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

diagnostic method

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I have written about Bioscan before; for instance here. Now there is more news about the device. In Germany, the manufacturers of Bioscan have been sued and found guilty of fraud.

The two managing directors of the company were sentenced to imprisonment for two and three years respectively and together they have to pay a fine of over 2.5 million euros. The presiding judge considered it proven that the manufacturers had sold useless devices. He said, “A measuring device that measures nothing is about as useful as a car that does not drive.” In addition, a former sales director was sentenced to a fine of 90 daily rates.

The three leading employees of the company were charged with commercial fraud and violations of the Therapeutic Products Advertising Act. The company from Pliezhausen had claimed that their device would measure blood and nutrient values in the body in an uncomplicated way and thus replace a time-consuming laboratory diagnosis.

The Bioscan device consists of two metal rods. You have to take them in your hand, according to the company’s instructions. They would then measure magnetic waves and produce a result. More than 200 medically important health data could allegedly be recorded, for example, cholesterol or testosterone levels. The court had summoned several experts to assess the device. However, they found that the device measured nothing except the current flowing through the cables.

The manufacturers had been doing a huge business with the device for years. The company is said to have earned almost 6 million euros. The devices are still being sold today, for instance, in Austria and Switzerland, among other countries. Despite all the criticism and the court case, the two managing directors had not stopped sales.

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When I googled ‘Bioscan’ yesterday (30/5), the website informed me that:

The BioScan system is an FDA cleared, state of the art testing machine that scans the body’s organs and functions for imbalances using electrodermal screening (EDS).

BioScan SRT

What Is Stress Reduction Testing?

SRT is a remarkable new procedure that combines the disciplines of Acupuncture, Biofeedback and Homeopathy with Laser Light technology. A computerized scan or test is done to see what your body is sensitive to, and how it is out of balance, then help it learn not to be.

Are there any side effects?

No. A small percentage of clients report slight flushing or congestion for a short time (an hour or so) after their session, but this is actually a sign that the body is detoxifying (a good thing)! This process is safe, fast, non-invasive and painless. Unlike skin tests the actual substance is not used, so the body perceives its presence, it as if it were there, but does not act upon it.

What does the BioScan SRT treat?

The BioScan SRT Wellness System does not diagnose or treat any specific condition. Through the use of our FDA-cleared biofeedback technology, the BioScan SRT is able to assess with a very high degree of specificity which substances create increased levels of stress to the body.These specific stress inducing substances are often times what trigger the nervous systems fight or flight reactions which are expressed in a myriad of symptoms that have been scientifically proven to be associated with high levels of stress.

What substances can the BioScan SRT identify as stressors? 

The BioScan SRT contains tens of thousands of substances in the main procedure libraries and up to an additional 50,000 substances in the advanced procedure libraries. This technology can identify almost every known substance that could possibly cause a stress reaction.

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And on the Internet, it takes just a minute to find a Bioscan device for sale. It would set you back by 119.98 Euros.

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Say no more!

Bioresonance is an alternative therapeutic and diagnostic method employing a device developed in Germany by Scientology member Franz Morell in 1977. The bioresonance machine was further developed and marketed by Morell’s son-in-law Erich Rasche and is also known as ‘MORA’ therapy (MOrell + RAsche). Bioresonance is based on the notion that one can diagnose and treat illness with electromagnetic waves and that, via resonance, such waves can influence disease on a cellular level.

On this blog, we have discussed the idiocy bioresonance several times (for instance, here and here). My favorite study of bioresonance is the one where German investigators showed that the device cannot even differentiate between living and non-living materials. Despite the lack of plausibility and proof of efficacy, research into bioresonance continues.

The aim of this study was to evaluate if bioresonance therapy can offer quantifiable results in patients with recurrent major depressive disorder and with mild, moderate, or severe depressive episodes.

The study included 140 patients suffering from depression, divided into three groups.

  • The first group (40 patients) received solely bioresonance therapy.
  • The second group (40 patients) received pharmacological treatment with antidepressants combined with bioresonance therapy.
  • The third group (60 patients) received solely pharmacological treatment with antidepressants.

The assessment of depression was made using the Hamilton Depression Rating Scale, with 17 items, at the beginning of the bioresonance treatment and the end of the five weeks of treatment.

