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

satire

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Prof Harald Walach has had a few rough weeks. First, he published his paper suggesting that Covid vaccinations do more harm than good which was subsequently retracted as flawed, if not fraudulent. Next, he published a paper showing that children are put in danger when wearing face masks suggesting that “decision-makers weigh the hard evidence produced by these experimental measurements accordingly, which suggest that children should not be forced to wear face masks.” Now, the journal put out the following announcement about it:

The Research Letter, “Experimental Assessment of Carbon Dioxide Content in Inhaled Air With or Without Face Masks in Healthy Children: A Randomized Clinical Trial,” by Harald Walach, PhD, and colleagues published online in JAMA Pediatrics on June 30, 2021,1 is hereby retracted.

Following publication, numerous scientific issues were raised regarding the study methodology, including concerns about the applicability of the device used for assessment of carbon dioxide levels in this study setting, and whether the measurements obtained accurately represented carbon dioxide content in inhaled air, as well as issues related to the validity of the study conclusions. In their invited responses to these and other concerns, the authors did not provide sufficiently convincing evidence to resolve these issues, as determined by editorial evaluation and additional scientific review. Given fundamental concerns about the study methodology, uncertainty regarding the validity of the findings and conclusions, and the potential public health implications, the editors have retracted this Research Letter.

To make things even worse, Walach’s University fired him because of his fraudulent anti-vax research. Poznan University of Medical Sciences tweeted on 6 July:

We wish to emphasize that the claims included in dr Harald Walach’s recent article in @Vaccines_MDPI do not represent the position of @PUMS_tweets . We find that the article lacked scientific diligence and proper methodology. Dr. Walach’s affiliation with PUMS was now terminated. Throughout the pandemic PUMS has actively promoted vaccination programs, offering scientific expertise in the media, broadcasting seminars, and reported on progress of the vaccination program. We consider vaccinations as the paramount tool in the global fight against the pandemic. We consider vaccinations as the paramount tool in the global fight against the #pandemic. Over 85% of our own academic community has already been vaccinated with support and encouragement from the University.

As I said, this is truly unlucky …

.. or perhaps not?

Come to think of it, it is lucky when pseudo-science and fraud are called out. It means that the self-cleaning mechanisms of science are working and we are protected from the harm done by charlatans.

Regular readers of this blog will know the US homeopath, Dana Ullman. He has been the star of several of my posts (for instance here, here, and here). Dana is prolific in his writing but he has published not published much in proper journals. Now he has almost doubled this list by publishing TWO (!) proper papers in real journals within just one month.

Congratulations, Dana!

The first is in CUREUS, a very unusual journal with a most unusual peer-review process. Allow me to show you the abstract of Dana’s article:

Homeopathic medicine is a controversial system of medicine that has been used worldwide for over 200 years. Recently, several governments, in part, owing to government-funded reviews of research on homeopathic medicine, have stopped reimbursements for homeopathic medicines and have discouraged their use by medical professionals. This review critically evaluates four government-funded reviews of clinical research on homeopathic medicine. An analysis of government-sponsored reviews of clinical research on homeopathic medicine was conducted, including two studies from Switzerland, one from England, and one from Australia. Three of the four government-funded reviews were critical of homeopathy, claiming that there was no reliable evidence that homeopathic medicines were effective. Three of these reviews had significant flaws, with potential ethical concerns raised in one of the reviews. The most comprehensive review of homeopathic research, including analysis of clinical and basic science concerns, found the most positive results for homeopathy.

The second paper was published in a journal called DOSE RESPONSE. The editor in chief of this journal is Prof E J Calabrese who has published numerous articles about homeopathy/hormesis. Here is the abstract of Dana’s 2nd article:

Serially diluted succussed solutions of a suitable drug/toxic substance can exhibit physicochemical and biological properties even far beyond Avogadro’s limit defying conventional wisdom. They can show hormesis, and homeopathy uses them as medicines. Many studies confirm that they can have an impact on gene expression different than controls. Water in the exclusion zone phase can have memory but for a short period. However, the nanoparticle as the physical substrate can hold information. Nanoparticle and exclusion zone duo as nanoparticle-exclusion zone shell can provide a prolonged memory. The Nanoparticle-Exclusion Zone Shell Model may be an important step toward explaining the nature and bioactivity of serially diluted succussed solutions used as homeopathic medicines. This model may also provide insight into the workings of hormesis. Hormesis is the primary phenomenon through which homeopathic phenomenon may have evolved exhibiting the principle of similars. Hahnemann exploited it to establish homeopathy. The nanoparticle-exclusion zone shells present in the remedy, selected on the principle of similars, can be patient-specific nanoparticles in a symptom syndrome-specific manner. They can carry the drug-specific information for safer clinical applications in an amplified form for high yielding. It suggests homeopathy is a type of nanopharmacology.

So, are Dana’s two articles significant? Both are reviews. The 1st tries to persuade us that homeopathy has clinical effects beyond placebo and that reports that say otherwise are full of errors and fraud and thus not reliable. The second tells us that these clinical effects of homeopathy can be explained by nano-pharmacology.

Is he right?

Please tell me what you think.

This study assessed the effects of being born under the zodiac sign Pisces on mortality. For that purpose, a retrospective observational study was conducted of the data from 26 Scandinavian intensive care units between 2009 and 2011. Patients aged 18 years or older with severe sepsis and in need of fluid resuscitation were included from the Scandinavian Starch for Severe Sepsis/ Septic Shock (6S) trial. The main outcome measure was the 90-day mortality.

The researchers included all 798 patients in the study; 70 (9%) of them were born under the sign of Pisces. The primary outcome (death within 90 days) occurred in 25 patients (35.7%) in the Pisces group, compared with 348 patients (48%) in the non-Pisces group (relative risk, 0.75; 95% CI, 0.54-1.03; one-sided P = 0.03).

The authors concluded that in a multicentre randomised clinical trial of IV fluids, being born under the sign of Pisces was associated with a decreased risk of death. Our study shows that with convenient use of statistics and an enticing explanatory hypothesis, it is possible to achieve significant findings in post-hoc analyses of data from large trials.

This is an excellent paper! It showcases the sort of nonsense one can do with datasets, statistics, and post hoc hypotheses. The authors entitled their article “Gone fishing in a fluid trial”, and this title should ensure that there are not some astrology nutters who mistake correlation for causation

… I hope

… but, of course, I am an optimist.

While working on yesterday’s post, I discovered another recent and remarkable article co-authored by Prof Harald Walach. It would surely be unforgivable not to show you the abstract:

The aim of this study is to explore experiences and perceived effects of the Rosary on issues around health and well-being, as well as on spirituality and religiosity. A qualitative study was conducted interviewing ten Roman Catholic German adults who regularly practiced the Rosary prayer. As a result of using a tangible prayer cord and from the rhythmic repetition of prayers, the participants described experiencing stability, peace and a contemplative connection with the Divine, with Mary as a guide and mediator before God. Praying the Rosary was described as helpful in coping with critical life events and in fostering an attitude of acceptance, humbleness and devotion.

The article impressed me so much that it prompted me to design a virtual study for which I borrowed Walach’s abstract. Here it is:

The aim of this study is to explore experiences and perceived effects of train-spotting on issues around health and well-being, as well as on spirituality. A qualitative study was conducted interviewing ten British adults who regularly practiced the art of train-spotting. As a result of using a tangible train-spotter diary and from the rhythmic repetition of the passing trains, the participants described experiencing stability, peace, and a contemplative connection with the Divine, with Mary as a guide and mediator before the almighty train-spotter in the sky. Train-spotting was described as helpful in coping with critical life events and in fostering an attitude of acceptance, humbleness, and devotion.

These virtual results are encouraging and encourage me to propose the hypothesis that Rosary use and train-spotting might be combined to create a new wellness program generating a maximum holistic effect. We are grateful to Walach et al for the inspiration and are currently applying for research funds to test our hypothesis in a controlled clinical trial.

 

Rudy Giuliani, the former mayor of New York and legal advisor of Donald Trump, is already facing a billion-dollar lawsuit for defamation. He also had his license to practice law revoked by the New York Bar Association for spreading lies about the 2020 election. I therefore can imagine that he needs some cheering up and could do with some good news.

