education
I missed this paper when it first came out in 2022. Yet, it seems potentially quite important and I, therefore, feel like discussing it here:
President of the UNESCO Committee on Bioethics Stefan Semplici called on the governments of all countries to ensure free and wider access of their citizens to alternative medicine and pay for this therapy through health insurance. Alternative medicine based on tradition – traditional medicine, in many poor countries is the only treatment option for the population. In developed countries, and especially in China and India, it enjoys well-deserved prestige (for example, acupuncture and herbal medicine) and is often integrated into the public health system.
The International Committee on Bioethics of UNESCO announced the recognition of these alternative therapies as an option for medical practice and, at the same time, as part of the identity of the cultural traditions of various nations. The UNESCO Universal Declaration on Bioethics and Human Rights includes the right to the highest attainable standard of health (Article 14), the right to respect for pluralism and cultural diversity (Article 12) and traditional knowledge (Article 17). The purpose of this document is to establish criteria for the respect and acceptability of different types of medicine without compromising the assurance of quality and patient safety that is essential in all treatments.
In order to adapt the traditions of traditional therapies to advances in medicine, this international organization calls on governments and the scientific community to collaborate with practitioners of alternative therapies to evaluate their effectiveness and safety and develop therapeutic standards and protocols for integrating traditional medicine into healthcare system. The UNESCO International Bioethics Committee believes that these methods should be seen as complementary to modern medicine, and not just an alternative to it.
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The United Nations Educational, Scientific and Cultural Organization (UNESCO) is an agency of the United Nations aimed at promoting world peace and security through international cooperation in education, arts, sciences, and culture. UNESCO’s International Bioethics Committee (IBC) is a body of 36 independent experts that follows progress in the life sciences and its applications in order to ensure respect for human dignity and freedom.
I have to say that I rarely have seen an announcement in so-called alternative medicine (SCAM) that is more confusing and less well thought through. The UNESCO Committee on Bioethics wants:
- alternative therapies as an option for medical practice,
- the highest attainable standard of health,
- to collaborate with practitioners of alternative therapies to evaluate their effectiveness and safety.
When I first read these lines, I asked myself: who on earth wrote such nonsense? It was certainly not written by someone who understands healthcare, SCAM, and evidence-based medicine.
As discussed almost permanently on this blog, most forms of SCAM have not been shown to generate more good than harm. This means that employing them ‘as an option in medical practice’ cannot possibly produce ‘the highest attainable standards of health’. In fact, the UNESCO plan would lead to lower not higher standards. How can a committee on bioethics not realize that this is profoundly unethical?
Collaboration with practitioners of alternative therapies to evaluate SCAM’s effectiveness and safety sounds a bit more reasonable. It ignores, however, that tons of evidence already exist but fail to be positive. Why do these experts in bioethics not advocate to first make a sober assessment of the published literature?
I must say that the initiative of the UNESCO Committee on Bioethics puzzles me a lot and disturbs me even more.
I’d be keen to learn what you think of it.
This article by a Postgraduate Trainee (Dept. of Case Taking and Repertory, National Institute of Homoeopathy, Govt. of India) an Assistant Professor (Dept. of Surgery, National Institute of Homoeopathy Govt. of India) and another Assistant Professor (Dept. of Obstetrics & Gynaecology, Midnapore Homoeopathic Medical College & Hospital, Govt. of West Bengal) might not be available online (Clinical Medicine and Health Research Journal, Volume 03, Issue 03, May – June 2023 Page No. 444-446) but it is I think worth discussing. Here is its abstract:
Warts are one of the common dermatological disorders caused by human papilloma viruses encountered in our day to day life. These are cutaneous or mucosal infection needs proper care and treatment to prevent its transmission and complete healing. Although mostly warts are dealt with the therapeutic approach, i.e. on the basis of its peculiar type and location but it can even be successfully treated by constitutional approach. This article is regarding a case of warts treated successfully with Rhus Tox followed by Ferrum Met selected as the simillimum and proved its effectiveness in a short period of time.
As the abstract is not very informative, let me show you also some sections from the paper itself:
The patient presented with warts on right wrist for 1 year. There were plane warts at back of wrist, which was smooth, slightly elevated and skin coloured. There was no history of warts or other benign skin disease in the family. This case treated with individualized homoeopathic medicine showed complete resolution of the warts. There is no cure for wart in conventional medicine except removal of them with various methods. Although it does not rule out the chance of recurrence, later on may deep organic disease. That is why a substantial number of warts patients resort to Complementary and Alternative Medicine (CAM), especially homoeopathy.
