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

fraud

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In 2007, we published a systematic review summarizing the efficacy of homeopathic remedies used as a sole or additional therapy in cancer care. We have searched the literature using the databases: Amed (from 1985); CINHAL (from 1982); EMBASE (from 1974); Medline (from 1951); and CAMbase (from 1998). Randomized and non-randomized controlled clinical trials including patients with cancer or past experience of cancer receiving single or combined homeopathic interventions were included. The methodological quality of the trials was assessed by Jadad score. Six studies met our inclusion criteria (five were randomized clinical trials and one was a non-randomized study); but the methodological quality was variable including some high-standard studies. Our analysis of published literature on homeopathy thus found insufficient evidence to support the clinical efficacy of homeopathic therapy in cancer care.

Meanwhile, more trials have emerged, not least a dubious study by Frass et al which is currently under investigation. This means that a new evaluation of the totality of the available evidence might be called for. I am pleased to report that such an assessment has just been published.

In this systematic review, the researchers included clinical studies from 1800 until 2020 to evaluate evidence of the effectiveness of homeopathy on physical and mental conditions in patients during oncological treatment.

In February 2021 a systematic search was conducted searching five electronic databases (Embase, Cochrane, PsychInfo, CINAHL, and Medline) to find studies concerning the use, effectiveness, and potential harm of homeopathy in cancer patients.

From all 1352 search results, 18 studies with 2016 patients were included in this SR. The patients treated with homeopathy were mainly diagnosed with breast cancer. The therapy concepts include single and combination homeopathic remedies (used systemically or as mouth rinses) of various dilutions. Outcomes assessed were the influence on toxicity of cancer treatment (mostly hot flashes and menopausal symptoms), time to drain-removal in breast cancer patients after mastectomy, survival, quality of life, global health and subjective well-being, anxiety, and depression as well as safety and tolerance.

The included studies reported heterogeneous results: some studies described significant differences in quality of life or toxicity of cancer treatment favoring homeopathy, whereas others did not find an effect or reported significant differences to the disadvantage of homeopathy or side effects caused by homeopathy. The majority of the studies have low methodological quality.

The authors concluded that, for homeopathy, there is neither a scientifically based hypothesis of its mode of action nor conclusive evidence from clinical studies in cancer care.

I predict that, if we wait another 15 years, we will have even more studies. I also predict that some of them will be less than reliable or even fake. Finally, I predict that the overall result will still be mixed and unconvincing.

Why can I be so sure?

  1. Because homeopathy lacks biological plausibility as a treatment of cancer (or any other condition).
  2. Because highly diluted homeopathic remedies are pure placebos.
  3. Because homeopathy has developed into a cult where one is no longer surprised to see studies emerging that are too good to be true.

I have previously reported that a Canadian naturopath, Jason Klop,  is under investigation for selling fecal Microbiota transplants to treat autistic children. Now, there is a new twist in this story.

On Twitter, J.N. Stea summarized it nicely:

This naturopath is fighting a judge so that he can charge parents about $15,000 to give his nephew’s poop to children as a treatment for autism. His lawyer argues that he should be allowed to since naturopathy isn’t scientific anyway.

Klop’s lawyer defends the naturopath against an investigation into his business of selling fecal microbiota transplants to families of autistic children. The College of Naturopathic Physicians (CoN) had banned Klop for selling, advertising, and manufacturing pills made from human feces claiming that Klop has been engaging in conduct not acceptable for a naturopathic physician. Klop’s lawyer, Jason Gratl, argued this was difficult to prove in a field that has a few restrictions and some ambiguous boundaries.

“What does it take to be a naturopath and do something that is not appropriate in a field so wide-ranging and open to interpretation?” the lawyer, Gratl, asked the court suggesting that the lack of scientific evidence supporting the use of fecal Microbiota Transplants (FMT) to treat autism is not necessarily relevant in this instance.

“Naturopaths can rely on science in certain aspects, but they are not bound to science,” Gratl said. He explained that naturopathic practices could be based on anecdotes and historical knowledge. Later, he pointed out that the field also includes homeopathy, which, some believe, involves magical thinking. It is definitely not scientific in its core.” After describing the case as a “tragedy”, Gratl called the allegations against his client “entirely unverfounded and scurrilous.”

I suspect it is nothing new to most readers, yet I find it gratifying to hear from a lawyer that naturopathy

  • is not science,
  • relies on anecdote instead of evidence,
  • and involves magical thinking.

I do think, however, that despite all this, naturopaths should not be allowed to do any odd nonsense that comes to their minds and fills their bank accounts quickly.

