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

cult

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The COVID-19 pandemic has been notable for the widespread dissemination of misinformation regarding the virus and appropriate treatment. The  objective of this study was to quantify the prevalence of non–evidence-based treatment for COVID-19 in the US and the association between such treatment and endorsement of misinformation as well as lack of trust in physicians and scientists.

This single-wave, population-based, nonprobability internet survey study was conducted between December 22, 2022, and January 16, 2023, in US residents 18 years or older who reported prior COVID-19 infection.

Self-reported use of ivermectin or hydroxychloroquine, endorsing false statements related to COVID-19 vaccination, self-reported trust in various institutions, conspiratorial thinking measured by the American Conspiracy Thinking Scale, and news sources.

A total of 13 438 individuals (mean [SD] age, 42.7 [16.1] years; 9150 [68.1%] female and 4288 [31.9%] male) who reported prior COVID-19 infection were included in this study. In this cohort, 799 (5.9%) reported prior use of hydroxychloroquine (527 [3.9%]) or ivermectin (440 [3.3%]). In regression models including sociodemographic features as well as political affiliation, those who endorsed at least 1 item of COVID-19 vaccine misinformation were more likely to receive non–evidence-based medication (adjusted odds ratio [OR], 2.86; 95% CI, 2.28-3.58). Those reporting trust in physicians and hospitals (adjusted OR, 0.74; 95% CI, 0.56-0.98) and in scientists (adjusted OR, 0.63; 95% CI, 0.51-0.79) were less likely to receive non–evidence-based medication. Respondents reporting trust in social media (adjusted OR, 2.39; 95% CI, 2.00-2.87) and in Donald Trump (adjusted OR, 2.97; 95% CI, 2.34-3.78) were more likely to have taken non–evidence-based medication. Individuals with greater scores on the American Conspiracy Thinking Scale were more likely to have received non–evidence-based medications (unadjusted OR, 1.09; 95% CI, 1.06-1.11; adjusted OR, 1.10; 95% CI, 1.07-1.13).

The authors concluded that, in this survey study of US adults, endorsement of misinformation about the COVID-19 pandemic, lack of trust in physicians or scientists, conspiracy-mindedness, and the nature of news sources were associated with receiving non–evidence-based treatment for COVID-19. These results suggest that the potential harms of misinformation may extend to the use of ineffective and potentially toxic treatments in addition to avoidance of health-promoting behaviors.

This study made me wonder to what extend a lack of trust in physicians or scientists, and conspiracy-mindedness are also linked to the use of so-called alternative medicine (SCAM) for treatning COVID infections. As I have often discussed, such associations have been reported regularly, e.g.:

The authors point out that the endorsement of misinformation related to COVID-19 has been shown to decrease the intention to vaccinate against COVID-19, to decrease the belief that it is required for herd immunity, and to correlate with forgoing various COVID-19 prevention behaviors. Such false information is largely spread online and often originates as disinformation intentionally spread by political actors and media sources, as well as illicit actors who profit from touting supposed cures for COVID-19.  A substantial minority of the public endorses false information related to COVID-19, although certain subgroups are more likely to do so, including those who are more religious, who distrust scientists, and who hold stronger political affiliations. Cultivating and maintaining trust is a crucial factor in encouraging the public to engage in prosocial health behaviors. The extent to which addressing conspiratorial thinking could represent a strategy to address obstacles to public health merits further investigation.

The Skeptic reported that a cardiologist and one of the UK’s most influential critics of the COVID-19 vaccine, Dr Aseem Malhotra, has been named the 2023 recipient of the “Rusty Razor” award, the prize given by The Skeptic to the year’s worst promoters of pseudoscience.

Dr Malhotra has made a name for himself over the last decade as a cardiologist who advocates strongly against the broad use of statins. He has described the drugs as a multi-billion dollar “con” by the pharmaceutical industry, saying that his critics have “received millions in research funding from the pharmaceutical industry”. He has described the link between heart disease and saturated fat as a “myth”, drawing criticism from the British Heart Foundation.

In 2017, his book The Pioppi Diet put forward a diet that he claimed could prevent 20 million deaths per year from cardiovascular disease. The book was named by the British Dietetic Association as one of the celebrity diets to most avoid – with the BDA highlighting his apparently Mediterranean diet excluded pasta and bread, but included coconuts.

Throughout the COVID-19 pandemic, Dr Malhotra has been a prolific and powerful voice spreading narratives that run contrary to the best available evidence. In 2021, his book The 21-Day Immunity Plan included a diet claimed to improve the immune system and help fight off infections – claims that drew criticism from medical professionals.

In 2022, Dr Malhotra released a paper claiming that COVID-19 mRNA vaccines posed a serious risk to cardiovascular health and that the vaccines were “at best a reckless gamble”. The paper was published in the Journal of Insulin Resistance – where Dr Malhotra sits on the editorial board.

Dr Malhotra and his campaign against the COVID-19 vaccine was subsequently praised in Parliament by Andrew Bridgen MP as part of the reasoning behind his ongoing anti-vaccine crusade. In January of this year, Dr Malhotra used a BBC interview about statins to claim that deaths from coronary artery disease were actually complications from the vaccine, prompting a slew of complaints, and an apology from the broadcaster.

The Skeptic Editor Michael Marshall said: “In our opinion, Dr Malhotra has been an incredibly prolific promoter of pseudoscience throughout the pandemic, including spreading the false notion that vaccines are responsible for thousands of excess deaths.

“Dr Malhotra’s media career has given him a very large platform, from which he spreads misinformation that undermines confidence in a health intervention that has saved the lives of countless people across the world. In doing so, he stokes the flames of conspiracy, paranoia and mistrust of medical consensus.

“For anyone with so large a platform to do this would be concerning enough, but Dr Malhotra shares these pseudoscientific messages as a registered medical professional whose opinions have influenced at least one current member of parliament.

“All of this, we feel, makes Dr Aseem Malhotra a highly deserving winner of the 2023 Rusty Razor award”

The ‘Rusty Razor’ award was announced as part of The Skeptic’s annual Ockham Awards at a ceremony that took place during Saturday’s QED conference on science and skepticism, in Manchester. Also recognised during the event was the Knowledge Fight podcast, who won the 2023 award for Skeptical Activism.