In this case, Ferrum Metallicum 0/1 was selected as a ‘similimum’ based on totality of symptoms, repertorial analysis and consultation with Homoeopathic Materia Medica, which was given more priority in this case. After seeing improvement, succeeding potency was prescribed. After Ferrum Met 0/4 all her complaints including warts disappeared. Thus, the outcome of this case of Plane Warts of the lady shows the success of individualized homoeopathic medicine in treatment of wart.
Conclusion:
This case report suggests homoeopathic treatment as a promising complementary or alternative therapy and emphasizes the need of repertorisation in individualized homoeopathic prescription. This case shows a positive role of homoeopathic in treating Warts. However, this is a single case study and requires well designed studies which may be taken up for future scientific validation.
This case report reminded me of an exciting and quite lovely story: at Exeter, we once conducted a wart study. It was a placebo-controlled, double-blind trial where the verum group received distant healing and the controls nothing at all. After planning the study, I was no longer involved in its running. As I happened to have a wart at the time, I offered myself to my team as a patient. They checked me out and admitted me into the study. For the next weeks, I either received the distant healing energy or nothing; neither I nor my team knew which. My wart was photographed and measured regularly.
And then it happened: shortly after the treatment period was over, my wart had gone. Everyone was excited, especially the UK healing scene. But we had to wait until the trial was finished, the results were calculated, and the random code was opened. The result: no difference between verum and placebo! We concluded that distant healing from experienced healers had no effect on the number or size of patients’ warts.
And my own, very personal wart?
It had disappeared spontaneously – I had been in the control group!
I know Indian homeopaths have a thing about healing warts (we discussed this before) but I am afraid the conclusions of this new paper ought to be re-written:
This case report does not suggest that homeopathic treatment is a promising complementary or alternative therapy. It shows the natural history of the condition in the disappearance of warts.
The current secondary analysis based on the WHO database (VigiBase) of individual case safety reports (ICSRs) focuses on the suspected cutaneous adverse drug reactions (ADRs) linked to traditional medicines (TMs).
All the ICSRs reported between 1st January 2016 and 30th June 2021 from the UN Asia region in VigiBase where at least one TM was suspected to cause cutaneous ADRs were included in the study. Data regarding demographic details, suspected drug, adverse reaction as per MedDRA term, the seriousness of the reaction, de-challenge, re-challenge, and clinical outcome for suspected cutaneous ADRs associated with TM were obtained from VigiBase and analyzed for frequency of reported events and suspected medicines.
A total of 3,523 ICSRs with 5,761 ADRs related to “skin and subcutaneous tissue disorders” were included in the analysis. Amongst these, 6.8% of ICSRs were reported as serious.
The most common ADRs were:
- pruritus (29.6%),
- rash (20.3%),
- urticaria (18.9%),
- hyperhidrosis (3.3%).
Artemisia argyi H.Lév. and Vaniot. (14.9%), Ginkgo biloba L. (5.1%), Vitis vinifera L. (4%), Vitex agnus-castus L. (3.8%), Silybum marianum (L.), Gaertn (3.5%), and Viscus album L. (2.7%) were some commonly suspected TMs for cutaneous ADRs. There were 46 cases of Stevens-Johnson syndrome and toxic epidermal necrolysis reported with TMs during the study period. Death was reported in 5 ICSRs.
The authors concluded that TMs are linked with various cutaneous ADRS ranging from pruritus to toxic epidermal necrolysis which may have serious consequences. TMs listed as suspected offending agents in this analysis, should be kept in mind while dealing with suspected cutaneous ADRs. Clinicians should be more vigilant in detecting and reporting events associated with TMs.
Herbal remedies have a reputation for being time-tested, gentle, harmless, and benign. Reports such as this one might make us doubt this cliche. More importantly, they should force us to ask whether the remedy we are tempted to try truly does generate more good than harm. In most instances, I fear, the answer is not positive.
Although the use of so-called alternative medicine (SCAM) is said to be rising among older adults, many do
not discuss these healthcare practices with their primary care practitioners (PCPs). This recent US survey sought to determine the prevalence of SCAM use and to identify factors associated with SCAM disclosure among patients ages 65 and older.
Participants completed an anonymous survey, which evaluated their SCAM use over the past year and disclosure of SCAM to a PCP. Additional questions queried demographics, patient health, and relationships with one’s PCP. Analyses included descriptive statistics, chi-square tests, and logistic regression.