In India, the homeopathic remedy, Arsenicum Album 30C (prepared from arsenic trioxide) is widely prescribed and publicly supplied to adults and children for preventing COVID infections. Inorganic arsenic, known as the “king of poisons” is a highly toxic substance with the potential to cause acute as well as chronic injury to multiple organ systems, mainly skin, lung, liver, and kidneys.

Indian researchers present three cases of acute liver injury, leading to the death of one patient with underlying non-alcoholic steatohepatitis (NASH) cirrhosis, after consumption of the homeopathic remedy AA30 for COVID-19 prevention.

Case one

A 70-year-old man with compensated non-alcoholic steatohepatitis (NASH)-related cirrhosis and diabetes mellitus consumed the homeopathic IB AA30 as prescribed for 12 weeks prior to the onset of symptoms. He presented with jaundice and abdominal distension within four weeks after the onset of loss of appetite and well-being. The patient was not on any other hepatotoxic agents, over-the-counter medications, or herbal and dietary supplements. Investigations revealed the presence of conjugated hyperbilirubinemia, ascites, and abnormal coagulation, suggestive of acute-on-chronic liver failure (ACLF). Further investigations to identify known causes of acute deterioration of underlying cirrhosis were performed, including a transjugular liver biopsy. All competing causes for acute liver injury were meticulously ruled out. These included infections-tests for immunoglobulin M (IgM) for viral hepatitis A and E; hepatitis B surface antigen and IgM antibody to hepatitis B core antigen; nucleic acid tests via polymerase chain reaction for hepatitis C; IgM for herpes zoster and herpes simplex, cytomegalovirus, parvovirus, Epstein-Barr virus. Complete auto-antibody testing for autoimmune hepatitis (AIH) was negative. The Roussel Uclaf Causality Assessment (RUCAM) demonstrated “probable” (score 7) drug-induced liver injury (DILI) and simplified AIH score was less than 5, revealing the cause of acute liver injury leading to ACLF as the homeopathic remedy, AA30. The liver biopsy revealed multiacinar hepatocyte necrosis, lymphocytic, neutrophilic, and eosinophilic inflammation in the absence of interface hepatitis, which were predominantly portal-based in the background of cirrhosis, suggestive of DILI. Analysis of drugs consumed could not be performed in view of inadequate sample availability. The patient and family consented to arsenic analysis in nail and hair samples which revealed extremely high levels of the heavy metal, supportive of arsenic toxicity and associated liver injury in the patient. Evaluation of hair and hair samples of two family members (below detection limits, method detection limit being 0.1 mg/kg), staying in the same household did not reveal levels signifying cluster arsenic poisoning from water or soil sources. The patient succumbed to complications related to ACLF, nine months after the initial diagnosis.

Case two

A 68-year-old male with systemic hypertension controlled on telmisartan who ingested AA30 as prescribed for four weeks prior to the onset of symptoms. There was no associated jaundice or cholestatic symptoms, but liver tests revealed acute hepatitis with an elevation of liver enzymes. The patient was not on any other hepatotoxic agents, over-the-counter medications, or herbal and dietary supplements. Further investigations did not reveal the presence of underlying chronic liver disease or portal hypertension. All competing causes for acute liver injury were meticulously ruled out similar to the extensive workup that was done in case one. The RUCAM demonstrated “probable” (score 8) DILI and simplified AIH score was less than 5, revealing the cause of acute non-icteric hepatitis as the homeopathic remedy, AA30. The liver biopsy revealed perivenular hepatocyte necrosis, with predominantly portal-based mixed cellular inflammation consisting of plasma cells, eosinophils, lymphocytes, and scattered neutrophils. Additionally, ballooning of hepatocytes was marked with scattered rosettes and moderate interphase hepatitis in the presence of mild portal and sinusoidal fibrosis suggestive of DILI. Acute hepatitis resolved after drug withdrawal and finite course of steroids within three months, without any recurrence on follow-up.

Case three

A 48-year-old overweight woman consumed homeopathic AA30 pills as COVID-19 preventive for one week prior to the onset of her symptoms of cholestatic jaundice. Prior to the development of jaundice, she had nonspecific gastrointestinal symptoms such as nausea and progressive loss of appetite. Liver tests revealed conjugated hyperbilirubinemia with highly raised liver enzymes. The patient was not on any other hepatotoxic prescription drugs, over-the-counter medications, or herbal and dietary supplements. Further investigations did not reveal the presence of underlying chronic liver disease or portal hypertension. All competing causes for acute liver injury were meticulously ruled out similar to the extensive workup that was done in case one. The RUCAM demonstrated “probable” (score 7) DILI and simplified AIH score was less than 5, revealing the cause of acute cholestatic hepatitis as the homeopathic remedy, AA30. The liver biopsy revealed spotty, focal hepatocyte necrosis, with predominantly portal-based neutrophilic and eosinophil-rich inflammation, moderate steatosis, and mild interface hepatitis with underlying mild perisinusoidal fibrosis, suggestive of DILI. The acute cholestatic hepatitis resolved after drug withdrawal and a finite course of steroids within six months, without any recurrence on follow-up.

