integrative medicine
Robert Jütte, a German medical historian, has long been a defender of homeopathy and other forms of so-called alternative medicine (SCAM). His latest paper refers to the situation in Switzerland where the public was given the chance to vote for or against the reimbursement of several SCAMs, including homeopathy. I reported previously about this unusual situation, e.g.:
- More about homeopathy in Switzerland: “Globuli only cause unnecessary healthcare costs”
- More on the situation of homeopathy in Switzerland
- SCAM in Switzerland: paediatricians couldn’t care less
- It’s official: Switzerland is going holistically round the bend
Unsurprisingly, Prof Jütte’s views are quite different from mine. Here is the abstract of his recent paper:
Behind the principle of involving users and voters directly in decision-making about the health care system are ideas relating to empowerment. This implies a challenge to the traditional view that scientific knowledge is generally believed to be of higher value than tried and tested experience, as it is the case with CAM. The aim of this review is to show how a perspective of the history of medicine and science as well as direct democracy mechanisms such as stipulated in the Swiss constitution can be used to achieve the acceptance of CAM in a modern medical health care system. A public health care system financed by levies from the population should also reflect the widely documented desire in the population for medical pluralism (provided that therapeutical alternatives are not risky). Otherwise, the problem of social inequality arises because only people with a good financial background can afford this medicine.
I think that Jütte’s statement that “a public health care system financed by levies from the population should also reflect the widely documented desire in the population for medical pluralism provided that therapeutical alternatives are not risky. Otherwise, the problem of social inequality arises because only people with a good financial background can afford this medicine” is untenable. Here are my reasons:
- Lay people are not normally sufficiently informed to decide which treatments are effective and which are not. If we leave these decisions to the public, we will end up with all manner of nonsense diluting the effectiveness of our health services and wasting our scarce public funds.
- Jütte seems to assume that SCAMs that are not risky do no harm. He fails to consider that ineffective treatments inevitably do harm by not adequately treating symptoms and diseases. In serious conditions this will even hasten the death of patients!
- Jütte seems concerned about inequity, yet I think this concern is misplaced. Not paying from the public purse for nonsensical therapies is hardly a disadvantage. Arguably, those who cannot affort ineffective SCAMs are even likely to benefit in terms of their health.
I do realize that there might be conflicting ethical principles at play here. I am, however, convinced that the ethical concern of doing more good than harm to as many consumers as possible is best realized by implementing the principles of evidence-based medicine. Or – to put it bluntly – a healthcare system is not a supermarket where consumers can pick and chose any rubbish they fancy.
I wonder who you think is correct, Jütte or I?
Many of you will be familiar with the ‘ALTERNATIVE MEDICINE HALL OF FAME’. It is my creation and meant to honour reserchers who have dedicated much of their professional career to investigating a form of so-called alternative medicine (SCAM) without ever publishing negative conclusions about it. Obviously, if anyone studies any therapy, he/she will occasionally produce a negative finding. This would be the case, even if he/she tests an effective treatment. However, if the treatment in question comes from the realm of SCAM, one would expect negative results fairly regularly. No therapy works well under all conditions, and to the best of my knowledge, no SCAM is a panacea!
This is why researchers who defy this inevitability are remarkable. If someone tests a treatment that is at best dubious and at worst bogus, we are bound to see some studies that are not positive. He/she would thus have a high or normal ‘TRUSTWORTHINESS INDEX‘ (another creation of mine which, I think, is fairly self-explanatory). Conversely, any researcher who does manage to publish nothing but positive results of a SCAM is bound to have a very low ‘TRUSTWORTHINESS INDEX‘. In other words, these people are special, so much so that I decided to honour such ‘geniuses’ by admitting them to my ALTERNATIVE MEDICINE OF FAME.
So far, this elite group of people comprises the following individuals:
- Helge Franke (osteopathy, Germany)
- Tery Oleson (acupressure , US)
- Jorge Vas (acupuncture, Spain)
- Wane Jonas (homeopathy, US)
- Harald Walach (various SCAMs, Germany)
- Andreas Michalsen ( various SCAMs, Germany)
- Jennifer Jacobs (homeopath, US)
- Jenise Pellow (homeopath, South Africa)
- Adrian White (acupuncturist, UK)
- Michael Frass (homeopath, Austria)
- Jens Behnke (research officer, Germany)
- John Weeks (editor of JCAM, US)
- Deepak Chopra (entrepreneur, US)
- Cheryl Hawk (chiropractor, US)
- David Peters (osteopathy, homeopathy, UK)
- Nicola Robinson (TCM, UK)
- Peter Fisher (homeopathy, UK)
- Simon Mills (herbal medicine, UK)
- Gustav Dobos (various SCAMs, Germany)
- Claudia Witt (homeopathy, Germany/Switzerland)
- George Lewith (acupuncture, UK)
- John Licciardone (osteopathy, US)
You will notice that the group does not yet contain a representative of anthroposophic medicine. Today, I intend to rectify this oversight by admitting Helmut Kiene (1952-). He has published plenty of studies and reviews on his pet subject; here are the ones that I found on Medline:
- Anthroposophic therapies in chronic disease: the Anthroposophic Medicine Outcomes Study (AMOS). Eur J Med Res. 2004 Jul 30;9(7):351-60.
- Anthroposophic medical therapy in chronic disease: a four-year prospective cohort study. Hamre HJ, Witt CM, Glockmann A, Ziegler R, Willich SN, Kiene H.BMC Complement Altern Med. 2007 Apr 23;7:10. doi: 10.1186/1472-6882-7-10.
