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

bogus claims

This review investigated the characteristics, hotspots, and frontiers of global scientific output in acupuncture research for chronic pain over the past decade. the authors retrieved publications on acupuncture for chronic pain published from 2011 to 2022 from the Science Citation Index Expanded (SCI-expanded) of the Web of Science Core Collection (WoSCC). The co-occurrence relationships of journals/countries/institutions/authors/keywords were performed using VOSviewer V6.1.2, and CiteSpace V1.6.18 analyzed the clustering and burst analysis of keywords and co-cited references.

A total of 1616 articles were retrieved. The results showed that:

  • the number of annual publications on acupuncture for chronic pain has increased over time;
  • the main types of literature are original articles (1091 articles, 67.5 %) and review articles (351 articles, 21.7 %);
  • China had the most publications (598 articles, 37 %), with Beijing University of Traditional Chinese Medicine (93 articles, 5.8 %);
  • Evidence-based Complementary and Alternative Medicine ranked first (169 articles, 10.45 %) as the most prolific affiliate and journal, respectively;
  • Liang FR was the most productive author (43 articles);
  • the article published by Vickers Andrew J in 2012 had the highest number of citations (625 citations).

Recently, “acupuncture” and “pain” appeared most frequently. The hot topics in acupuncture for chronic pain based on keywords clustering analysis were experimental design, hot diseases, interventions, and mechanism studies. According to burst analysis, the main research frontiers were functional connectivity (FC), depression, and risk.

The authors concluded that this study provides an in-depth perspective on acupuncture for chronic pain studies, revealing pivotal points, research hotspots, and research trends. Valuable ideas are provided for future research activities.

I might disagree with the authors’ conclusion and would argue that they have demonstrated that:

  1. the acupuncture literature is dominated by China, which is concerning because we know that 1) these studies are of poor quality, 2) never report negative findings, and 3) are often fabricated;
  2. the articles tend to be published in journals that are more than a little suspect.

As we have seen recently, the reliable evidence that acupuncture remains effective is wafer-thin. Therefore, I feel that we are currently being misled by a flurry of rubbish publications that have one main aim: to distract from the fact that acupuncture might be nonsense.

I have featured the ‘Münster Circle‘ before. The reason why I do it again today is that we have just published a new Memorandum entitled HOMEOPATHY IN THE PHARMACY. Here is its summary which I translated into English:

Due to questionable regulations in German pharmaceutical law, homeopathic medicines can be given the status of a medicinal product without having to provide valid proof of efficacy. As medicinal products, these preparations may then only be dispensed to customers in pharmacies, which, however, creates an obligation to also supply them on request or prescription. Many pharmacies go far beyond this and advertise homeopathic medicines as a useful therapy option by advertising them prominently in the window. In addition, customers are recommended to use them, corresponding lecture events are supported, and much more. Often, homeopathic preparations are even produced according to pharmacies’ own formulations and marketed under their own name.

For pharmacists and pharmaceutical technical assistants (PTAs) to perform their important task in the proper supply of medicines to the population, they must have successfully completed a scientific study of pharmacy or state-regulated training. This is to ensure that customers are informed and properly advised about their medicines according to the current state of knowledge.

After successfully completing their training or studies, PTAs and pharmacists are undoubtedly able to recognize that homeopathic medicines cannot be effective beyond placebo. They do not have any significant content of active ingredients – if, for example, the high potencies that are considered to be particularly effective still have any active ingredients at all. Consequently, pharmacists and PTAs act against their better knowledge to the detriment of their customers if they create the impression through their actions that homeopathic medicines represent a sensible therapeutic option and customers are thereby encouraged to buy and use them.

Although homeopathics have no potential for direct harm in the absence of relevant amounts of pharmacologically active substances in the preparations, their distribution should nevertheless be viewed critically. The use of homeopathy can mean losing valuable time and delaying the start of effective therapy. It is often accompanied by criticism, even rejection of scientifically oriented medicine and public health, for example when homeopathy is presented as the antithesis to a threatening “pharmaceutical mafia”.