The chemical analysis and toxicology (inductively coupled optical emission spectroscopy and triple-quadrupole gas chromatography with tandem mass spectroscopy method) on two sets of AA30 samples retrieved from case three revealed D-mannose, melezitose, and arsenic respectively, demonstrating batch-to-batch variation due to poor manufacturing practices.

The authors draw the following conclusions: Health regulatory authorities, physicians, general and patient population must be aware of the potential harms associated with the large-scale promotion of untested, alternative medical systems during a medical emergency so as to prevent an “epidemic” of avoidable DILI within the ongoing pandemic. Even though ultra-diluted homeopathic remedies, found ineffective as shown in large-scale meta-analysis, are considered safe for use due to the absence of any active compound beyond 12C dilution. Nonetheless, poor manufacturing practices, use of concentrated tincture formulations, and adulteration and contamination of homeopathic remedies can still pose considerable toxicity in predisposed persons. From a scientific and evidence-based standpoint, it is imperative that the general population and at-risk persons understand that vaccination, and not untested, misleading IBs, remains the best available armamentarium against COVID-19 which helps in fighting back the pandemic.

How often have I pointed out that “the highly diluted homeopathic remedy may be harmless, but the homeopath isn’t”? I think I should amend this message to:
The highly diluted homeopathic remedy may be harmless, but neither the homeopath nor the manufacturer of the remedies is necessarily harmless.

 

Alan Gaby, the assistant editor of the journal Integr Med has written an interesting commentary about widespread fraud in natural health products research. Here is an excerpt of his article:

During the past 49 years, I have reviewed and analyzed more than 50 000 papers from the biomedical literature, most of which were related to the field of nutritional medicine. Doing this work has given me some understanding of how to assess the reliability of a study. Over the past 10 to 15 years, an uncomfortably large and growing number of published papers related to my area of expertise have left me wondering whether the research was fabricated; that is, whether people were writing papers about research that had not actually been conducted. If the studies were not actually conducted, the publishing of this research is an affront to all who value integrity in science, and it has the potential to harm practitioners and patients who rely on its findings.

The studies that have raised concerns have come primarily from Iran and to a lesser extent from Egypt, China, India, Japan, and a few other countries. Characteristics of these concerning studies typically include one or more of the following:

  1. The study comes from an investigator or research group that has published an enormous number of randomized clinical trials in a relatively short period of time.
  2. The number of participants in the trial is unusually large, when considering the resources that appear to be available to the researchers.
  3. The recruitment period for the trial is unusually short.
  4. The paper is submitted to a journal unusually rapidly after the study is completed, or in some cases before it would have been possible to have completed the trial.
  5. A randomized double-blind trial is conducted before there is any preliminary evidence of efficacy in humans (such as case reports or uncontrolled trials). Because double-blind trials are expensive to conduct, such trials are generally reserved for treatments for which there is some evidence of efficacy.
  6. The magnitude of the reported improvement is much larger than is typically seen in trials using just one or two nutrients.
  7. No funding source is listed or the study is listed as self-funded. This is of particular concern when the sample size or study design suggests that the study was expensive.
  8. The design of the study raises ethical issues, such as participants not being permitted to use treatments that are known to be effective.
  9. One or more baseline characteristics of the study group appear to be implausible.
  10. The research was conducted by a student as part of a graduate school thesis, and the magnitude of the project seems to have been beyond the capabilities and resources of a student.

__________________________________

What Gaby alludes to is a problem indeed. I have previously posted about the Chinese aspect of this story. What Gaby does not mention is the fact that even many studies of so-called alternative medicine (SCAM) which seem to be not overtly fraudulent are nevertheless highly suspect. I am referring to trials that are fatally flawed and/or studies that draw unwarranted conclusions. These are, of course, the types of studies that are the main target of this blog. Because they are so numerous, I feel that the damage they do is much bigger than that of the more overtly fraudulent papers.