One hundred seventy-three participants answered surveys (response rate=23%). The Main findings were as follows:
- Sixty percent reported the use of at least one form of SCAM in the past year.
- Among those using SCAM, 64% disclosed use to their PCP.
- Patients disclosed supplements/herbal products and naturopathy/homeopathy/acupuncture at a higher rate than bodywork techniques and mind-body practices (71.9% and 66.7% vs. 48% and 50%).
- The only factor significantly associated with disclosure was trust in one’s PCP (odds ratio=2.97; confidence interval=1.01–8.73).
- The most commonly used types of SCAM were herbal products/dietary supplements (37.0%), mind-body therapies (28.9%), bodywork techniques (26.6%), and naturopathy/acupuncture/homeopathy (8.7%).
The authors concluded that clinicians may improve SCAM disclosure rates in older adults by inquiring about all types of SCAM and continuing to invest in their patient relationships, specifically by building trust.
The one-year prevalence of SCAM use – 60% – is extraordinary and considerably higher than in other surveys. How can this be explained?
I think that two factors might have played a role: firstly the survey was tiny, and secondly, its response rate was dismal. People who have no interest in SCAM would probably have not responded. Thus the prevalence figure is way too high and the survey is not representative of any population.
Having said that, I believe that some of the conclusions are still correct. As I have pointed out so often already:
- doctors need to ask their patients about SCAM usage;
- once they have identified a SCAM user, they need to advise him/her responsibly;
- to do that, they need to know about SCAM;
- as most doctors have little knowledge about the subject, they need to learn;
- failing to do that is not ethical behavior.
The ‘American Heart Association News’ recently reported the case of a 33-year-old woman who suffered a stroke after consulting a chiropractor. I take the liberty of reproducing sections of this article:
Kate Adamson liked exercising so much, her goal was to become a fitness trainer. She grew up in New Zealand playing golf and later, living in California, she worked out often while raising her two young daughters. Although she was healthy and ate well, she had occasional migraines. At age 33, they were getting worse and more frequent. One week, she had the worst headache of her life. It went on for days. She wasn’t sleeping well and got up early to take a shower. She felt a wave of dizziness. Her left side seemed to collapse. Adamson made her way down to the edge of the tub to rest. She was able to return to bed, where she woke up her husband, Steven Klugman. “I need help now,” she said.
Her next memory was seeing paramedics rushing into the house while her 3-year-old daughter, Stephanie, was in the arms of a neighbor. Rachel, her other daughter, then 18 months old, was still asleep. When she woke up in the hospital, Adamson found herself surrounded by doctors. Klugman was by her side. She could see them, hear them and understand them. But she could not move or react.
Doctors told Klugman that his wife had experienced a massive brain stem stroke. It was later thought to be related to neck manipulations she had received from a chiropractor for the migraines. The stroke resulted in what’s known as locked-in syndrome, a disorder of the nervous system. She was paralyzed except for the muscles that control eye movement. Adamson realized she could answer yes-or-no questions by blinking her eyes.
Klugman was told that Adamson had a very minimal chance of recovery. She was put on a ventilator to breathe, given nutrition through a feeding tube, and had to use a catheter. She learned to coordinate eye movements to an alphabet chart. This enabled her to make short sentences. “Am I going to die?” she asked one of her doctors. “No, we’re going to get you into rehab,” he said.
Adamson stayed in the ICU on life support for 70 days before being transferred to an acute rehabilitation facility. She could barely move a finger, but that small bit of progress gave her hope. In rehab, she slowly started to regain use of her right side; her left side remained paralyzed. Therapists taught her to swallow and to speak. She had to relearn to blow her nose, use the toilet and tie her shoes.
She was particularly fond of a social worker named Amy who would incorporate therapy exercises into visits with her children, such as bubble blowing to help her breathing. Amy, who Adamson became friends with, also helped the children adjust to seeing their mother in a wheelchair.
Adamson changed her dream job from fitness trainer to hospital social worker. She left rehab three and a half months later, still in a wheelchair but able to breathe, eat and use the toilet on her own. She continued outpatient rehab for another year. She assumed her left side would improve as her right side did. But it remained paralyzed. She would need to use a brace on her left leg to walk and couldn’t use her left arm and hand. Still, two years after the stroke, which happened in 1995, Adamson was able to drive with a few equipment modifications…
In 2018, Adamson reached another milestone. She graduated with a master’s degree in social work; she’d started college in 2011 at age 49. “It wasn’t easy going to school. I just had to take it a day at a time, a semester at a time,” she said. “The stroke has taught me I can walk through anything.” …
Now 60, she works with renal transplant and pulmonary patients, helping coordinate their services and care with the rest of the medical team at Vanderbilt University Medical Center. “Knowing that you’re making a difference in somebody’s life is very satisfying. It takes me back to when I was a patient – I’m always looking at how I would want to be treated,” she said. “I’ve really come full circle.”
