EBM
As we all know, the FDA cannot require that dietary supplements be proven effective before they are sold. Yet, Robert F. Kennedy Jr. once said the FDA is exhibiting an “aggressive suppression” of vitamins, dietary supplements, and other substances and that he will end the federal agency’s “war on public health”.
With Kennedy now in the driver’s seat, the supplement industry expects to make bolder health claims for its products and to get the government, private insurers, and flexible spending accounts to pay for supplements, essentially putting them on an equal footing with FDA-approved pharmaceuticals.
The day Kennedy was sworn in as secretary of Health and Human Services, Trump issued a “Make America Healthy Again” agenda instructing health regulatory agencies to “ensure the availability of expanded treatment options and the flexibility for health insurance coverage to provide benefits that support beneficial lifestyle changes and disease prevention.” Kennedy added that dietary supplements are one key to good health. Supplement makers now want programs like health savings accounts, Medicare, and even benefits from the Supplemental Nutrition Assistance Program, or SNAP, to pay for vitamins, fish oil, protein powders, herbal remedies and probiotics.
In speeches and in a pamphlet called “The MAHA Mandate,” Emord and alliance founder Robert Verkerk said Kennedy would free companies to make greater claims for their products’ alleged benefits. Emord said his group was preparing to sue the FDA to prevent it from restricting non-pharmaceutical products.
With their ‘Mandate’ Emord and Verkerk want “to shift the healthcare paradigm towards one that restores the health of the American people through a holistic and individual-centered approach that works with, rather than against, nature”.
But do they ever question whether:
- vitamins do anything at all to people who eat a normal diet?
- fish oil is effective and safe for which conditions?
- protein powders have any effects beyond eating a steak?
- herbal remedies generate more good than harm?
- probiotics work for which conditions?
The short answer is no. To me, it seems that the MAHA are as uninterested in the evidence regarding efficacy and safety (quite possible they know how flimsy it is) as they are keen on the promotion of quackery.
This fascinating article [ full title: THE CRIMINAL OFFENSE OF QUACK MEDICINE AND QUACK PHARMACY (ART. 254 OF THE CRIMINAL CODE)] was written by Igor Vuković, PhD, Professor at the University of Belgrade, Faculty of Law. Here is its English language abstract:
The development of conventional medicine throughout history was accompanied by the appearance of quackery. On the one hand, in the absence of trained doctors, people all the same needed treatment, which was generally available only from unqualified persons. On the other hand, this need has generated greed and often deception regarding the expected success in treatment. This caused this phenomenon to be considered a criminal offense in most legislations. However, with the increasing legalization of the so-called complementary (alternative) medicine, whose methods are less scientifically proven, the attitude towards quackery is somewhat changing. The author notes that the scope of the act of „providing other medical services“ is particularly debated, since in that way acts of not only treatment but also medical assistance and care are brought under the framework of incrimination. Serbian law also considers as punishable acts of quack pharmacy, which is defined as preparing or issuing of medicaments without the appropriate professional qualification. This incrimination also raises important questions, which the author tries to answer. In the conclusion, it is stated that, according to the factual situation, situations of quackery can
often be brought under the criminal offense of fraud.
Even though it is not always clear to me what the authors meant to express, I feel that surely he is right in raising some of the issues related to so-called alternative medicine (SCAM). On this blog, I have repeatedly highlighted legal aspects of SCAM as they arose, e.g.:
- The ‘Healing Power of God’: a religious group was found guilty of manslaughter of a diabetic girl
- Prison sentence for a German HEILPRAKTIKER who issued false vaccination certificates
- Arrests in Germany of healthcare professionals who issued fake COVID certificates
- Boots the Chemist, legal complaints, and alternative medicines
- Homeopathy on the NHS: the first legal challenge
- Time for the legal profession to have a serious look at homeopathy?
- A scale of misdemeanors by SCAM practitioners towards patients and the public
- A warning for consumers and healthcare professionals: DO NOT USE THIS HOMEOPATHIC PRODUCT!
- Chiropractors charged with sexual assault
- Yoga guru arrested for rape and human trafficking
- Medicare fraud by chiropractors costs taxpayers millions
- A $2.6M Insurance Fraud by Chiropractors and Doctors?