Well, Rudy, here it is!

Giuliani has been given a very special award.

In recognition of his truly outstanding achievements in dishonesty and his contribution to disinformation, Rudy Giuliani is the winner of the Center for Inquiry’s first Full of Bull Award!

A rogue’s gallery of celebrity hucksters was drawn up who best represent the threat posed by the wholesale rejection of reality. Calling out these infamous purveyors of flimflam and nonsense, the Center for Inquiry asked the public to vote for who was the worst offender.

It could not have been an easy choice, but now the voters have spoken: 41.7 percent of voters chose Giuliani over these other superspreaders of the infodemic:

Why Giuliani? He really gave his all to rise above the field over the past year as a dedicated champion of bogus COVID-19 cures at the peak of a global pandemic and chief spreader of the highly dangerous Big Lie about the 2020 election. “America’s Mayor” no more, Giuliani has slid to the fringes of conspiracy theories and quack medicine, truly embodying what it takes to be an all-around Full of Bull champion.

At the time of reporting, no reaction of the awardee was available. Yet, we can be confident that Rudy will treasure the award above all other distinctions and that he will display it prominently in his office. The Center for Inquiry wants to thank everyone for voting and for being a part of the reality-based community, it intends to remain committed to taking on bull artists of all stripes.

By guest blogger Michael Scholz

For several years, the “flower essences” invented by Dr. Edward Bach had a difficult time in the European Union and especially Germany. The manufacturers were regularly taken to court for violating the EU Health Claim Regulation. This now culminates in the fact that the manufacturer, Nelsons, who sells the “Original Bach Flowers” in Germany, was forced to rename its popular “Rescue” remedies.

What happened?

The “Rescue” remedies were promoted with statements such as “calm and strong through the day” and “recommended use in emotionally exciting situations, e.g. at work” or to “face emotional challenges”. The competitor, Annoyax Nutripharm, regarded this as a health-related statement that is prohibited according to the EU Health Claim Regulation. Since the “Bach Flower Remedies” are not considered to be medicinal products in Germany, they are treated as food supplements, according to a ruling by the Oberlandesgericht (Higher Regional Court) Hamburg in 2007.

As it is strictly forbidden to advertise food supplements with health-related claims that are unproven, Annoyax Nutripharm filed a lawsuit against Nelsons that all the way to the Bundesgerichtshof (Federal High Court of Justice) in Karlsruhe. Since the case concerned European law, the judges in Karlsruhe referred it to the European Court of Justice in Luxemburg.

The judges wanted two questions clarified: 1. Are the “Rescue” remedies to be regarded simply as Brandy due to their alcohol content of 27%? (in which case, health-related claims would be strictly forbidden). 2. Does the product’s name “Rescue” itself constitute a violation of the Health Claims Regulation?

The Luxemburg judges ruled “No” and “Yes”. “No”, it is not Brandy, although the „essences“ consist of a considerable quantity of alcohol, the recommended dose is too small to be intoxicating. But “Yes”, the term “Rescue” does indeed violate the Health Claim Regulation. So the plaintiff won – and what is the result?

When the Health Claims Regulation was enacted in 2005, a transition period until 2022 was established. This applied to all products that were sold using the same brand name and composition before 2005. This now gave the defendant – Nelsons – the opportunity to use Edward Bach’s 135th anniversary for launching an advertising campaign that praises the court-ordered renaming as „modernization“ for the 21st century. And as you see, the new name is a paragon of creativity, innovation & modernism, indeed (//irony:off): “Rescue” becomes – drum roll – “Rescura”. Yes, I looked just like that too…

This pyrrhic victory for the plaintiffs shows how important it is to protect the European citizens against misleading advertising. And – far more important – it is now established through a ruling of the Federal High Court of Justice that “Bach Flowers” are an esoterical concept devoid of medical evidence.

Vaccinations lead to masturbation! This surprising claim comes from Zita Schwyter, a Swiss anti-vaxxer, and practitioner of so-called alternative medicine (SCAM). Is there any evidence for a link? The only evidence I could find seems to suggest that the causal link (if there is one) goes in the opposite direction: “Women engaging in mutual masturbation were nearly two times more likely to decline the free vaccine.

