For instance: The observed advantage of early chiropractic care mirrors the results of a prior study on a population of adults aged 18–84. The suggestion is that chiropractic saves patients from taking opioids.
It does not need a lot of fantasy to guess why some people might want to create this impression. I am sure that chiropractors would be delighted if the US public felt that their manipulations were the solution to the opioid crisis. For many months, they have been trying hard enough to pretend this is true. Yet, I know of no convincing data to demonstrate it.
The new investigation thus turns out to be a lamentable piece of pseudo research. Retrospective case-control studies can obviously not establish cause and effect, particularly if they do not even account for the severity of the symptoms or the outcomes of the treatment.
People often say WHAT’S THE HARM?
Why not let Prince Charles promote any nonsense he likes?
Let him be!
He means well!
He is not harming anyone!
I think this attitude is not correct. Charles’s advocacy of quackery is by no means harmless. This is one of the points I have been trying to make repeatedly, most recently in my biography of Charles.
And there are plenty of examples for this; just think of the Gerson therapy (a whole chapter in the said book). Another, less obvious example is homeopathy. Charles has promoted homeopathy during all his adult life. When he fell ill with COVID in the early phase of the pandemic, the realm of homeopathy predictably decided that he recovered so well because he homeopathic treatment. A report dated 7 April 2020, for example, is quite clear about it:
British Crown Prince Charles has been “101 per cent” cured of COVID-19 using Ayurveda and Homeopathy treatment, Union Minister of State for AYUSH Shripad Naik … “I am proud that the Ministry which I head, managed to cure such a great man, there is no greater credit than this. He may have some problem (admitting to it) because the system in his country does not give recognition to Ayurveda. He may have felt he would violate rules, that is why his refusal to admit is obvious,” Naik told a local cable news channel in an interview late on Monday. “I believe 101 per cent, that he has been cured (using Ayurveda and Homeopathy),” Naik also said.
On April 2, Naik had told a press conference in Goa, that Prince Charles had been cured of COVID-19 after seeking treatment from a Bengaluru-based alternative treatment resort, SOUKYA International Holistic Health Centre’ run by a doctor Isaac Mathai. A day after his statement, Clarence House, the official residence of Prince Charles had said that the claim was incorrect and that the royal “followed the medical advice of the National Health Service in the UK and nothing more”. The royal had been diagnosed COVID-19 positive last month.
Naik in the cable TV interview on Monday continued to insist that Ayurveda and Homeopathy had indeed cured the Prince and that it was a “victory” for Indian traditional medicine systems. Naik also said that there was no need to disbelieve the doctor Isaac Mathai, who cured Prince Charles. “The man (Dr. Mathai) himself is saying this. He is a doctor, an owner of a resort, he is trustworthy, when he says this, it is a victory of our Indian system,” Naik said.
The royal denial had little effect; Indian officials had persuaded themselves and key decision-makers that Charles’s case was proof for homeopathy’s effectiveness against COVID. Consequently, homeopathy was widely used for that purpose. As a result, millions of Indians deemed themselves sufficiently protected (possibly not taking other measures seriously). And the rest is history: in the summer of 2020, about 1000 Indians per day were reported to have died of COVID (the number of unreported deaths was estimated to be even higher).
The point I am trying to make is this: the promotion of quackery by a ‘VIP’ can have dramatic unforeseen consequences, even if (like in Charles’s case) a direct cause-effect relationship is impossible to prove.
Three days ago, I reported a new study of homeopathy. At the time, I had not seen the full paper. Now, thanks to a kind reader sending it to me, I can report more details.
To recap:
In this double-blind, cluster-randomized, placebo-controlled, four parallel arms, community-based, clinical trial, a 20,000-person sample of the population residing in Ward Number 57 of the Tangra area, Kolkata, was randomized in a 1:1:1:1 ratio of clusters to receive one of three homeopathic medicines:
- Bryonia alba 30cH,
- Gelsemium sempervirens 30cH,
- Phosphorus 30cH,
- or an identical-looking placebo.
The treatment period lasted for 3 (children) or 6 (adults) days. All the participants, who were aged 5 to 75 years, received ascorbic acid (vitamin C) tablets of 500 mg, once per day for 6 days. In addition, instructions on a healthy diet and general hygienic measures, including handwashing, social distancing, and proper use of facemasks and gloves, were given to all the participants.