- Center for Inquiry files a lawsuit against Boiron
- A naturopath responsible for the death of two cancer patients was sentenced to two years
- MMS-salesman Andreas Kalcker has been arrested in Argentina
- US Chiropractor in court for making false claims related to COVID-19
- Alleged sexual misconduct serves a blow to osteopathy in France
- The lack of chiropractic ethics: “valid consent was not obtained in a single case”
- “We hope that the publicity surrounding this event will highlight the dangers of chiropractic”… A statement of the family of the man who died after treatment of a ‘vertebral subluxation complex’
- Walmart is being sued for selling homeopathic products
Even a short glance at this list makes it obvious, I think, that there are plenty of legal issues in and around SCAM. I feel it would be important that we all – consumers, clinicians, researchers, lawyers and politicians – become aware of them and, when necessary, act accordingly.
On this blog and elsewhere, we have many people doubting that COVID vaccinations were effective; some even claim that they were detrimental to our long-term health. In this context, cardiac conditions are often mentioned, as they constitute a significant category of potentially serious post-COVID conditions.
Perhaps these doubters will find this new analysis relevant. The objective of this systematic review was to synthesise the evidence on the factors associated with the development of post-COVID cardiac conditions, the frequency of clinical outcomes in affected patients, and the potential prognostic factors. A systematic review was conducted using the databases EBSCOhost, MEDLINE via PubMed, BVS, and Embase, covering studies from 2019 to December 2023. A total of 8343 articles were identified, and seven met the eligibility criteria for data extraction. The protective effect of vaccination stood out among the associated factors, showing a reduced risk of developing post-COVID cardiac conditions. Conversely, COVID-19 reinfections were associated with an increased risk of cardiovascular outcomes. Regarding the main outcomes in these patients, most recovered, although some cases persisted beyond 200 days of follow-up. The study included in the analysis of prognostic factors reported that the four children who did not recover by the end of the study were between two and five years old and had gastrointestinal symptoms during the illness.
The authors concluded that the present findings provide valuable contributions to a better understanding of the evolution of post-COVID cardiac conditions. Despite the limited number of eligible studies, this review offers insights that describe the progression of cardiac conditions, from their onset to medium-term follow-up of patients. The protection offered by the COVID-19 vaccination regimen was observed beyond the acute phase of the disease, reducing the risk of developing post-COVID cardiac conditions. Public policies encouraging vaccination should be promoted to prevent SARS-CoV-2 infections and reinfections. Given that both COVID-19 and heart diseases occupy a significant place on the global health agenda, post-COVID cardiac conditions deserve due attention. Although most patients recover in the short term, some require care for many months to prevent chronicity and complications, particularly in vulnerable groups such as children and older adults. COVID-19 emerged as a pandemic in 2020, and four years later, it continues to impact the entire planet. This study provides important evidence to guide government policies on post-COVID conditions surveillance, prevention, and targeted healthcare interventions. Although this review compiles the available evidence on the topic, it is clear that there is still much to learn about post-COVID cardiac conditions. Strengthening the research agenda by proposing and conducting primary studies on the subject is important. Additionally, this review should be regularly updated as new studies are published in the field.
I would be delighted to hear that this new analysis has persuaded some doubters that COVID vaccinations are, after all. helpful interventions – but (as always on such occasions) I will not hold my breath!
Constipation is characterized by persistent difficulty in defecating. It is a common disorder in the community particularly affecting the elderly and those with intellectual disabilities and neuropsychiatric disorders. It can also be caused by numerous medications including analgesic, antidepressant, antihypertensive and anticholinergic agents. It may be asymptomatic or it may produce abdominal pain/cramps, bloating, nausea and anorexia progressing to urinary incontinence and fecal impaction, or paradoxical diarrhea due to overflow.
This review demonstrated that constipation may also kill you. A wide range of mechanisms associated with constipation may result in death including:
- bowel obstruction,
- stercoral colitis with ulceration,
- perforation and peritonitis,
- respiratory compromise,
- abdominal compartment syndrome,
- venous thrombosis with pulmonary thromboembolism.
Moreover, constipation may exacerbate pre-existing diseases and treatments such as laxative and enemas may be lethal. The autopsy examination of a case with constipation and megacolon should take into account all of the pre-existing conditions, as well as the possibility of underlying disorders such as Hirschprung disease. Review of the decedent’s medical and drug history and level of supportive care will be important. Toxicological evaluations may be useful.