The Münster Circle appeals to pharmacists and PTAs to stop advertising homeopathic medicines as an effective therapeutic option, to stop producing and marketing them themselves, and to advise their customers that homeopathic preparations are not more effective than placebo. The professional organizations of pharmacists and other providers of further training are called upon to no longer offer courses on homeopathy – except for convincingly refuting the often abstruse claims of the supporters.

_______________________

I have pointed out for at least 20 years now that pharmacists have an ethical duty toward their clients. And this duty does not involve misleading them and selling them useless homeopathic remedies. On the contrary, it involves advising them on the basis of the best existing evidence.

When I started writing and talking about this, pharmacists seemed quite interested (or perhaps just amused?). They invited me to give lectures, I published an entire series of articles in the PJ, etc. Of late, they seem to be fed up with hearing this message and the invitations have well and truly stopped.

They may be frustrated with my message – but not as frustrated as I am with their inertia. In my view, it is nothing short of a scandal that homeopathic remedies and similarly bogus treatments still feature in pharmacies across the globe.

This happens with such a regularity that I have decided to write about it; in fact, I shall do that in the form of an ‘open letter‘ to all concerned.

Background

A person or group of persons compose a complaint about my work in which they allege that I am engaged in a decade-long vendetta specifically against their particular form of so-called alternative medicine (SCAM). This letter is sent to me, or to a publisher of my articles/books, or to my peers at the university, or to anyone else they consider appropriate. Such interventions can at times be quite entertaining or even hilariously funny, but if they occur too often, they are also mildly irritating and wasteful. Foremost, they are based on a fundamental misunderstanding that might be worth clearing up with this …

 Open Letter

Dear advocate of the specific SCAM in question,

Dear professional organization of the specific SCAM in question,

I am sorry that my lecture/article/blog post/book/interview caused concern and led you to feel that I am running a long-term campaign or vendetta against the specific SCAM that you advocate. This letter is to assure you that your feeling is entirely erroneous: I am in no way targeting your specific SCAM.

If you have a look at my most recent book, for instance, you will see that, in it, I discuss a total of 202 different forms of SCAM and that – with good reason – I am highly critical of the vast majority of these methods. Imagine what it would mean to run a vendetta or campaign against all of these specific SCAMs. I would need a sizable team of co-workers involving lawyers, researchers, administrators, etc. to manage the task. I would also need plenty of funds to support the campaign, and I would most likely have more legal cases going than I have hair on my head.

The truth is that, since my retirement ~10 years ago, I do my research with no assistance whatsoever, I get no financial support or compensation for my work, and I am in contact with lawyers only when they ask me to serve as an expert witness. There simply is no evidence for the campaign that you feel does exist and you evidently misjudge my motives for criticizing your specific SCAM.

My aim is not to defame your specific SCAM or SCAM in general. I have no reason to do this. My aim is simply to inform the public responsibly and to prevent vulnerable people from getting harmed or ripped off. As I have studied the subject systematically for three decades, I feel I am competent, entitles, and duty-bound to try and do this.

I sincerely hope you are able to see the difference: you seem to think that I am destructively out to get you or your SCAM, while in truth I am constructively doing what responsible healthcare professionals (should) do.

Now that this misunderstanding has been cleared up, I thank you for reconsidering your position and stopping to claim things about me that are not true.

Best regards

Edzard Ernst

Remember the Bavarian Homeopathy Study? I reported about it only a few days ago. Now the ‘German Homeopathic Doctors Association’ has published an interview with someone who allegedly knows more about it. Here is my translation:

Dr. Springer, what does it actually mean politically that this study came about at all?

First of all, it means that the work of several years was worthwhile and that we were able to convince those responsible with a carefully elaborated study design. It also shows how enormously important it is to have solid political contacts with parties, MPs, parliamentary groups, and spokespersons in health committees. In addition to persuasion, personal credibility and professional competence are indispensable for the growth of such contacts. This is also shown by the fact that LIMed (List of Integrative Medicine) in Bavaria (as in some other federal states) has succeeded in sending committed colleagues to the representations of the State Medical Association and the Medical District and County Association.