I agree, Malhortra is a deserverd winner. The prize raises, in my view, an important question:

WHAT ON EARTH IS THE GENERAL MEDICIN COUNCIL (GMC) DOING ABOUT THIS GUY?

Malhotra’s activities have been compared to the case of Andrew Wakefield who falsely claimed that the MMR vaccine was linked to autism. While Wakefield was ultimately struck off by the GMC in 2010, the regulator has so far rebuffed repeated pleas to investigate Dr Malhotra.

The BMJ recently reported that Dr. Matt Kneale, who had previously complained to the GMC about the conduct of Aseem Malhotra, was told that the GMC would not be investigating Malhotra because his statements were not sufficiently “egregious” to merit action and he had a right to “freedom of speech.” Kneale’s appeal against this decision in 2023 was also turned down.

Kneale has now filed a claim with the High Court, arguing that the GMC should consider not only whether a doctor’s behaviour could harm individual patients but also whether their actions undermined public trust in medicine. He said that this was particularly important when examining statements relating to vaccines, where doctors with a high profile on social media could potentially cause great harm.

The US ‘Public Citizen‘ is an American non-profit, progressive consumer rights advocacy group, and think tank based in Washington, D.C. They recently published an article entitled “FDA Guidance on Homeopathic Drugs: An Ongoing Public Health Failure“. Here are a few excerpts:

In December 2022, the U.S. Food and Drug Administration (FDA) issued new guidance on homeopathic drug products. The guidance states that the agency now “intends to apply a risk-based enforcement approach to the manufacturing, distribution and marketing of homeopathic drug products.”

Under this new risk-based approach, the agency plans to target its enforcement actions against homeopathic drug products marketed without FDA approval that fall within the following limited categories:

  • products with reports of injury that, after evaluation, raise potential safety concerns
  • products containing or purportedly containing ingredients associated with potentially significant safety concerns (for example, infectious agents or controlled substances)
  • products that are not administered orally or topically (for example, injectable drug products and ophthalmic drug products)
  • products intended to be used to prevent or treat serious or life-threatening diseases
  • products for vulnerable populations, such as immunocompromised individuals, infants and the elderly
  • products with significant quality issues (for example, products that are contaminated with foreign materials or objectionable microorganisms)

But this new FDA guidance fails to adequately address the public health threat posed by the agency’s decades-long permissive approach to these illegal drug products.

Under FDA regulations, prescription and over-the-counter (OTC) homeopathic products are considered drugs and are supposed to be subject to the same review and approval requirements as all other prescription and OTC medications. However, under a flawed enforcement policy issued in 1988, the FDA has allowed these drug products to be marketed in the U.S. without agency review or approval. Thus, all products labeled as homeopathic are being marketed without the FDA having evaluated their safety, effectiveness or quality…

… there is no plausible physiologic or medical basis to support the theory underlying homeopathy, nor is there evidence from well-designed, rigorous clinical trials showing that homeopathic drugs are safe and effective.

The FDA should declare unequivocally that all unapproved homeopathic drug products are illegal and direct all manufacturers to immediately remove such products from the market. In the meantime, as we have recommended for many years, consumers should not use homeopathic products. At best, the products are a waste of money, given the lack of any evidence that they are effective. At worst, they could cause serious harm because of the lack of FDA oversight to ensure safety.

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I fully agree with these sentiments. The harm caused by homeopathy is considerable and multi-facetted. Many previous posts have discudded these problems, e.g.:

Having warned about the dangers of homeopathy for decades, I feel it is high time for regulators across the world to take appropriate action.

It has been reported that a UK Conservative candidate for the next general election reportedly claimed she healed a man’s hearing through the power of prayer. Kristy Adams has been chosen to represent the Conservatives in Mid Sussex at the next general UK election, which is expected to take place in May or the autumn of next year. Mrs Adams previously stood as the Tory candidate in Hove in 2017, placing a distant second behind Labour MP Peter Kyle.

In a recording from 2010, the Conservative hopeful reportedly told the King’s Arms Church in Bedford how she healed a deaf man by placing her hands over his ears and saying: “Be healed in Jesus’s name”. Mrs Adams is reported to have said: “He had hearing aids in both ears and I just thought that wasn’t right. It just annoyed me. I said ‘can I pray for you?’ and his eyes lit up, which is unusual when you offer to pray for someone’s healing.” After removing her hands, she claims the man could hear without his hearing aids. “I don’t know if he was more surprised or me,” she reportedly said.

Speaking to The Argus during her 2017 election campaign, Mrs Adams said she had asked the Daily Mirror to remove a story about the alleged recording but refused to answer whether she believed non-scientific medical miracles can happen. She said: “Millions of Christians around the world pray every day to help people.”

On this blog, we have discussed the alleged healing powers of prayer before, e.g.:

Suffice to say, perhaps, that the evidence for prayer as a therapy is not positive.

It has been reported that two London councils have written to parents to warn that children who are not vaccinated against measles may need to self-isolate for 21 days if a classmate is infected with the disease. It comes after modelling by the UK Health Security Agency (UKHSA) warned that up to 160,000 cases could occur in the capital alone as a result of low vaccination rates. Just three-quarters of London children have received the two required doses of the MMR jab, which protects against measles. This is 10 per cent lower than the national average.

Barnet Council wrote to parents on July 20 warning that any unvaccinated child identified as a close contact of a measles case could be asked to self-isolate for up to 21 days. “Measles is of serious concern in London due to low childhood vaccination rates. Currently we are seeing an increase in measles cases circulating in neighbouring London boroughs, so now is a good time to check that your child’s MMR vaccination – which not only protects your child against measles but also mumps and rubella – is up to date,” the letter reads. “Children who are vaccinated do not need to be excluded from school or childcare,” the letter added.

Neighbouring Haringey Council also warned that children without both MMR doses may be asked to quarantine for 21 days. Just over two-thirds (67.9 per cent) of children in the area had received both doses by the age of five. The councils stated that they had sent the letters based on guidance by the UKHSA, but the agency said that headteachers should consider “excluding” unvaccinated pupils who become infected with measles rather than instructing them to self-isolate.