- Anthroposophic art therapy in chronic disease: a four-year prospective cohort study. Hamre HJ, Witt CM, Glockmann A, Ziegler R, Willich SN, Kiene H.Explore (NY). 2007 Jul-Aug;3(4):365-71. doi: 10.1016/j.explore.2007.04.008.
- Rhythmical massage therapy in chronic disease: a 4-year prospective cohort study. Hamre HJ, Witt CM, Glockmann A, Ziegler R, Willich SN, Kiene H.J Altern Complement Med. 2007 Jul-Aug;13(6):635-42. doi: 10.1089/acm.2006.6345
- Anthroposophic vs. conventional therapy for chronic low back pain: a prospective comparative study. Hamre HJ, Witt CM, Glockmann A, Wegscheider K, Ziegler R, Willich SN, Kiene H.Eur J Med Res. 2007 Jul 26;12(7):302-10.
- Viscum album L. extracts in breast and gynaecological cancers: a systematic review of clinical and preclinical research. Kienle GS, Glockmann A, Schink M, Kiene H.J Exp Clin Cancer Res. 2009 Jun 11;28(1):79. doi: 10.1186/1756-9966-28-79.
- Anthroposophic therapy for children with chronic disease: a two-year prospective cohort study in routine outpatient settings. Hamre HJ, Witt CM, Kienle GS, Meinecke C, Glockmann A, Willich SN, Kiene H.BMC Pediatr. 2009 Jun 19;9:39. doi: 10.1186/1471-2431-9-39
- Predictors of outcome after 6 and 12 months following anthroposophic therapy for adult outpatients with chronic disease: a secondary analysis from a prospective observational study. Hamre HJ, Witt CM, Kienle GS, Glockmann A, Willich SN, Kiene H.BMC Res Notes. 2010 Aug 3;3:218. doi: 10.1186/1756-0500-3-218.
- Pulpa dentis D30 for acute reversible pulpitis: A prospective cohort study in routine dental practice. Hamre HJ, Mittag I, Glockmann A, Kiene H, Tröger W.Altern Ther Health Med. 2011 Jan-Feb;17(1):16-21.
- Use and safety of anthroposophic medications for acute respiratory and ear infections: a prospective cohort study. Hamre HJ, Glockmann A, Fischer M, Riley DS, Baars E, Kiene H.
- [Clinical research on anthroposophic medicine:update of a health technology assessment report and status quo]. Kienle GS, Glockmann A, Grugel R, Hamre HJ, Kiene H.Forsch Komplementmed. 2011;18(5):269-82. doi: 10.1159/000331812. Epub 2011 Oct 4.
- Anthroposophical medicine: a systematic review of randomised clinical trials. Kienle GS, Hamre HJ, Kiene H.Wien Klin Wochenschr. 2004 Jun 30;116(11-12):407-8; author reply 408. doi: 10.1007/BF03040923.
- Eurythmy therapy in chronic disease: a four-year prospective cohort study. Hamre HJ, Witt CM, Glockmann A, Ziegler R, Willich SN, Kiene H.BMC Public Health. 2007 Apr 23;7:61. doi: 10.1186/1471-2458-7-61.
- Long-term outcomes of anthroposophic therapy for chronic low back pain: A two-year follow-up analysis. Hamre HJ, Witt CM, Kienle GS, Glockmann A, Ziegler R, Willich SN, Kiene H.J Pain Res. 2009 Jun 25;2:75-85. doi: 10.2147/jpr.s5922.
- Health costs in anthroposophic therapy users: a two-year prospective cohort study. Hamre HJ, Witt CM, Glockmann A, Ziegler R, Willich SN, Kiene H.BMC Health Serv Res. 2006 Jun 2;6:65. doi: 10.1186/1472-6963-6-65.
- Use and safety of anthroposophic medications in chronic disease: a 2-year prospective analysis. Hamre HJ, Witt CM, Glockmann A, Tröger W, Willich SN, Kiene H.Drug Saf. 2006;29(12):1173-89. doi: 10.2165/00002018-200629120-00008.
- Anthroposophic therapy for chronic depression: a four-year prospective cohort study. Hamre HJ, Witt CM, Glockmann A, Ziegler R, Willich SN, Kiene H.BMC Psychiatry. 2006 Dec 15;6:57. doi: 10.1186/1471-244X-6-57.
- Health costs in patients treated for depression, in patients with depressive symptoms treated for another chronic disorder, and in non-depressed patients: a two-year prospective cohort study in anthroposophic outpatient settings. Hamre HJ, Witt CM, Glockmann A, Ziegler R, Kienle GS, Willich SN, Kiene H.Eur J Health Econ. 2010 Feb;11(1):77-94. doi: 10.1007/s10198-009-0203-0.
- Outcome of anthroposophic medication therapy in chronic disease: a 12-month prospective cohort study. Hamre HJ, Witt CM, Glockmann A, Ziegler R, Kienle GS, Willich SN, Kiene H.Drug Des Devel Ther. 2009 Feb 6;2:25-37.
- Clinical research in anthroposophic medicine. Hamre HJ, Kiene H, Kienle GS.Altern Ther Health Med. 2009 Nov-Dec;15(6):52-5.
- Anthroposophic therapy for attention deficit hyperactivity: a two-year prospective study in outpatients. Hamre HJ, Witt CM, Kienle GS, Meinecke C, Glockmann A, Ziegler R, Willich SN, Kiene H.Int J Gen Med. 2010 Aug 30;3:239-53. doi: 10.2147/ijgm.s11725.
- Anthroposophic therapy for asthma: A two-year prospective cohort study in routine outpatient settings. Hamre HJ, Witt CM, Kienle GS, Schnürer C, Glockmann A, Ziegler R, Willich SN, Kiene H.J Asthma Allergy. 2009 Nov 24;2:111-28.