No new confirmed COVID-19 cases were diagnosed in the target population during the follow-up timeframe of 1 month-December 20, 2020 to January 19, 2021-thus making the trial inconclusive.
The Phosphorus group had the least exposure to COVID-19 compared with the other groups. In comparison with placebo, the occurrence of unconfirmed COVID-19 cases was significantly less in the Phosphorus group (week 1: odds ratio [OR], 0.1; 95% confidence interval [CI], 0.06 to 0.16; week 2: OR, 0.004; 95% CI, 0.0002 to 0.06; week 3: OR, 0.007; 95% CI, 0.0004 to 0.11; week 4: OR, 0.009; 95% CI, 0.0006 to 0.14), but not in the Bryonia or Gelsemium groups.
The authors concluded that the trial was inconclusive. The possible effect exerted by Phosphorus necessitates further investigation.
When I first blogged about this, I commented with this question: If you conduct a COVID prevention trial, would you not make sure that rigorous testing for COVID of all participants is implemented? Having seen the full paper, The question remains unanswered. Here is all that the authors write about the outcome measures:
(a) Primary outcome—Occurrence of newly diagnosed (confirmed by detection of the SARS-CoV-2 RNA in nasopharyngeal swab by real-time reverse transcription polymerase chain reaction (RT-PCR) or rapid antigen test) COVID-19 infections as per Government of India records.
(b) Secondary outcome—Occurrence of unconfirmed COVID19 cases as assessed clinically during home visits. It was defined as abrupt onset (within the last 10 days) of fever (100.4°F or 38°C body temperature) with two or more of the following: loss of taste or smell, dry cough, shortness of breath, sore throat, congestion or runny nose, headache, malaise, fatigue, myalgia, limb or joint pain, chest pain or pressure, conjunctivitis, diarrhea, nausea or vomiting, skin rashes, discoloration of fingers or toes.
The timeline was up to 30 days after completing the recommended dosage or once the person reported COVID-19 positive, whichever was earlier. Data were collected weekly by teams of homeopaths from home visits and/or via telephone, whenever required.
I am not entirely sure what this means but I think “as per Government of India records” indicates that they did not bother to systematically measure the primary endpoint of their study. Instead, they relied on the data from occasional unsystematic testing. My suspicion is further confirmed by the authors’ statement in their discussion section: “a manual search of the Government records during the trial phase could not identify a single confirmed COVID-19 positive case belonging to the study population … Enhanced numbers of testing could have changed the outcome of the trial“.
If my suspicion is true, the study is a joke – and not a good one at that. It would mean that considerable funds and efforts have been wasted. It would also mean that the conclusion drawn by the authors “the trial was inconclusive” is inaccurate. It was not inconclusive but it was fatally flawed from its outset.
Yes, today is WORLD CANCER DAY. A good time to remind us that SCAM providers are often a serious risk to cancer patients. Here is a very recent case in point:
It has been reported that a naturopath from Laval in Quebec who describes herself as a “cancer specialist” notably by offering coffee enemas, has been found guilty of the illegal practice of medicine. The Court of Quebec ruled that Annie Juneau, owner of the Vitacru Group, led people to believe that she had “medical knowledge and [that she was] was able to diagnose a health deficiency”. The fine for the offense can vary between $2,500 and $62,000 and which remains to be determined.
The College of Physicians of Quebec (CMQ) conducted an investigation where an agent claiming to be looking for information on colon therapy under an assumed name consulted the therapist. The naturopath charged a little over $300 for the visit and the purchase of prescribed natural products. During the consultation, the naturopath, Annie Juneau, claimed that “we are brainwashed by the medical community”. She introduced herself as a “cancer specialist” and explained that she could even treat patients suffering from advanced stage 4 cancer.
The website of the naturopath praised the merits of the coffee enema, a practice believed to date back to ancient Egypt, stating that “cancer patients deprived of its benefits are unable to detoxify at the speed that optimal healing requires.” ON the Internet and in person, Annie Juneau illegally led a reasonable person to believe that she could perform acts reserved for doctors, the court ruled. In her defense, the naturopath argued that her website contained disclaimers stating that she does not offer medical advice and that she clearly identifies herself as a naturopath. However, the court ruled that such disclaimers are not sufficient protection of the public.