Data published by the UKHSA showed that 128 cases of measles were recorded between January 1 and June 30 this year, compared to 54 cases in the whole of 2022. Two-thirds of the cases were detected in London. The agency have said that there is a high risk of cases linked to overseas travel leading to outbreaks in specific population groups such as young people and under-vaccinated communities.

Dr Vanessa Saliba, a consultant epidemiologist at UKHSA, said: “When there are measles cases or outbreaks in nurseries or schools, the UKHSA health protection team will assess the situation, together with the school and other local partners, and provide advice for staff and pupils. “Those who are not up to date with their MMR vaccinations will be asked to catch up urgently to help stop the outbreak and minimise disruption in schools.”

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Measles is a significant concern with approximately 10 million people infected annually causing over 100,000 deaths worldwide. In the US before use of the measles vaccine, there were estimated to be 3 to 4 million people infected with measles annually, causing 400 to 500 deaths. Complications of measles include otitis media, diarrhea, pneumonia, and acute encephalitis. Measles is a leading cause of blindness in the developing world, especially in those who are vitamin A deficient. Malnourished children with measles are also at higher risk of developing noma (or cancrum oris), a rapidly progressive gangrenous infection of the mouth and face. Most deaths due to measles are caused by pneumonia, diarrhea, or neurological complications in young children, severely malnourished or immunocompromised individuals, and pregnant women. A rare sequela of measles is subacute sclerosing panencephalitis.

Back in 2003, we investigated what advice UK homeopaths, chiropractors and general practitioners give on measles, mumps and rubella vaccination programme (MMR) vaccination via the Internet. Online referral directories listing e-mail addresses of UK homeopaths, chiropractors and general practitioners and private websites were visited. All addresses thus located received a letter of a (fictitious) patient asking for advice about the MMR vaccination. After sending a follow-up letter explaining the nature and aim of this project and offering the option of withdrawal, 26% of all respondents withdrew their answers. Homeopaths yielded a final response rate (53%, n = 77) compared to chiropractors (32%, n = 16). GPs unanimously refused to give advice over the Internet. No homeopath and only one chiropractor advised in favour of the MMR vaccination. Two homeopaths and three chiropractors indirectly advised in favour of MMR. More chiropractors than homeopaths displayed a positive attitude towards the MMR vaccination.  We concluded that some complementary and alternative medicine providers have a negative attitude towards immunisation and means of changing this should be considered.

The problem is by no means confined to the UK. German researchers, for instance, showed that belief in homeopathy and other parental attitudes indicating lack of knowledge about the importance of vaccinations significantly influenced an early immunisation. Moreover, being a German homeopath has been independently associated with lower own vaccination behavior. Data from France paint a similar picture.

Some homeopaths, of course, claim that ‘homeopathic vaccinations’ are effective and preferable. My advice is: DON’T BELIEVE THESE CHARLATANS! A recent study demonstrated that homeopathic vaccines do not evoke antibody responses and produce a response that is similar to placebo. In contrast, conventional vaccines provide a robust antibody response in the majority of those vaccinated.

Swedish researchers examined the relationship between cognitive ability and prompt COVID-19 vaccination using individual-level data on more than 700,000 individuals in Sweden.

The analyses were based on individual-level data from several administrative registers in Sweden. The study population consisted of all men and women who enlisted for military service in Sweden between 1979 and 1997. During this period, enlistment was mandatory for men the year they turned 18 or 19. Women could not enlist for military service before 1980 but were then allowed to do so on a voluntary basis.

The study population thus covered almost the entire population of Swedish men born between 1962 and 1979, in total 750,381, as well as the sample of women who enlisted during the period of 1980–1997, in total 2703. In addressing the role of confounders, the researchers analyzed the sub-sample of 6750 twin brothers (3375 twin-pairs) in the enlistment records (identified by shared biological mother and year and month of birth).

The results show a strong positive association between cognitive ability and swift vaccination, which remained even after controlling for confounding variables with a twin-design. Consistent with this, the researchers showed that simplifying the vaccination decision through pre-booked vaccination appointments alleviates almost all of the inequality in vaccination behavior.

The authors concluded that the complexity of the vaccination decision may make it difficult for individuals with lower cognitive abilities to understand the benefits of vaccination.

On this blog, we have repeatedly discussed similar or related findings, e.g.:

I know, it would be politically incorrect, unkind, unhelpful, etc. but is anyone not tempted to simplify the issue by assuming that people who are against (COVID) vaccinations are intellectually challenged?

The ‘ALTERNATIVE MEDICINE HALL OF FAME’ is my creation amd is meant to honour reserchers who have dedicated much of their professional career to investigating a form of so-called alternative medicine (SCAM) without ever publishing negative conclusions about it. Obviously, if anyone studies any therapy, he/she will occasionally produce a negative finding. This would be the case, even if he/she tests an effective treatment. However, if the treatment in question comes from the realm of SCAM, one would expect negative results fairly regularly. No therapy works well under all conditions, and to the best of my knowledge, no SCAM is a panacea!

This is why researchers who defy this inevitability must be remarkable. If someone tests a treatment that is at best dubious and at worst bogus, we are bound to see some studies that are not positive. He/she would thus have a high or norma ‘TRUSTWORTHINESS INDEX‘ (another creation of mine which, I think, is fairly self-explanatory). Conversely, any researcher who does manage to publish nothing but positive results of a SCAM is bound to have a very low ‘TRUSTWORTHINESS INDEX‘. In other words, these people are special, so much so that  I decided to honour such ‘geniuses’ by admitting them to my ALTERNATIVE MEDICINE OF FAME.