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Constipation is defined as having fewer than three bowel movements per week or experiencing difficulty in passing stool. The condition is common and often difficult to treat. WebMD recommends diet and lifestyle changes, such as:
- Drink an extra two to four glasses of water a day, unless your doctor tells you to limit fluids for another reason.
- Try warm liquids, especially in the morning.
- Add fruits and vegetables to your diet.
- Eat prunes and bran cereal.
- Exercise most days of the week. When you move your body, the muscles in your intestines are more active, too.
- Don’t ignore the urge to poop. Listen to your body when it’s telling you it’s time to go.
- Eat foods with probiotics such as yogurt and kefir.
- Skip processed meats, fried foods, and refined carbs such as white bread, pasta, and potatoes. You can eat lean meats such as poultry and low-fat dairy products.
- Keep a food diary and make a note of any foods that constipate you.
- Adjust how you sit on the toilet. Raising your feet, leaning back, or squatting may make it easier to poop.
- Take an over-the-counter fiber supplement (Metamucil®, MiraLAX®, Citrucel® or Benefiber®). Start with a small amount at first.
- Avoid reading or using your phone or other devices while you’re trying to move your bowels.
- Drink less alcohol and caffeinated drinks, which can make you dehydrated.
- Talk to your doctor about bowel training. It can help train your body to pass stool shortly after breakfast every morning.
- Don’t rush when going to the bathroom. Give yourself time to relax, which can help your digestive muscles relax.
- Talk to your doctor about any medications that could be causing your constipation.
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Because conventional options are often not as successful as hoped, many sufferers turn to so-called alternative medicine (SCAM). But is SCAM really a solution?
A recent review found that “acupuncture or electroacupuncture and herbal medicine are effective in treating
constipation, whereas findings on massage and moxibustion are inconclusive.” Our own assessment [‘Oxford Handbook…’ (2008)] of the evidence disagrees and rated as follows:
- Beneficial: Psyllium
- Likely to be beneficial: abdominal massage, biofeedback, fibre
- Unknown effectiveness: acupuncture, aloe vera, ayurvedic medicine, meditation, Padma Lax, probiotics, herbal tea.
Whichever way we turn it, constipation is a more serious condition than many of us think, and neither conventional healthcare nor SCAM are convincingly successful in helping those who suffer from it.
As we have discussed previously, there is an outbreak of measles affecting unvaccinated children in the US. In an attempt to reassure the US public, Robert F. Kennedy Jr., said that the U.S. Department of the Health and Human Services is watching the Texas measles outbreak. “It’s not unusual,” he claimed when pressed by reporters. “We have measles outbreaks every year.” This, of course, is quite misleading.
Yes, there are regular outbreaks, but they are hardly comparable to the current one. The last person to succumb to measles in the US died in 2015 during an outbreak in Clallam County, Washington state, in which only a couple dozen people were infected. Measles was then identified as the cause of death of a woman. The autopsy found that she had “several other health conditions and was on medications that contributed to a suppressed immune system,” the US Health Department said at the time.
Kennedy misstated a number of further facts:
- Kennedy claimed that most of the patients who had been hospitalized were there only for “quarantine.” Dr. Lara Johnson at Covenant, the hospital in question, contested that characterization. “We don’t hospitalize patients for quarantine purposes,” said Johnson, the chief medical officer.
- Kennedy claimed that two people had died of measles. Yet Andrew Nixon, the spokesperson for the Department of Health and Human Services clarified that, at the time, the U.S. Centers for Disease Control and Prevention has identified only one death.
Gaines County has reported 80 measles cases so far. It has one of the highest rates of school-aged children in Texas who have opted out of at least one required vaccine, with nearly 14% skipping a required dose last school year.
Some of the hospitalised patients’ respiratory issues progressed to pneumonia, and they needed an oxygen tube to breathe, Johnson explained. Others had to be intubated, though Johnson declined to say how many. “Unfortunately, like so many viruses, there aren’t any specific treatments for measles,” she said. “What we’re doing is providing supportive care, helping support the patients as they hopefully recover.”
Last week, Trump seemed to buy into the already thoroughly debunked vaccines-cause-autism conspiracy that Kennedy famously has been promoting for years. Trump claimed that the Pennsylvania Dutch’s simplistic and unvaccinated lifestyle could be used as a potential model to avoid the disorder.
Meanwhile, multiple vaccine projects have been stopped by Kennedy. He paused a multimillion-dollar project to create a new Covid-19 vaccine in pill form on Tuesday. This project was a $460 million contract with Vaxart to develop a new Covid vaccine in pill form, with 10,000 people scheduled to begin clinical trials on Monday. Of that, $240 million was reportedly already authorized for preliminary research.