The results showed a statistically significant difference for the treatment methods applied to the analyzed groups (p=0.0001). The authors also found that the therapy accelerates the healing process in patients with depressive disorders. Improvement was observed for the analyzed groups, with a decrease of the mean values between the initial and final phase of the level of depression, of delta for Hamilton score of 3.1, 3.8 and 2.3, respectively.

The authors concluded that the bioresonance therapy could be useful in the treatment of recurrent major depressive disorder with moderate depressive episodes independently or as a complementary therapy to antidepressants.

One could almost think that this is a reasonably sound study. But why did it generate such a surprising result?

When reading the full paper, the first thing one notices is that it is poorly presented and badly written. Thus there is much confusion and little clarity. The questions keep coming until one comes across this unexpected remark: the study was a retrospective study…

This explains some of the confusion and it certainly explains the surprising results. It remains unclear how the patients were selected/recruited but it is obvious that the groups were not comparable in several ways. It also becomes very clear that with the methodology used, one can make any nonsense look effective.

In the end, I am left with the impression that mutton is being presented as lamb, even worse: I think someone here is misleading us by trying to convince us that an utterly bogus therapy is effective. In my view, this study is as clear an example of scientific misconduct as I have seen for a long time.

Yes, today is WORLD CANCER DAY. A good time to remind us that SCAM providers are often a serious risk to cancer patients. Here is a very recent case in point:

It has been reported that a naturopath from Laval in Quebec who describes herself as a “cancer specialist” notably by offering coffee enemas, has been found guilty of the illegal practice of medicine. The Court of Quebec ruled that Annie Juneau, owner of the Vitacru Group, led people to believe that she had “medical knowledge and [that she was] was able to diagnose a health deficiency”. The fine for the offense can vary between $2,500 and $62,000 and which remains to be determined.

The College of Physicians of Quebec (CMQ) conducted an investigation where an agent claiming to be looking for information on colon therapy under an assumed name consulted the therapist. The naturopath charged a little over $300 for the visit and the purchase of prescribed natural products. During the consultation, the naturopath, Annie Juneau, claimed that “we are brainwashed by the medical community”. She introduced herself as a “cancer specialist” and explained that she could even treat patients suffering from advanced stage 4 cancer.

The website of the naturopath praised the merits of the coffee enema, a practice believed to date back to ancient Egypt, stating that “cancer patients deprived of its benefits are unable to detoxify at the speed that optimal healing requires.” ON the Internet and in person, Annie Juneau illegally led a reasonable person to believe that she could perform acts reserved for doctors, the court ruled. In her defense, the naturopath argued that her website contained disclaimers stating that she does not offer medical advice and that she clearly identifies herself as a naturopath. However, the court ruled that such disclaimers are not sufficient protection of the public.

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This case is the latest in a long row of naturopaths (and other SCAM practitioners) risking the lives of cancer patients. Here are a few recent ones that we have discussed on this blog:

The Foundation for Vertebral Subluxation has a ‘clinical practice guideline/best practices project’ that would search, gather, compile and review the scientific literature going as far back as January 1998. Their new Chapter on the chiropractic care of children was peer-reviewed and approved by 196 chiropractors from several countries and included chiropractors specializing in pediatric and maternal care such as Diplomates and others certified in such care. The Best Practices document, developed through the Foundation’s Best Practices Initiative includes a Recommendation statement as follows:

Since vertebral subluxation may affect individuals at any age, chiropractic care may be indicated at any time after birth. As with any age group, however, care must be taken to select adjustment methods most appropriate to the patient’s stage of development and overall spinal integrity. Parental education by the chiropractor concerning the importance of evaluating children for the presence of vertebral subluxation is encouraged as are public health initiatives geared toward screening of children for vertebral subluxation beginning at birth.

I am afraid there may be some errors in the new document. Allow me therefore to post a corrected version:

Since vertebral subluxations do not exist, they cannot affect individuals regardless of age. Chiropractic adjustments are thus not indicated at any time after birth. Parental education by the chiropractor concerning the importance of evaluating children for the presence of vertebral subluxation is discouraged as are public health initiatives geared toward screening of children for vertebral subluxation beginning at birth.

Or, as an American neurologist once put it so much more succinctly:

Don’t let the buggers touch your neck!

Yesterday, my new book arrived on my doorstep.

WHAT JOY!