Adamson has adapted to doing things one-handed in a two-handed world, such as cooking and tying her shoes. She also walks with a cane. To stay in shape, she works with a trainer doing functional exercises and strength training. She has a special glove that pulls her left hand into a fist, allowing her to use a rowing machine and stationary bike….
Adamson is especially determined when it comes to helping her patients. “I work really hard to be an example to them, to show that we are all capable of going through difficult life challenges while still maintaining a positive attitude and making a difference in the world.”
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What can we learn from this story?
Mainly two things, in my view:
- We probably should avoid chiropractors and certainly not allow them to manipulate our necks. I know, chiros will say that the case proves nothing. I agree, it does not prove anything, but the mere suspicion that the lock-in syndrome was caused by a stroke that, in turn, was due to upper spinal manipulation plus the plethora of cases where causality is much clearer are, I think, enough to issue that caution.
- Having been in rehab medicine for much of my early career, I feel it is good to occasionally point out how important this sector often neglected part of healthcare can be. Rehab medicine has been a sensible form of multidisciplinary, integrative healthcare long before the enthusiasts of so-called alternative medicine jumped on the integrative bandwagon.
At first glance, the article entitled ‘Homeopathy: A State of the Science Review With Recommendations for Practical Therapies in Midwifery Practice‘ looks interesting and fairly solid; it was published in a mainstream, peer-reviewed midwifery journal; it is lengthy and thus seems thorough; it cites 125 references; and its two American authors have respectable affiliations (Art of Nursing Care Inc., Playa del Ray, California. Sonoran University of Health Sciences, Tempe, Arizona.). Yet, it does not take long to discover that ‘solid’ is not the term to describe it accurately. In fact, the paper is one of the worst examples of pseudo-science that I have ever come across. Let me just show you its conclusions:
This state of the science review has explored the history of homeopathy, its evidence base, manufacturing, regulation, and licensure. We have examined some of the controversies between homeopathy and conventional medicine in an effort to provide an overview and understanding of homeopathic science. Suggestions for practical therapies for use in midwifery practice have been given.
Despite misperceptions, homeopathy has become a well-established global practice with a growing body of research to support its benefits. Homeopathic medicines provide a comprehensive treatment approach to the myriad of conditions encountered in the midwifery practice model of care. With homeopathy’s generally accepted safety profile, low risk of side effects, few drug interactions, and low risk of overdose, midwives educated in homeopathic science can be confident that homeopathy provides a satisfactory complement for patients seeking alternative practices.
Increased opportunities for clinical research of homeopathic medicines by large funding organizations is recommended to advance patient care, understanding, and acceptance of the whole person and inform future health policy. Researchers around the world have begun to investigate the unanswered questions verifying the safety and efficacy of homeopathic treatment and the future of homeopathic research is promising. As homeopathic science continues to evolve, many health care professionals, including midwives, now seem open to adding homeopathy to complement their system of care for the whole person.
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In the article, we find two short paragraphs dealing with the effectiveness of homeopathy:
Essential to these debates are questions surrounding theories of homeopathy, such as the Law of Minimum Dose, like cures like, nonstandardized dosing, and symptom evaluation in a manner different from that of conventional medicine. It has been argued that the homeopathic paradigm is different from conventional scientific concepts associated with evidence-based medicine such as independent replication, confirmation of findings, measurement, and interpretation of results based on homeopathy’s reliance on individualized treatments and it basic tenets of the Principle of Similars and Law of Minimum Dose.69, 68 Conventional medicine practitioners find it counterintuitive that further dilution of a substance is believed to enhance its healing power when compared with a less dilute substance.65 For example, if the level of dilution is unmeasurable, how can the active ingredient be found, and is it even there?22 Recent research using nanopharmacology is beginning to uncover, identify, and characterize these ingredients in ultradiluted remedies and may help to answer these questions.39, 70 Debates arise concerning why individuals with similar symptoms often receive different treatments.22 Others ask whether homeopathic remedies perhaps inadvertently lead consumers to forgo conventional treatments that have been proven to work.5, 21, 22, 65
Interestingly, studies examining placebo therapies have appeared in scientific literature with increasing frequency, and some have compared the effectiveness of placebos with homeopathic remedies.68, 71–73 Multiple studies that have examined homeopathic treatments have found them equivalent to or no more effective than placebo,65, 68 whereas other studies found either measurable success or that patients perceived their outcomes as improved following homeopathic treatment.26, 75, 74 Mathie et al conducted a systematic review and meta-analysis focused on randomized controlled trials of nonindividualized homeopathic treatments. Authors reported that the quality of evidence was too low to determine whether homeopathic treatment results were distinguishable from those of placebo.72 These issues cited above represent some of the inconsistencies surrounding the theoretical basis and effectiveness of homeopathic therapies.