- Anthroposophic therapy for migraine: a two-year prospective cohort study in routine outpatient settings. Hamre HJ, Witt CM, Kienle GS, Glockmann A, Ziegler R, Rivoir A, Willich SN, Kiene H.Open Neurol J. 2010;4:100-10.
- Antibiotic Use in Children with Acute Respiratory or Ear Infections: Prospective Observational Comparison of Anthroposophic and Conventional Treatment under Routine Primary Care Conditions. Hamre HJ, Glockmann A, Schwarz R, Riley DS, Baars EW, Kiene H, Kienle GS.Evid Based Complement Alternat Med. 2014;2014:243801.
- An assessment of the scientific status of anthroposophic medicine, applying criteria from the philosophy of science. Baars EW, Kiene H, Kienle GS, Heusser P, Hamre HJ.Complement Ther Med. 2018 Oct;40:145-150.
- Anthroposophic vs. conventional therapy of acute respiratory and ear infections: a prospective outcomes study. Hamre HJ, Fischer M, Heger M, Riley D, Haidvogl M, Baars E, Bristol E, Evans M, Schwarz R, Kiene H.Wien Klin Wochenschr. 2005 Apr;117(7-8):256-68. doi: 10.1007/s00508-005-0344-9.
- Long-term outcomes of anthroposophic treatment for chronic disease: a four-year follow-up analysis of 1510 patients from a prospective observational study in routine outpatient settings. Hamre HJ, Kiene H, Glockmann A, Ziegler R, Kienle GS.BMC Res Notes. 2013 Jul 13;6:269. doi: 10.1186/1756-0500-6-269
- Eurythmy Therapy in anxiety. Kienle GS, Hampton Schwab J, Murphy JB, Andersson P, Lunde G, Kiene H, Hamre HJ.Altern Ther Health Med. 2011 Jul-Aug;17(4):56-63
- Mistletoe in cancer – a systematic review on controlled clinical trials. Kienle GS, Berrino F, Büssing A, Portalupi E, Rosenzweig S, Kiene H.Eur J Med Res. 2003 Mar 27;8(3):109-19.
- Anthroposophic therapy of respiratory and ear infections. Hamre HJ, Fischer M, Heger M, Riley D, Haidvogl M, Baars E, Bristol E, Evans M, Schwarz R, Kiene H.Wien Klin Wochenschr. 2005 Jul;117(13-14):500-1. doi: 10.1007/s00508-005-0389-9
- Complementary cancer therapy: a systematic review of prospective clinical trials on anthroposophic mistletoe extracts.
Eur J Med Res. 2007 Mar 26;12(3):103-19.
- Review article: Influence of Viscum album L (European mistletoe) extracts on quality of life in cancer patients: a systematic review of controlled clinical studies. Kienle GS, Kiene H.Integr Cancer Ther. 2010 Jun;9(2):142-57.
- [Anthroposophic medicine: health technology assessment report – short version].
Forsch Komplementmed. 2006;13 Suppl 2:7-18. doi: 10.1159/000093481. Epub 2006 Jun 26.
- Bilateral Asynchronous Renal Cell Carcinoma With Lung Metastases: A Case Report of a Patient Treated Solely With High-dose Intravenous and Subcutaneous Viscum album Extract for a Second Renal Lesion. Reynel M, Villegas Y, Kiene H, Werthmann PG, Kienle GS.Anticancer Res. 2019 Oct;39(10):5597-5604. doi: 10.21873/anticanres.13754.
- Long-term survival of a patient with an inoperable thymic neuroendocrine tumor stage IIIa under sole treatment with Viscum album extract: A CARE compliant clinical case report. Reynel M, Villegas Y, Werthmann PG, Kiene H, Kienle GS.Medicine (Baltimore). 2020 Jan;99(5):e18990. doi: 10.1097/MD.0000000000018990
- Long-Term Survival of a Patient with Recurrent Dedifferentiated High-Grade Liposarcoma of the Retroperitoneum Under Adjuvant Treatment with Viscum album L. Extract: A Case Report. Reynel M, Villegas Y, Werthmann PG, Kiene H, Kienle GS.Integr Cancer Ther. 2021 Jan-Dec;20:1534735421995258. doi: 10.1177/1534735421995258.
- Intralesional and subcutaneous application of Viscum album L. (European mistletoe) extract in cervical carcinoma in situ: A CARE compliant case report. Reynel M, Villegas Y, Kiene H, Werthmann PG, Kienle GS.Medicine (Baltimore). 2018 Nov;97(48):e13420.
- High-Dose Viscum album Extract Treatment in the Prevention of Recurrent Bladder Cancer: A Retrospective Case Series.
Perm J. 2015 Fall;19(4):76-83. doi: 10.7812/TPP/15-018.
- Disappearance of an advanced adenomatous colon polyp after intratumoural injection with Viscum album (European mistletoe) extract: a case report. von Schoen-Angerer T, Goyert A, Vagedes J, Kiene H, Merckens H, Kienle GS.J Gastrointestin Liver Dis. 2014 Dec;23(4):449-52. doi: 10.15403/jgld.2014.1121.234.acpy.
- Viscum Album in the Treatment of a Girl With Refractory Childhood Absence Epilepsy. von Schoen-Angerer T, Madeleyn R, Kienle G, Kiene H, Vagedes J.J Child Neurol. 2015 Jul;30(8):1048-52. doi: 10.1177/0883073814541473. Epub 2014 Jul 17.
- Improvement of Asthma and Gastroesophageal Reflux Disease With Oral Pulvis stomachicus cum Belladonna, a Combination of Matricaria recutita, Atropa belladonna, Bismuth, and Antimonite: A Pediatric Case Report. von Schoen-Angerer T, Madeleyn R, Kiene H, Kienle GS, Vagedes J.Glob Adv Health Med. 2016 Jan;5(1):107-11. doi: 10.7453/gahmj.2015.019. Epub 2016 Jan 1.