So far, this elite group of people comprises the following individuals:

  1. Tery Oleson (acupressure , US)
  2. Jorge Vas (acupuncture, Spain)
  3. Wane Jonas (homeopathy, US)
  4. Harald Walach (various SCAMs, Germany)
  5. Andreas Michalsen ( various SCAMs, Germany)
  6. Jennifer Jacobs (homeopath, US)
  7. Jenise Pellow (homeopath, South Africa)
  8. Adrian White (acupuncturist, UK)
  9. Michael Frass (homeopath, Austria)
  10. Jens Behnke (research officer, Germany)
  11. John Weeks (editor of JCAM, US)
  12. Deepak Chopra (entrepreneur, US)
  13. Cheryl Hawk (chiropractor, US)
  14. David Peters (osteopathy, homeopathy, UK)
  15. Nicola Robinson (TCM, UK)
  16. Peter Fisher (homeopathy, UK)
  17. Simon Mills (herbal medicine, UK)
  18. Gustav Dobos (various SCAMs, Germany)
  19. Claudia Witt (homeopathy, Germany/Switzerland)
  20. George Lewith (acupuncture, UK)
  21. John Licciardone (osteopathy, US)

Today, it is my great pleasure to admit another osteopath to the HALL OF FAME:

Helge Franke

Helge is a German Heilpraktiker and Osteopath. On his website, he lists his publications (kindly saving me the effort of doing a Medline search):

  1. Osteopathic manipulative treatment for nonspecific low back pain: a systematic review and meta-analysis. BMC Muskuloskeletal Disorders, 2014
  2. Effectiveness of osteopathc manipulative therapy for managing symptoms of irritable bowel syndrome: a systematic review. Journal of the American Osteopathic Association, 2014
  3. Why reservations remain: A critical reflection about the systematic review and meta-analysis “Osteopathic manipulative treatment for low back pain” by Licciardone et al. Journal of Bodywork & Movement Therapies, 2012, Elsevier
  4. Osteopathic Manipulative Treatment (OMT) for Lower Urinary Tract Symptoms (LUTS) in Women. A Systematic Review and Meta-analyses. Journal of Bodywork & Movement Therapies, 2012, Elsevier
  5. Comment: Is a postural-structural-biomechanical model, within manual therapy, viable? A JBMT debate. Journal of Bodywork & Movement Therapies (2011) 15, 259-261, Elsevier
  6. Die manuelle Behandlung des Kniegelenks – veraltetes Verfahren oder alternative Option? Naturheilpraxis mit Naturmedizin 9-2010, 1019-1026, Pflaum Verlag
  7. CRPS und Osteopathie – Grenzen und Möglichkeiten DO – Deutsche Zeitschrift für Osteopathie 3-2010, 6-8, Hippokrates Verlag
  8. Research and osteopathy: An interview with Dr Gary Fryer by Journal of Bodywork & Movement Therapies. 14, 304-308, Elsevier
  9. „…there is not much we can say without any doubt“ DO Life about Gary Fryer DO – Deutsche Zeitschrift für Osteopathie 1-2010, 4-5, Hippokrates Verlag
  10. Fred Mitchell und die Entwicklung der Muskel-Energie-Techniken DO – Deutsche Zeitschrift für Osteopathie 2-2009, 4-5, Hippokrates Verlag
  11. A randomized trial of arthroscopic surgery for osteoarthritis of the knee. Commentary Forschende Komplementärmedizin 2008 Dec 15(6), 354-5, Karger
  12. Evidence-informed management of chronic low back pain with spinal manipulation and mobilization. Commentary Forschende Komplementärmedizin 2008 Dec 15(6), 353-4, Karger
  13. Interview mit Prof. Eyal Lederman Teil 1 Osteopathische Medizin, 2/2007, S.15-21, Elsevier
  14. Interview mit Prof. Eyal Lederman Teil 2 Osteopathische Medizin, 3/2007, S.22-27, Elsevier
  15. Artikel über das 3. Internationale Symposium über die Fortschritte in der osteopathischen Forschung. Osteopathische Medizin, 1-2007, S.23-24, Elsevier
  16. Die richtige Haltung des Behandlers Osteopathische Medizin, 4-2006, S.8-10, Elsevier
  17. Interview mit Laurie Hartman Osteopathische Medizin, 4-2006, S. 11-16, Elsevier
  18. Herausgeber des Sonderheftes „Functional Technique” Osteopathische Medizin, 2-2006, Elsevier
  19. Harold Hoover, Charles Bowles, William Johnston und die Geschichte der Funktionellen Technik Osteopathische Medizin, 2-2006, S.4-12, Elsevier
  20. Interview mit Harry Friedman Osteopathische Medizin, 2-2006, S.25-30, Elsevier
  21. Funktionelle Technik – Praxis Osteopathische Medizin, 2-2006, S.17-23, Elsevier
  22. Osteopathische Diagnose und Behandlung des Hüftgelenks Naturheilpraxis mit Naturmedizin, 10-2006, S.1383-1393, Pflaum-Verlag
  23. Bericht über das 2-Tage Seminar von Prof. Laurie Hartman in München Naturheilpraxis mit Naturmedizin, 5-2006, S.754-755, Pflaum Verlag
  24. Bewusstsein für Bewegung. Die minimale Hebeltechnik und das Behandlungskonzept von Laurie Hartman Osteopathische Medizin, 4-2006, S.4-7, Elsevier
  25. ICAOR 6 / Interview mit Florian Schwerla Osteopathische Medizin, 3-2006, S.15-17, Elsevier
  26. Muscle Energy Technique – Geschichte, Modell und Wirksamkeit Teil 1 Geschichte Osteopathische Medizin 2-2005, S.4-10, Elsevier
  27. Muscle Energy Technique – Geschichte, Modell und Wirksamkeit Teil 2 Modell Osteopathische Medizin 3-2005, S.4-10, Elsevier
  28. Muscle Energy Technique – Geschichte, Modell und Wirksamkeit Teil 3 Wirksamkeit Osteopathische Medizin 4-2005, S.4-10, Elsevier
  29. Die Behandlung der Rippen mit Muskel-Energie-Techniken Naturheilpraxis mit Naturmedizin, 10-2005, S. 1353-1359, Pflaum Verlag

Yes, I agree! The list is confusing because it contains all sorts of papers, including even interviews. Let’s do a Medline search after all and find the actual studies published by Franke:

  1. Osteopathic manipulative treatment (OMT) for lower urinary tract symptoms (LUTS) in women. Franke H, Hoesele K.J Bodyw Mov Ther. 2013 Jan;17(1):11-8. doi: 10.1016/j.jbmt.2012.05.001. Epub 2012 Jun 17.
  2. Effectiveness of osteopathic manipulative treatment for pediatric conditions: A systematic review. Franke H, Franke JD, Fryer G.J Bodyw Mov Ther. 2022 Jul;31:113-133. doi: 10.1016/j.jbmt.2022.03.013. Epub 2022 Mar 24.
  3. Muscle energy technique for non-specific low-back pain. Franke H, Fryer G, Ostelo RW, Kamper SJ. Cochrane Database Syst Rev. 2015 Feb 27;(2):CD009852. doi: 10.1002/14651858.CD009852.pub2.
  4. Osteopathic manipulative treatment for nonspecific low back pain: a systematic review and meta-analysis. Franke H, Franke JD, Fryer G.BMC Musculoskelet Disord. 2014 Aug 30;15:286. doi: 10.1186/1471-2474-15-286.
    Effectiveness of osteopathic manipulative therapy for managing symptoms of irritable bowel syndrome: a systematic review. Müller A, Franke H, Resch KL, Fryer G.J Am Osteopath Assoc. 2014 Jun;114(6):470-9. doi: 10.7556/jaoa.2014.098.
  5. Osteopathic manipulative treatment for low back and pelvic girdle pain during and after pregnancy: A systematic review and meta-analysis. Franke H, Franke JD, Belz S, Fryer G.J Bodyw Mov Ther. 2017 Oct;21(4):752-762. doi: 10.1016/j.jbmt.2017.05.014. Epub 2017 May 31.
  6. Evidence-informed management of chronic low back pain with spinal manipulation and mobilization Franke H.Forsch Komplementmed. 2008 Dec;15(6):353-4
  7. Osteopathic manipulative treatment for chronic nonspecific neck pain: A systematic review and meta-analysis Helge Franke, Jan-David Franke, Gary Fryer, 2015 Int J Osteop Med.

Not a huge list, I agree. Yet it is respectable, particularly if we consider that Franke managed to squeeze out a little positive message even from cases where the data are fairly clearly negative. Another thing that I find noteworthy is the fact that Franke, as far as I can see, never published a clinical trial. He seems to specialize in reviews – and perhaps that is understandable: if one is compelled to spinning the message from fairly negative evidence to a positive conclusion, reviews might be better suited.

Altogether, I think Helge Franke deserves his place in the ALTERNATIVE MEDICINE HALL OF FAME!

As I mentioned before: it’s the season for awards and prizes:

It goes all the way back to 1982 when the Australian Skeptics instituted an award to be presented annually at the National Convention to individuals or organisations who made the most outrageous claim of a paranormal or pseudoscientific nature in the preceding year. After conferring with leading American Skeptic and illusionist, James Randi, who had earlier instituted a Bent Spoon award, it was decided that the Australian version would also commemorate one of the less useful, though widely acclaimed, alleged paranormal claims; the psychic ability to distort items of cutlery. So was born the Australian Bent Spoon Award. Some years later, in a masterpiece of alliteration, it was decided that the preamble to the award should read “presented to the perpetrator of the most preposterous piece of paranormal or pseudoscientific piffle”.

For a nomination to be accepted it should include the following details:The Bent Spoon Award on its Plinth

  • The name and contact details of the nominator (only the name will be listed on the website)
  • The name of the person or organisation being nominated
  • The reason for the nomination, including a clear explanation of the link to the paranormal or to pseudo-science

The ‘Bent Spoon’ is reserved for people who do their woo in Australia. The organisers also reserve the right to reject nominations that are deemed inappropriate. In particular, defamatory or frivolous nominations will not be accepted.

If you feel like nominating you favourite Australian anti-hero, use this link to email your nomination for 2023.

Click here to see the list of all current nominations.

And here is the fascinating list of former winners that reads like a ‘WHO IS WHO IN AUSTRALIAN QUACKERY’:

  • 2022: Maria Carmela Pau, for selling useless COVID vaccination exemption certificates, and claiming medical qualifications she did not have.
  • 2021: Craig Kelly MP, for spreading misinformation about COVID and vaccinations, and offering dubious cures and conspiracy theories.
  • 2020: Pete Evans for the promotion of the pseudoscientific non-medical BioCharger and continuing his anti-vaccination position.
  • 2019: SBS-TV program “Medicine or Myth” for promoting certain alternative medical treatments as if they had scientific credibility as opposed to placebo effectiveness.
  • 2018: Sarah Stevenson/Sarah’s Day for the promotion of questionable natural health remedies via her vast network of followers.
  • 2017: National Institute of Complementary Medicine and the University of Western Sydney for the continued promotion of disproved and unproved alternative medicine practices.
  • 2016: Judy Wilyman, Brian Martin, and the University of Wollongong for awarding Wilyman a doctorate on the basis of a PhD thesis riddled with errors, misstatements, poor and unsupported ‘evidence’ and conspiratorial thinking.
  • 2015: Pete Evans, chef, for his diet promotions, campaigns against fluoridation and support of anti-vaccinationists.
  • 2014: Dr Larry Marshall, Chief Executive, CSIRO for his support of water divining.
  • 2013: Chiropractors’ Association of Australia and the Chiropractic Board of Australia for failing to ensure their own members – including some committee members – adhere to their policy announcements.
  • 2012: Fran Sheffield of Homeopathy Plus! for advocating the use of magical sugar and water in place of tried and true vaccination for many deadly diseases, most notably Whooping Cough.
  • 2011: RMIT University “for having a fundamentalist chiropractic education program – if the word education can be used in this way – and for endorsing the practice by targeting children and infants in their on-campus paediatric chiropractic clinics”
  • 2010: the Australian Curriculum and Reporting Authority (ACARA) for its draft science curriculum.
  • 2009: Meryl Dorey and the deceptively named Australian Vaccination Network, who spread fear and misinformation about vaccines
  • 2008: Prof Kerryn Phelps
  • 2007: Marena Manzoufas, Head of Programming at the ABC for her sterling work in authorising the television show Psychic Investigators, made worse by putting it to air in the Catalyst timeslot
  • 2006: The pharmacists of Australia, who manage to forget their scientific training long enough to sell quackery and snake oil (such as Homoeopathy and ear candles) in places where consumers should expect to get real medical supplies and advice. Video of award here.
  • 2005: The ABC television program Second Opinion for the uncritical presentation of many forms of quackery.
  • 2004: The producers of the ABC television show The New Inventors, principally for giving consideration to an obvious piece of pseudoscience, the AntiBio water water conditioning system
  • 2003: The Complementary Healthcare Council
  • 2002: Gentle Heal Pty Ltd for the selling of fake (Homoeopathic) vaccine.
  • 2001: The Lutec “Free Energy Generator”
  • 2000: Jasmuheen who claims one can live without food and water.
  • 1999: Mike Willesee for the ‘documentary’ Signs From God.
  • 1998: Southern Cross University for offering a degree course in naturopathy, while also claiming to be conducting research into whether there was actually any validity to naturopathy.
  • 1997: Dr. Viera Scheibner – Anti-immunisation advocate
  • 1996: Marlo Morgan – American new age author who claimed in her book Mutant Message Downunder, that Australian Aborigines could levitate.
  • 1995: Tim McCartney-Snape for his promotion of the Foundation for the Adulthood of Mankind.
  • 1994: Commonwealth Attorney General for an enterprise agreement with its 2,400 employees that included a clause so any employee, who had taken sick leave, need not provide a medical certificate signed by a medical practitioner, but could provide one signed by a naturopath, herbalist, iridologist, chiropractor or one of assorted other “alternative” practitioners.
  • 1993: Steve Vizard’s Tonight Live programme (Channel 7).
  • 1992: Allen S Roberts, archaeological research consultant for a search for Noah’s Ark.
  • 1991: Woman’s Day magazine for its coverage and support of the paranormal, in particular astrology.
  • 1990: Mafu, multilifed entity, channelled by Penny Torres Rubin and who, despite millennia of experience, was remarkable for the banality of his/her pronouncements.
  • 1989: Diane McCann who wrote that Adelaide was built on one of the temples of Atlantis.
  • 1988: None
  • 1987: Anne Dankbaar, Adelaide “psychic”, whose discovery of the Colossus of Rhodes created something of a media stir until it was shown to be modern builders rubble.
  • 1986: Peter Brock, prominent racing driver, whose highly touted “energy polariser” generated more heat in the motoring media than it did energy in his car.
  • 1985: The Findhorn Festival Group, which sponsored the visit to Australia of American “psychic dentist” Willard Fuller. “Brother” Willard left town just ahead of some injunctions from real dentists.
  • 1984: Melbourne Metropolitan Board of Works for its payment of $1,823 to US “psychic archaeologist” Karen Hunt to use divining rods to detect an alleged “Electromagnetic Photo Field”
  • 1983: Dennis Hassel, “medium” whose chief trick was to make his hand disappear.
  • 1982: Tom Wards, self proclaimed “psychic”, whose predictions in the popular press were renowned for their inaccuracy.