What is special about this study?

As far as I know, it is the first study worldwide to be carried out with hand-shaken high potencies (C 200 and C 1000). If the results were positive, the mechanism of action of homeopathy would not be clarified, but it would be proven that highly potentised medicinal substances have a healing effect that can be objectified scientifically.

Who is the sponsor of this study?

The Bavarian Parliament voted with an absolute majority to scientifically investigate the role of complementary medicine in the fight against increasing antibiotic resistance. Several study designs were submitted on this question, and our study approach won the bid in the end. The Bavarian State Ministry of Health and Care is financing the study and has won the Technical University of Munich as a partner – after all, it is one of Germany’s universities of excellence. This removes all doubts about the correct scientific conduct of the study.

What is to be investigated in the study?

It relates to a diagnosis with great relevance to healthcare: Women often suffer from recurrent urinary tract infections, which are often treated with antibiotics. This is always associated with the risk of causative bacteria developing resistance to antibiotics. As homeopathically qualified doctors, we know from decades of experience that we can reduce and even end the frequency of recurrent urinary tract infections and their occurrence with our homeopathic remedies. We want to put this experience to the test scientifically with this study.

How do you see the chances for a positive study result?

As doctors, we know what we do and what we can do. We will do everything in our power to show that we can do it! I would also like to take this opportunity to thank all those who have made this study possible and who are providing us with professional and scientific support!-

The interview was conducted by Ulf Riker, MD.

___________________________

The interview raises several questions:

  1. Dr. Springer confirms that the existence of the study and its financial support is mostly due to political influence. Is this how good science should be generated?
  2. Is it true that the study is the first to investigate potency homeopathy? Considering that the bestselling homeopathic, Oscillococcinum, is sold in the C200 potency, this seems to be a very questionable statement.
  3. If the results were to come out positive, would we really re-write the textbooks of physics and chemistry which state that the absence of an active molecule cannot have an effect?
  4. Does the involvement of the Technical University truly remove all doubts about the correct scientific conduct of the study?
  5. If the homeopathically qualified doctors conducting the study already claim to know from decades of experience that they can reduce and even end the frequency of recurrent urinary tract infections with homeopathic remedies, are they not going to be too biased in conducting such a study?
  6. If the trialists are determined to do everything in their power to show that homeopathy works, will the study generate a reliable result?
  7. My last question is, how reliable is Dr. Springer? I found another interview of him dated 2021. In it he stated about the homeopathic treatment of COVID patients: ” [There is a} group of Covid-19 patients … [to] whose successful treatment we as homeopathic physicians can certainly contribute. The symptomatology of these patients is considerable, sometimes severe, but not life-threatening. They suffer from headaches and pain in the limbs, dizziness, fever, have the often-quoted “dry cough”, sweat, and usually feel very weak. But they have not yet developed clinical symptoms of pneumonia. These patients – and they are by no means few – can be helped by medical homeopathy, I am firmly convinced, curatively. Provided, of course, that a very precise, individual homeopathic anamnesis is carried out, the patient is closely followed, the course of the disease is closely observed and the remedy administered is adjusted if necessary. By preventing an acute condition and hospitalization in these patients homeopathy could make a not inconsiderable contribution to overcoming these greatest health and social challenges in one hundred years.” That, I think might answer my question.

As I pointed out before, the study design looks rigorous. After reading this interview, I have my doubts that its execution will be rigorous as well.

I recently came across a truly baffling article. As it is in German, I translated it for you:

Supply shortages have kept pharmacies on tenterhooks for months, with more than 400 common medicines missing. The German Central Association of Homeopathic Doctors (DZVhÄ) suggests switching to alternative medicine as a solution: “We have homeopathic medicines that have been tried and tested in practice for more than 200 years and can replace many medicines that are currently not available,” says the president of the DZVhÄ , Dr Michaela Geiger.

The DZVhÄ is convinced that homeopathic medical practices can replace fever-reducing medicines, but in many cases also antibiotics and much more. However, Geiger qualifies: “Due to our medical training, we also know that cancer drugs such as the often cited Tamoxifen cannot be replaced by homeopathy”.