Furthermore, the FDA’s Vaccines and Related Biological Products Advisory Committee, or VRBPAC, was scheduled to meet in March to discuss the strains that would be included in next season’s flu shot, but federal officials told the committee that the meeting was canceled, said committee member Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia. Offit told NBC News that no explanation was given for the cancellation of the yearly spring meeting, which comes in the middle of a flu season in which 86 children and 19,000 adults have died, according to the Centers for Disease Control and Prevention. In an email to NBC, Norman Baylor, a former director of the FDA’s Office of Vaccine Research and Review, said, “I’m quite shocked. As you know, the VRBPAC is critical for making the decision on strain selection for the next influenza vaccine season.”
Finally, an upcoming CDC vaccine advisory committee meeting was also postponed last week. The Advisory Committee on Immunization Practices, or ACIP, was scheduled to meet Feb. 26 through Feb. 28. The group of independent experts convenes three times a year on behalf of the CDC to weigh the pros and cons of newly approved or updated vaccines. The postponement will put Kennedy at odds with Sen. Bill Cassidy, R-La., who is a doctor and the chair of the Senate Committee on Health, Education, Labor and Pensions, which oversees HHS. Kennedy had promised Cassidy to give the Senate prior notice before making changes to certain vaccine programs. “If confirmed, he [Kennedy] will maintain the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices without change,” Cassidy said in a speech on the Senate floor supporting Kennedy’s HHS nomination earlier this month.
The dangerous mess the new US governement got itself into within days of alledgedly governing seems monsterous. It is hard to conclude that Kennedy is competent or has abandonned his longstanding anti-vax stance. He clearly does not persue a reasonable strategy to protect the US from outbreaks of infections, endemics or pandemics. On the contrary, he is playing fast and loose with the health of US citizens and. as a consequence, with the health of all of us.
I was fascinated and horrified in equal measure to watch Donald Trump speaking at the CPAC talking about a medical topic – autism to be precise. Here are his words (minus the gibberish he always adds to disguise the stupidity of his phrases):
…15 years ago, there was one case per 10 000, some say 20 000 US citizens. Now the figure is 1 in 36. There’s something wrong. Bobby (Robert F. Kennedy Jr.) is gonna find it, working with Dr. Oz; by the way, working with Dr. Oz…
The audience of conservatives cheered blissfully!
What Trump said at the CPAC was not original. He uttered almost identical nonsense before (except he also claims the rate is now 1 in 34); it seems to be one of his set pieces for amusing the intellactually challenged.
A few days ago Trump signed an executive order (EO) calling for the creation of a ‘Make America Healthy Again’ Commission, which the White House says will be “tasked with investigating and addressing the root causes of America’s escalating health crisis.” In the EO, the figures are, however, a little different: “Autism spectrum disorder now affects 1 in 36 children in the United States — a staggering increase from rates of 1 to 4 out of 10,000 children identified with the condition during the 1980s.”
- 15 years ago was not the 1980s;
- 1 in 10 000 is not the same as 1 to 4 out of 10,000 children.
But, as we are often told, we must not take Trump literally; it’s the ‘BIG PICTURE’ that counts!
A little research reveals that the 1 in 36 prevalence figure originates from this survey. It was not focussed on autism but on autism spectrum disorder (ASD).
- Autism is a specific disorder within the broader category of ASD.
- ASD refers to a range of conditions that share some commonalities.
- Autism has distinct characteristics and symptoms.
- ASD includes conditions like autism, Asperger’s syndrome, childhood disintegrative disorder, and an unspecified form of pervasive developmental disorder.
Is it really too difficult for Trump to differentiate between autism and ASD?
Or is the reason that this would not fit his agenda?
The survey concluded that “findings from the ADDM Network 2020 surveillance year indicate higher ASD prevalence than previous estimates from the ADDM Network and continuing evidence of a marked shift in the demographic composition of children identified with ASD compared with previous years. Although earlier ADDM Network reports have shown higher prevalence among higher-SES White children compared with other groups, the latest data indicate consistently higher prevalence among Black and Hispanic children compared with White children, and no consistent association between ASD and SES. Furthermore, this is the first ADDM Network report in which the prevalence of ASD among girls has exceeded 1%. Since 2000, the prevalence of ASD has increased steadily among all groups, but during 2018–2020, the increases were greater for Black and Hispanic children than for White children. These data indicate that ASD is common across all groups of children and underscore the considerable need for equitable and accessible screening, services, and supports for all children.”