- Use of Iscador, an extract of European mistletoe (Viscum album), in cancer treatment: prospective nonrandomized and randomized matched-pair studies nested within a cohort study. Grossarth-Maticek R, Kiene H, Baumgartner SM, Ziegler R.Altern Ther Health Med. 2001 May-Jun;7(3):57-66, 68-72, 74-6 passim
WHAT A LIST!
It makes several things very clear to me:
- Kiene is a productive researcher
- He likes observational studies and case reports
- He dislikes the idea of rigorously testing a hypothesis
- He never publishes a negative finding about anthroposophical medicine
- He certainly deserves to be admitted to the ALTERNATIVE MEDICINE HALL OF FAME!
Welcome Helmut
The ‘University College of Osteopathy’ announced a proposal to merge with the AECC University College (AECC UC). Both institutions will seek to bring together the two specialist providers to offer a “unique inter-disciplinary environment for education, clinical practice and research in osteopathy, chiropractic, and across a wide range of allied health and related disciplines”.
The partnership is allegedly set to unlock significant opportunities for growth and development by bringing together the two specialist institutions’ expertise and resources across two locations – in Dorset and central London.
As a joint statement, Chair of the Board of Governors at AECC UC, Jeni Bremner and Chair of the Board of Governors at UCO, Professor Jo Price commented:
“We believe the proposed merger would further the institutional ambitions for both of our organisations and the related professional groups, by allowing us to expand our educational offering, grow student numbers and provide a unique inter-disciplinary training environment, providing students the opportunity to be immersed in multi-professional practice and research, with exposure to and participation in multi-disciplinary teams.
“There is also an exciting and compelling opportunity to expedite the development of a nationally unique, and internationally-leading MSK Centre of Excellence for Education and Research, developed and delivered across our two sites.”
The announcement is accompanied by further uncritical and promotional language:
Established as the first chiropractic training provider in Europe, AECC UC has been at the forefront of evidence-based chiropractic education, practice and research for more than 50 years. The institution is on an exciting journey of growth and development, having expanded and diversified its academic portfolio and activity beyond its traditional core offering of chiropractic across a broad range of allied health courses and apprenticeships, working closely with NHS, local authority and other system partners across Dorset and the south-west. The proposed merger with UCO would allow AECC UC to enhance the breadth and depth of its offer to support the expansion and development of the health and care workforce across a wider range of partners.
Now in its 106th year, UCO is one of the UK’s leading providers of osteopathic education and research with an established reputation for creating highly-skilled, evidence-informed graduates. UCO research is recognised as world-leading, delivering value to the osteopathic and wider health care community.
Sharon Potter, Acting Vice-Chancellor of UCO, said:
“As an institution that has long been at the forefront of osteopathic education and research, we are committed to ensuring further growth and development of the osteopathic profession.
“UCO has been proactively considering options to future-proof the institution. Following a review of strategic options, UCO is delighted by the proposed merger, working closely with AECC UC to ensure that UCO and osteopathy thrives as part of the inter-professional health sciences landscape, both academically and clinically. There is significant congruence between UCO and AECC UC in our strong aligned values, commitment to and delivery of excellent osteopathic education, clinical care and research, and opinion leadership.
“AECC UC has a strong track record of respecting the differences in professions, evidenced by the autonomy across the 10 different professional groups supported by the institution. The merger will not only mean we are protecting UCO through preserving its osteopathic heritage and creating a sustainable future, but that our staff and students can collaborate with other professional groups such as physiotherapy, chiropractic, sport rehabilitation, podiatry and diagnostic imaging, in a multidisciplinary MSK and rehabilitation environment unlike anywhere else in the UK.”
Professor Lesley Haig, Vice-Chancellor of AECC UC, commented:
“Preserving the heritage of UCO and safeguarding its future status as the flagship osteopathy training provider in the UK will be critical, just as it has been to protect the chiropractic heritage of the AECC brand. UCO is seen as synonymous with, and reflective of, the success of the osteopathy profession and we fully recognise and respect the important role that UCO plays not only as a sector-leading provider of osteopathic education, research and clinical care, but as the UK’s flagship osteopathy educational provider.
“Overall it is clear that UCO and AECC UC already have a common values base, similar understanding of approaches to academic and clinical delivery, and positive relationships upon which a future organisational structure and opportunities can be developed. It’s an exciting time for both institutions as we move forward in partnership to create something unique and become recognised nationally and internationally as a centre of excellence.”
The proposed merger would continue the already founded positive relations between the institutions, where regular visits, sharing of good practice, and collaborative research work are already taking place. Heads of terms for the potential merger have now been agreed and both institutions are entering into the next phase of discussions, which will include wide consultation with staff, students and other stakeholders to produce a comprehensive implementation plan.
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In case this bonanza of platitudes and half-truths has not yet overwhelmed you, I might be so bold as to ask 10 critical questions:
- What is an “evidence-based chiropractic education”? Does it include the messages that 1) subluxation is nonsense, 2) chiropractic manipulations can cause harm, 3) there is little evidence that they do more good than harm?
- How an an “expansion and development of the health and care workforce” be anticipated on the basis of the 3 points I just made?
- What does the term “evidence-informed graduates” mean? Does it mean they are informed that you teach them nonsense but instruct them to practice this nonsense anyway?
- Do “options to future-proof the institution” include the continuation of misleading the public about the value of chiropractic/osteopathy?