The homeopathic doctors respond directly to the sharpest argument of their critics: “But let’s assume that homeopathy only works via the placebo effect, as is being rumored, even then it would be an option, especially if other options are lacking,” says DZVhÄ vice-president Dr. Ulf Riker. Since homeopathically trained doctors can judge the general course of a disease, they can also distinguish a placebo effect from a medicinal effect.

If fever medication for children is lacking, parents should not be deprived of another “therapy option”, Riker said. “If you do not get your conventional fever medication in the coming weeks, visit a specialist pharmacy for naturopathy and homeopathy. If you are due for a medical consultation, experienced homeopathic doctors can prescribe a suitable homeopathic medicine for you,” he says.

Why do I find this so intriguing?

Essentially, what we have learned from the article is the following:

  1. “Tried and tested in practice for more than 200 years” is ‘homeopathy speak’ for “effective”, even if the evidence tells us otherwise.
  2. Homeopathic remedies can replace many evidence-based conventional medications such as fever-reducing medicines, antibiotics, and much more, even if the evidence tells us otherwise.
  3. Homeopaths know that cancer drugs cannot be replaced by homeopathy – except for those homeopaths who seem to have forgotten this simple lesson.
  4. Homeopathic placebos are a realistic option when there is a supply problem with effective drugs, even if the evidence tells us otherwise.
  5. Homeopathically trained doctors can distinguish a placebo effect from a medicinal effect, even if there is no evidence that any clinician can reliably do this.
  6. Homeopathic doctors prescribe suitable homeopathic medicine. Suitable for whom? As it is ineffective, it is unsuitable for the patient. Therefore, Riker is probably talking about the homeopath.

So, what have we really learned from this article? I don’t know about you, but I got the impression that the president and the vice president of the DZVhÄ do not seem to mind putting patients in danger, as long as they can promote homeopathy.

 

Wellness seems to be everywhere these days – I mean of course the term, not the state or condition. On Medline, we find in excess of 500 000 articles on wellness, just for the year 2022! Wellness is en vogue, sexy, politically correct, etc. It looks good to talk and write about it. Most importantly it is good business. A report by the Global Wellness Institute stated that in 2020 the wellness industry was valued at $4.5 trillion and continues to grow at a frightening rate.

Having studied some of the recent literature on the subject, I get the impression that, for many, wellness is foremost an excuse for waffling utter nonsense. Let me, therefore, today ask just 5 simple questions about wellness that are likely to reduce the wellness of the ‘wellness brigade’:

1.What is wellness?

It is quite evidently a sector that is unable to define itself. Here are just a few of the definitions that have been suggested. Wellness is:

A 2018 review revealed that there is a lack of a uniform definition of wellness and showed that there is insufficient evidence to support the clinical utility of a single particular wellness instrument.

2. How do we measure wellness? 

The short answer to this question is: nobody is quite sure. There simply is no generally accepted, well-validated measure. A few domains come to mind:

  • physical functioning,
  • somatic symptoms, e.g. pain,
  • psychological symptoms,
  • social functioning,
  • needs and satisfaction.

But there is no simple means to quantify wellness. If you think that I am exaggerating, consider this recent review: 79 mental wellness instruments were identified. Most studies did not provide a definition for mental wellness. We identified thirteen mental wellness concepts from 97 studies, namely: life satisfaction, mental wellbeing [general], resilience, self-efficacy, self- esteem, connectedness, coping, self-control, mindfulness/spiritual, hope, sense of coherence, happiness, and life purpose.

3. What affects wellness?

The short answer is: potentially everything. My very own wellness, for instance, deteriorates sharply, if I have to read yet another nonsensical article about it.

4. Which interventions improve wellness?

As we have seen in my previous post, this is where so-called alternative medicine (SCAM) comes in. Since there is no measure to quantify wellness, we just have to take the word of SCAM proponents for it: SCAM improves wellness!!!

It’s obvious!

Which specific SCAM?

Can I see the evidence?