The authors of the survey caution that the findings in their report are subject to at least seven limitations.
- First, the methods rely on the availability, quality, and completeness of existing information and records to ascertain ASD cases and other indicators. Although all sites had access to special education classification data, certain sites did not have access to education records for their entire population, limiting the ability to identify children with ASD exclusively identified and served through their schools. Sites requested records from public school special education programs but did not review private school education records. Incomplete information could lead to misclassifying children’s cognitive ability, overestimating the age when they were first evaluated or when ASD was diagnosed, or failing to ascertain that the children were identified as having ASD. Sex information reflects what is represented in children’s records and might not reflect their gender identity.
- Second, the case definition for intellectual disability was measured using a child’s latest cognitive test or examiner statement of a child’s cognitive ability. Diagnostic and special education eligibility criteria for intellectual disability requires concurrent adaptive functioning deficits. IQ scores are not necessarily stable measures of intellectual ability over time, can increase among children with ASD in response to intensive early therapeutic interventions, and might be unstable during early childhood. The age at which children had their most recent test or examiner impression of cognitive ability varied by site.
- Third, the ADDM Network sites are not intended to be representative of the states in which the sites are located. ADDM Network sites are selected through an objective and competitive process, and findings do not necessarily generalize to all children aged 8 years in the United States. Interpretations of temporal trends can be complicated by changing surveillance areas, case definitions, data source access, and diagnostic practices.
- Fourth, small numbers result in imprecise estimates for certain sites and subgroups, and estimates falling below the selected threshold for statistical precision were suppressed.
- Fifth, the surveillance data system does not collect the number of ASD ICD codes a child received at a specific source, limiting comparability to analyses of claims/billing databases that consider number of ICD codes received.
- Sixth, the COVID–19 pandemic resulted in reduced access to records from some sources at certain sites; it was often possible to electronically obtain some data elements from these sources but not manually review the full contents of records. Disruptions in services and school closures during 2020 might have resulted in less documentation of ASD in records, which could decrease ASD ascertainment by ADDM sites.
- Seventh, the prevalence of undetected ASD in each community as well as false-positive ASD diagnoses and classifications are unknown.
So, Trump charged Robert F. Kennnedy Jr. to investigate why ASD is on the increase. As it happens, Kennedy already knows the conclusion of this investigation. He has often stated widely debunked claims that autism is caused by vaccinations. For instance, in a 2023 interview with Fox News, he squarely claimed that “autism comes from vaccines”. This theory was popularised by the discredited ex-doctor Andrew Wakefield based on a fraudulent paper that was later retracted by the Lancet. Multiple studies have subsequently demonstrated that there is no link between vaccines and autism.
Luckily Kennedy has Dr. Oz – yes the very Dr. Oz who has featured many times on my blog (see for instance here, here and here) – to help him get to the bottom of what Trump believes to be a mystery. Those two will be quite an unbeatable team (neither of them has ever done proper research in this area; Oz promotes any quackery that fills his pockets, and Kennedy would not recognise reliable science, if it bit him in his behind)! Perhaps they could start their investigation by reading the many papers that have already found at least some of the plausible reasons for the above-cited figures, e.g:
- The Real Reasons Autism Rates Are Up in the U.S. | Scientific American
- Is Autism Really Increasing?
- Factors Causing an Increase in Autism | Psych Central
- Autism: Cases on the Rise; Reason for Increase a Mystery
- Recognising autism in healthcare – PubMed
Oh, I almost forgot: they don’t need to read such demanding papers. They already have the answer to the autism mystery!
PS
The use of so-called alternative medicine (SCAM) has been widely recognized as a potential contributor to the emergence of vaccine scepticism and refusal. However, a direct correlation between trust in SCAM and vaccine scepticism is still a matter of discussion.
The objective of this study is to explore the multidimensional factors that explain the association between SCAM usage and vaccine scepticism. Qualitative and quantitative research designs were adopted to examine whether visiting SCAM practitioners directly contributes to vaccine scepticism and to identify whether anti-vaccination attitudes are caused by other social, and cultural factors.
