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

charlatan

1 2 3 36

Yesterday was the 80th anniversary of the Kristallnacht, the infamous start of the Nazi holocaust. For Cristian Becker, a German PR man who is currently spending much of his time promoting homeopathy and attacking critics of homeopathy, it was the occasion to publish this tweet:

I will try to translate it for you:

Today, on 9 November, all fundamentalist GWUP-sceptics such as Natalie Grams and Edzard Ernst reflect on what hate can bring about. First, one hates homeopathy, then advocates of homeopathy, and then it can seem as though one tolerates violence.

I struggle to respond to such vitriolic stupidity.

What makes this even more shocking is the fact that, as far as I see, none of the professional bodies of German homeopathy have distanced themselves for it.

I know Dr Grams a little, and can honestly say that neither of us ‘hates’ homeopathy nor homeopaths. And crucially, we both detest violence.

If such pseudo-arguments are now being used by the defenders of homeopathy, it mainly shows, I think, two things:

  1. They clearly have run out of real arguments which, in turn, suggests that the end of publicly funded homeopathy is imminent.
  2. Homeopathic remedies are not an effective therapy against feeble-mindedness.

The Clinic for Complementary Medicine and Diet in Oncology was opened, in collaboration with the oncology department, at the Hospital of Lucca (Italy) in 2013. It uses a range of alternative therapies aimed at reducing the adverse effects of conventional oncology treatments.

Their latest paper presents the results of complementary medicine (CM) treatment targeted toward reducing the adverse effects of anticancer therapy and cancer symptoms, and improving patient quality of life. Dietary advice was aimed at the reduction of foods that promote inflammation in favour of those with antioxidant and anti-inflammatory properties.

This is a retrospective observational study on 357 patients consecutively visited from September 2013 to December 2017. The intensity of symptoms was evaluated according to a grading system from G0 (absent) to G1 (slight), G2 (moderate), and G3 (strong). The severity of radiodermatitis was evaluated with the Radiation Therapy Oncology Group (RTOG) scale. Almost all the patients (91.6%) were receiving or had just finished some form of conventional anticancer therapy.

The main types of cancer were breast (57.1%), colon (7.3%), lung (5.0%), ovary (3.9%), stomach (2.5%), prostate (2.2%), and uterus (2.5%). Comparison of clinical conditions before and after treatment showed a significant amelioration of all symptoms evaluated: nausea, insomnia, depression, anxiety, fatigue, mucositis, hot flashes, joint pain, dysgeusia, neuropathy.

The authors concluded that the integration of evidence-based complementary treatments seems to provide an effective response to cancer patients’ demand for a reduction of the adverse effects of anticancer treatments and the symptoms of cancer itself, thus improving patient’s quality of life and combining safety and equity of access within public healthcare systems. It is, therefore, necessary for physicians (primarily oncologists) and other healthcare professionals in this field to be appropriately informed about the potential benefits of CMs.

Why do I call this ‘wishful thinking’?

I have several reasons:

  1. A retrospective observational study cannot establish cause and effect. It is likely that the findings were due to a range of factors unrelated to the interventions used, including time, extra attention, placebo, social desirability, etc.
  2. Some of the treatments in the therapeutic package were not CM, reasonable and evidence-based. Therefore, it is likely that these interventions had positive effects, while CM might have been totally useless.
  3. To claim that the integration of evidence-based complementary treatments seems to provide an effective response to cancer patients’ is pure fantasy. Firstly, some of the CMs were certainly not evidence-based (the clinic’s prime focus is on homeopathy). Secondly, as already pointed out, the study does not establish cause and effect.
  4. The notion that it is necessary for physicians (primarily oncologists) and other healthcare professionals in this field to be appropriately informed about the potential benefits of CMs is not what follows from the data. The paper shows, however, that the authors of this study are in need to be appropriately informed about EBM as well as CM.

I stumbled across this paper because a homeopath cited it on Twitter claiming that it proves the effectiveness of homeopathy for cancer patients. This fact highlights why such publications are not just annoyingly useless but acutely dangerous. They mislead many cancer patients to opt for bogus treatments. In turn, this demonstrates why it is important to counterbalance such misinformation, critically evaluate it and minimise the risk of patients getting harmed.