- Does the”delivery of excellent osteopathic education, clinical care and research, and opinion leadership” account for the fact that the evidence for osteopathy is weak at best and for most conditions negative?
- By “preserving its osteopathic heritage”, do you intend to preserve also the reputation of your founding father, Andrew Taylor Still, who did many dubious things. In 1874, for instance, he was excommunicated by the Methodist Church because of his “laying on of hands”; specifically, he was accused of trying to emulate Jesus Christ, labelled an agent of the Devil, and condemned as practicing voodoo. Or do you prefer to white-wash the osteopathic heritage?
- You also want “to protect the chiropractic heritage”; does that mean you aim at white-washing the juicy biography of the charlatan who created chiropractic, DD Palmer, as well?
- “UCO and AECC UC already have a common values base” – what are they? As far as I can see, they mainly consist in hiding the truth about the uselessness of your activities from the public.
- How do you want to “recognised nationally and internationally as a centre of excellence”? Might it be a good idea to begin by critically assessing your interventions and ask whether they do more good than harm?
- Crucially, what is really behing the merger that you are trying to sell us with such concentrated BS?
Anja Zeidler (born 1993) became known in 2012 as the most successful fitness personality in Switzerland. After joining the bodybuilding scene in Los Angeles, a phase of self-discovery followed. Anja published her development and became what one nowadays calls an ‘INFLUENCER’. As Managing Director and Content Director of her own company, Anja Zeidler GmbH, Anja has made a name for herself as a public figure far beyond the fitness market with her activities as a ‘Selflove Influencer’, blogger, book author, motivational speaker, presenter and expert in the food & health sector. Furthermore, she is completing a degree at the Academy of Naturopathy for Holistic Health.
About a year and a half ago, Anja Zeidler had a desmoid tumor removed from under her left breast – and now it was reported to be back. The conventional treatment methods are clear: another surgical procedure or radiation. But Zeidler said she wants to wait with such interventions. For the time being, she has decided to go her own way. She wants to “balance any imbalances” with her naturopathic doctor and wishes to fight the disease on her own and with a “positive mindset.”
“On a spiritual level, they say that tumors can be related to trauma. That’s why I’ve tried breathing exercises and cocoa ceremonies. With these methods, I get into my subconscious and get closer to traumas, which I am not aware of, and try to dissolve them. So far, blatant things have come up that I had long forgotten and repressed,” she says enthusiastically. In addition, Zeidler wants to give up refined sugar with immediate effect, keep better control of her diet in general – even in her stressful everyday life – and drink freshly squeezed celery and beetroot juice every morning. In addition, she relies on “natural capsules with and grape seed OPC.” “I’ve read in studies that certain types of fungi and strong antioxidants like OPC are supposed to fight tumor cells.” There I follow the motto: ‘if it doesn’t help, at least it does not harm.'”
Zeidler’s tumor is a desmoid tumor, an abnormal growth that arises from connective tissues. These tumors are generally not considered malignant because they do not spread to other parts of the body; however, they can aggressively invade the surrounding tissue and can be very difficult to remove surgically. These tumors often recur, even after apparently complete removal.
Zeidler commented: “I am convinced that with a positive mindset you can contribute extremely much to the healing process. If the checks reveal rapid growth, I will of course seek medical treatment. Then I would opt for radiation.”
The trouble with ‘influencers’ is that they are gullible and influence the often gullible public to become more gullible. Thus their influence might cost many lives. Personally, I hope that the young woman does well with her erstwhile refusal of evidence-based treatments. Yet, I fear that the ‘Academy of Naturopathy for Holistic Health’ will teach her a lot of BS about the power of natural cancer cures. The sooner she agrees to have her tumor treated based on evidence, the better her prognosis, I’m sure.
The COVID-19 pandemic has been notable for the widespread dissemination of misinformation regarding the virus and appropriate treatment. The objective of this study was to quantify the prevalence of non–evidence-based treatment for COVID-19 in the US and the association between such treatment and endorsement of misinformation as well as lack of trust in physicians and scientists.
This single-wave, population-based, nonprobability internet survey study was conducted between December 22, 2022, and January 16, 2023, in US residents 18 years or older who reported prior COVID-19 infection.
Self-reported use of ivermectin or hydroxychloroquine, endorsing false statements related to COVID-19 vaccination, self-reported trust in various institutions, conspiratorial thinking measured by the American Conspiracy Thinking Scale, and news sources.
A total of 13 438 individuals (mean [SD] age, 42.7 [16.1] years; 9150 [68.1%] female and 4288 [31.9%] male) who reported prior COVID-19 infection were included in this study. In this cohort, 799 (5.9%) reported prior use of hydroxychloroquine (527 [3.9%]) or ivermectin (440 [3.3%]). In regression models including sociodemographic features as well as political affiliation, those who endorsed at least 1 item of COVID-19 vaccine misinformation were more likely to receive non–evidence-based medication (adjusted odds ratio [OR], 2.86; 95% CI, 2.28-3.58). Those reporting trust in physicians and hospitals (adjusted OR, 0.74; 95% CI, 0.56-0.98) and in scientists (adjusted OR, 0.63; 95% CI, 0.51-0.79) were less likely to receive non–evidence-based medication. Respondents reporting trust in social media (adjusted OR, 2.39; 95% CI, 2.00-2.87) and in Donald Trump (adjusted OR, 2.97; 95% CI, 2.34-3.78) were more likely to have taken non–evidence-based medication. Individuals with greater scores on the American Conspiracy Thinking Scale were more likely to have received non–evidence-based medications (unadjusted OR, 1.09; 95% CI, 1.06-1.11; adjusted OR, 1.10; 95% CI, 1.07-1.13).