Prof. Fabricio Benedetti is one of the world’s leading experts in the study of placebo effects. I have mentioned his excellent work before, for instance, here where he cautioned that quackery has today one more weapon on its side, which is paradoxically represented by the hard science–supported placebo mechanisms. Now he has expressed his concerns even more clearly in an article entitled “Alternative and natural medicine quackery is on the rise. Here’s why the placebo effect is part of the problem”. Here are a few excerpts from this excellent paper:

For several decades now, many scientists, including me, have been working hard to reveal the full power and scope of the placebo effect — the amazing ability of a simple sugar pill or other non-pharmaceutical “fake intervention” to improve someone’s quality of life. This research has been crucial to giving scientific credibility to a powerful psychological effect. But the advances of science have also backfired, spawning an alternative industry that preys on the vulnerable…

All this means that some alternative medicines can indeed have positive outcomes for patients, though not necessarily through the mechanisms that the therapy’s inventors supposed, but rather through a placebo effect. This holds true for treatments ranging from strange talismans to acupuncture — studies have shown that pain relief is about the same for patients receiving true acupuncture with needles, for example, as for those receiving sham acupuncture with trick needles.

The scientific advances in understanding placebo are fascinating. But one unfortunate outcome of all this work is that profit-seeking companies and individuals now have a new weapon: It is no longer necessary to demonstrate the effectiveness of their proposed therapies; it is enough to assert that these work because of the placebo effect. I receive myriad eccentric proposals for new therapies, ranging from talismans and concoctions to mascots and weird rituals. Their inventors claim that these are capable of inducing substantial health benefits and often seek my endorsement. These proposals have stepped up sharply in recent years. Sadly, the science of the placebo effect is fueling this new breed of pseudoscience…

So, if a salesperson says: “This concoction (or ritual or talisman) will reduce your pain,” it is not necessarily a lie, as the placebo effect may indeed stimulate pain-relieving circuits in the brain. But anyone could truthfully use these words, within limits.

These marketers often overstate the size of the possible response, claim to provide a “cure” rather than pain relief or incorrectly suggest that only their own expensive products will have this effect. Even worse, they may present the products as an alternative to more effective traditional medications for serious conditions such as cancer. In other words, they prey on the vulnerable by making undeliverable promises, purportedly backed by the science of placebo.

Even if taking a placebo can reduce symptoms such as pain, this isn’t always the best course of action. An apparently trivial pain may, for example, be the first sign of something far more serious. Treating the pain alone may prevent diagnosis by a physician or delay important medical treatments…

…Education, communication and honesty are the best friends of medical practice. Patients and health care professionals deserve to know what placebos can and cannot do.

The research and medical communities must be more transparent about the efficacy of many conventional pharmacological and nonpharmacological treatments, by acknowledging that some of them are useful whereas some others are not. Many over-the-counter products have doubtful efficacy, for example. Honesty will boost patients’ trust and confidence in medicine, which are the best antidotes to quackery.

 

BRAVO PROF BENEDETTI!

I was made aware of an advertisement announcing that the ‘international health lecturer’, Barbara O’Neill, is soon (19-26 June) coming to the UK.

Who is Barbara O’Neill? I hear you ask.

Here is more interesting information about her:

The NSW Health Care Complaints Commission conducted an investigation into the professional conduct of Mrs Barbara O’Neill, an unregistered practitioner who provides services as a naturopath, nutritionist and health educator.

Complaints received by the Commission alleged that Mrs O’Neill makes dubious and dangerous health claims that are not evidence based or supported by mainstream medicine, regarding: infant nutrition; causes and treatment of cancer; antibiotics; and vaccinations.  Some of the non-evidence based comments made in Mrs O’Neill’s publications include:

  • raw goat’s milk is an appropriate substitute for breast milk in infant nutrition;
  • cancer is a fungus that can be treated with bicarbonate soda and can be cured by following a program that includes the cancer conquering diet and sodium bicarbonate wraps for the body;
  • pregnant women diagnosed with Strep B do not have to take antibiotics;
  • there are no safe vaccines; vaccinations have caused an epidemic of ADHD, autism, epilepsy and cot death.

The investigation found that Mrs O’Neill has limited qualifications in the area of nutrition and dietetics, which she attained more than 10 years ago. Of particular concern to the Commission is that Mrs O’Neill is providing health advice beyond the limits of her training and experience. Mrs O’Neill considers herself qualified to provide health advice in highly complex and specialised areas such as cancer treatment, use of antibiotics for Strep B and immunisation, in circumstances where it is clear her knowledge is limited.

The investigation also found that Mrs O’Neill does not recognise that she is misleading vulnerable people (including mothers and cancer sufferers) by providing very selective information.  The misinformation has real potential to have a detrimental effect on the health of individuals because Mrs O’Neill also discourages mainstream treatment for cancer, antibiotics and vaccinations.