Its full title is CHARLES, THE ALTERNATIVE PRINCE. AN UNAUTHORISED BIOGRAPHY. I guess that it also clarifies its contents. In case you want to know more, here is the full list of topics:

Foreword by Nick Ross v  Charles, The Alternative Prince: An Unauthorised Biography
1. Why this Book? 1
2. Why this Author? 5
3. Words and Meanings 10
4. How Did It All Start? 13
5. Laurens van der Post 17
6. The British Medical Association 25
7. Talking Health 31
8. Osteopathy 37
9. Chiropractic 43
10. The Foundation of Integrated Health 50
11. Open Letter to The Times 56
12. The Model Hospital 62
13. Integrated Medicine 66
14. The Gerson Therapy 73
15. Herbal Medicine 77
16. The Smallwood Report 82
17. World Health Organisation 90
18. Traditional Chinese Medicine 96
19. The ‘GetWellUK’ Study 100
20. Bravewell 106
21. Duchy Originals Detox Tincture 110
22. Charles’ Letters to Health Politicians 115
23. The College of Medicine and Integrated Health 120
24. The Enemy of Enlightenment 126
25. Harmony 132
26. Antibiotic Overuse 142
27. Ayurvedic Medicine 147
28. Social Prescribing 154
29. Homeopathy 160
30. Final Thoughts 169
Glossary 180
End Notes 187
Index 202

In case you want to know more, here is chapter 1 of my book:

Over the past two decades, I have supported efforts to focus healthcare on the particular needs of the individual patient, employing the best and most appropriate forms of treatment from both orthodox and complementary medicine in a more integrated way.[1]

The Prince of Wales 1997

This is a charmingly British understatement, indeed! Charles has been the most persistent champion of alternative medicine in the UK and perhaps even in the world. Since the early 1980s, he has done everything in his power

  • to boost the image of alternative medicine,
  • to improve the status of alternative practitioners,
  • to make alternative therapies more available to the general public,
  • to lobby that it should be paid for by the National Health Service (NHS),
  • to ensure the press reported favourably about the subject,
  • to influence politicians to provide more support for alternative medicine.

He has fought for these aims on a personal, emotional, political, and societal level. He has used his time, his intuition, his influence, and occasionally his money to achieve his goals. In 2010, he even wrote a book, ‘Harmony’, in which he explains his ideas in some detail[2] (discussed in chapter 25, arguably the central chapter of this biography). Charles has thus become the undisputed champion of the realm of alternative medicine. For that he is admired by alternative practitioners across the globe.

Yet, his relentless efforts are not appreciated by everyone (another British understatement!). There are those who view his interventions as counter-productive distractions from the important and never-ending task to improve modern healthcare. There are those who warn that integrating treatments of dubious validity into our medical routine will render healthcare less efficient. There are those who claim that the Prince’s preoccupation with matters that he is not qualified to fully comprehend is a disservice to public health. And there are those who insist that the role of the heir to the throne does not include interfering with health politics.

  • So, are Charles’ ideas new and exciting?
  • Or are they obsolete and irrational?
  • Has Charles become the saviour of UK healthcare?
  • Or has he hindered progress?
  • Is he a role model for medical innovators?
  • Or the laughing stock of the experts?
  • Is he a successful reformer of healthcare?
  • Or are his concepts doomed to failure?

Charles appears to evade critical questions of this nature. Relying on his intuition, he unwaveringly pursues and promotes his personal beliefs, regardless of the evidence (Box 1). He believes strongly in his mission and is, as most observers agree, full of good intentions. If he even notices any criticism, it is merely to reaffirm his resolve and redouble his efforts. He is reported to work tirelessly, and one could easily get the impression that he is obsessed with his idea of integrating alternative medicine into conventional healthcare.

I have observed Charles’ efforts around alternative medicine for the last 30 years. Occasionally, I was involved in some of them. For 19 years, I have headed the world’s most productive team of researchers in alternative medicine. This background puts me in a unique position to write this account of Charles’ ‘love affair’ with alternative medicine. It is not just a simple outline of Charles’ views and actions but also a critical analysis of the evidence that does or does not support them. In writing it, I pursue several aims:

    1. I want to summarise this part of medical history, as it amounts to an important contribution to the recent development of alternative medicine in the UK and beyond.
    2. I hope to explain how Charles and other enthusiasts of alternative medicine think, what motivates them and what logic they follow.
    3. I will contrast Charles’ beliefs with the published evidence as it pertains to each of the alternative modalities (treatments and diagnostic methods) he supports.
    4. I want to stimulate my readers’ ability to think critically about health in general and alternative medicine in particular.