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This case is the latest in a long row of naturopaths (and other SCAM practitioners) risking the lives of cancer patients. Here are a few recent ones that we have discussed on this blog:
The Foundation for Vertebral Subluxation has a ‘clinical practice guideline/best practices project’ that would search, gather, compile and review the scientific literature going as far back as January 1998. Their new Chapter on the chiropractic care of children was peer-reviewed and approved by 196 chiropractors from several countries and included chiropractors specializing in pediatric and maternal care such as Diplomates and others certified in such care. The Best Practices document, developed through the Foundation’s Best Practices Initiative includes a Recommendation statement as follows:
Since vertebral subluxation may affect individuals at any age, chiropractic care may be indicated at any time after birth. As with any age group, however, care must be taken to select adjustment methods most appropriate to the patient’s stage of development and overall spinal integrity. Parental education by the chiropractor concerning the importance of evaluating children for the presence of vertebral subluxation is encouraged as are public health initiatives geared toward screening of children for vertebral subluxation beginning at birth.
I am afraid there may be some errors in the new document. Allow me therefore to post a corrected version:
Since vertebral subluxations do not exist, they cannot affect individuals regardless of age. Chiropractic adjustments are thus not indicated at any time after birth. Parental education by the chiropractor concerning the importance of evaluating children for the presence of vertebral subluxation is discouraged as are public health initiatives geared toward screening of children for vertebral subluxation beginning at birth.
Or, as an American neurologist once put it so much more succinctly:
Don’t let the buggers touch your neck!
The ‘Society of Physicians and Scientists for Health, Freedom and Democracy’ (Gesellschaft der Mediziner und Wissenschaftler für Gesundheit, Freiheit und Demokratie e.V. MWGFD) recently held a press coference where they presented its 10-point plan for a Corona phase-out concept. Here are their 10 demands (my translation):
- Immediate cessation of COVID vaccinations and in particular compulsory COVID vaccination.
- End all non-evidence-based non-pharmaceutical measures (NPI’s), such as lockdowns, school closures, mandatory masks in public spaces, isolation, quarantine, contact tracing, stand-off rules, as well as RT-PCR and rapid antigen testing of people without symptoms of disease, and immediately open sports venues, restaurants, churches and cultural institutions to all without access conditions
- Pandemic management must be sensibly controlled on the basis of science and evidence, including correct testing of the genuinely ill and correct recording of the epidemic situation. Since this has been neglected for two years, we demand the resignation of the previous advisory experts.
- Drawing up easily applicable concepts for the prevention and early treatment of COVID-19 and also for the inpatient and, if necessary, intensive medical treatment of severe courses.
- The dominance of one single logic, namely the virological logic, must be ended. Other aspects, such as economic, social, psychological, educational and holistic medical considerations must be included.
- Reassuring the population about sufficient medical care for all
- The media should provide wide-ranging comprehensive information, according to the ethical guidelines for journalists formulated in the Press Code, without creating fear and panic.
- Provide programmes to treat the physical and psychological trauma caused by the operations, especially for children and adolescents
- Ending the care crisis through appropriate measures
- Separation of powers, justice and freedom
Who would put their name to such complete idiocy?
You may well ask!