The investigation determined that Mrs O’Neill breached the Code of Conduct for Unregistered Health Practitioners under Schedule 3 of the Public Health Regulation 2012 in respect of:

  • Clause 3(1): a health practitioner must provide health services in a safe and ethical manner;
  • Clause 5(1): a health practitioner must not hold himself or herself out as qualified, able or willing to cure cancer or other terminal illnesses;
  • Clause 7(1): a health practitioner must not attempt to dissuade clients from seeking or continuing with treatment by a registered medical practitioner;
  • Clause 12(1): a health practitioner must not engage in any form of misrepresentation in relation to the products or services he or she provides or as to his or her qualifications, training or professional affiliations;
  • Clause 15: a health practitioner must maintain accurate, legible and contemporaneous clinical records for each client consultation.

The Commission is satisfied that Mrs O’Neill poses a risk to the health and safety of members of the public and therefore makes the following prohibition order:

  • Mrs O’Neill is permanently prohibited from providing any health services, as defined in s4 Of the Health Care Complaints Act 1993, whether in a paid or voluntary capacity.

The Commission has determined to make its Statement of Decision publicly available under section 41B(3)(c) of the Health Care Complaints Act 1993 but has removed material which it considers to be confidential information.

The full Public Statement of Decision can be read here

____________________________

Barbara has clear and concise messages:

  • Vaccinations have caused an epidemic of ADHD, autism, epilepsy and cot death.
  • Cancer is a fungus that can be treated with bicarbonate soda.

Just what we needed in the UK!?

Or maybe not.

Yes, we did get used to being lied to by our PM. We are also slowly getting used to our NHS being vandalized by our Tory government. But that does not mean that we now should opt to cure cancer with baking soda.

Perhaps it would be better to use existing legislation (e.g. the cancer act) and stop this ‘international health lecturer’ in her tracks?

 

PS

In case you wonder who might organize such an event, it is this one:

Manna House Health Education & Wellness is a community interest company that works with people to improve their health. Manna House has been using natural health principles to help the body heal itself. It was established for the purpose of educating people in the principles and laws of healthful living.

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.

________________________

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.

_________________________

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.

_________________________

Say no more!

I was alerted to the following conference announcement:

The MEP Interest Group on Integrative Medicine and Health is delighted to invite you to the event ‘Integrative Medicine and Health in prevention and management of COVID-19 and long COVID’ on Thursday 2 June 16.0018.00 CEST.

This event will give you in-depth information about:

Expert speakers will share their knowledge and insights about how:

• Complementary and Integrative Medicine and Health interventions can improve resilience to COVID-19 infection.

• Promoting resilience and health restoration can reduce the risk of severe COVID-19 or development of Long COVID.

• These interventions can improve the recovery from Long COVID.

Key speakers and topics:

Therapeutic strategies of complementary medicines in the COVID 19 pandemic and Long COVID in addition to conventional medicine

Dr Joanna Dietzel, MD Neurologist, Acupuncturist. Department for integrative & complementary medicine, Institute of social medicine, epidemiology and health economics, Charité – Universitätsmedizin Berlin, Germany.

Chinese herbal medicine treatment in cases of infections with SARS-CoV-2 – therapeutic strategies for COVID-19 and Long COVID

Dr Christian Thede, MD, General practitioner, specialised in Acupuncture and Chinese Medicine. Former lecturer in Chinese medicine, University of Witten-Herdecke, Germany

Instructor for Acupuncture and Chinese Medicine at International Society of Chinese Medicine (SMS).

Traditional and Complementary Medicine contributions to health system resilience during COVID-19 – the WHO perspective

Dr Geetha Kopalakrishna, MD, Bachelor of Ayurvedic Medicine & Surgery

Technical Officer at Traditional, Complementary & Integrative Medicine, Department of Service Delivery and Safety, World Health Organization, Geneva, Switzerland

Key member of the AYUSH-based COVID-19 response Task Force for the Government of India.

Research programme into integrative medicine’s contribution to improving resilience to COVID-19 infection and reducing the risk of severe COVID-19 or development of Long COVID

Dr Helene M. Langevin, Director at National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, Maryland (MD), USA. Previously, Director of the Harvard Osher Center for Integrative Medicine and professor of medicine at Harvard Medical School, Boston (MA) and professor of neurological sciences at the Larner College of Medicine at the University of Vermont (VT).

Q&A sessions after the presentations.

Resilience to infections: a solution for COVID-19 and other infectious illnesses

Studies show that certain common medical conditions put people at higher risk for severe illness and death from COVID-19. Nearly two-thirds of COVID-19 hospitalizations could be attributed to obesity, diabetes, hypertension, and heart failure. There is increasing awareness that a health system that focuses on improving health could prevent all these conditions to a large extent.