My book will thus provide an opportunity to weigh the arguments for and against alternative medicine. In that way, it might even provide Charles with a substitute for a discussion about his thoughts on alternative medicine which, during almost half a century, he so studiously managed to avoid.

In pursuing these aims there are also issues that I hope to avoid. From the start, I should declare an interest. Charles and I once shared a similar enthusiasm for alternative medicine. But, as new evidence emerged, I changed my mind and he did not. This led to much-publicised tensions and conflicts. Yet it would be too easy to dismiss this book as an act of vengeance. It isn’t. I have tried hard to be objective and dispassionate, setting out Charles’ claims as fairly as I can and comparing them with the most reliable evidence. As much as possible:

    1. I do not want my personal discords with Charles to get in the way of objectivity.
    2. I do not want to be unfairly dismissive of Charles and his ambitions.
    3. I do not want to be disrespectful about anyone’s deeply felt convictions.
    4. I do not aim to weaken the standing of our royal family.

My book follows Charles’ activities in roughly chronological order. Each time we encounter a new type of alternative medicine, I will try to contrast Charles’ perceptions with the scientific evidence that was available at the time. Most chapters of this book are thus divided into four parts

    1. A short introduction
    2. Charles’ views
    3. An outline of the evidence
    4. A comment about the consequences

While writing this book, one question occurred to me regularly: Why has nobody so far written a detailed history of Charles’s passion for alternative medicine? Surely, the account of Charles ‘love affair’ with alternative medicine is fascinating, diverse, revealing, and important!

I hope you agree.

BOX 1

The nature of evidence in medicine and science

  • Evidence is the body of facts, often created through experiments under controlled conditions, that lead to a given conclusion.
  • Evidence must be neutral and give equal weight to data that fail to conform to our expectations.
  • Evidence is normally used towards rejecting or supporting a hypothesis.
  • In alternative medicine, the most relevant hypotheses often relate to the efficacy of a therapy.
  • Such hypotheses are best tested with controlled clinical trials where a group of patients is divided into two subgroups and only one is given the therapy to be tested; subsequently the results of both groups are compared.
  • Experience does not amount to evidence and is a poor indicator of efficacy; it can be influenced by several phenomena, e.g. placebo effects, natural history of the condition, regression towards the mean.
  • If the results of clinical studies are contradictory, the best available evidence is usually a systematic review of the totality of rigorous trials.
  • Systematic reviews are methods to minimise random and selection biases. The most reliable systematic reviews are, according to a broad consensus, those from the Cochrane Collaboration.

[1] https://www.princeofwales.gov.uk/speech/article-hrh-prince-wales-titled-science-and-homeopathy-must-work-harmony-daily-telegraph

[2] https://www.amazon.co.uk/Harmony-New-Way-Looking-World/dp/0007348037

In case you want to know even more – and I hope you do – please get yourself a copy.

The Corona Committee (Corona Ausschuss) was founded in Berlin in July 2020 by the lawyers Viviane Fischer, Antonia Fischer, Dr. Reiner Füllmich, and Dr. Justus Hoffmann. Its aim is to provide a “factual analysis” of the coronavirus events and the consequences of the measures taken against them. In live sessions lasting several hours, the committee hears experts from all COVID-affected fields.

In an interview, Dr. Fuellmich said: “The decision to set up a Corona Inquiry Committee came about in the first telephone conversation Viviane Fischer and I ever had. After I had spoken out in the USA via various videos since April 2020 about the fact that the principle ‘audiatur et altera pars’ (hear the other side as well) had been blatantly violated here on the part of the government, I had come back to Germany from the USA because I felt that this was now my place and that I had to stand up here to ensure that our democracy and our constitutional state did not go completely to the dogs. I wanted to organize a symposium on the legal issues surrounding Corona, but I didn’t know any critical lawyers in Germany. I called my old friend Dr. Wolfgang Wodarg, whom I knew from the Justice Working Group at Transparency International, and he then referred me to Viviane Fischer.”