Sorry, no questions allowed!

And if you dare to insist on evidence, the ‘wellness brigade’ would just give you a pitiful smile and say: wellness has to be experienced, not measured.

5. Are there risks?

Yes, of course! Here are just some of them:

  • The treatments advocated for wellness almost invariably cost money.
  • The treatments advocated for wellness almost invariably cause direct and indirect harm, as discussed in many of my previous posts.
  • Wellness treatments tend to give the impression that one can buy wellness like an expensive piece of clothing without putting in any real effort oneself.

Considering all this, I’d like to offer my very own definition of the sector:

Wellness is a fashionable paradise for charlatans in which they are protected from scientific scrutiny and feel at liberty to bullshit to their hearts’ content. 

 

Drip IV is “Australia’s first and leading mobile healthcare company specialising in assisting with nutritional deficiencies”. They claim to provide a mobile IV service that is prescribed and tailored individually to your nutritional needs. Treatment plans and customised infusions are determined by a medical team to suit individual requirements. They deliver vitamins, minerals and amino acids directly to the body via the bloodstream, a method they state allows for optimal bioavailability.

These claims are a little puzzling to me, not least because vitamins, minerals and amino acids tailored individually to the nutritional needs of the vast majority of people would mean administering nothing at all. But I guess that virtually every person who consults the service will get an infusion [and pay dearly for it].

The Australian Therapeutic Goods Administration (TGA) seems to have a similarly dim view on Drip IV. The TGA has just issued 20 infringement notices totalling $159,840 to the company and to one of its executive officers. The reason: unlawful advertising of intravenous infusion products to Australian consumers on a company website and social media. Ten notices totalling $133,200 were issued to the company and ten notices totalling $26,640 were issued to an executive officer. The TGA considers the intravenous infusion products to be therapeutic goods because of the claims made about them, and the advertising to be unlawful because the advertisements allegedly:

  • contained prohibited representations, such as claims regarding cancer.
  • contained restricted representations such as that the products would alleviate fatigue caused by COVID-19, assist in the treatment of Graves’ Disease and Alzheimer’s Disease, and support the treatment of autoimmune diseases such as Multiple Sclerosis. No TGA approval had been given to make such claims.
  • referred to ingredients that are prescription only, such as glutathione. Prescription medicines cannot be advertised directly to the public in Australia.
  • contained a statement or picture suggesting or implying the products were ‘TGA Approved’. Advertising of therapeutic goods cannot include a government endorsement.
  • contained a statement or picture expressing that the goods were ‘miraculous’.

Vitamin infusions have become very popular around the globe. There are now thousands of clinics offering this service, and many of them advertise aggressively with claims that are questionable. Here is just one example from the UK:

Modern life is hectic. If you are looking to boost your wellbeing, increase your energy levels, lift your mood and hydrate your body, Vitamin IV Infusions are ideal. Favoured by celebrities such as Madonna, Simon Cowell and Rihanna, Vitamin IV Infusions are an easy, effective way of delivering vitamins, minerals and amino acids directly into your bloodstream via an IV (intravenous) drip. Vitamins are essential for normal growth and staying healthy – but our bodies can’t produce all of the nutrients we need to function and thrive. That’s why more than one in three people take daily vitamin supplements – often without realising that only 15% of the active nutrients consumed orally actually find their way into their bloodstream. With Vitamin IV Infusions, the nutrients enter your bloodstream directly and immediately, and are delivered straight to your cells. We offer four different Vitamin IV Infusions, so you can choose the best combination for your personal needs, while boosting your general health, energy and wellbeing.

My advice to consumers is a little different and considerably less costly:

  1. to ensure you get enough vitamins, minerals, and amino acids, eat a balanced diet;
  2. to boost your well-being, sit down and calculate the savings you made by NOT using such a service;
  3. to increase your energy levels, take a nap;
  4. to lift your mood, recount the money you saved and think of what nice things you might buy with it;
  5. to hydrate your body drink a glass of water.

Perhaps it is time the authorities in all countries had a look at what these clinics are offering and what health claims they are making. Perhaps it is time they act as the TGA just did.