Long COVID

More than 40% of people who have or had COVID-19 get long COVID, and among people who needed hospitalization, the statistics go up to 57%. The recovery from such post viral syndromes will be greatly helped by offering patients access to complementary and integrative medicine interventions that aim at restoring their health balance.

MEP Interest Group on Integrative Medicine and Health

The event is hosted by the members of the MEP Interest Group on Integrative Medicine & Health:

Michèle Rivasi, Greens/EFA, France

Sirpa Pietikäinen, EPP, Finland

Tilly Metz, Greens/EFA, Luxembourg

Margrete Auken, Greens/EFA, Denmark

Romana Jerković, S&D, Croatia

Manuela Ripa, Greens/EFA, Germany

I had not been aware of the ‘MEP Interest Group on Integrative Medicine & Health‘. Therefore, I looked it up and found this:

The newly established Interest Group on Integrative Medicine & Health continues the work of the former MEP Interest Group on CAM. This group brings together MEPs who work collectively to promote the inclusion of CAM as part of Integrative Medicine & Health in all possible European Parliament public health policy.

Why an Interest Group in the European Parliament?

One in two EU citizens uses complementary medicine either alongside or as an alternative to conventional biomedical care. This high demand is not yet reflected in EU or national health policy or provision. In addition, there is diversity in complementary medicine regulation across the EU. There are differences in who can practice complementary medicine, what qualifications are required and how services are offered and financed. These discrepancies mean that citizens experience practical and attitudinal barriers that limit their access to and use of TCIM.

The health sector in the EU Member States is facing considerable challenges, such as antimicrobial resistance (AMR), increasing prevalence of Non-Communicable Diseases (NCDs) and soaring costs. Complementary medicine can offer a significant contribution to meet these challenges. These modalities are “integrative”, offering patient-centered healthcare, based on evidence-informed integration of conventional biomedicine and complementary medicine. Integrative Medicine and Health focuses on the whole person and considers the individual in its physical, psychological, spiritual, social and environmental context. It is inclusive of all professions and practices that use this approach and meets the demand of EU citizens for a more holistic, patient-centered approach in medicine. At the same time, TCIM is at the center of political and scientific debate. In this context, a forum for discussion on Integrative and Complementary Medicine’s contribution to EU health systems will bring clarity and rationality to this debate.

Aims and objectives of the Interest Group on Integrative Medicine & Health

  • Establish and maintain a forum for discussion and action with all stakeholders regarding Integrative Medicine and Health.
  • Raise awareness of Integrative Medicine and its contribution to more sustainable healthcare systems in the EU and a more holistic approach to health.
  • Focus on the integration of complementary modalities into the health systems of the EU Member States.
  • Protect and promote citizens’ right to choose their own healthcare while providing access to Integrative Medicine and Health information.
  • Advocate for EU involvement in setting unified standards to regulation of Integrative Medicine and Health.

__________________________________

Unified standards? But what about high or perhaps just scientific standards? What about first doing the research and then making claims about CAM or TCIM or however you decide to call it? Has common sense gone out of fashion?

Yes, you guessed it: I am seriously underwhelmed by all this. To show you why, let me list just a few claims from the above two statements that are based purely on wishful thinking:

  • Complementary and Integrative Medicine and Health interventions can improve resilience to COVID-19 infection.
  • These interventions can improve the recovery from Long COVID.
  • Studies show that certain common medical conditions put people at higher risk for severe illness and death from COVID-19.
  • The recovery from such post viral syndromes will be greatly helped by offering patients access to complementary and integrative medicine interventions that aim at restoring their health balance.
  • One in two EU citizens uses complementary medicine either alongside or as an alternative to conventional biomedical care.
  • The health sector in the EU Member States is facing considerable challenges, such as antimicrobial resistance (AMR), increasing prevalence of Non-Communicable Diseases (NCDs) and soaring costs. Complementary medicine can offer a significant contribution to meet these challenges.
  • These modalities are “integrative”, offering patient-centered healthcare, based on evidence-informed integration of conventional biomedicine and complementary medicine.
  • Integrative medicine … meets the demand of EU citizens for a more holistic, patient-centered approach in medicine.

I find all this confusing and concerning in equal measure. I also seriously doubt that the forum for discussion on Integrative and Complementary Medicine will bring clarity and rationality to this debate. If they really wanted a debate, they would need to include a few critical thinkers; can anyone recognize one on the list of speakers? I cannot!