The ‘Speerspitze‘, an “anonymous collective of contrarians, Corona deniers, Nazi witches and conspiracy heretics” considers the work of the Corona Committee to be “one of the most important pillars of the fight against the madness to which we have been subjected for the last year and a half and [has] great respect for all the activists, actors, and interviewees of the Committee who publicly denounce with their name and face what is happening.” Numerous further websites have joined in the promotion of the Corona Committee.

However, if you look at the information that the Corona Committee is disseminating, and if you are able to think critically, you are likely to come to very different conclusions:

– There is the expert who warns that the unvaccinated could soon be picked up and put into concentration camps. There is the threat of a “manhunt”, and loving parents might then have to hide their children under the boards of the floor at home to prevent them from being sprayed to death.

– There is the man who claims that Israel’s government is currently carrying out a holocaust on its own population (“You can see that by how many people are dying from the vaccinations”). A guest declares that there are “something like living octopuses” in the vaccine against Corona.

Anyone who takes a look at the many tediously long videos will quickly realize that every Corona denier, vaccination opponent, conspiracy theorist, mask opponent, and lateral thinker, no matter how paranoid, have their say here and spreads their pipe dreams under the guise of evidence-based information with the nodding approval of the lawyers present. Opposition is never raised and there is no trace of ‘audiatur et altera pars’; everyone agrees: worldwide, all governments are hell-bound at smashing everything there is to govern.

For those who are still not fed up, the website of the Corona Committee offers written answers to 31 very specific questions. Here is just one.

QUESTION: IS THE COVID-19 DISEASE SEVERE AND WIDESPREAD?

ANSWER: No, most people have no or only mild flu symptoms. Children and adolescents are extremely rarely affected. Post-mortem examinations by a Hamburg forensic pathologist on over 100 elderly people who died with a positive corona test revealed at least one other serious cause of death in all cases. Other published figures are mostly based on non-transparent attributions and assumptions without excluding other causes. Often, no attention was even paid to other pathogens or previous medication.

Factual analyses?

Afraid not!

For a long time, I have been wondering where the penetratingly vociferous opposition to COVID vaccinations in Germany might come from. After studying the dangerous nonsense that the Corona Committee has been spreading for many months, I wonder a little less.

(texts in German were translated by me)

Compelling evidence has long shown that diagnostic imaging for low back pain does not improve care in the absence of suspicion of serious pathology. However, the effect of imaging use on clinical outcomes has not been investigated in patients presenting to chiropractors. The aim of this study was to determine if diagnostic imaging affects clinical outcomes in patients with low back pain presenting for chiropractic care.

A matched observational study using prospective longitudinal observational data with a one-year follow-up was performed in primary care chiropractic clinics in Denmark. Data were collected from November 2016 to December 2019. Participants included low back pain patients presenting for chiropractic care, who were either referred or not referred for diagnostic imaging at their initial visit. Patients were excluded if they were younger than 18 years, had a diagnosis of underlying pathology, or had previously had imaging relevant to their current clinical presentation. Coarsened exact matching was used to match participants referred for diagnostic imaging with participants not referred for diagnostic imaging on baseline variables including participant demographics, pain characteristics, and clinical history. Mixed linear and logistic regression models were used to assess the effect of imaging on back pain intensity and disability at two weeks, three months, and one year, and on global perceived effect and satisfaction with care at two weeks.

A total of 2162 patients were included, and 24.1% of them were referred for imaging. Near perfect balance between matched groups was achieved for baseline variables except for age and leg pain. Participants referred for imaging had slightly higher back pain intensity at two weeks (0.4, 95%CI: 0.1, 0.8) and one year (0.4, 95%CI: 0.0, 0.7), and disability at two weeks (5.7, 95%CI: 1.4, 10.0), but these differences are unlikely to be clinically meaningful. No difference between groups was found for the other outcome measures. Similar results were found when a sensitivity analysis, adjusted for age and leg pain intensity, was performed.

The authors concluded that diagnostic imaging did not result in better clinical outcomes in patients with low back pain presenting for chiropractic care. These results support that current guideline recommendations against routine imaging apply equally to chiropractic practice.

This study confirms what most experts suspected all along and what many chiropractors vehemently denied for years. One could still argue that the outcomes do not differ much and therefore imaging does not cause any harm. This argument would, however, be wrong. The harm it causes does not affect the immediate clinical outcomes.  Needless imaging is costly and increases the cancer risk.