Acupuncture is a branch of alternative medicine where pseudo-science abounds. Here is yet another example of this deplorable phenomenon.

This study was conducted to evaluate the efficacy of acupuncture in the management of primary dysmenorrhea.

Sixty females aged 17-23 years were randomly assigned to either a study group or a control group.

  • The study group received acupuncture for the duration of 20 minutes/day, for 15 days/month, for the period of 90 days.
  • The control group did not receive acupuncture for the same period.

Both groups were assessed on day 1; day 30 and day 60; and day 90. The results showed a significant reduction in all the variables such as the visual analogue scale score for pain, menstrual cramps, headache, dizziness, diarrhoea, faint, mood changes, tiredness, nausea, and vomiting in the study group compared with those in the control group.

The authors concluded that acupuncture could be considered as an effective treatment modality for the management of primary dysmenorrhea.

These findings contradict those of a recent Cochrane review (authored by known acupuncture-proponents) which included 42 RCTs and concluded that there is insufficient evidence to demonstrate whether or not acupuncture or acupressure are effective in treating primary dysmenorrhoea, and for most comparisons no data were available on adverse events. The quality of the evidence was low or very low for all comparisons. The main limitations were risk of bias, poor reporting, inconsistency and risk of publication bias.

The question that I ask myself is this: why do researchers bother to conduct studies that contribute NOTHING to our knowledge and progress? The new study had a no-treatment control group which means it cannot control for the effects of placebo, the extra attention, social desirability etc. In view of the fact that already 42 poor quality trials exist, it is not just useless to add a 43rd but, in my view, it is scandalous! A 43rd useless trial:

  • tells us nothing of value;
  • misleads the public;
  • pollutes the medical literature;
  • is a waste of resources;
  • undermines the trust in clinical research;
  • is deeply unethical.

It is high time to stop such redundant, foolish, wasteful and unethical pseudo-science.

 

The ‘CANADIAN COLLEGE OF HOMEOPATHIC MEDICINE’ has posted an interesting announcement:

Homeopathic Treatment of Asthma with Homeopath Kim Elia www.wholehealthnow.com/bios/kim-elia

In asthma, bronchial narrowing results in coughing, wheezing, shortness of breath, and a sense of tightness in the chest. Traditional treatments, such as bronchodilator and steroidal inhalers, reasonably control the condition, but cure is elusive. Side effects and long-term use can eventually be quite damaging, including impairment of immune function and growth rate in children. Homeopathy has an excellent track record in treating this debilitating illness, and offers the hope of weaning off of traditional injurious treatments, replacing them with a far gentler and deeper-acting solution.

About Kim Elia

Students from around the world have expressed appreciation and admiration for Kim’s superb knowledge of the history of homeopathy, his deep understanding of homeopathic prescribing, and his extensive knowledge of materia medica. He is known for his dynamic and distinctive teaching methods which reflect his immense knowledge of the remedies and his genuine desire to educate everyone about this affordable and effective healing modality.

END OF QUOTE

There a few facts that the college seems to have forgotten to mention or even deliberately distorted:

  1. Asthma is a potentially lethal disease; each year, hundreds of patients die during acute asthma attacks.
  2. The condition can be controlled with conventional treatments.
  3. The best evidence fails to show that homeopathy is an effective treatment of asthma.
  4. Therefore, encouraging homeopathy as an alternative for asthma, risks the unnecessary, premature death of many patients.

And who is Kim Elia?

Here is some background (from his own website):

  • Apparently, he was inspired to study homeopathy when he read Gandhi’s quote about homeopathy, “Homeopathy cures a greater percentage of cases than any other method of treatment. Homeopathy is the latest and refined method of treating patients economically and non-violently.” He has been studying homeopathy since 1987 and graduated from the New England School of Homeopathy.
  • Kim is the former Director of Nutrition at Heartwood Institute, California.
  • He was the Director of Fasting at Heartwood.
  • Kim was a trainer at a company providing whole food nutritional supplements.
  • Kim serves as CEO of WholeHealthNow, the distributors of OPUS Homeopathic Software and Books in North America.
  • Kim provides and coordinates software training and support, and oversees new software development with an international team of homeopaths and software developers.
  • He was inspired to create the Historic Homeopathic Timeline, and is responsible for a growing library of recorded interviews and presentations with today’s world renowned homeopaths.
  • Kim was the principal instructor and developer of the four year classical homeopathy program at the Hahnemann Academy in Tokyo and Osaka, Japan.
  • He is currently developing new homeopathy projects.