I fear the aim of the group and their meeting is to mislead us all into thinking that CAM, TCIM, etc. generate more good than harm without ever delivering the evidence for that assumption. Therefore, I suggest they rename both the conference as well as their group:

Wishful thinking in prevention and management of COVID-19 and long COVID

and

MEP Interest Group on Wishful Thinking and Promotion of Quackery

 

 

PS

As an antidote to wishful thinking, I recommend reading some proper science papers on the subject. Here are the conclusions of an up-to-date and wishful-thinking-free review on the subject of post-acute infection syndrome:

Unexplained post-acute infection syndromes (PAISs) appear to be an under-recognized feature of a spectrum of infectious diseases in a minority of patients. At present, our understanding of the underlying pathophysiologic mechanisms and etiologic factors is poor and there are no known objective markers or effective therapeutic options. More basic biomedical research is needed. The overlap of symptoms, signs, and general features of the individual PAISs suggests the involvement of shared pathological pathways and the possibility that common diagnostic markers, or even a unified etiological model, might be established.

However, some symptoms or clinical characteristics seem to be trigger-specific or more prevalent in one PAIS than in others, emphasizing the need for cohorts with a well-documented infectious trigger. The overall clinical picture of many PAISs often overlaps with the presentation of post-infectious ME/CFS or fibromyalgia, or resembles other fatiguing, neurological, or rheumatic disorders. Exploiting existing knowledge of these conditions might help guide future scientific discovery and progress in clinical care.

The SARS-CoV-2 pandemic uncovered a significant gap in knowledge about post-acute sequelae of infectious diseases and identified the need for better diagnostic care and clinical infrastructure for patients experiencing these long-term effects. In addition to basic biomedical research, more needs to be done to refine diagnostic criteria and obtain more reliable estimates of the prevalence and societal burden of these disorders to help shape health-policy decisions. Moreover, we call for unified nomenclature and better conceptualization of post-acute infection symptoms.

There is much to be done, but the unprecedented amount of attention and resources that have recently been allocated to the study of COVID-19-related pathology brings a promise of much-needed progress in the wider field of unexplained infection-associated chronic disability.

I was alerted to the following short article from ‘The Blackpool Gazette‘:

Criminals have been using the brand name Pfizer to sell fake homeopathic vaccines to residents, according to police. The white tablets are sold under the pretence that they are an alternative to traditional vaccines, but actually contain no active ingredient. Analysis conducted by Lancashire Police revealed the tablets were nothing more than sugar pills. “Please note Pfizer do not produce any tablets as a cure or prophylactic for COVID-19,” a spokesman for the force added.

What is homeopathy?

Homeopathy is a “treatment” based on the use of highly diluted substances, which practitioners claim can help the body heal itself, according to the NHS. A 2010 House of Commons Science and Technology Committee report on homeopathy said that homeopathic remedies perform no better than placebos. In 2017, NHS England said it would no longer fund homeopathy on the NHS as the lack of any evidence for its effectiveness did not justify the cost. This was backed by a High Court judgement in 2018.

I think there might be a slight misunderstanding here. The homeopathic remedy might not be fake, as it was produced according to the concepts of homeopathy. It is homeopathy itself that is fake. To me, it looks as though we are dealing with the German product I mentioned a while ago. Let me remind you:

Many people believe that homeopathy is essentially plant-based – but they are mistaken! Homeopathic remedies can be made from anything: Berlin wall, X-ray, pus, excrement, dental plaque, mobile phone rays, poisons … anything you can possibly think of. So, why not from vaccines?

This is exactly what a pharmacist specialized in homeopathy thought.

It has been reported that the ‘Schloss-Apotheke’ in Koblenz, Germany offered for sale a homeopathic remedy made from the Pfizer vaccine. This has since prompted not only the Chamber of Pharmacists but also the Paul Ehrlich Institute and Pfizer to issue statements. On Friday (30/4/2021) morning, the pharmacy had advertised homeopathic remedies based on the Pfizer/Biontech vaccine. The Westphalia-Lippe Chamber of Pharmacists then issued an explicit warning against it. “We are stunned by this,” said a spokesman. The offer has since disappeared from the pharmacy’s website.

On Friday afternoon, the manufacturer of the original vaccine also intervened. The Paul Ehrlich Institute released a statement making it clear that a vaccine is only safe “if it is administered in accordance with the marketing authorization.”

The Schloss-Apotheke had advertised the product in question with the following words:

“We have Pfizer/BioNTech Covid-19-Vaccine in potentized form up to D30 as globules or dilution (for discharge) in stock.”

The chamber of pharmacists countered with a warming under the heading “Facts instead of Fake News” on Facebook and Instagram:

“Whatever they might contain: These remedies are no effective protection against Covid-19.”