My father invented a therapy for which there was no disease, my mother caught it and died.”

This type of scurrility makes me laugh. And it reminds me of the missing link in so-called alternative medicine (SCAM). We have heard about alternative therapies, alternative diagnostic methods, but what about alternative diseases and conditions? Here are some that SCAM practitioners seem to be oddly fond of:

  • – adrenal fatigue
  • – chi deficiency
  • – yeast overgrowth
  • – leaky gut syndrome
  • – leaky brain syndrome
  • – chronic Lyme disease
  • – various food ‘sensitivities’
  • – methylation dysfunction
  • – spinal subluxation
  • – vaccine-induced ‘toxicity’
  • – toxin-overload

But surely, these cannot be enough! For the field of SCAM to make progress, we definitely need many more. So, I had a brainstorm and came up with the following suggestions:

  • Ataxia: the condition (of many SCAM practitioners, but also others) where patients fail to declare their income to the taxman; usually cured by a short stay in the nick.
  • Cardioversion: an insurmountable dislike of conventional clinicians like cardiologists; a self-limiting condition that usually improves after receiving proper medical attention during a serious illness.
  • Collagen: a genetic disorder that shows itself through a strong dislike of experts who have been to college; incurable.
  • Deepak Chopra Syndrome: a serious neurosis where the patient cannot stop uttering BS; incurable.
  • Digitoxin: the unfortunate condition where a spiritual healer sends toxic spirits into the patient via his/her fingers; needs urgent detox.
  • Donovan bodies: a psychiatric affliction where patients are compelled to look and sing like Donavan; requires a sound-proof cell.
  • Duodenal ulcer: an unfortunate condition where the patient has two denal ulcers at the same time; emergency Reiki is advised.
  • Dyspepsia: the pathological preference of Coke over Pepsi; incurable.
  • Familial diseases: an umbrella term for all the few conditions that SCAM practitioners actually know about; can improve with reading a few textbooks.
  • Free radicals: terrorists on the run; call the police!
  • Fungal infection: a rare form of food poisoning where the magic mushrooms were off; needs detox.
  • Iridocyclitis: an obsession that afflicts iridologists who cannot stop riding bicycles; incurable.
  • Keratosis: the dangerous situation where a patient develops an aversion to his/her carer; change of carer is often needed.
  • Murial dyslexia: the inability to be able to read the writing on the wall; incurable.
  • Myositis: is always worse than your ositis.
  • Osteoblast: an event where, after chiropractic manipulation, a bone breaks with an audible noise; see an orthopedic surgeon.
  • Semi-colon: the embarrassing situation where a colonic irrigationist managed to clean out only half of the colon; manageable by changing your therapist.

If you, the reader, can think of more ways to expand the repertoire of SCAM terminology, please feel free to let us all know by posting your ideas below.

I have long cautioned that chiropractic overuse of X-rays is a safety problem. Is this still an issue? A recent paper was aimed at finding out.

The objective of this review was to determine the diagnostic and therapeutic utility of routine or repeat radiographs (in the absence of red flags) of the cervical, thoracic or lumbar spine for the functional or structural evaluation of the spine. Investigate whether functional or structural findings on repeat radiographs are valid markers of clinically meaningful outcomes. The research objectives required that the researchers determine the validity, diagnostic accuracy and reliability of radiographs for the structural and functional evaluation of the spine.

The investigators searched MEDLINE, CINAHL, and Index to Chiropractic Literature from inception to November 25, 2019. They used rapid review methodology recommended by the World Health Organization. Eligible studies (cross-sectional, case-control, cohort, randomized controlled trials, diagnostic and reliability) were critically appraised. Studies of acceptable quality were included in our synthesis.

Twenty-three papers were critically appraised. No relevant studies assessed the clinical utility of routine or repeat radiographs (in the absence of red flags) of the cervical, thoracic or lumbar spine for the functional or structural evaluation of the spine. No studies investigated whether functional or structural findings on repeat radiographs are valid markers of clinically meaningful outcomes. Nine low risk of bias studies investigated the validity (n = 2) and reliability (n = 8) of routine or repeat radiographs. These studies provided no evidence of clinical utility.