WHY WOULD ANY RESPECTABLE AUTHOR WRITE SUCH MISLEADING NONSENSE?
WHY WOULD ANY RESPECTABLE JOURNAL PUBLISH IT?
The answers to these questions might be found at the end of the paper:
Support for this supplement has been provided by Boiron USA. Boiron representatives provided no input into the article content.
Sharon Bond, CNM, PhD, who was an Associate Editor of the Journal of Midwifery & Women’s Health during the initial drafting of the manuscript, received compensation from Boiron USA for the assistance she provided the authors with editing and proofreading of the manuscript. Dr. Bond was not involved in the editorial review of or decision to publish this article.
The findings and conclusions in this supplement are those of the authors and do not necessarily reflect the official position of the host organizations, the American College of Nurse-Midwives, John Wiley & Sons, Inc., or the opinions of the journal editors.
I would argue that publishing such an article is unethical and amounts to scientific misconduct!
Serbian tennis player Novak Djokovic has made tennis history by winning a record 23rd Grand Slam tournament at the French Open in Paris. The controversial star is well-known for promoting wellness fads and pseudoscience and was spotted wearing a ‘nanotechnology patch’ throughout the tournament in Paris. Djokovic claimed that it was the “biggest secret of his career” and without the device, he would not have achieved what he has professionally.
What on earth is that? You may well ask.
Here is the answer to that question from the manufacturer of the device:
Taopatch uses nanotechnology material. Nanotechnology it is the study and application of exceedingly small things, in the range of 1 to 100 nanometers. It has become important in many fields: chemistry, biology, physics, engineering, medicine, and others. Taopatch® is a small disk, 1 cm in diameters and less than 1 mm thick, containing nanoparticles called “quantum dots” with a hypoallergenic coating. These quantum dots “pick up” infrared radiation from the body and emit another radiation in the range of visible light, like that used by the low-level and ultra-low-level laser therapy (Scoppa et al., 2016) plus far Infrared, near Infrared and nourishing UV light. These photons exert a favorable effect when applied to sensitive points of the human body (acupuncture points). These devices have been certified by an independent laboratory to be free of any substances having a pharmacological action that may be released and absorbed by subjects who place the devices on the skin.
SCIENTIFIC STUDIES AND BENEFITS
Balance, posture, movement, and sports
The upright posture marks a great achievement in its evolutionary path, allowing it to integrate itself more efficiently with the environment. Balance, movement efficiency, and muscle coordination are important for human activity. Electromagnetic fields interact with biological structures and may improve these functions of the organism, as is demonstrated in the following studies. The effect of the Taopatch® on the posture control of 45 healthy subjects and two multiple sclerosis patients was studied by Genua et al. (2015/2016). The purpose of posture is the maintenance of balance. Thus, 15 healthy subjects were given the Taopatch®, 15 a placebo, and 15 were control subjects. The researchers demonstrated an improvement of the relationship between balance and energy expenditure for the subjects using the device relative to placebo and control subjects. These results further suggested the application of nanotechnology devices to rehabilitation protocols and sports. This research is being continued on the use of the devices by multiple sclerosis patients.
A careful analysis of the effect of quantum dot devices (referred to as “H. I. T. postural devices”) was done by Di Summa et al., 2018. The devices were applied to 20 subjects with no equilibrium disorders. The subjects, aged between 25 and 35 years old, underwent standard stabilometric examinations (the study of body sway during quiet standing). The tests showed a statistically significant improvement in posture, meaning an increased accuracy for voluntary movements. The researchers concluded that the electromagnetic devices interact with the human electromagnetic fields, acting on the postural control system’s components.