What the site does not reveal is his expertise in treating asthma.

The Canadian College of Homeopathic Medicine claims to be dedicated to the training of homeopaths according to the highest standard of homeopathic education, emphasizing the art and practice of homeopathy as outlined in Hahnemanns’s Organon of the Medical Art. We aim to further the field of homeopathy as a whole through the provision of quality, primary homeopathic care.

If that is what the highest standard of homeopathic education looks like, I would prefer an uneducated homeopath any time!

On this blog, I have repeatedly discussed chiropractic research that, on closer examination, turns out to be some deplorable caricature of science. Today, I have another example of what I would call pseudo-research.

This RCT compared short-term treatment (12 weeks) versus long-term management (36 weeks) of back and neck related disability in older adults using spinal manipulative therapy (SMT) combined with supervised rehabilitative exercises (SRE).

Eligible participants were aged 65 and older with back and neck disability for more than 12 weeks. Co-primary outcomes were changes in Oswestry and Neck Disability Index after 36 weeks. An intention to treat approach used linear mixed-model analysis to detect between group differences. Secondary analyses included other self-reported outcomes, adverse events and objective functional measures.

A total of 182 participants were randomized. The short-term and long-term groups demonstrated significant improvements in back and neck disability after 36 weeks, with no difference between groups. The long-term management group experienced greater improvement in neck pain at week 36, self-efficacy at week 36 and 52, functional ability and balance.

The authors concluded that for older adults with chronic back and neck disability, extending management with SMT and SRE from 12 to 36 weeks did not result in any additional important reduction in disability.

What renders this paper particularly fascinating is the fact that its authors include some of the foremost researchers in (and most prominent proponents of) chiropractic today. I therefore find it interesting to critically consider the hypothesis on which this seemingly rigorous study is based.

As far as I can see, it essentially is this:

36 weeks of chiropractic therapy plus exercise leads to better results than 12 weeks of the same treatment.

I find this a most remarkable hypothesis.

Imagine any other form of treatment that is, like SMT, not solidly based on evidence of efficacy. Let’s use a new drug as an example, more precisely a drug for which there is no solid evidence for efficacy or safety. Now let’s assume that the company marketing this drug publishes a trial based on the hypothesis that:

36 weeks of therapy with the new drug plus exercise leads to better results than 12 weeks of the same treatment.

Now let’s assume the authors affiliated with the drug manufacturer concluded from their findings that for patients with chronic back and neck disability, extending drug therapy plus exercise from 12 to 36 weeks did not result in any additional important reduction in disability.

WHAT DO YOU THINK SUCH A TRIAL CAN TELL US?

My answer is ‘next to nothing’.

I think, it merely tells us that

  1. daft hypotheses lead to daft research,
  2. even ‘top’ chiropractors have problems with critical thinking,
  3. SMT might not be the solution to neck and back related disability.

I REST MY CASE.

 

According to the 2014 European Social Survey, Spain is relatively modest when it comes to using alternative therapies. While countries such as Austria, Denmark, Estonia, Finland, France, Germany, Lithuania, Sweden and Switzerland all have 1-year prevalence figures of over 30%, Spain only boasts a meagre 17%. Yet, its opposition to bogus treatments has recently become acute.

In 2016, it was reported that a master’s degree in homeopathic medicine at one of Spain’s top universities has been scrapped. Remarkably, the reason was “lack of scientific basis”. A university spokesman confirmed the course was being discontinued and gave three main reasons: “Firstly, the university’s Faculty of Medicine recommended scrapping the master’s because of the doubt that exists in the scientific community. Secondly, a lot of people within the university – professors and students across different faculties – had shown their opposition to the course. Thirdly, the postgraduate degree in homeopathic medicine is no longer approved by Spain’s Health Ministry.”