The authors’ conclusions are clear: We found no evidence that the use of routine or repeat radiographs to assess the function or structure of the spine, in the absence of red flags, improves clinical outcomes and benefits patients. Given the inherent risks of ionizing radiation, we recommend that chiropractors do not use radiographs for the routine and repeat evaluation of the structure and function of the spine.

In the paper, the authors provided further valuable information and background:

In the United States in 2010, the rate of spine radiographs within 5 days of presenting to a chiropractor was 204 per 1000 new patients. An analysis of national trends in the United States suggests that the rate of spinal radiography by chiropractors and podiatrists increased by 14.4% between 2003 and 2015. This increase occurred despite the publication of several evidence-based clinical practice guidelines and clinical prediction rules to assist chiropractors in determining the indication for spine radiographs to assist with diagnosing a pathology. Overall, guidelines suggest that radiographs are indicated when signs and symptoms of potentially serious underlying pathology (red flags) are identified through the clinical history and physical examination. However, on its own, an isolated “red flag” may have a high false positive rate for the diagnosis of underlying spinal pathology, such as cancer. For example, the presence of a solitary “red flag” such as age over 50 years may not be sufficient to warrant taking spine radiographs. Therefore, clinicians are encouraged to combine sound clinical judgement and the assessment of red flags when ordering radiographs.

In the absence of “red flags”, the use of spinal radiographs is not recommended. Nevertheless, factions of chiropractors, including the International Chiropractic Association promote the use of routine or repeat radiographs to assess the structure and function of the spine. This practice which dates back to 1910 was initiated when no evidence was available to guide the judicious use of spine radiographs. Historically, these groups of chiropractors have argued that radiographs are helpful to measure postural abnormalities, identify vertebral misalignment or subluxation and guide treatment with spinal manipulative therapy. The belief that radiographs are useful to detect and correct spine structure and function provides the foundation for many chiropractic technique systems that are still in use today. To our knowledge, approximately 23 chiropractic techniques use spine radiography (including full spine radiography) to guide the clinical management of patients. These include the Gonstead, Chiropractic BioPhysics®, Toggle-Recoil, and National Upper Cervical Chiropractic Association (NUCCA) techniques. Proponents of these techniques claim that the use of routine and repeat radiographs is supported by scientific evidence and have published a guideline to assist clinicians with the biomechanical assessment of spinal subluxation in chiropractic clinical practice using radiography. However, these claims have not yet been evaluated for their clinical utility, the benefit a patient gains from a test or treatment. This was a particular concern for the College of Chiropractors of British Columbia (CCBC) which regulates the practice of chiropractic in the province of British Columbia, Canada. The mission of the CCBC is to protect the public by regulating British Columbia’s doctors of chiropractic to ensure safe, qualified and ethical delivery of care.

The references from these two paragraphs can be found in the original paper. One reference the authors did not include was my article of 1998 which, at the time, received plenty of angry responses from chiropractors. Here is its conclusion: DATA SUGGEST AN OVERUSE OF RADIOGRAPHY BY THE CHIROPRACTIC PROFESSION. THIS CONSTITUTES A SAFETY PROBLEM THAT DESERVES TO BE TAKEN SERIOUSLY AND REQUIRES FURTHER RESEARCH.

Twenty-two years later, do I get the impression that the chiropractic profession might not be the fastest in getting its act together?

On his website, Phillip Hughes – D. Hom (Med), M.A.R.H, describes himself as follows:

In the early 1990’s my life was turned upside-down by a prolapsed disk in my back, putting me in traction in a hospital for 6 weeks! The doctor’s prognosis was poor, leaving me with little hope of full mobility, and no choice but to seek treatment elsewhere.

I decided on Homeopathy, and after treatment I experienced real change in my condition within a month, and was completely well within 3 months. I was so inspired by this I decided to study Homeopathy myself – and in 1994 I enrolled at the Hahnemann College of Homeopathy in London, qualifying in 1998.

After qualifying I set up my first clinic in Waterloo, Liverpool. I also became a senior lecturer at the Hahnemann College of Homeopathy, and founder of the Liverpool branch of the Hahnemann College.

I then moved my clinic to College Road Crosby, when I took up the role of secretary of Homeopathic Medical Association (since resigned). It was during this time that my wife Rosa found a lump in her breast, motivating us again to seek safer and alternative treatments, this time using Thermography. We now run Thermography and Homeopathic clinics side by side.