Malchiodi Albedi et al. (2017) studied the effect of Taopatch® devices on the postural control of a set of 30 female, healthy subjects. As in the previously mentioned study, stabilometric tests were performed. Active patches were applied to 15 subjects, and sham patches to other 15 subjects in a double-blind protocol. The comparison of active patches vs. sham patches (placebos) showed an evident decrease in the sway path for the active patches, strong evidence of improved posture control.
Carbonari et al. (2020) evaluated the effect of occlusal splints and Taopatch® devices on athletes’ muscular performance, balance, and posture. A set of tests were completed: surface electromyography (sEMG), kinesiography, the squat jump and counter movement jump, and the handgrip test. The results demonstrated that the occlusal splint and Taopatch® applied alone or together immediately improved strength and balance.
Help for patients with multiple sclerosis
Lomeo et al. (2019) evaluated the use of nanotechnological devices for posture control, range of motion of the joints, and general well-being on patients affected by Multiple Sclerosis (MS). Two Taopatch® devices were applied to 28 patients. This research showed that this technology improves movement, proprioception, balance, and general well-being.
The protocols included the self-evaluation test SF-36 Health Survey (a questionnaire to indicate the health status), the international index EDSS (Expanded Disability Status Scale, a method of quantifying disability in multiple sclerosis and monitoring changes over time), and several accelerometer tests (lower limbs, lumbar flexion, and head movements).
The SF-36 and EDSS tests clearly indicated an improvement in the well-being of the patients. In particular, the SF-36 test demonstrated ameliorations in physical activity, pain, general health, vitality, social activities, emotional and mental health. The improvements were maintained after one year.
The accelerometer tests showed significant improvements in the left hip, right hip, and lumbar inflections. It is important to note that the improvements appear at three months and are also maintained after one year.
Help for dental care of handicapped subjects
Patients with motor, psychomotor, sensory, or intellectual handicaps may present problems for dental care administration. A group of seven patients with light-moderate handicaps (2 with autism, 2 unable to walk due to a stroke, 1 with Parkinson, 1 with Martin-Bell syndrome, 1 with 21 trisomy) were treated with and without the application of Taopatch® (Sedran et al., 2017). The device permitted better management of the procedure, with less fatigue for the patients and more comfort for the operator.
Improvement of antioxidative defense of cells and cell proliferation in biological models
Reactive oxygen species (ROS) are significant environmental contaminants. At high ROS concentrations, damage to cellular components occurs, such as proteins, lipids, and nucleic acids. The activity of patches containing nanocrystals in the presence of ROS was studied for two biological models, Saccaromyces cerevisiae colonies and Pisum sativum plants. (Benedetti et al., 2018). The patches were exposed to the radiation of specific routers. The treated colonies showed an active defense against reactive oxygen species, and the plant cells increased proliferation. Thus, the results reported in this research suggest extending the application of this technology to fight the effects of various contaminants and reducing the use `of biological and chemical materials for environmental defense.
REFERENCES
Benedetti, S., Degrassi C., De Martino A., Beninati S., Cappello F., Bonivento P. (2018). Improvement of Antioxidative Defense of Cells Exposed to Radio Frequencies by a Nanotechnology Device. Journal of Biomaterials, 2(1), 20-23. doi:10.11648/j.jb.20180201.15
Carbonari, B., Balducci, F., Cesaretti, G., Cesanelli, L., Botticelli, D., Messina, G. (2020). Performance, balance and posture variations with Occlusal Splint and Taopatch® devices. A retrospettive cross-over study. J Sports Med Phys Fitness, epub Jul. 30. doi: 10.23736/S0022-4707.20.11053-3.
Di Summa, F., Capobianco, F.S., Shevchenko, A., De Martino, A., Beninati, S., Baldoni, E., Lumbau, A.M.I., Chessa, G.I. (2018). Improvement of Postural Reprogramming by a Nanotechnology Device. International Journal of Biomedical Materials Research. 6(3), 57-61. doi: 10.11648/j.ijbmr.20180603.11.
Genua, D., Bruno, F., Caldarera, G., Nanotecnologie e Postura. Master’s Thesis. (Italian). UNIVERSITÀ DEGLI STUDI DI PALERMO, SCUOLA DELLE SCIENZE UMANE E DEL PATRIMONIO CULTURALE, MASTER IN POSTUROLOGIA E BIOMECCANICA (2015/2016).
Lomeo, A., Cacciaguerra, C., Garsia, D., Scolaro, A. (2019). The use of nanotechnological devices in degenerative cerebral pathologies: Perspective study on 28 patients with multiple sclerosis (French). Hegel, 9(2), 114-121.