The autum seems to be the season for awards. I recently mentioned the ‘Gloden Plank‘ and now The Skeptic announced the Ockham Awards the annual awards celebrating the very best work from within the skeptical community. The awards draw attention to people who work hard to promote skepticism. The Ockhams honour outstanding campaigns, activism, blogs, podcasts, and other contributors to the skeptical cause.

Nominations for the 2023 Ockham Awards are now open! Simply complete the nomination form to submit your nominations.

A photograph of the Rusty Razor award: a rusty classic style straight razor encased in plastic with "The Rusty Razor" etched at the bottom.

The Rusty Razor is an entirely different award. It recognises individuals or organisations who have been prominent promoters of unscientific ideas within the last year. Last year’s Rusty Razor went to the Global Warming Policy Foundation, set up in 2009 by climate change denier Nigel Lawson. The Foundation has published several reports downplaying the threat of climate change.

Previous Rusty Razor winners included

  • Dr Mike Yeadon for his anti-vaccination BS,
  • Dr Didier Raoult for his promotion of hydroxychloroquine as a treatment for COVID-19,
  • Andrew Wakefield for his ongoing promotion of anti-vaxx misinformation,
  • Gwyneth Paltrow for her pseudoscience-peddling wellness empire, Goop.

The awards are, as always, based on the nominations received from the skeptical community. This is your chance to see your skeptic hero and your most prolific charlatan regognised.

So, what are you waiting for? Submit your nominations now!

Nominations will close on September 9th. Winners will be chosen by the editorial board of THE SKEPTIC, and the winners will be announced at QED in Manchester on September 23rd.

Joe Dispenza is not all that well known in Europe but, in the US,  he is all the rage as a health guru. Despite pretending to be a top (neuro)scientist and expert of quantum physics, Dispenza has, as far as I can see, just three Medline-listed papers to his credit. Here are their abstracts:

No 1 is entitled “Meditation-induced bloodborne factors as an adjuvant treatment to COVID-19 disease

The COVID-19 pandemic has resulted in significant morbidity and mortality worldwide. Management of the pandemic has relied mainly on SARS-CoV-2 vaccines, while alternative approaches such as meditation, shown to improve immunity, have been largely unexplored. Here, we probe the relationship between meditation and COVID-19 disease and directly test the impact of meditation on the induction of a blood environment that modulates viral infection. We found a significant inverse correlation between length of meditation practice and SARS-CoV-2 infection as well as accelerated resolution of symptomology of those infected. A meditation “dosing” effect was also observed. In cultured human lung cells, blood from experienced meditators induced factors that prevented entry of pseudotyped viruses for SARS-CoV-2 spike protein of both the wild-type Wuhan-1 virus and the Delta variant. We identified and validated SERPINA5, a serine protease inhibitor, as one possible protein factor in the blood of meditators that is necessary and sufficient for limiting pseudovirus entry into cells. In summary, we conclude that meditation can enhance resiliency to viral infection and may serve as a possible adjuvant therapy in the management of the COVID-19 pandemic.