The members of the MWGFD are:
- Prof. Dr. med. Sucharit Bhakdi, Facharzt für Mikrobiologie und Infektionsepidemiologie, ehem. Direktor des Instituts für Medizinische Mikrobiologie und Hygiene der Johannes Gutenberg-Universität Mainz
- Dr. med. Thomas Binder, Kardiologe, Vorstand Aletheia – Medizin und Wissenschaft für Verhältnismässigkeit, Wettingen, Schweiz
- Prof. Dr. med. Arne Burkhardt, Facharzt für Pathologie, Reutlingen
- Prof. Dr.-Ing. Aris Christidis, ehem. Technische Hochschule Mittelhessen, Giessen Fachbereich Mathematik, Naturwissenschaften und Informatik
- Andreas Diemer, Arzt für Allgemeinmedizin und Naturheilverfahren, Diplom- Physiker, Musiker, Leiter der Akademie Lebenskunst und Gesundheit, Gernsbach
- Dr. med. univ. Dr. phil. Christian Fiala, Facharzt für Frauenheilkunde und Geburtshilfe, Arzt für Allgemeinmedizin, Tropenmedizin, Wien
- Dr. med. Heinrich Fiechtner, Hämatologe und Internistischer Onkologe, Stuttgart
- Daniela Folkinger, Psychologische Beraterin, Lehrerin, Thurmansbang
- Dr. med. Margareta Griesz-Brisson, Neurologin, London und Müllheim, BW
- Prof. Dr. med. Dr. phil. Martin Haditsch, Facharzt für Mikrobiologie, Virologie und Infektionsepidemiologie, Hannover
- Dr. Dr. Renate Holzeisen, Rechtsanwältin, Bozen
- Prof. Dr. rer. hum. biol. Ulrike Kämmerer, Humanbiologin, Universitätsklinikum Würzburg
- Prof. Dr. Christian Kreiß, Volkswirtschaftler, Hochschule Aalen
- Prof. Dr. Christof Kuhbandner, Pädagogische Psychologie, Universität Regensburg
- Prof. Dr. med. Walter Lang, Pathologe, Hannover
- Werner Möller, Intensivpfleger und Atmungstherapeut, Stuttgart, Gründer der Initiative „Pflege für Aufklärung“
- Prof. Dr. Werner Müller, Rechnungswesen, Controlling, Steuern, Fachbereich Wirtschaft der Hochschule Mainz
- Cornelia Reichl, Heilpraktikerin, Passau
- Prof. Dr. rer. nat. Karina Reiß, Mikrobiologie, Quincke-Forschungszentrum der Christian-Albrechts-Universität zu Kiel
- Dr. med. Konstantina Rösch, Allgemeinärztin, Graz
- Prof. Dr. phil. Franz Ruppert, Psychotraumatologie, psychologische Psychotherapie, Psychologie, Katholische Stiftungshochschule München
- Heiko Schöning, Arzt, Hamburg
- Univ.-Prof. Dr. med. Dr. rer. nat. M. Sc. Christian Schubert, Klinik für Medizinische Psychologie, Medizinische Universität Innsbruck.
- Prof. Dr. Martin Schwab, Lehrstuhl für Bürgerliches Recht, Verfahrens- und Unternehmensrecht, Universität Bielefeld
- Univ.-Prof. Dr. med. Andreas Sönnichsen, Abteilung für Allgemeinmedizin und Familienmedizin, Medizinische Universität Wien, bis Januar 2021 Vorsitzender des Deutschen Netzwerks Evidenzbasierte Medizin,
- Priv. Doz. Dr. med. Josef Thoma, HNO-Arzt, Berlin.
- Prof. Dr. Hans-Werner Vohr, Immunologie und Immuntoxikologie, Universität Düsseldorf.
- Prof. Dr. Dr. Daniel von Wachter, Professor für Philosophie an der Internationalen Akademie für Philosophie im Fürstentum Liechtenstein
- Prof. Dr. Harald Walach, klinischer Psychologe, Gesundheits-wissenschaftler, Leiter des Change Health Science Instituts, Berlin
- Dr. med. Ronald Weikl, Facharzt für Frauenheilkunde und Geburtshilfe, Praktischer Arzt, Naturheilverfahren, Passau
- Ernst Wolff, Autor, Finanzexperte und freier Journalist, Berlin
As we see, the ‘Society of Physicians and Scientists for Health, Freedom and Democracy’ does not just contain physicians and scientists but also – contrary to its name – simple non-academic loons. And, of course, an important member – the main reason for today blogging about it – it includes SCAM practitioners and – most importantly – Prof Harald Walach who has featured so regularly on this blog.
There has been much discussion recently about the best way to persuade anti-vaxxers to change their minds. As they seem completely resistant to the scientific consensus, this has so far not been an easy task. Many experts tell us that we foremost must not ridicule them. I think the ’10 demands’ show that this is also not necessary because they are so very efficient in doing that themselves.
My second entry into this competition is so special that I will show you its complete, unadulterated abstract. Here it is:
Objective
To compare the safety differences between Chinese medicine (CM) and Western medicine (WM) based on Chinese Spontaneous Reporting Database (CSRD).