Pharmacy manager, Annette Eichele, of the Schloss-Apotheke claimed she had not sold homeopathic Corona vaccines and stressed that effective vaccines of this kind do not exist. According to Eichele, only an additional “mini drop” of the original Biontech vaccine had been used and “highly potentized” and prepared homeopathically. According to Eichele, Corona vaccinations that had already been administered were thus to have a “better and more correct effect with this supplementary product, possibly without causing side effects … but this is not scientifically proven”. The homeopathic product had been produced only on customer request and had been sold less than a dozen times in the past weeks. Ten grams of the remedy were sold for about 15 Euros. On Twitter, Eichele stated: „Wir haben nichts Böses getan, wir wollten nur Menschen helfen!“ (We have done nothing evil, we only wanted to help people). I am reminded yet again of Bert Brecht who observed:

“The opposite of good is not evil but good intentions”.

_______________________

If I am right, the remedy is not truly fake but a genuine product of a fake concept, namely homeopathy. In that case, the term ‘criminal’ might need to be applied to homeopathy itself – an interesting thought!

The cardiothoracic surgeon and famous US woo merchant, Dr. Mehmet Oz, is probably known to most readers. I have previously mentioned him several times, for instance, here and here. His institution, Columbia University in New York City, has had many (I’d say too many) years of patience with his relentless promotion of outright and often dangerous quackery. Now it has been reported that the university has finally cut ties with Dr. Oz:

“It took Columbia far too long to remove Oz from its otherwise distinguished medical faculty,” Henry Miller, MD, of the Pacific Research Institute in California, told MedPage Today via email. Miller stressed that “the ‘Oz controversy’ was never about free speech. It was about an unethical grifter whose claims and pronouncements were not supported by science and were injurious to consumers — in the interest of financial benefit to Oz himself. That constitutes professional misconduct.”

The university’s Irving Medical Center quietly ended its relationship with Oz at the end of April, according to The Daily Beast. He had been removed from several pages of the medical center’s website in mid-January. In 2018, Oz’s title had been changed to professor emeritus and special lecturer, according to reports. A spokesperson for Columbia University confirmed the 2018 change in an email to MedPage Today.

In 2015, Miller and colleagues sent a letter to Lee Goldman, MD, MPH, dean of the Faculties of Health Sciences and Medicine at the university, calling for Oz’s expulsion. Oz had “repeatedly shown disdain for science and for evidence-based medicine” and “manifested an egregious lack of integrity by promoting quack treatments and cures in the interest of personal financial gain,” according to Miller’s group…

In 2014, Oz was called to testify before the Senate Subcommittee on Consumer Protection, Product Safety, and Insurance during a hearing on false advertising in the diet and weight-loss industry. Senators grilled Oz regarding statements he made on “The Dr. Oz Show” that promoted green coffee bean extract as a “miracle pill” for weight loss.

But long before that hearing, tensions had built between Oz and the medical community because of his penchant for spouting dubious medical claims on his TV show and in the media. For example, in a 2011 segmentABC News‘ chief health and medical editor Richard Besser, MD, called out a purported “study” of arsenic in apple juice that Oz conducted for an episode of his show.

Besser charged that Oz’s science was shoddy because he reported total arsenic rather than the breakdown between organic and inorganic arsenic — only the latter of which is known to be toxic. Even the FDA sent the show a letter before the segment aired saying it would be “irresponsible and misleading” to report the results.

Oz again broke with medical science during the pandemic when he touted hydroxychloroquine as a cure for COVID-19, even as evidence mounted that it had no effect on disease course.

Oz is currently running for a U.S. Senate seat in Pennsylvania as a Republican candidate. Former President Trump endorsed Oz, touting Oz’s medical and academic credentials in a statement, according to NPR: “He even said that I was in extraordinary health, which made me like him even more (although he also said I should lose a couple of pounds!).”

__________________________

I have to admit that I find these reports somewhat puzzling. Don’t get me wrong: it’s not that I don’t think Oz deserves to be dismissed. In fact, he had already richly deserved it many years ago. What I find, however, odd is that giving someone the title ’emeritus professor’ can hardly be called ‘cutting ties’ with him. In some ways, it is even the opposite (I should know because I currently have this status).

When I looked up Oz, Columbia listed him as:

Oz, Mehmet C. (MD)
Special Lecturer in the Department of Surgery
Phone: 212.305.4434 · Fax: 212.342.3520
Location: MHB, Rm. 435-62

Similarly, the website of the Irving Medical Center is full of entries about Oz. Confusion is therefore more than justified, I think.

What is needed, I feel, is a clear statement from Columbia University about its relationship with Dr. Oz. Are they still proud of his considerable fame/notoriety, or did they in fact have the integrity to cut ties with one of the most self-aggrandizing woo merchants of all times?

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