No 2 is entitled “The Mathematical Characterization of the Complexity Matching during a Healing Circle Meditation

The aim of the study is to evaluate the complexity matching between the HRVs of the group of Healers and the Healee during the various stages of the meditation protocol by employing a novel mathematical approach based on the H-rank algorithm. The complexity matching of heart rate variability is assessed before and during a heart-focused meditation in a close non-contact healing exercise. The experiment was conducted on a group of individuals (eight Healers and one Healee) throughout the various phases of the protocol over a ~75-minute period. The HRV signal for the cohort of individuals was recorded using high resolution HRV recorders with internal clocks for time synchronization. The Hankel transform (H-rank) approach was employed to reconstruct the real-world complex time series in order to measure the algebraic complexity of the heart rate variability and to assess the complexity matching between the reconstructed H-rank of the Healers and Healee during the different phases of the protocol. The integration of the embedding attractor technique was used to aid in the visualization of reconstructed H-rank in state space across the various phases. The findings demonstrate the changes in the degree of reconstructed H-rank (between the Healers and the Healee) during the heart-focused meditation healing phase by employing mathematically anticipated and validated algorithms. It is natural and thought-provoking to contemplate the mechanisms causing the complexity of the reconstructed H-rank to come closer; it can be explicitly stated that the purpose of the study is to communicate a clear idea that the H-rank algorithm is capable of registering subtle changes in the healing process, and that there was no intention of delving deep to uncover the mechanisms involved in the HRV matching. Therefore, the latter might be a distinct goal of future research.

No 3 is entitled “Large effects of brief meditation intervention on EEG spectra in meditation novices

This study investigated the impact of a brief meditation workshop on a sample of 223 novice meditators. Participants attended a three-day workshop comprising daily guided seated meditation sessions using music without vocals that focused on various emotional states and intentions (open focus). Based on the theory of integrative consciousness, it was hypothesized that altered states of consciousness would be experienced by participants during the meditation intervention as assessed using electroencephalogram (EEG). Brainwave power bands patterns were measured throughout the meditation training workshop, producing a total of 5616 EEG scans. Changes in conscious states were analysed using pre-meditation and post-meditation session measures of delta through to gamma oscillations. Results suggested the meditation intervention had large varying effects on EEG spectra (up to 50 % increase and 24 % decrease), and the speed of change from pre-meditation to post-meditation state of the EEG co-spectra was significant (with 0.76 probability of entering end-meditation state within the first minute). There was a main 5 % decrease in delta power (95 % HDI = [-0.07, -0.03]); a global increase in theta power of 29 % (95 % HDI = [0.27, 0.33]); a global increase of 16 % (95 % HDI = [0.13, 0.19]) in alpha power; a main effect of condition, with global beta power increasing by 17 % (95 % HDI = [0.15, 0.19]); and an 11 % increase (95 % HDI = [0.08, 0.14]) in gamma power from pre-meditation to end-meditation. Findings provided preliminary support for brief meditation in altering states of consciousness in novice meditators. Future clinical examination of meditation was recommended as an intervention for mental health conditions particularly associated with hippocampal impairments.

Unimpressed?

Me too!

It seems noteworthy that none of these articles support any of the many outlandish therapeutic claims Dispenza makes. In these papers, Dispenza give his affiliation as “Encephalon, LLC, Rainier, WA”. My seraches for this institution led me to the website of Dispenza’s company that tries to sell you all sorts of strange stuff and bombards you with irritating platitudes about spirituality and related subjects. Here you will also find several of Dispenza’s books. Naturally, they were big successes. The latest volume is called ‘Becoming Supernatural‘. Its topics include:

  • Demystifying the body’s seven energy centers and how you can balance them to heal
  • How to free yourself from the past by reconditioning your body to a new mind
  • How you can create reality in the generous present moment by changing your energy
  • The difference between third-dimension creation and fifth-dimension creation
  • The secret science of the pineal gland and its role in accessing mystical realms of reality
  • The distinction between space-time vs. time-space realities

By now, I am beginning to suspect that “Dr. Joe”, as he likes to wrongly depict himself, is an 18 carrat bullshitter, and I feel like learning more about him and his incredible popularity.

So, who is Joe Dispenza?

Dispenza trained as a chiropractor and, in 1986, he had a cycling accident that left him with six compressed vertebrae – at least that is what he likes to tell journalists. Allegedly, doctors told him he might never walk again and recommended spine surgery. But he knew better, checked himself out of the hospital, and reconstructed his vertebrae with his mind. Within 10 weeks he was walking again. “I made a deal with myself that if I was ever able to walk again I would spend the rest of my life studying the mind-body connection,” he claimed in a 2018 interview. If you don’t know about vertebral compression fractures, this sounds like an unusal recovery. If you, however, know about such injuries, the course of events is not abnormal.

Ever since, Dispenza uses his mind to heal others. His website contains ~40 testimonials of people claiming he cured their cancer or their multiple sclerosis or their infertility. Under the heading of “coherence healing,” the site boasts Dispenza and his disciples have “produced profound biological changes in multitudes of individuals around the world” and “observed hundreds of healings from a wide variety of health conditions.” In a 2020 interview Dispenza bragged about bringing children onstage at his retreats to cure them of “really serious health conditions.” He claimed to have cured a 76-year-old woman of Parkinson’s. He said his treatments cured illness faster than chemotherapy and that “profound and prestigious universities” in the United States wanted to study his methods. “[We’ve seen] tumors disappearing, people stepping out of wheelchairs, blind people seeing, deaf people hearing—crazy stuff,” he stated. “This is biblical proportions stuff.”

Dispenza likes to present himself as a scientist. “Learning” becomes “forging new synaptic connections” and changing one’s behavior becomes “reorganizing circuits.” He claims that meditating in the presence of others—combining “coherent fields,” as he calls this—opens up “interference patterns of fractal geometry that are doors to dimensions.” During performances, he occasionally brings followers on stage to share the “miracles” they experienced at the workshops that day, such as a woman who claimed she regained her depth perception after decades of encephalitis. “She got a biological upgrade … and all she did was make up her mind to do it,” he told the audience.

Back in 2012, I published a post entitled “How to become a charlatan” where I provide several practical instructions for all who intend to persue this career:

1. Find an attractive therapy and give it a fantastic name

Did I just say “straight forward”? Well, the first step isn’t that easy, after all. Most of the really loony ideas turn out to be taken: ear candles, homeopathy, aura massage, energy healing, urine-therapy, chiropractic etc. As a true charlatan, you want your very own quackery. So you will have to think of a new concept.

Something truly ‘far out’ would be ideal, like claiming the ear is a map of the human body which allows you to treat all diseases by doing something odd on specific areas of the ear – oops, this territory is already occupied by the ear acupuncture brigade. How about postulating that you have super-natural powers which enable you to send ‘healing energy’ into patients’ bodies so that they can repair themselves? No good either: Reiki-healers might accuse you of plagiarism.