The authors concluded that, in this survey study of US adults, endorsement of misinformation about the COVID-19 pandemic, lack of trust in physicians or scientists, conspiracy-mindedness, and the nature of news sources were associated with receiving non–evidence-based treatment for COVID-19. These results suggest that the potential harms of misinformation may extend to the use of ineffective and potentially toxic treatments in addition to avoidance of health-promoting behaviors.
This study made me wonder to what extend a lack of trust in physicians or scientists, and conspiracy-mindedness are also linked to the use of so-called alternative medicine (SCAM) for treatning COVID infections. As I have often discussed, such associations have been reported regularly, e.g.:
- Homeopathy as an Adjuvant to Standard Care in Moderate and Severe Cases of COVID-19
- Arrests in Germany of healthcare professionals who issued fake COVID certificates
- Classical homeopathy worsens the prognosis of patients infected with COVID-19.
- “No jabby-jabby for me! Praise GOD!” But now this antivaxer has died of COVID-related pneumonia
- Homeopathy for COVID: opinions expressed on Twitter
- Efficacy of Persian barley water on clinical outcomes of hospitalized moderate-severity COVID-19 patients
- Effectiveness of Homeopathic Arsenicum album 30C in the Prevention of COVID-19
- Homoeopathy in the Prophylaxis and Symptomatic Management of COVID-19
- Is aromatherapy the answer to long-COVID? I fear not!
- Anthroposophical hospital defies COVID-19 regulations
- An Ayurvedic medication is effective for patients suffering from mild to moderate COVID-19 – true or false?
- Homeopathy for COVID-19: A randomized, double-blind, placebo-controlled trial shows that it does not work
- Micronutrient supplements for patients with COVID-19 infection
- A new trial of homeopathy for preventing COVID-19 infections
- Homeopathy and other SCAMs for long-COVID: WHERE IS THE EVIDENCE?
- Upper Bavaria is struggling with COVID-19, not least due to so-called alternative medicine
- And again: is vitamin C the solution for COVID-19 infections?
- Parents’ Willingness to Vaccinate with a COVID-19 Vaccine: strongly influenced by homeopathy
- A new study of homeopathy for the prevention of COVID-19 infections
- Homeopathic Treatment for COVID-19: a case of scientific misconduct and/or irresponsible behavior?
- The ‘AYUSH COVID-19 Helpline’: have they gone bonkers?
- Adjunctive homeopathic treatment of hospitalized COVID-19 patients. A case study of homeopathic delusion
- US Chiropractor in court for making false claims related to COVID-19
- Chinese Herbal Medicine for COVID-19? The evidence remains unconvincing
- Vitamin C and/or zinc for managing COVID patients?
- An RCT on the efficacy of ayurvedic treatment on asymptomatic COVID-19 patients
- Herbal solutions to the COVID-19 pandemic?
The authors point out that the endorsement of misinformation related to COVID-19 has been shown to decrease the intention to vaccinate against COVID-19, to decrease the belief that it is required for herd immunity, and to correlate with forgoing various COVID-19 prevention behaviors. Such false information is largely spread online and often originates as disinformation intentionally spread by political actors and media sources, as well as illicit actors who profit from touting supposed cures for COVID-19. A substantial minority of the public endorses false information related to COVID-19, although certain subgroups are more likely to do so, including those who are more religious, who distrust scientists, and who hold stronger political affiliations. Cultivating and maintaining trust is a crucial factor in encouraging the public to engage in prosocial health behaviors. The extent to which addressing conspiratorial thinking could represent a strategy to address obstacles to public health merits further investigation.
The current BMJ has an article entitled UK could have averted 240 000 deaths in 2010s if it matched other European nations. Here is its staring passage:
The UK has fallen far behind its international peers on a range of health outcomes and major policy reforms are required to reverse this, a report1 has concluded.
Analysts from the Institute for Public Policy Research (IPPR) calculated that there would have been 240 000 fewer deaths in the UK between 2010 and 2020 if the UK matched average avoidable mortality in comparable European nations.
The report says the UK’s poor outcomes are partly down to people’s inability to access healthcare in a timely manner, a problem that has intensified since the pandemic.
To tackle this, the progressive think tank has put forward a 10 point plan to shift the NHS from a sickness service to a prevention service. It says primary care should be placed at the heart of a “prevention first” NHS with a nationwide rollout of neighbourhood health hubs to deliver integrated health and care services in every local area…
INTEGRATED HEALTH?
Isn’t that the nonsense Charles III, Michael Dixon, THE COLLEGE OF MEDICINE AND INTEGRATED HEALTH and many others promote? The integrated health we discussed so often before, e.g.:
- Prince Charles becomes patron of the ‘College of Medicine and Integrated Health’
- The ‘All-Party Parliamentary Group for Integrated Healthcare (PGIH) have just published a new report – and it’s full of surprises
- Eurocam press release in favor of integrated medicine
- A new definition of ‘INTEGRATED MEDICINE’
- Integrative medicine: one of the most colossal deceptions in healthcare today
- INTEGRATED MEDICINE: a disservice to patients?
- Integrated/integrative medicine: a paradise for charlatans?
The UK ‘Integrated Medicine Alliance’ offers information sheets on all of the following treatments: Acupuncture, Alexander Technique, Aromatherapy, Herbal Medicine, Homeopathy, Hypnotherapy, Massage, ,Naturopathy, Reflexology, Reiki, Tai Chi, Yoga Therapy. The one on homeopathy, for example, tells us that “homeopathy … can be used for almost any condition either alone or in a complementary manner.” Is the BMJ thus promoting homeopathy and similar dubious treatments?
The answer is, of course, NO!