Malchiodi Albedi, G., 1, Corna, S., Aspesi, A., Clerici, D., Parisio, C., Seitanidis, J., Cau, N., Brugliera, L., Capodaglio, P. (2017). Effects of nanotechnology-based devices on postural control in healthy subjects. J Sports Med Phys Fitness, epub Sep 5. Doi: 10.23736/S0022-4707.17.07530-2.
Scoppa, F., Gallamini, M., Belloni, G. (2016). Treating Balance Disorders with Ulllt Acupuncture Stimulation: A Further Pilot Study on Normal Subjects Confirms Clinical Applicability of Treatment. J Nov Physiother, 6(285). doi:10.4172/2165-7025.1000285.
Sedran, A., Rizzi R., Sindici, E., Sedran, A. Use of TAOPATCH nanotechnology for dental care on HCP subjects (2017). SIOH Meeting, Milan, 5-6-7 October. University of Turing, Department of Surgical Sciences, Dental School.
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Convinced?
Me neither!
What Novak Djokovic has yet again demonstrated, in my view, is the fact that expectation can influence physical outcomes (and that you don’t need many critical thinking skills to become a tennis star).
Enthusiasts of so-called alternative medicine (SCAM) sometimes remind me of the French philosopher, Blaire Pascal, and his famous wager. Blaise Pascal (1623-1662) argued that, because it is impossible to either prove or disprove the existence of God, it would probably be best to wager in favor of his existence. In case one got it wrong, little would be lost; in case one was correct, everything was gained.
Likewise, enthusiasts of SCAM often argue that, because of the lack of evidence for many SCAMs, one cannot be sure whether they work or not. Thus it would probably be best to wager in favor of SCAM and make use of it. In case one got it wrong, little would be lost; in case one was correct, everything was gained.
This line of thinking is common and, at first glance, it seems to be “a safe bet”. However, once we analyze it critically, it quickly falls apart. To explain, it might be best to choose a concrete example. Let’s assume, therefore, that we are talking about a cancer patient who wants to leave no stone unturned to cure her cancer.
So, she goes on the Internet and does her ‘research’. As soon as she has found a SCAM that might suit her, another one crops up, and then another, and then dozens. Which SCAM should she use? There are hundreds of SCAM cancer “cures” being promoted to the unsuspecting and vulnerable. Since one is as unproven as the next, our patient has a hard time deciding which SCAM to try. Applying all simultaneously or consecutively would be “betting on the safe side,” but is not a realistic option. If nothing else, it would be an unaffordable full-time job.
A further flaw in Pascal’s approach to SCAM relates to the fact that we are unable to prove the existence of God, but scientists are entirely capable of finding out about SCAM and its effects on cancer patients. After all, that’s what clinical trials are designed for. If for a particular SCAM, no studies are available (which is often the case), it probably means that it is not worth the effort of testing the claims that are being made for it. SCAM cancer cures are ‘alternatives’ for one main reason: they are implausible, so much so that the chances of them doing more good than harm usually approach zero.
And there is yet another caveat: while accepting the existence of God might be not associated with major harm (I know, some people would dispute this), many SCAMs are by no means free of risks. Therefore it is simply not true to assume that “little is lost” in case they do not work.
Direct harm can occur through the interactions of some form of SCAM with prescription drugs, for instance. But the potential for indirect harm is much more important. Here the risks range from raising false hopes or financial exploitation to undermining rationality in a much more general sense. By far the biggest indirect risk is that SCAM is used as a replacement for effective treatments. Most patients do not approach SCAM to give up conventional medicine entirely. But SCAM practitioners can be most persuasive, and some over-enthusiastic SCAM therapists do try to convince their patients to abandon life-saving treatments.
Pascal’s wager was disputed when it was first published. As a result of the ensuing discussions, significant advances were made, for instance, in the area of probability theory. Applying Pascal’s wager to SCAM, as many enthusiasts do, is however a very different matter. I am afraid, the benefits of doing so might not outweigh the risks.
This survey evaluated the attitude of healthcare professionals toward the use of so-called alternative medicine (SCAM) to improve current care. A questionnaire on the current practice and opinions about SCAM use was sent to healthcare professionals in Amsterdam UMC, who work for the department of hematology or oncology. Oncologists, hematologists, residents, (specialized) nurses, dieticians, (hospital)pharmacists, and pharmacy technicians were asked to participate.