In her practice, Schwyter offers homeopathic treatments, hara massage, “vaccination consultations”, quantum medicine, ‘Matrix Energetics’, colon cleansing, and other SCAMs. Schwyter claims that vaccinations cause “vaccination disease” with symptoms such as sleep disorders, dyslexia, stuttering, autism, brain tumors, the tendency to masturbate, allergic reactions, cancer, swelling and redness at the injection site, or aching limbs. According to Zita Schwyter, chronic diseases and autoimmune diseases have only been on the rise since vaccination was introduced, and that, according to her fallacious thinking, implies a causal relationship.

On the website of her practice, Schwyter tells us that “Fühlen Sie sich in guten Händen und vertrauen Sie Ihre Gesundheit der ganzheitlichen Gemeinschaftspraxis vor Ort an. Ein professionelles Therapeutenteam mit einem fundierten Fachwissen, jahrelangen Ausbildungen und weitreichenden Erfahrungen erwartet Sie.”  (Feel in good hands and entrust your health to the holistic group practice on site. A professional team of therapists with in-depth expertise, years of training and extensive experience awaits you.) And elsewhere, she states that “Durch meine berufliche Laufbahn verstehe ich mich deshalb als kompetentes Bindeglied zwischen Schulmedizin und Naturheilkunde, spezialisiert auf dem Gebiet der Homöopathie. Die richtige Person also, die Ihre Beschwerden ganzheitlich erfassen, richtig interpretieren und Sie mit dem angemessenen Behandlungskonzept zu besserer Gesundheit führen kann.” (Through my professional career, I therefore see myself as a competent link between conventional medicine and naturopathy, specializing in the field of homeopathy. The right person, therefore, who can grasp your complaints holistically, interpret them correctly and lead you to better health with the appropriate treatment concept.)

Homeopathy, Schwyter claims on the same site, can effectively treat the following conditions:

  • Joint pain
  • Rheumatism
  • Gout
  • Allergies
  • Neurodermatitis,
  • Acne
  • Shingles
  • Asthma
  • Hay fever
  • Varicose veins
  • Reynauds syndrome
  • Gynecological diseases
  • Pregnancy pains
  • Migraine
  • Chronic headache
  • Diarrhea
  • Constipation
  • Chronic bowel inflammation
  • Epilepsy
  • Multiple sclerosis
  • Parkinson’s disease
  • High blood pressure
  • Dizziness
  • Diabetes mellitus
  • Metabolic disorders
  • Liver/gall bladder problems
  • Acute and chronic childhood diseases
  • Growth and development disorders in children
  • Susceptibility to infections
  • Flu
  • Otitis media
  • Coughing
  • Convalescence from acute diseases
  • Chronic injury sequelae
  • Sleep disorders
  • Learning difficulties
  • Exhaustion
  • Nervousness
  • Depression
  • Anxiety
  • Obsessive-compulsive disorders
  • Diseases resistant to conventional medicine
  • And much more

Call me a skeptic, but somehow, I doubt Schwyter’s competence, expertise, and professionalism. But I do admire her humor!

You may not like it, but we do seem to live in the age of the ‘alternative truth’. It might necessitate reconsidering some of our definitions. A lie, for instance, was formerly defined as making an untrue statement with intent to deceive. Does that definition need to be revised in the age of the ‘alternative truth’?

Laura Kuenssberg, the political editor of the BBC, seems to think so. She recently published an interesting new definition of a lie: “… outright lying … is relatively rare. It is too easily found out. Only one senior politician still in the game has ever privately told me something that was utterly, entirely, and completely untrue.” She wrote this in an article about our PM, Boris Johnson who, by old standards, would probably qualify as a habitual liar. And as the BBC political editor cannot easily call him that, she conveniently moved the goal post and defined a lie to be something “utterly, entirely, and completely untrue”.

So, here we have it, the age of alternative truths has redefined the lie!

But I am not starting to write political rants – tempting though it often is – there is enough to rant about in so-called alternative medicine (SCAM). The questions I asked myself are these: how does SCAM measure up to the new Kuenssberg definition, and how gullible have we become?