The BMJ supports INTEGRATED HEALTH as defined not by quacks but by real experts: “Integrated care, also known as integrated health, coordinated care, comprehensive care, seamless care, or transmural care, is a worldwide trend in health care reforms and new organizational arrangements focusing on more coordinated and integrated forms of care provision. Integrated care may be seen as a response to the fragmented delivery of health and social services being an acknowledged problem in many health systems.”
I have often wondered why quacks use established terms, give it a different meaning and use it for confusing the public. I suppose the answer is embarrassingly simple: they thrive on confusion, want to hide the fact that they have no convincing arguments of their own, and like to use the established terminology of others in order to push their agenda and maximize their benefits.
This randomised, double blind controlled trial compared the efficacy of curcumin versus omeprazole in improving patient reported outcomes in people with dyspepsia.
The interventions were:
- curcumin alone (C),
- omeprazole alone (O),
- curcumin plus omeprazole (C+O).
Patients in the combination group received two capsules of 250 mg curcumin, four times daily, and one capsule of 20 mg omeprazole once daily for 28 days.
Main outcome measure was unctional dyspepsia symptoms on days 28 and 56, assessed using the Severity of Dyspepsia Assessment (SODA) score. Secondary outcomes were the occurrence of adverse events and serious adverse events.
A total of 206 patients were enrolled in the study and randomly assigned to one of the three groups; 151 patients completed the study. Demographic data (age 49.7±11.9 years; women 73.4%), clinical characteristics and baseline dyspepsia scores were comparable between the three groups. Significant improvements were observed in SODA scores on day 28 in the pain (−4.83, –5.46 and −6.22), non-pain (−2.22, –2.32 and −2.31) and satisfaction (0.39, 0.79 and 0.60) categories for the C+O, C, and O groups, respectively. These improvements were enhanced on day 56 in the pain (−7.19, –8.07 and −8.85), non-pain (−4.09, –4.12 and −3.71) and satisfaction (0.78, 1.07, and 0.81) categories in the C+O, C, and O groups, respectively. No significant differences were observed among the three groups and no serious adverse events occurred.
The authors concluded that curcumin and omeprazole had comparable efficacy for functional dyspepsia with no obvious synergistic effect.
This study, which was funded by the Thai Traditional and Alternative Medicine Fund, has been picked up by the press and is being lauded as a solid proof of efficacy. Its authors too are not half proud of their splendid trial:
This multicentre randomised controlled trial provides highly reliable evidence for the treatment of functional dyspepsia. PPIs, widely used and approved for over-the-counter use, were compared with curcumin, a popular herbal remedy. The study design, including double blind randomisation, minimised biases. Participants met strict criteria, underwent endoscopy and were tested for H pylori infection. Furthermore, we implemented measures to minimise biases by ensuring that the individuals administering the drugs, participants receiving the drugs and individuals conducting the assessment remained blinded to the type of medications administered to the participants. The trial was carried out in hospitals, and certified individuals used standardised questionnaires for assessments. Statistical methods were appropriate and followed accepted principles.
Two follow-up appointments were scheduled, and blood tests showed no abnormal symptoms or liver function abnormalities. However, participants with high body mass index indicated a trend towards liver function impairment in the curcumin group, suggesting the need for larger studies. Some participants did not provide follow-up information, which is a study weakness. However, the number of participants who provided this information was sufficient for statistical analysis and the majority of the participants attended the follow-up visit. Therefore, it can be deduced from the results that even if the number of participants followed after drug administration increased, the study findings would not be significantly different. Another limitation of this study was the absence of long term follow-up data for all patients after treatment. This is a question that will require further investigation.
The strength of the study lies in its relevance to daily clinical practice, providing additional drug options in addition to PPIs alone, without added side effects. The study was unbiased, partially funded by government organisations and the first well designed trial comparing curcumin with PPI for functional dyspepsia, with confirmation through endoscopy and ruling out H pylori infection. Limitations of this study included the small number of patients who were lost to follow-up and the lack of long term follow-up data.
However, I am far less impressed.
Why?
Curcumin is bright yellow and has a very distinct taste/smell. Even though curumin was given in capsules, patients can easily tell what they are taking. I therefore doubt that they were adequately blinded. In fact, the authors seem to agree when they state the following:
We observed that despite improvements in pain and non-pain scores, there was no significant improvement in the SODA satisfaction scores in the O and C+O groups (table 3). A possible explanation for this observation could be related to the taste and/or smell of curcumin, which might have caused reduced pleasantness for the participants while ingesting it. This potential discomfort could offset the improvements in pain and non-pain symptoms, leading to the non-significant change in satisfaction score. Further studies may be needed to explore this hypothesis as well as to improve the palatability of curcumin.
Sadly, the success of blinding (which under such circumstances should always be tested) was not reported and probably not even quantified. If many patients were de-blinded, it seems inevitable that their expectation influenced the results. In other words, the much-lauded effect of curcumin might just be due to placebo and curcumin might be entirely useless. Or, to put it bluntly, the trial was not nearly as good as many made it out to be.
PS
Sad to see that the reviewers of a reputable journal failed to pick up on this significant flaw.
King Charles III is an enthusiastic, albeit uncritical proponent of so-called alternative medicine (SCAM). Does that boost his popularity in the general population? Or does it have the opposite effect? I am not aware of reliable data on this issue, yet I suspect it is neither here nor there. So, his waning popularity is probably caused by other factors.
A survey of more than 2,000 adult Brits found that overall, 62% want to keep the monarchy and 59% of people thought Charles was “personally doing a good job”.. At first glance, this looks not too bad for Charles and William but a more detailed analysis is far less optimistic: among 18 to 24-year-olds, only 30% say the monarchy is “good for Britain”. This “remarkable difference between generations”, demonstrates that younger people are much less supportive on remaining a monarchy and more sceptical about the Royal Family representing good value for money.