The results support the idea that SCAM users tend to exhibit more vaccine scepticism compared to non-users. However, preferring a holistic health model, individual autonomy, and a negative perception of biomedicine representatives emerged as more influential factors in understanding the connection between the prevalence of SCAM utilization and vaccine scepticism.
The authors concluded that the results of this study indicate that people who regularly visit SCAM practitioners are more likely to be vaccine sceptics and have a higher tendency to vaccine scepticism. This is in line with other findings, suggesting that trust in SCAM is one of the factors affecting vaccine scepticism. This research conducted among people visiting healthcare professionals specializing in SCAM extends our knowledge for a deeper understanding of the other aspects behind this relationship. This implies that SCAM itself is not the direct predictor of vaccine scepticism; rather, an individualized holistic worldview and a lack of trust in medical professionals play a much more significant role in antivaccine attitudes. In addition, this investigation has shown that instead of expressing general dissatisfaction with biomedicine, the respondents displayed frustration with the individuals representing conventional medicine and the quality of the healthcare services provided. Notably, in the interviews, the participants indicated that their use of SCAM did not cause their vaccine scepticism, although they considered alternative healthcare options to be more valuable in dealing with several health issues. Instead of critiquing SCAM and vaccine scepticism, which contribute to the further polarization of society, a key policy priority regarding building trust in vaccines should therefore focus on strategies to improve healthcare services and develop medical doctors’ soft skills. A future follow-up evaluation investigating vaccine scepticism among complementary and alternative medicine users would be very useful to address vaccine scepticism more deeply.
So, individualized ‘holistic’ worldview and a lack of trust in medical professionals seem to have two simultaneous effects: they tend to make people turn towards SCAM and they render them skeptical about vaccinations. This makes sense – I never assumed anything else. I never thought that a SCAM in itself might, by some undefined magic, turn people into antivaxers. It always had to be a common denominator, like a general outlook or attitude that would prompt both the SCAM-use and the dislike of vaccines.
As the authors imply, this might be good news and point to one solution for two different problems: improve conventional healthcare and, as a result, both SCAM-use will diminish and vaccine acceprance will increase. The trouble is that this is easier said than done!
It does not happen every day that the prestigeous German FRANKFURTER ALLGEMEINE ZEITUNG publishes an in-depth analysis of TCM (Traditional Chinese Medicine) and even discusses several of the themes that we, here on this blog, have often debated. Allow me, therefore, to translate a few passages from the recent FAZ article entitled “Der Fluch der alten Dinge” (The Curse of Old Things):
… TCM has countless followers in many countries. ‘TCM is a wonderful medicine that thinks ‘holistically’, that sees not just one organ but the whole person and that offers very good treatment options,’ says Dominik Irnich. He heads the German Medical Association for Acupuncture. Although there is not evidence for all indications, TCM is ‘a scientifically based option for a number of diseases, the effects of which have been proven many times over’…
Meanwhile, Beijing wants to utilise the positive image of TCM to present itself in a good light and promote exports. The current five-year plan also provides for the creation of around 20 TCM positions for epidemic prevention and control. Critics, on the other hand, see patients at risk due to insufficiently tested therapies – and medicine as a whole: many studies are hardly valid and distort the state of science…
The top leadership of the Chinese Communist Party is using the ‘old things’ to increase its global influence and utilise TCM not only in its own country, but also as an export hit. The global TCM market is estimated to be worth many billions of euros annually, but there are no reliable figures – not least because it often includes illegally traded products such as rhino horn or donkey skin, which has led to mass killings.
Officially, Beijing prosecutes illegal trade and promotes science-based medicine, but the interests are intertwined. Even under Mao, traditional methods were used in China as a favourable alternative to imported medicines, and Beijing is currently increasingly allowing them to be reimbursed. At the same time, China’s leadership is trying to anchor TCM products in healthcare worldwide, for example as part of a ‘health Silk Road’ in Africa. During the Covid-19 pandemic, the state not only used TCM products en masse in its own country, Chinese foreign representatives also distributed them to Chinese people in Europe. This included a product based on gypsum, apricot kernels and plant parts called Lianhua Qingwen. According to a report published by the consulate in Düsseldorf, this was distributed even though the sale of medicines outside of pharmacies is generally punishable by law.
Beijing has also been successful at the level of the World Health Organisation (WHO), which promotes traditional medicine from China. ‘This was part of the interests and election programme of former Chinese Director-General Margaret Chan,’ says WHO consultant Ilona Kickbusch. The WHO drew up standards for acupuncture training, including knowledge of the ‘function and interactive relationship of qi, blood, essence and fluid’, as the document states.