 

If you think that scanning through dozens of new scientific articles every week is a dry and often somewhat tedious exercise, you are probably correct. But every now and then, this task is turned into prime entertainment by some pseudoscientists trying to pretend to be scientists. Take, for instance, the latest homeopathy study by Indian researchers with no less than 9 seemingly impressive affiliations:

  • 1Department of Organon of Medicine and Homoeopathic Philosophy, National Institute of Homoeopathy, Ministry of AYUSH, Govt. of India, Salt Lake, Kolkata, West Bengal, India.
  • 2Department of Organon of Medicine and Homoeopathic Philosophy, National Institute of Homoeopathy, Ministry of AYUSH, Govt. of India, Block GE, Sector III, Salt Lake, Kolkata, West Bengal, India.
  • 3Department of Homoeopathy, State Homoeopathic Dispensary, Karaila, Pratapgarh, Uttar Pradesh, India.
  • 4Department of Homoeopathy, State Homoeopathic Dispensary, Tulsipur, Shrawasti, Uttar Pradesh, India.
  • 5Department of Materia Medica, National Institute of Homoeopathy, Ministry of AYUSH, Govt. of India, Salt Lake, Kolkata, West Bengal, India.
  • 6State Homoeopathic Dispensary, Mangalbari Rural Hospital, Matiali Block, Jalpaiguri, West Bengal, under Department of Health & Family Welfare, Govt. of West Bengal, India.
  • 7Department of Repertory, The Calcutta Homoeopathic Medical College and Hospital, Govt. of West Bengal, Kolkata, West Bengal, India.
  • 8Department of Homoeopathy, East Bishnupur State Homoeopathic Dispensary, Chandi Daulatabad Block Primary Health Centre, Village and Post Office: Gouripur (South), Police Station Bishnupur, West Bengal, under Department of Health & Family Welfare, Govt. of West Bengal, India.
  • 9Department of Repertory, D. N. De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India.

Now that I have whetted your appetite, here is their study:

Lumbar spondylosis (LS) is a degenerative disorder of the lumbar spine. Despite substantial research efforts, no gold-standard treatment for LS has been identified. The efficacy of individualized homeopathic medicines (IHMs) in lumbar spondylosis (LS) is unknown. In this double-blind, randomized, placebo-controlled trial, the efficacy of IHMs was compared with identical-looking placebos in the treatment of low back pain associated with LS. It was conducted at the National Institute of Homoeopathy, West Bengal, India.

Patients were randomized to receive IHMs or placebos; standardized concomitant care was administered in both groups. The Oswestry low back pain and disability questionnaire (ODQ) was used as the primary outcome measure; the Roland-Morris questionnaire (RMQ) and the short form of the McGill pain questionnaire (SF-MPQ) served as secondary outcome measures. They were measured at baseline and every month for 3 months. Intention-to-treat analyses (ITT) were used to detect any inter-group differences using two-way repeated measures analysis of variance models overall and by unpaired t-tests at different time points.

Enrolment was stopped prematurely because of time restrictions; 55 patients had been randomized (verum: 28; control: 27); 49 could be analyzed by ITT (verum: 26; control: 23).

The results are as follows:

  • Inter-group differences in ODQ (F 1, 47 = 0.001, p = 0.977), RMQ (F 1, 47 = 0.190, p = 0.665) and SF-MPQ total score (F 1, 47 = 3.183, p = 0.081) at 3 months were not statistically significant.
  • SF-MPQ total score after 2 months (p = 0.030) revealed an inter-group statistical significance, favoring IHMs against placebos.
  • Some of the SF-MPQ sub-scales at different time points were also statistically significant: e.g., the SF-MPQ average pain score after 2 months (p = 0.002) and 3 months (p = 0.007).
  • Rhus Toxicodendron, Sulphur, and Pulsatilla nigricans were the most frequently indicated medicines.

The authors concluded that owing to failure in detecting a statistically significant effect for the primary outcome and in recruiting a sufficient number of participants, our trial remained inconclusive.