I had never heard of Mr Hughes until yesterday, when it was reported that he had treated a Sean Walsh, a young musician, for Hodgkin lymphoma that had initially been controlled with chemotherapy, but had later returned. Here is an excerpt from the sad story:

Sean was having scans at a clinic – Medical Thermal Imaging – run by a couple called Philip and Rosa Hughes. Philip Hughes, a homeopath, had previously told Sean’s parents he’d successfully treated Rosa for breast cancer. Dawn [Sean’s girlfriend] went along to Sean’s first appointment. “Phil was just talking all about how damaging chemotherapy is, you know, on the human body… saying, ‘I’ve had lots of people come to my clinic, but by the time I get them, they’re shot with all this chemotherapy, so I can’t help them … And then he was talking all about how you can change your diet, which can reverse cancer. He’d said that Rosa had developed breast cancer. She’d had a lump in her breast, and she decided not to do hospital treatment, and she was going to, you know, reverse the cancer herself. So obviously Sean’s listening to this thinking, ‘Well, if one person’s done it, and then I’m hearing other little stories off them, I can do this’. Sean’s scans did carry a disclaimer, stating that thermography does not see or diagnose cancer and recommending further clinical investigation. But the scan results seemed reassuring – and Sean was convinced his cancer had gone. ‘Medical Thermal Imaging’ describe their scans as “100% safe and radiation-free”.

To find out more about the service the Hughes were offering, a BBC reporter went to the clinic where Sean had his scans, posing as a patient who’d found a lump. They were seen by Rosa Hughes, who had provided scans for Sean. Rosa told our reporter that when she went to the breast clinic to have her lump investigated, she should have an ultrasound rather than a mammogram. This is a transcript of what she said: “Not a mammogram, because you’re going to get radiated, and it’s going to squash… and the amount of women that have had their tumours, the tumour burst, that spreads cancer.”

[The BBC] asked cancer specialist Prof Andrew Wardley, of Manchester’s Christie Hospital, to review the medical claims Rosa Hughes made to our reporter. “That’s preposterous. You don’t burst tumours, they are solid. You do squash the breast down to do a mammogram, it is unpleasant but it’s a short-term thing. You do not spread cancer by doing a mammogram, that’s a complete fallacy.” Rosa and Philip Hughes say they “utterly reject” the allegation that they gave Mr Walsh inappropriate advice. They added they had “consistently made clear” that thermography can only be used alongside other tests, such as MRIs or mammograms.

At first Sean believed he had cured his own cancer. But tragically Sean was wrong. Gradually his health declined, until he was rushed to hospital in Liverpool where medical staff found he had multiple tumours in his stomach and chest. He did eventually receive chemotherapy but it was too late.

Sean died in January 2019.

On Philip Hughes’ website, he advertises his services with the help of several testimonials from happy customers. Here is one of them:

In November 2000, I had an aggressive Sarcoma Tumour removed along with my left lung. Shortly after surgery I was referred to Weston Park Hospital, Sheffield for ‘follow up’ treatments where I was offered both chemotherapy and radiotherapy. At around the same time, I first visited Waterloo Homeopathic Clinic on a friends recommendation. After this initial introduction to Homeopathy I began ti educate myself about my condition and possible treatments. Consequently I considered chemotherapy to be a crude option and decided to refuse it. However, the frightening thought of this aggressive tumour returning encourages me to go ahead with a six week course of radiotherapy as a precaution alongside Homeopathic treatment. Accordingly this holistic approach resulted in my immune system being boosted by Homeopathy and my body prepared for this medical treatment. Leading up to the radiotherapy and during the six weeks of treatments, I took a rang of Homeopathic remedies. Radium Brom, in my opinion, was undoubtedly the input that enabled me to go through an intense course of treatment daily and continue my healthy recovery. I didn’t miss a days work and finished a half marathon only three weeks after completing the radiotherapy. I have since remained in good health and all checks been clear.

I have said it often, but it seems I have to say it again: the homeopathic remedy might be harmless, but the homeopath isn’t!

 

 

 

PS

The BBC documentary provides many more details about Sean and another of Mr Hughes’ patients. It also shows some rare footage from the inside of the Gerson clinic in Mexico where Sean went for a while. Very sad but well worth watching!!!

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