A few weeks ago, I had the great pleasure of being invited to a science festival in Bilbao and was impressed by the buoyant sceptic movement in Spain. At the time, two of my books were published in Spanish and received keen interest by the Spanish press.

 

And now, it has been reported that Spain’s Ministry of Health has released a list of only 2,008 homeopathic products whose manufacturers will have to apply for an official government license for if they wish to continue selling them. The homeopathic producers have until April 2019 to prove that their remedies actually work, which may very well completely slash homeopathic products in Spain.

It’s the latest blow for Spain’s homeopathy industry, once worth an estimated €100 million but which has seen a drop in public trust and therefore sales of around 30 percent in the last five years. Spain’s Health Ministry stopped allowing homeopathy treatments from being prescribed as part of people’s social security benefits, along with acupuncture, herbal medicine and body-based practices such as osteopathy, shiatsu or aromatherapy.

“Homeopathy is an alternative therapy that has not shown any scientific evidence that it works” Spanish Minister of Health Maria Luisa Carcedo is quoted as saying in La Vanguardia in response to the homeopathic blacklist. “I’m committed to combatting all forms of pseudoscience.”

Dr Alok Pareek has been elected as the World President of the International Homeopathic Medical league (LMHI – Liga Medicorum Homoeopathica Internationalis), the largest, oldest and only association of Medical Homeopaths in the World. He is the first Asian in 4 decades to bring this honour to India. Dr Alok Pareek was elected at the 71st World Congress of the LMHI held in Buenos Aires, Argentina on 23rd August 2016. He was elected unopposed by over 70 member countries. He has been elected for a three year tenure from 2016 to 2019

Dr. Alok Pareek runs a homeopathic hospital together with his father R.S. Pareek in Agra, India with fifty beds, treating around two hundred patients daily. His clinical practice spans thirty years. This extensive experience has given him a wealth of opportunity to carry out and refine homeopathic treatment in a wide range of acute and emergency situations…  Dr. Pareek demonstrates that homeopathy has much to offer in acute and emergency settings. He aims to increase the confidence of practitioners, to improve results and encourage them to offer safe and effective treatment in this important field, enabling homeopathy to take its place alongside conventional approaches within mainstream medicine. “As an Emergency Medicine physician who deals with life threatening diseases on a daily basis, I found Dr. Pareek’s homeopathic approach to be full of well-rounded clinical criteria and plenty of wise advice to the homeopathic doctor. I truly hope to be in medicine long enough to see us practice ‘hand in hand’ and enjoy the great benefits of this marvelous ‘scientific marriage’ in my emergency medicine patients.” Gladys H. Lopez M.D., M.P.H. USA Board Certified in Emergency ­Medicine

These two quotes might give you a fairly good impression of Dr Alok Pareek.

But why do I dedicate an entire post to him?

The reason is that I was alerted to one of his books entitled ‘Cancer is curable with homeopathy’. Even though it is obviously a translation from English, I could not find the original; so you have to bear with me as I translate for you the German abstract copied below:

75 years of homeopathic experience by father and son from India are expressed in this book about the homeopathic cure of cancers. Based on excellently documented cases, it demonstrates how homeopathy is clearly superior to chemotherapy and radiotherapy. We experience how a cure is possible even for such a serious disease as cancer in advanced stages. Dr D. Spinedi (Switzeralnd) estimates the immense experience of the doctors Pareek as ‘essential basic knowledge that should be accessible to all homeopaths’. It is a book that gives courage to both patients and therapists.

Zusammen 75 Jahre homöopathischer Erfahrung von Vater und Sohn Pareek aus Indien mit Tausenden von Patienten finden in diesem Buch ihren Niederschlag in der homöopathischen Heilung von Krebserkrankungen. Anhand exzellent dokumentierter Fallbeispiele wird gezeigt, wie in klassischer Arbeitsweise die Homöopathie der Chemotherapie und der Strahlentherapie deutlich überlegen ist. Wir erleben mit, wie Heilung bei einer so schweren Krankheit wie Krebs auch noch in fortgeschrittenen Stadien durch Homöopathie möglich ist. Dr. D. Spinedi (Schweiz) wertet die immense Erfahrung der Dres. Pareek als “unverzichtbares Grundlagenwissen, das allen Homöopathen zugänglich sein sollte.” Ein Buch, das Patienten wie Therapeuten Mut macht!