Methods
Reports of adverse events (AEs) caused by CM and WM in the CSRD between 2010 and 2011 were selected. The following assessment indicators were constructed: the proportion of serious AEs (PSE), the average number of AEs (ANA), and the coverage rate of AEs (CRA). Further comparisons were also conducted, including the drugs with the most reported serious AEs, the AEs with the biggest report number, and the 5 serious AEs of interest (including death, anaphylactic shock, coma, dyspnea and abnormal liver function).
Results
The PSE, ANA and CRA of WM were 1.09, 8.23 and 2.35 times higher than those of CM, respectively. The top 10 drugs with the most serious AEs were mainly injections for CM and antibiotics for WM. The AEs with the most reports were rash, pruritus, nausea, dizziness and vomiting for both CM and WM. The proportions of CM and WM in anaphylactic shock and coma were similar. For abnormal liver function and death, the proportions of WM were 5.47 and 3.00 times higher than those of CM, respectively.
Conclusion
Based on CSRD, CM was safer than WM at the average level from the perspective of adverse drug reactions.
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Perhaps there will be readers who do not quite understand why I find this paper laughable. Let me try to answer their question by suggesting a few other research subjects of similar farcicality.
- A comparison of the safety of vitamins and chemotherapy.
- A study of the relative safety of homeopathic remedies and antibiotics.
- An investigation into the risks of sky diving in comparison with pullover knitting.
- A study of the pain caused by an acupuncture needle compared to molar extraction.
In case my point is still not clear: comparing the safety of one intervention to one that is fundamentally different in terms of its nature and efficacy does simply make no sense. If one wanted to conduct such an investigation, it would only be meaningful, if one would consider the risk-benefit balance of both treatments.
The fact that this is not done here discloses the above paper as an embarrassing attempt at promoting Traditional Chinese Medicine.
PS
In case you wonder about the affiliations of the authors and their support:
- School of Management, Nanjing University of Posts and Telecommunications, Nanjing, 210003, China
Jian-xiang Wei - School of Internet of Things, Nanjing University of Posts and Telecommunications, Nanjing, 210003, China
Zhi-qiang Lu, Guan-zhong Feng & Yun-xia Zhu
The review was supported by the Major Project of Philosophy and Social Science Research in Jiangsu Universities and the Postgraduate Research & Practice Innovation Program of Jiangsu Province, China.
Yes, there is a new paper on homeopathic Arnica!
And yes, it arrives at a positive conclusion.
How is this possible?
Let’s have a look.
The authors conducted a systematic review and metaanalysis, following a predefined protocol, of all studies on the use of homeopathic Arnica montana in surgery. They included all randomized and nonrandomized studies comparing homeopathic Arnica to a placebo or to another active comparator and calculated two quantitative meta-analyses and appropriate sensitivity analyses.
Twenty-three publications reported on 29 different comparisons. One study had to be excluded because no data could be extracted, leaving 28 comparisons. Eighteen comparisons used placebo controls, nine comparisons an active control, and in one case Arnica was compared to no treatment. The metaanalysis of the placebo-controlled trials yielded an overall effect size of Hedge’s g = 0.18 (95% confidence interval -0.007/0.373; p = 0.059). Active comparator trials yielded a highly heterogeneous significant effect size of g = 0.26. This is mainly due to the large effect size of non-randomized studies, which converges against zero in the randomized trials.
The authors concluded that homeopathic Arnica has a small effect size over and against placebo in preventing excessive hematoma and other sequelae of surgeries. The effect is comparable to that of anti-inflammatory substances.
This review has many remarkable (or should I say, suspect?) features, e.g.:
- Its authors are famous (or should I say, infamous) advocates of homeopathy not known for their objectivity (including Prof Walach).
- Some of the trials included in the analysis are unpublished conference proceedings usually only published as an abstract (ref 29).
- Others were published in journals such as ‘Allgemeine Homoeopathische Zeitung‘ which is unlikely to manage a decent peer-review system (ref 46).
- Some trials used Arnica in low potencies that contained active molecules, and nobody doubts that active molecules can have effects (ref 32 and 37).
- One study seems to be a retrospective case-control study (ref 38).
- The primary endpoints of several studies were not those evaluated in the review (e.g. ref 42).
- One study used a combination of herbal and homeopathic arnica in the verum group which means the observed effect cannot be attributed to homeopathy (ref 31).