Now that I (and hopefully you too) have recovered from laughing out loud, let me point out why this paper had me in stitches:

  • The trial was aborted not because of a “time limit” but because of slow recruitment, I presume. The question is why were not more patients volunteering? Low back pain with LS is extremely common. Could it be that patients know only too well that homeopathy does not help with low back pain?
  • If a trial gets aborted because of very low patient numbers, it is probably best not to publish it or at least not to evaluate its results at all.
  • If the researchers insist on publishing it, their paper should focus on the reason why it did not succeed so that others can learn from their experience by avoiding their mistakes.
  • However, once the researchers do run statistical tests, they should be honest and conclude clearly that, because the primary outcome measure showed no inter-group difference, the study failed to demonstrate that the treatment is effective.
  • The trial did not “remain inconclusive”; it was squarely negative.
  • The editor of the journal HOMEOPATHY should know better than to publish such nonsense.

A final thought: is it perhaps the ultimate proof of homeopathy’s ‘like cures like’ assumption to use sound science (i.e. an RCT), submit it to the homeopathic process of endless dilutions and succussions, and – BINGO – generate utter nonsense?

Migraines are common headache disorders and risk factors for subsequent strokes. Acupuncture has been widely used in the treatment of migraines; however, few studies have examined whether its use reduces the risk of strokes in migraineurs. This study explored the long-term effects of acupuncture treatment on stroke risk in migraineurs using national real-world data.

A team of Taiwanese researchers collected new migraine patients from the Taiwan National Health Insurance Research Database (NHIRD) from 1 January 2000 to 31 December 2017. Using 1:1 propensity-score matching, they assigned patients to either an acupuncture or non-acupuncture cohort and followed up until the end of 2018. The incidence of stroke in the two cohorts was compared using the Cox proportional hazards regression analysis. Each cohort was composed of 1354 newly diagnosed migraineurs with similar baseline characteristics. Compared with the non-acupuncture cohort, the acupuncture cohort had a significantly reduced risk of stroke (adjusted hazard ratio, 0.4; 95% confidence interval, 0.35–0.46). The Kaplan–Meier model showed a significantly lower cumulative incidence of stroke in migraine patients who received acupuncture during the 19-year follow-up (log-rank test, p < 0.001).

The authors concluded that acupuncture confers protective benefits on migraineurs by reducing the risk of stroke. Our results provide new insights for clinicians and public health experts.

After merely 10 minutes of critical analysis, ‘real-world data’ turn out to be real-bias data, I am afraid.

The first question to ask is, were the groups at all comparable? The answer is, NO; the acupuncture group had

  • more young individuals;
  • fewer laborers;
  • fewer wealthy people;
  • fewer people with coronary heart disease;
  • fewer individuals with chronic kidney disease;
  • fewer people with mental disorders;
  • more individuals taking multiple medications.

And that are just the variables that were known to the researcher! There will be dozens that are unknown but might nevertheless impact on a stroke prognosis.

But let’s not be petty and let’s forget (for a minute) about all these inequalities that render the two groups difficult to compare. The potentially more important flaw in this study lies elsewhere.

Imagine a group of people who receive some extra medical attention – such as acupuncture – over a long period of time, administered by a kind and caring therapist; imagine you were one of them. Don’t you think that it is likely that, compared to other people who do not receive this attention, you might feel encouraged to look better after your health? Consequently, you might do more exercise, eat more healthily, smoke less, etc., etc. As a result of such behavioral changes, you would be less likely to suffer a stroke, never mind the acupuncture.

SIMPLE!

I am not saying that such studies are totally useless. What often renders them worthless or even dangerous is the fact that the authors are not more self-critical and don’t draw more cautious conclusions. In the present case, already the title of the article says it all:

Acupuncture Is Effective at Reducing the Risk of Stroke in Patients with Migraines: A Real-World, Large-Scale Cohort Study with 19-Years of Follow-Up

My advice to researchers of so-called alternative medicine (SCAM) and journal editors publishing their papers is this: get your act together, learn about the pitfalls of flawed science (most of my books might assist you in this process), and stop misleading the public. Do it sooner rather than later!