A decade ago, the same YouGov tracking survey found 17% preferred an elected head of state, which in this latest survey has risen to 26%. On the question whether Britain should continue to be a monarchy or be replaced with an elected head of state, the poll found:
- 62% wish no change,
- 26% want an elected head of state,
- 11% don’t know.
On the question whether the Royal Family is good value for money, 75% of the over-65s believe they are, but only 34% of 18 to 24-year-olds feel the same. And while 80% of the over-65s want Britain to stay as a monarchy, that figure falls to 37% for the 18 to 24-year-olds. There is also less support for the royals in Scotland or Wales than in England, where London has higher levels of people against the monarchy than elsewhere in the country.
Historian and royal commentator Ed Owens says the lack of support among the young should “certainly be of concern” to the Royal Family. But he says it will be difficult for the royals to turn this around, when many of the factors are outside their control. Dr Owens says opposition to the monarchy is part of a wider sense of “disenchantment” for younger generations about issues such as unaffordable housing, stagnant wages and student debt. “The system doesn’t seem to be working for them, so why should they celebrate an institution that seems to be at the heart of that system?” says Dr Owens.
Graham Smith, chief executive of the anti-monarchy campaign Republic, said the survey showed a “general trend of falling support, and that younger people will not be won back to the monarchist cause. Sooner rather than later we’ll see support for the monarchy fall below 50%.”
When the 1st edition of my book about about Charles’ (at the time, he was still ‘Prince of Wales’) love affair with SCAM came out, it was reviewd by the Daily Mail. They courageously asked Charles’ press office for a comment on it. A Clarence House spokesperson then told the journalist: ‘The Prince of Wales believes in combining the best of evidence based, conventional medicine with an holistic approach to healthcare – treating the whole person rather than just the symptoms of disease and taking into account the effects on health of factors such as lifestyle, the environment and emotional well-being.’ I know this is not all that meaningful and just a (fairly daft and uninformed) formular for getting rid of a tedious request, yet – for what it’s worth – it does not indicate that, in the realm of SCAM, Charles is all that open to change. More recent activities of King Charles seem to support this impression.
With regards to his overall popularitiy in the UK, this might mean that Charles will continue to lose the support of skeptics, while gaining the one of SCAM enthusiasts.
And the net result of this?
I fear it will almost be negligible.
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.
“The decline of homeopathy, the ‘medicine’ that doesn’t cure anything” is the title of a remarkable article in EL PAIS of which I take the liberty of showing you a few key passages:
In the more than 200 years that have passed since its invention, no one has been able to prove that homeopathy is actually capable of curing anything with its alleged medicines that have no active ingredients…
…EL PAÍS reached out to some of its main promoters, such as the pharmaceutical company Boiron, leader in the sector; the Spanish Association of Homeopathy Pharmacists and the Spanish Society of Homeopathic Doctors. In the absence of a response from all three, the explanations are given by experts who are more critical of the discipline.
Many people who used to consume homeopathy were not even aware that this was the case. Fernando Frías, one of the activists who worked to undermine the discipline’s remaining prestige, recalls that people did not believe them when they were told that compounds with diluted Berlin Wall were sold to overcome the feelings of oppression and anxiety. This was actually commercialized under the premise that “like cures like”: if the Berlin Wall oppressed, a piece of it diluted in water should remedy it. “Many were under the impression that it was just a natural therapy and that we were making things up to attack it,” says Frías…
… There has been a lot of debate about how to regulate an alleged drug whose only effect is, in truth, the placebo effect. In 2001, the European Parliament issued a directive that covered its use in countries with a homeopathic tradition; sources explain that this happened due to the pressure exerted by both the industries and the governments of countries where pseudoscience is deep-rooted, such as France (where Boiron is headquartered) or Germany, where its consumption is much higher than in others, such as Spain.
“Having regard to the particular characteristics of these homeopathic medicinal products, such as the very low level of active principles they contain and the difficulty of applying to them the conventional statistical methods relating to clinical trials, it is desirable to provide a special, simplified registration procedure for those homeopathic medicinal products which are placed on the market without therapeutic indications in a pharmaceutical form and dosage which do not present a risk for the patient,” states the directive.
In its more than two centuries of history, this is not the first time that homeopathy loses ground. Still, Frías warns, it cannot be ruled out that at some point something will come up that will make it fashionable again. “Look at the example of chemtrails [the condensation trails left by airplanes that some conspiracy theorists believe are a way of poisoning the population from the air]. It seemed that no one remembered them anymore, but now they’re back,” he says. Frías cites the astrophysicist and disseminator Javier Armentia, who states that beliefs are like a rubber duck: no matter how much they sink, they always resurface. “Especially if there is money behind,” he adds.
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As reported previously, homeopathy and other forms of so-called alternative medicine (SCAM) have come under fire in Spain. In 2017, ‘HOMEOPATHY PLUS‘ reported that “in a reversal of the 2015 Royal Legislative Decree, the Minister of Health has withdrawn homeopathic remedies and outlawed the practice in Spain’s national health services.” In 2018, more than 400 people signed an open letter triggered by the case of a cancer patient who died after preferring homeopathy to regular treatment. “Let’s be clear: pseudoscience kills,” begins the letter. Since then, the struggle of Spanish rational thinkers to stop misleading information about SCAM in general and homeopathy, in particular, has only intensified.
Spain is thus joining other European countries in opposing misinformation about homeopathy. Contrary to what some have claimed (for instance, in the comments section of this blog), most of the opponents do not want to restrict the public’s choice. People who wish to use homeopathy should be able to do so (but should pay for it themselves). However, the choice must be based on evidence-based information.