Perhaps the strangest feature relates to the methodology used by the review authors: “Where data were only available in graphs, data were read off the graph by enlarging the display and reading the figures with a ruler.” I have never before come across this method which must be wide open to bias.
Considering all of these odd features, I think that the small effect size over and against placebo in preventing excessive hematoma and other sequelae of surgeries reported by the review authors is most likely due to a range of factors that have nothing whatsoever to do with homeopathy.
So, does the new review show that homeopathic Arnica is “efficacious”? I don’t think so!
Robert F. Kennedy Jr. is the son of assassinated Senator Robert. F. Kennedy, and the nephew of President John F. Kennedy. He is famous – or rather infamous – for being outspoken in his opposition to vaccines, including the COVID-19 vaccine. Here is the relevant section from Wikipedia:
During the COVID-19 pandemic, Kennedy promoted multiple conspiracy theories related to COVID-19 including false claims both Anthony Fauci and the Bill & Melinda Gates Foundation are trying to profit off a vaccine, and suggesting that Bill Gates would cut off access to money of people who do not get vaccinated, allowing them to starve. In August 2020, Kennedy appeared in an hour-long interview with Alec Baldwin on Instagram, where he touted a number of incorrect and misleading claims about vaccines and public health measures related to the COVID-19 pandemic. Baldwin was criticized by public health officials and scientists for allowing Kennedy’s proclamations to go unchallenged. Kennedy has promoted misinformation about the COVID-19 vaccine, falsely suggesting that it contributed to the death of 86-year-old Hank Aaron and others. In February 2021 his Instagram account was blocked for “repeatedly sharing debunked claims about the coronavirus or vaccines.” The Center for Countering Digital Hate identified Kennedy as one of the main propagators of conspiracy theories about Bill Gates and 5G phone technology. His success as a conspiracy theorist increased his social media impact considerably; between the Spring and the Fall of 2020, his Instagram account grew from 121,000 followers to 454,000.
In November 2021, Kennedy’s book The Real Anthony Fauci: Bill Gates, Big Pharma, and the Global War on Democracy and Public Health was published wherein he alleges Fauci sabotaged treatments for AIDS, violated federal laws, and conspired with Bill Gates and social media companies such as Facebook to suppress any information about COVID-19 cures, to leave vaccines as the only options to fight the pandemic.[217][218] In the book, Kennedy calls Fauci “a powerful technocrat who orchestrated and executed the historic 2020 coup against Western democracy”. He claims Fauci and Bill Gates plan to prolong the pandemic and exaggerate its effects, promoting expensive vaccinations for the benefit of “a powerful vaccination cartel”.[219] The Neue Zürcher Zeitung has said of the book “…polemics alternate with chapters that pedantically seek to substantiate Kennedy’s accusations with numerous quotations and studies.”[219]
Kennedy wrote the foreword for Plague of Corruption (2020), a book by former research scientist and anti-vaccine conspiracy theorist Judy Mikovits.[220]
Kennedy appeared as a speaker at the partially violent demonstration in Berlin on August 29, 2020, where populist groups called for an end to restrictions caused by COVID-19.[221][222] His YouTube account was removed in late September 2021 for breaking the company’s new policies on vaccine misinformation
A recent analysis centered on 812,000 anti-vaccine posts shared on Facebook or Twitter between February 1 and March 16, 2021. Two-thirds of the posts were shared by what CCDH calls the “Disinformation Dozen”:
- Joseph Mercola,
- Robert F. Kennedy, Jr.,
- Ty and Charlene Bollinger,
- Sherri Tenpenny,
- Rizza Islam,
- Rashid Buttar,
- Erin Elizabeth,
- Sayer Ji,
- Kelly Brogan,
- Christiane Northrup,
- Ben Tapper,
- Kevin Jenkins.
Last week, Kennedy Jr. has surpassed himself. Addressing an anti-vaccination rally in Washington, DC on Sunday, Kennedy was reported to compare COVID-19 vaccination mandates to the Holocaust, saying that “Even in Hitler’s Germany… you could hide in the attic like Anne Frank did.”
The reaction of the official memorial of Auschwitz, the largest Nazi concentration camp in which more than 1 million people were murdered, was quick and (to my mind) justified: they accused the Kennedy Jr of “moral and intellectual decay”