About a century ago, Royal Raymond Rife developed special microscopes and claimed he could visualize living microorganisms, including viruses too small to be seen with any other existing technology, via the color of auras emitted as they vibrated. In 1961, he explained this as follows: “A special risley prism which works on a counter rotation principle selects a portion of the light frequency which illuminates these viruses in their own characteristic chemical colors by emission of coordinative light frequency and the viruses become readily identifiable by the colors revealed on observation.”. The principles and alleged function of these microscopes have never been validated, and they have never been adopted for use.

Rife went on to postulate that the microorganisms he was seeing were involved in human diseases, including cancer . He also invented a machine that he claimed could transmit radio frequency energy into a person and vibrate these microorganisms at a “mortal oscillatory rate”, thereby killing them and improving the disease they were causing. The concept that diseases can be cured by radio frequency energy, originally proposed by Albert Abrams and referred to as ‘radionics’, was later investigated and disproven. Nonetheless, there remain enthusiasts who believe in Rife’s work, claim it was suppressed as part of an elaborate conspiracy. and continue to sell energy-transmitting devices and cures.

Rife machines (also called a Rife frequency generator.) produce low electromagnetic energy waves. These waves are similar to radio waves. Supporters of the treatment claim that the Rife machine can treat different conditions including cancer. There is no reliable evidence that the Rife machine works as a cure for cancer.

The Rife machine produces low-energy waves, also called radiofrequency electromagnetic fields. They have low energy compared to x-rays or radiotherapy.

Here is what proponents of the Rife therapy say:

… Although no official health claims are made for Rife therapy, testimonials from many countries point to its efficacy in the support of the body in maintaining or regaining good, natural health. A good Rife machine normally contains all of the original Royal Rife frequencies plus others that have been researched and utilised over the years.

WHAT IS THE PROCEDURE?

In most Rife sessions the client is seated. They have their feet on footplate electrodes and in their lap they hold in their hands plasma tubes. Thus they get the frequencies in normal form through the feet and in radio wave form through their hands. There are variations on this but this is the basic set up.

Some practitioners will occasionally employ something called a Beam Ray Tube. This is essentially a large plasma tube on a stand that plugs into the machine. The client just sits in front of it, about 3 feet away, while the frequencies are generated. In this instance the client does not have to hold anything or have their feet on footplates.

HOW LONG DO SESSIONS LAST?

The length of a session varies, depending on what is being addressed. Any session would be a minimum of 30 minutes but in serious or chronic conditions can last over 2 hours, occasionally more. However, clients can take breaks during the therapy.

HOW FREQUENT ARE TREATMENTS?

Once a week or once a fortnight is a common pattern of treatments. But in the case of more frequent sessions a minimum of 48 hours should be left between therapy. The duration of treatments varies on the condition being addressed. Sometimes it’s just a few visits…for conditions like Lyme Disease the treatments are ongoing for well over a year. The practitioner will answer your specific questions on this.

There are also frequencies to support regeneration and boost functions such as the immune system, the adrenals and several others.

ARE THERE ANY CONTRAINDICATIONS?

Rife therapy is not suitable for people with pacemakers or similar devices. It should not be given to children under 4 years of age. If a client is undergoing radiotherapy or frequency therapy for kidney stones etc there should should be no Rife sessions administered during these periods.

The day after some sessions a client may occasionally get a Herxheimer’s reaction. This is a feeling of tiredness, almost as if one is about to go down with flu. It was named after Dr Herxheimer who, along with one other doctor, discovered that when the liver and kidneys etc get overworked in disposing of waste products, this phenomena happens. The answer is just to drink lots of fluid to help the body dispose of the cells or toxins that have been eliminated by the Rife session. The day after that, the client is back to normal and usually feeling better than before the session.

I think that such promotional texts could and should be much shorter, more truthful, and hugely more informative, e.g.:

Rife therapy is not biologically plausible, has never been shown to be effective for any condition, might have adverse effects, and is not cheap. Therefore, we have a responsibility to warn consumers and patients not to use it.

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