In 2019, the WHO member states decided to add a chapter on ‘traditional medicine’ to the standard classification of diseases. Doctors can now code alleged patterns of ‘qi stagnation’ or yang deficiency of the liver. The umbrella organisation of European science academies EASAC criticised this as a ‘significant problem’: doctors and patients could be misled and pressure could be exerted on healthcare providers to reimburse unscientific approaches. Nature magazine found: ‘The WHO’s association with drugs that have not been properly tested and could even be harmful is unacceptable for the organisation that has the greatest responsibility and power to protect human health.’ …
In general, the study situation on therapies that are categorised as TCM is extremely confusing. The evidence is ‘terrible’, says the physician Edzard Ernst, who has analysed such procedures. ‘There are thousands of studies – that’s part of the problem.’ Many studies come from China, but it is known that a large proportion are invalid or falsified. It is almost impossible to report critically on TCM there: according to media reports, a doctor was imprisoned for three months in 2018 after criticising a TCM remedy. In 2020, Beijing even considered banning criticism of TCM, but refrained from doing so after an outcry.
According to Ernst, the quality of even some of the meta-analyses from the respected Cochrane Collaboration is ‘hair-raising’ due to the inclusion of unreliable studies, and according to some Chinese researchers, acupuncture works for everything. Prof. Unschuld said at an event a year ago that he was asked in China not to address critical issues.
‘In a country without the open and free critical culture that is common in democratic countries, the control mechanisms are missing,’ says Jutta Hübner, Professor of Integrative Oncology at Jena University Hospital. The inclusion of Chinese studies, which almost never report negative results, can create a much too positive image of TCM at a formally very high level of scientific evidence, without the results being reliable…
Instead of allowing the research to be carried out by proponents, it would be desirable ‘if the universities in particular remembered that they have the duty to be critical,’ says physician Edzard Ernst. However, some university clinics prefer to advertise TCM methods in order to attract patients and money.
- slightly improved BPH symptoms measured with the International Prostate Symptom Score (IPSS) at follow-ups of up to 12 months (standardized mean difference [SMD] -2.06, 95% confidence intervals [CI] [-3.22, -0.91] very low certainty evidence, 6 studies),
- reduced prostate specific antigen (PSA) levels (mean difference [MD] -0.37 ng/ml, 95% CI [-0.50, -0.23] low certainty evidence, 4 studies)
- had little effect on quality of life (SMD -0.59, 95% CI [-1.57, 0.38] very low certainty evidence, 2 studies).
The main reasons for downgrading the evidence were study limitations (studies judged to be at an unclear or high risk of bias), inconsistency (considerable heterogeneity), and imprecision (small effect sizes and wide confidence intervals around effect estimates). All six studies reported no adverse-effects.
- positive but not truly honest about the limitations of the evidence (we see this regularly on my blog);
- or they are sufficiently critical and thus arrive, like our above paper, at unequivocal (and sadly not very helpul) conclusions.
As this is so, we see very few SRs that conclude “there is sound evidence to show that SCAM xy is effective (or ineffective)”. Yet, such verdicts would be what consumers need.
The cause of the first scenario (false-positive conclusion) is that reviewers are biased and want to demonstrate that SCAM works. Such authors behave unethically, in my view, because they mislead the public and might cause untold harm. The cause of the second scenario (unequivocal conclusion) is the poor quality of the primary studies. This phenomenon too is mostly due to over-enthusiastic researchers who want to prove their SCAM instead of testing it. Conducting a clinical trial is far from easy or cheap. It is beyond me, why so many SCAM trialists do not try their best to do it well!
If you think of it, the most likely reason is that they are not really interested in finding the truth but mainly want to promote their agenda. If you don’t believe me, have a look at my ALTERNATIVE MEDICINE HALL OF FAME and the amazing men and women in it.
It is time, I think, that SCAM researcher learn the most basic principle of their profession: science is not a game where you set out to confirm what you believe. Science works by
- formulating a hypothesis,
- doing your very best to prove your hypothesis wrong,
- only if it cannot be proven wrong, assuming that it probably is correct.