Let’s play a little game to find out, shall we?

I provide 10 statements commonly used by the SCAM fraternity, and I ask you to consider which of them is “utterly, entirely, and completely untrue”.

  1. Chiropractic manipulations have been proven to do more good than harm.
  2. Acupuncture is effective for chronic pain.
  3. Homeopathy is supported by sound evidence.
  4. Homeopathic remedies act as nano-particles.
  5. Natural means safe.
  6. Integrative medicine is in the best interest of patients.
  7. Chiropractic subluxations do exist.
  8. Detox is a concept that makes sense.
  9. SCAM practitioners treat the root causes of disease.
  10. SCAM is cost-effective.

Next, please count the number of statements that are “utterly, entirely, and completely untrue”. This will give you a figure between 0 and 10. I propose that it can be used as a measure of gullibility.

I suggest the following grading:

  • 10 – 8 = not gullible
  • 7 – 5 = gullible
  • 4 – 2 = very gullible
  • 1 – 0 = dangerously gullible.

And here you have the ‘Edzard Ernst measure of gullibility’!

 

In Germany, homeopathy had a free ride for a very long time. In recent years, however, several doctors, pharmacists, scientists, etc. have started opposing the fact that the public has to pay for ineffective treatments such as homeopathics. As a consequence, homeopaths have begun to fight back. The weapons they chose are often not the most subtle. Now they seem to have reached a new low; the Board of the German Central Association of Homeopathic Physicians (DZVhÄ) has sent an open letter to the Board of the German Society of Internal Medicine (DGIM) and to the participating colleagues of the 127th Congress of the DGIM from April 17 – 20, 2021 in an attempt to stop an invited lecture of a critic of homeopathy.

Here is my translation of the letter:

Dear colleagues on the board of the DGIM,

We were very surprised to read that an ENT colleague will speak on homeopathy at the 127th Congress of Internal Medicine. Dr. Lübbers is known up and down the country as a media-active campaigner against homeopathy. His “awakening experience” he had, according to his own account, when he had to fish homeopathic pills out of the ear of a child with otitis, since then he is engaged – no: not for better education, in the mentioned case of the parents or other users – against the method homeopathy (which was certainly not “guilty” of the improper application!).

It has surely not escaped you that in all media again and again only a small handful of self-proclaimed “experts” – all from the clique of the skeptic movement! – are heard on the subject of homeopathy. A single (!) fighter against homeopathy is a physician who completed her training in homeopathy and practices for a time as a homeopath. All the others come from non-medical and other occupational groups. In contrast, there are several thousand medical colleagues throughout Germany who stand on the ground of evidence-based medicine, have learned conventional medicine, implement it in their practices, and have completed a recognized continuing education program in homeopathy.

In the German Central Association of Homeopathic Physicians – the oldest medical professional association in Germany – 146 qualified internists are currently registered as members, in addition to numerous other medical specialists, all of whom are actively practicing medicine.

Question: Why does the German Society for Internal Medicine invite an ENT specialist, of all people, who lectures on homeopathy without any expertise of his own? Why not at least a specialist colleague in internal medicine? Or even a colleague who could report on the subject from her own scientific or practical experience? For example, on the topic of “hyperaldosteronism,” would you also invite a urologist or orthodontist? And if so, why?

Dear Board of Directors of the DGIM: As an honorary board member of the German Central Association of Homeopathic Physicians e.V.. (DZVhÄ) – and a specialist in internal medicine – I am quite sure that we could immediately name several colleagues with sufficient expertise as homeopathically trained and experienced internists, if you are really interested in a solid and correct discourse on the subject of homeopathy. Under the above-mentioned circumstances, there is, of course, rather the suspicion that it should not be about, but rather exclusively against homeopathy.

If it is planned for a later congress, e.g. in 2022, to deal again with the topic of homeopathy in a truly professionally well-founded and possibly even more balanced form: please contact us at any time! As medical colleagues, we are very interested in a fair and unprejudiced professional discourse.