It is by Jove not often that I am speechless, but today, that’s exactly what I am.

The AMERICAN INSTITUTE OF HOMEOPATHY (AIH) is the oldest national medical association in the United States. The AIH’s mission is “to promote the science and art of homeopathic medicine, to safeguard the interests of the homeopathic medical profession, to improve the standards of homeopathic medical education, to educate the medical and scientific communities about the scientific basis for homeopathic medicine, and to increase public knowledge and acceptance of homeopathy as a medical specialty.”

The AIH is about to hold its annual conference. This year’s theme is “Tackling Patients with Severe Pathology”. The announcement reads as follows:

Homeopathy has been found to be effective in the great majority of patients suffering from infectious and autoimmune diseases. The limits of homeopathic treatment are encountered in the treatment of patients with Parkinson’s disease, ALS and late-stage cancers. After finding a way to treat patients with Parkinson’s disease with homeopathy, Dr. Saine began to apply this approach to cancer patients in stages III and IV. In this seminar, he will review case analysis, posology and case management for this cohort of patients.

We are fortunate to have the opportunity to learn from Dr. Saine in this seminar. He is recognized as one of the foremost homeopathic teachers and clinicians in the world, with special expertise in extremely difficult cases of severe and advanced pathology.

Who, for heaven sake, is this foremost homeopathic teachers and clinicians in the world, Dr Saine?, I asked myself after reading this (and even more so after listening to the rather spectacular video provided with the announcement). Here is what I found out about him:

Dr. Saine is a 1982 graduate of the National College of Naturopathic Medicine in Portland, Oregon. He is board-certified in homeopathy (1988) by the Homeopathic Academy of Naturopathic Physicians and has been teaching and lecturing on homeopathy since 1985. He is considered one of the world’s foremost experts on the subject of homeopathy.

And this is what non-doctor* Saine writes about medicine etc.:

The Organon of Medicine is a blueprint on how to practice medicine rationally and wisely through an integration of all the fundamental principles of medicine into a comprehensive whole. Unfortunately, to the detriment of the sick, very few homeopaths have delved, as Hahnemann did, into the practice of lifestyle medicine and the use of complementary care to homeopathy.

With rare exceptions, patients will present with a portion of their disease that ensues from an unhealthy environment or ways of living. The role of the physician is to determine in the equation of disease what is primarily due to an untuned vital force versus a causa occasionalis, as both will have to be addressed in due time.

After reading and listening to all this I am mildly shocked.

It does not seem to me that the AIH is fit for purpose. Neither am I convinced that non-doctor Saine should be let near any patient, let alone one with cancer or another severe pathology.

There should be a law protecting patients from this sort of thing!

[*in the context of healthcare, a doctor is for me someone who has studied medicine]

For years, Margaret McCartney, a GP from Scotland, wrote a weekly column in the BMJ. It was invariably well-worth reading. Recently, she regrettably ended it by publishing her last article entitled  A summary of four and a half years of columns in one column. In it, she makes 36 short points. They are all poignant, but the one that made me think most (probably because it is relevant to my work and this blog) reads as follows:

Many people seek to make money from those who don’t understand science. Doctors should call out bollocksology when they see it.

On this blog, I have often discussed people who make money from consumers and patients who are unable to detect the quackery they are being sold. No doubt, the most famous case of me doing this was when, in 2009, I criticised Prince Charles and his ‘Dodgy Originals Detox Tincture’. It made many headlines; the BBC, for instance, reported:

Edzard Ernst, the UK’s first professor of complementary medicine, said the Duchy Originals detox tincture was based on “outright quackery”.

There was no scientific evidence to show that detox products work, he said.

Duchy Originals says the product is a “natural aid to digestion and supports the body’s elimination processes”.

But Professor Ernst of Peninsula Medical School said Prince Charles and his advisers appeared to be deliberately ignoring science, preferring “to rely on ‘make-believe’ and superstition”.

He added: “Prince Charles thus financially exploits a gullible public in a time of financial hardship.”

Marketed as Duchy Herbals’ Detox Tincture, the artichoke and dandelion mix is described as “a food supplement to help eliminate toxins and aid digestion”.