To put it bluntly: investigators who use science to prove their point are not scientists but pseudo-scientists, and sadly SCAM has more than its fair share of such charlatans (drunken men using a lamp-post for support rather than enlightenment!). To put it even more bluntly: to prevent serious harm – because that sort of thing does a lot of real harm! – researchers who repeatedly show themselves to be incapable of doing unbiased science (again, see my ALTERNATIVE MEDICINE HALL OF FAME), should be banned from doing research.
CNN reported that a measles outbreak is growing in a rural area of West Texas where vaccination rates are well below the recommended level. In late January, two children in Gaines County were hospitalized for measles. On Wednesday, the state health department issued a health alert:
The Texas Department of State Health Services (DSHS) is reporting an outbreak of measles in Gaines County. At this time, six cases have been identified with symptom onset within the last two weeks, all among unvaccinated school-aged children who are residents of Gaines County.
Due to the highly contagious nature of this disease, additional cases are likely to occur in Gaines County and the surrounding communities. DSHS advises clinicians to follow the below measles immunization recommendations for the communities affected by the outbreak and immediately report any suspected cases to your local health department, preferably while the patient is in your presence.
To immediately increase the measles immunity and prevent disease occurrence in the affected communities, DSHS advises the following immunization recommendations for residents of Gaines County:
- Infants ages 6 to 11 months:
- Administer an early dose of measles, mumps, and rubella (MMR) vaccine.
- Follow the CDC’s recommended schedule and get:
- Another dose at 12 through 15 months.
- A final dose at 4 through 6 years.
- Children over 12 months old:
- If the child has not been vaccinated, administer one dose immediately and follow with a second dose at least 28 days after the first.
- If the child has received one dose, administer the second dose as soon as possible, at least 28 days after the first.
- Teen and adults with no evidence of immunity:
Administer one dose immediately and follow with a second dose at least 28 days after the first.
As of last Friday afternoon, the outbreak has jumped to 14 confirmed cases and six probable cases among people who are symptomatic and had close contact with infected individuals.
Investigations are ongoing, as cases have been identified also in parts of the region that are outside the Gaines County lines where the first cases were reported.
All the cases are believed to be among people who are not vaccinated against measles, and most of them are children.
A record share of US kindergartners had an exemption for required vaccinations last school year, leaving more than 125,000 new schoolchildren without coverage for at least one state-mandated vaccine, according to data published by the US Centers for Disease Control and Prevention in October.
The US Department of Health and Human Services has set a goal that at least 95% of children in kindergarten will have gotten two doses of the measles-mumps-rubella (MMR) vaccine, a threshold necessary to help prevent outbreaks of the highly contagious disease. The US has now fallen short of that threshold for four years in a row. MMR coverage is particularly low in Gaines County, where nearly 1 in 5 incoming kindergartners in the 2023-24 school year did not get the vaccine.
In the health alert Wednesday, the Texas health department warned that additional cases are “likely to occur in Gaines County and the surrounding communities” due to the highly contagious nature of the disease.
Officials recommend that residents of Gaines County immediately improve their immunity and help prevent disease spread by ensuring that they are up to date on vaccinations. Children and adults who have not been vaccinated should get one dose immediately, followed by a second dose after 28 days. Infants between 6 and 11 months should get an early dose of the vaccine, and children who have had their first shot should get their second as soon as possible.
‘US News’ adds the following: As Robert F. Kennedy Jr., one of the most influential purveyors of dangerous vaccine misinformation, prepares to take the helm of the Department of Health and Human Services, researchers say such bills have a higher chance of passing and that more parents will refuse vaccines because of false information spread at the highest levels of government.
“Mr. Kennedy has been an opponent of many health-protecting and life-saving vaccines, such as those that prevent measles and polio,” scores of Nobel Prize laureates wrote in a letter to the Senate. Having him head HHS, they wrote, “would put the public’s health in jeopardy.”…
On this blog, we have discussed Kennedy’s imbecilic attitudes to measles and other health issues several times, e.g.:
- Robert F. Kennedy Jr.: Here is what you can do to prevent his appointment
- The ‘International Chiropractors Association’ Congratulated Robert F. Kennedy, Jr. on His Selection as ‘Secretary of Health and Human Services’
- Donald Trump might try to “outlaw” some vaccinations in the US
- The ‘moral and intellectual decay’ of COVID disinformants
In the forseeable future, we will most certainly encounter endemics and epidemics. I fear that, with Kennedy in charge of the US Department of Health and Human Services, the danger for them to grow into pandemics is hugely increased.