Among eligible healthcare professionals, 77 responded to the questionnaire (34%). Overall, 87% of healthcare
professionals indicated it is important to be aware of their patient’s SCAM use, and all find the potential of drug–herb interactions important. However, more than half of the healthcare professionals inquire about the patient’s SCAM use infrequently. In addition, only 15% of the healthcare professionals stated they had sufficient knowledge of SCAM to advise patients on their use of SCAM.
The authors concluded that healthcare professionals are aware of the potential risks of SCAM use in combination with anti-cancer treatment. However, SCAM use is not yet discussed with every patient. This may be due to healthcare professionals’ lack of knowledge about SCAM.
This survey would in itself be fairly irrelevant; it employed only a tiny convenience sample and its findings cannot be generalized. Yet, it produced results that have been shown dozens of times before, and it might therefore be a good idea to remind ourselves of their relevance and implications.
- Patients use SCAM whether we want it or not.
- Contrary to what is often said, SCAM is not harmless.
- Therefore conventional healthcare professionals need to know about their patients’ SCAM use.
- To find out, healthcare professionals need to ask specific questions about SCAM.
- Next, they must advise their patients responsibly (this is an ethical obligation, not a choice).
- In order to do that they need to learn the essentials about SCAM.
- Failing to do this means failing their patients.
The General Chiropractic Council (GCC) “regulates chiropractors in the UK to ensure the safety of patients undergoing chiropractic treatment”. One might have assumed that they thus fulfill the important role of controlling the profession. Yet, one would have assumed wrongly. Instead of controlling, the GCC usually prefers promoting the profession. Their recent Chiropractic Patient Satisfaction and Experience is a good example. Let me show you several important sections of this document:
The outcomes reported here highlight two key findings:
• Overwhelmingly, chiropractic patients report high levels of satisfaction and positive experiences with their care. This was true both in the literature that examined international patient cohorts as well as the specific data collected from UK based chiropractic patients.
• A strong therapeutic relationship and good communication between patient and chiropractor underpins high satisfaction scores and a positive experience. This was confirmed both in the international literature and through both quantitative and qualitative analysis of specific data collected from UK based chiropractic patients.
Conclusion
This report shows that both existing literature and de novo data collection from patients receiving chiropractic care in the UK highlight excellent perceived experience and high satisfaction with such care.
Factors such as therapeutic alliance and communication are strongly associated with these positive perceptions by patients although other factors such as treatment beliefs were also significantly associated with satisfaction scores.
Recommendations
• To offer the highest quality of care, both in terms of clinical outcomes and patient experience, chiropractors should be explicitly skilled at curating excellent therapeutic alliances and communication with patients.
• Such skills and competences within chiropractic care delivery should receive higher visibility within the chiropractic profession generally and more specifically through advocacy within leading institutions and core emphasis within chiropractic curricula.
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By changing a few words, I have adapted the above excerpts to become a Customer Satisfaction and Experience Report of a fictitious hamburger joint published by the Hamburger General Council (HGC) of Great Britain which regulates hamburger joints in the UK to ensure the safety of consumers undergoing hamburger nutrition:
The outcomes reported here highlight two key findings:
• Overwhelmingly, customers report high levels of satisfaction and positive experiences with their restaurant. This was true both in the literature that examined international consumer cohorts as well as the specific data collected from UK based customers.
• A strong professional relationship and good communication between customer and service personell underpins high satisfaction scores and a positive experience. This was confirmed both in the international literature and through both quantitative and qualitative analysis of specific data collected from UK based hamburger consumers.
Conclusion
This report shows that both existing literature and de novo data collection from consumers eating hamburgers in the UK highlight excellent perceived experience and high satisfaction with such service.
Factors such as personal alliance and communication are strongly associated with these positive perceptions by consumers although other factors such as appetite were also significantly associated with satisfaction scores.
Recommendations
• To offer the highest quality of service, both in terms of profit and patient experience, hamburger vendors should be explicitly skilled at curating excellent professional alliances and communication with customers.
• Such skills and competences within hamburger delivery should receive higher visibility within the gastronomic trade generally and more specifically through advocacy within leading institutions and core emphasis within servers’ curricula.
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If you get the impression that I am taking the Mickey of the GCC, you are not mistaken. Yet, this post also has slightly more serious purposes. I wanted to 1) show how, in the chiropractic profession, pure BS is often disguised as research, and 2) question whether the GCC is fit for purpose.
On a more constructive note: there are many open questions that urgently need addressing in the realm of chiropractic (e.g. do chiropractors more good than harm?). I, therefore, suggest that the GCC stops publishing idiotic promotional documents disguised as research and gets on with its responsibilities.