But you get the gist, I am sure, and will be able to invent something. When you do, give it a memorable name, the name can make or break your new venture.

2. Invent a fascinating history

Having identified your treatment and a fantastic name for it, you now need a good story to explain how it all came about. This task is not all that tough and might even turn out to be fun; you could think of something touching like you cured your moribund little sister at the age of 6 with your intervention, or you received the inspiration in your dreams from an old aunt who had just died, or perhaps you want to create some religious connection [have you ever visited Lourdes?]. There are no limits to your imagination; just make sure the story is gripping – one day, they might make a movie of it.

3. Add a dash of pseudo-science

Like it or not, but we live in an age where we cannot entirely exclude science from our considerations. At the very minimum, I recommend a little smattering of sciency terminology. As you don’t want to be found out, select something that only few experts understand; quantum physics, entanglement, chaos-theory and Nano-technology are all excellent options.

It might also look more convincing to hint at the notion that top scientists adore your concepts, or that whole teams from universities in distant places are working on the underlying mechanisms, or that the Nobel committee has recently been alerted etc. If at all possible, add a bit of high tech to your new invention; some shiny new apparatus with flashing lights and digital displays might be just the ticket. The apparatus can be otherwise empty – as long as it looks impressive, all is fine.

4. Do not forget a dose of ancient wisdom

With all this science – sorry, pseudo-science – you must not forget to remain firmly grounded in tradition. Your treatment ought to be based on ancient wisdom which you have rediscovered, modified and perfected. I recommend mentioning that some of the oldest cultures of the planet have already been aware of the main pillars on which your invention today proudly stands. Anything that is that old has stood the test of time which is to say, your treatment is both effective and safe.

5. Claim to have a panacea

To maximise your income, you want to have as many customers as possible. It would therefore be unwise to focus your endeavours on just one or two conditions. Commercially, it is much better to affirm in no uncertain terms that your treatment is a cure for everything, a panacea. Do not worry about the implausibility of such a claim. In the realm of quackery, it is perfectly acceptable, even common behaviour to be outlandish.

6. Deal with the ‘evidence-problem’ and the nasty sceptics

It is depressing, I know, but even the most exceptionally gifted charlatan is bound to attract doubters. Sceptics will sooner or later ask you for evidence; in fact, they are obsessed by it. But do not panic – this is by no means as threatening as it appears. The obvious solution is to provide testimonial after testimonial.

You need a website where satisfied customers report impressive stories how your treatment saved their lives. In case you do not know such customers, invent them; in the realm of quackery, there is a time-honoured tradition of writing your own testimonials. Nobody will be able to tell!

7. Demonstrate that you master the fine art of cheating with statistics

Some of the sceptics might not be impressed, and when they start criticising your ‘evidence’, you might need to go the extra mile. Providing statistics is a very good way of keeping them at bay, at least for a while. The general consensus amongst charlatans is that about 70% of their patients experience remarkable benefit from whatever placebo they throw at them. So, my advice is to do a little better and cite a case series of at least 5000 patients of whom 76.5 % showed significant improvements.

What? You don’t have such case series? Don’t be daft, be inventive!

8. Score points with Big Pharma

You must be aware who your (future) customers are (will be): they are affluent, had a decent education (evidently without much success), and are middle-aged, gullible and deeply alternative. Think of Prince Charles! Once you have empathised with this mind-set, it is obvious that you can profitably plug into the persecution complex which haunts these people.

An easy way of achieving this is to claim that Big Pharma has got wind of your innovation, is positively frightened of losing millions, and is thus doing all they can to supress it. Not only will this give you street cred with the lunatic fringe of society, it also provides a perfect explanation why your ground-breaking discovery has not been published it the top journals of medicine: the editors are all in the pocket of Big Pharma, of course.

9. Ask for money, much money

I have left the most important bit for the end; remember: your aim is to get rich! So, charge high fees, even extravagantly high ones. If your treatment is a product that you can sell (e.g. via the internet, to escape the regulators), sell it dearly; if it is a hands-on therapy, charge heavy consultation fees and claim exclusivity; if it is a teachable technique, start training other therapists at high fees and ask a franchise-cut of their future earnings.

Over-charging is your best chance of getting famous – or have you ever heard of a charlatan famous for being reasonably priced?  It will also get rid of the riff-raff you don’t want to see in your surgery. Poor people might be even ill! No, you don’t want them; you want the ‘worried rich and well’ who can afford to see a real doctor when things should go wrong. But most importantly, high fees will do a lot of good to your bank account.

 

Could it be that Joe Dispenza is the most successful pupil of my crash-course in charlatanism?

 

 

PS

I have been asked by the NY Post to answer a few questions about Dispenza. Allow me to present them to you here:

What makes Dispenza so dangerous (his advice, obsession with manifesting, etc.)?

Dispenza is at his most dangerous firstly when he implies that he can cure serious illness. In this way, he can cause the premature death of many patients. Secondly, he systematically undermines rational thinking which inevitably will cause significant harm to the already badly damaged US society. As Voltaire once pointed out: those who make you believe in absurdities can make you commit atrocities.

 

Why, in your opinion, has he amassed a cult-like following?

In 2012 I published a satirical piece entitled ‘How to become a charlatan’ (How to become a charlatan (edzardernst.com)). It seems to me that Dispenza followed my instructions to the letter providing a masterclass on fooling the public. He is a textbook example of a charismatic pseudoscientist (e.g.: I am a “researcher of epigenetics, quantum physics & neuroscience“) touting pure bullshit (e.g.: “new science is emerging that empowers all human beings to create the reality they choose”). He may be a charlatan but he is very good at it, runs a highly sophisticated campaign, and is laughing all the way to the bank.

 

For readers who find themselves enamored by Dispenza, what advice would you give them?

My advise is to take a step back and do a reality check: ‘Dr.Joe’ is not a medical doctor or neuroscientist but a chiropractor. He does not understand quantum physics. He has not published any meaningful scientific studies. His proclamations are nothing but platitudes or empty phrases. My advice also is to ask yourself: are you sure you are not the victim of your own gullibility?

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