Yours sincerely

Dr. med. Ulf Riker, Internist – Homeopathy – Naturopathy

2nd chairman DZVhÄ / 1st chairman LV Bayern

________________

What are Riker and the DZVhÄ trying to say with this ill-advised, convoluted, and poorly written letter?

Let me try to put his points a little clearer:

  • They are upset that the congress of internists invited a non-homeopath to give a lecture about homeopathy.
  • The person in question, Dr. Lübbers, is an ENT specialist and, like all other German critics of homeopathy (apart from one, Dr. Grams), does not understand homeopathy.
  • There are thousands of physicians who do understand it and are fully trained in homeopathy.
  • They would therefore do a much better job in providing a lecture.
  • So, would the German internists please invite homeopaths for their future meetings?

And what is Riker trying to achieve?

  • It seems quite clear that he aims to prevent criticism of homeopathy.
  • He wishes to replace it with pro-homeopathy propaganda.
  • Essentially he wants to stifle free speech, it seems to me.

To reach these aims, he does not hesitate to embarrass himself by sending and making publicly available a very stupid letter. He also behaves in a most unprofessional fashion and does not mind putting a few untruths on paper.

Having said that, I will admit that they are in good company. Hahnemann was by all accounts a most intolerant and cantankerous chap himself. And during the last 200 years, his followers have given ample evidence that critical thinking has remained an alien concept for them. Consequently, such behavior seems not that unusual for German defenders of homeopathy. In recent times they have:

Quite a track record, wouldn’t you agree?

But, I think, attempting to suppress free speech beats it all and must be a new low in the history of homeopathy.

 

Previous studies have shown inconclusive results of homeopathy in the treatment of warts. A team of Indian homeopaths aimed to assess the feasibility of a future definitive trial, with a preliminary assessment of differences between effects of individualized homeopathic (IH) medicines and placebos in the treatment of cutaneous warts.

A double-blind, randomized, placebo-controlled trial (n = 60) was conducted at the dermatology outpatient department of D.N. De Homoeopathic Medical College and Hospital, West Bengal. Patients were randomized to receive either IH (n = 30) or identical-looking placebo (n = 30). Primary outcome measures were numbers and sizes of warts; the secondary outcome was the Dermatology Life Quality Index (DLQI) questionnaire measured at baseline, and every month up to 3 months. Group differences and effect sizes were calculated on the intention-to-treat sample.

Attrition rate was 11.6% (IH, 3; placebo, 4). Intra-group changes were significantly greater (all < 0.05, Friedman tests) in IH than placebo. Inter-group differences were statistically non-significant (all > 0.05, Mann-Whitney U tests) with small effect sizes-both in the primary outcomes (number of warts after 3 months: IH median [inter-quartile range; IQR] 1 [1, 3] vs. placebo 1 [1, 2]; p = 0.741; size of warts after 3 months: IH 5.6 mm [2.6, 40.2] vs. placebo 6.3 [0.8, 16.7]; p = 0.515) and in the secondary outcomes (DLQI total after 3 months: IH 4.5 [2, 6.2] vs. placebo 4.5 [2.5, 8]; p = 0.935). Thuja occidentalis (28.3%), Natrum muriaticum (10%) and Sulphur (8.3%) were the most frequently prescribed medicines. No harms, homeopathic aggravations, or serious adverse events were reported.

The Indian homeopaths draw the following conclusion: As regards efficacy, the preliminary study was inconclusive, with a statistically non-significant direction of effect favoring homeopathy. The trial succeeded in showing that an adequately powered definitive trial is both feasible and warranted.

INCONCLUSIVE?

No, the findings are not inconclusive at all! Read the results again: they confirm that homeopathy is a placebo therapy.

So, why is this trial worth writing about?

Surely, we did not expect anything else than a negative outcome from such a study?!

No, we didn’t.

But there is still something quite remarkable about this study: I have previously noted that virtually all studies of homeopathy by Indian researchers report positive results. AND THIS ONE DOESN’T!!!

Alright, it tries to hide the fact that the findings were negative, but this already seems to be a step in the right direction. So, well done, my Indian friends!!!

Perhaps one day, you will be able to admit that homeopathy is a placebo therapy?

 

 

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