It costs £10 for a 50ml bottle…

At the time, I got a right blocking from my dean, Prof John Tooke, for my audacity. As far as I could see, there was almost no support from the UK medical profession. Since then, the exploitation of the public by quacks has not diminished; on the contrary, I have the feeling that it is thriving. And are doctors calling out bollocksology left right and centre? No, they are not!

Of course, some do occasionally raise their voices (and some do it even regularly). But mostly, it is the group of non-medical sceptics who open their mouths and try their best to prevent harm. Yet, I wholly agree with my friend Margret: doctors have a responsibility and must do more.

And why don’t they?

I think, there are several reasons for their inactivity:

  • doctors are frightfully busy,
  • doctors often don’t know how much bollocksology is out there,
  • doctors don’t (want to) see how dangerous much of this bollocksology is,
  • doctors fail to realise that it would be their ethical responsibility to speak out against bollocksology,
  • some doctors do not seem to understand science either,
  • some doctors are active bollocksologists themselves,
  • some doctors simply don’t care.

This clearly is a depressing state of affairs! But, at the same time, it also is a cheerful occasion for me to thank all those doctors who are the laudable exceptions, who do care, who do think critically, who see their ethical responsibility, and who do something about the never-ending flood of bollocksology endangering their patients’ health and wealth.

It’s been often said that we live in the age of information.  Everyone can get tons of it at the click of a button. This is undoubtedly true. Sadly, it also means that we are exposed to tons of misinformation, and sometimes it seems to me that we now live in THE AGE OF MISINFORMATION.

Here I will explain the consequences of this phenomenon on two examples that, at first glance, seem to have nothing in common at all (other than being close to my heart):

  • Homeopathy
  • Brexit

With homeopathy, the public are confronted by a steady flood of misinformation from the powerful homeopathy lobby who tell us quite incredible untruths about it:

  • Homeopathy is effective
  • Homeopathy is harmless
  • Homeopathy is natural
  • Homeopathy is holistic
  • Homeopathy is supported by many of the brightest people
  • Homeopathy is an important contribution to public health
  • Homeopathy prevents epidemics
  • Homeopathy works through quantum effects
  • Homeopathy is nano-medicine
  • Homeopathy is energy medicine
  • Homeopathy works for infants
  • Homeopathy works in animals
  • Homeopathy works for plants
  • Homeopathy is the victim of a propaganda campaign against it

Those who put out this multi-level misinformation pretend that they inform the public. Of course, the public must be informed – how else could they possibly make informed choices? (If this important aim requires a bit of cheating here and there, so be it!)

And the public reacts as directed: they buy homeopathic preparations in droves. The result is that the promoters of homeopathy can claim that THE PUBLIC IS VOTING WITH THEIR FEET! The people have decided, they say, homeopathy is a good thing!

_______________________________________________________________

With Brexit, the public is confronted by a steady flood of misinformation from the powerful Brexit lobby who tell us quite incredible untruths about it:

  • Brexit is going to give us our country back
  • Brexit is good for the economy
  • Brexit will mean more money for the NHS
  • Brexit will be easy
  • Brexit will allow us to trade with the rest of the world
  • Brexit will keep foreigners out
  • Brexit is going to create jobs
  • Brexit is good for our industry
  • Brexit is good for farmers
  • Brexit is good for the environment
  • Brexit will free us from the shackles of the EU
  • Brexit will strengthen our alliance with the US

Those who put out this multi-level misinformation pretend that they inform the public. Of course, the public must be informed – how else could they possibly make informed choices? (If this important aim requires a bit of cheating here and there, so be it!)

And the public reacts as directed: they buy into the lies of the Brexiteers in droves. The result is that the promoters of Brexit can claim that THE PUBLIC HAS VOTED WITH THEIR FEET! The people have decided, they say, Brexit is a good thing!

_____________________________________________________________

Yes, I know, this is a bit simplistic. But the point I am trying to make is surely valid: misinformation not only leads to wrong and often dangerous decision, it is also the way charlatans try to fool us with their circular arguments and justify their blatant lies.

1 2 3 36
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.”


Click here for a comprehensive list of recent comments.

Categories