survey
- pain,
- anxiety,
- fatigue,
- feelings (eg, happy, calm)
on 0- to 10-point numeric rating scales. Data were analyzed with Wilcoxon signed rank tests.
- What on earth is a ‘mixed-method, feasibility, pilot study’? A hallmark of pseudo-researchers seems to be that they think they can invent their own terminology.
- There is no objective, validated outcome measure.
- The conclusion that ‘Reiki is feasible‘ has been known and does not need to be tested any longer.
- The conclusion that ‘Reiki improved positive emotions and feelings and decreased negative measures’ is false. As there was no control group, these improvements might have been caused by a whole lot of other things than Reiki – for instance, the extra attention, placebo effects, regression towards the mean or social desirability.
- The conclusion that ‘implementing Reiki in clinical practice should be further explored to improve mental health and well-being’ is therefore not based on the data provided. In fact, as Reiki is an implausible esoteric nonsense, it is a promotion of wasting resources on utter BS.
Does it matter?
Why not let pseudo-scientists do what they do best: PSEUDO-SCIENCE?
I think it matters because:
- Respectable institutions like the Mayo Clinic should not allow its reputation being destroyed by quackery.
- The public should not be misled by charlatans.
- Patients suffering from mental health problems deserve better.
- Resources should not be wasted on pseudo-research.
- ‘Academic journals like ‘Glob Adv Integr Med Health’ have a responsibility for what they publish.
- ‘The ‘Academic Consortium for Integrative Medicine & Health‘ that seems to be behind this particular journal claim to be “the world’s most comprehensive community for advancing the practice of whole health, with leading expertise in research, clinical care, and education. By consolidating the top institutions in the integrative medicine space, all working in unison with a common goal, the Academic Consortium is the premier organizational home for champions of whole health. Together with over 86 highly esteemed member institutions from the U.S., Australia, Brazil, Canada and Mexico, our collective vision is to transform the healthcare system by promoting integrative medicine and health for all.” In view of the above, such statements are a mockery of the truth.
This study was aimed at investigating how Spanish media reinforce a positive image of dietary supplements in the treatment of children, potentially leading to harmful health attitudes and behaviors.
The researchers conducted a quantitative content analysis of 912 news articles published between 2015 and 2021 in Spanish media outlets discussing dietary supplements for children. They used a frequency analysis and a proportion comparison to analyze variables such as the reach of news, tone of news, mentions of health professional consultation, association with natural products, media specialization, intertextuality, and headline mentions.
The study found a 60% increase in publications discussing dietary supplements for children during the study period. The content analysis indicates that these articles predominantly present dietary supplements in a positive light, often without robust scientific evidence. Furthermore, many do not emphasize the need for medical consultation, which may contribute to unsupervised consumption of supplements, particularly among minors. This highlights the critical importance of professional guidance when considering dietary supplements for children. Additionally, the frequent emphasis on the “natural” attributes of these products raises concerns regarding consumer perceptions and potential safety risks.
The authors concluded that their study reveals a problem regarding the portrayal of dietary supplements for children in Spanish media. The overly optimistic image, lack of scientific basis, and failure to recommend medical supervision may contribute to unsupervised consumption among minors, risking their health due to misinformed decisions influenced by media portrayal.
I would add that this problem exists not just for children and not just in Spain. It has long been noted to put consumers of all ages and from all countries at risk. The authors kindly cite our own study from 2006 that concluded: “UK national newspapers frequently publish articles on CATs for cancer. Much of this information seems to be uncritical with a potential for misleading patients.”
Even several years before that, my late friend Thomas Weimayr and I published this study in the BMJ:
The media strongly influences the public’s view of medical matters.1 Thus, we sought to determine the frequency and tone of reporting on medical topics in daily newspapers in the United Kingdom and Germany. The following eight newspapers were scanned for medical articles on eight randomly chosen working days in the summer of 1999: the Times, the Independent, the Daily Telegraph, and the Guardian in the United Kingdom, and Frankfurter Allgemeine Zeitung, Süddeutsche Zeitung, Frankfurter Rundschau, and Die Welt in Germany. All articles relating to medical topics were extracted and categorised according to subject, length, and tone of article (critical, positive, or neutral).
A total of 256 newspaper articles were evaluated. The results of our analysis are summarised in the table. We identified 80 articles in the German newspapers and 176 in the British; thus, British newspapers seem to report on medical topics more than twice as often as German broadsheets. Articles in German papers are on average considerably longer and take a positive attitude more often than British ones. Drug treatment was the medical topic most frequently discussed in both countries (51 articles (64%) in German newspapers and 97 (55%) in British). Surgery was the second most commonly discussed medical topic in the UK newspapers (32 articles; 18%). In Germany professional politics was the second most commonly discussed topic (11 articles; 14%); this category included articles about the standing of the medical profession, health care, and social and economic systems—that is, issues not strictly about treating patients.
Because our particular interest is in complementary medicine, we also calculated the number of articles on this subject. We identified four articles in the German newspapers and 26 in the UK newspapers. In the United Kingdom the tone of these articles was unanimously positive (100%) whereas most (3; 75%) of the German articles on complementary medicine were critical.
This analysis is, of course, limited by its small sample size, the short observation period, and the subjectivity of some of the end points. Yet it does suggest that, compared with German newspapers, British newspapers report more frequently on medical matters and generally have a more critical attitude (table). German newspapers frequently discuss medical professional politics, a subject that is almost totally absent from newspapers in the United Kingdom.
The proportion of articles about complementary medicine seems to be considerably larger in the United Kingdom (15% v 5%), and, in contrast to articles on medical matters in general, reporting on complementary medicine in the United Kingdom is overwhelmingly positive. In view of the fact that both healthcare professionals and the general public gain their knowledge of complementary medicine predominantly from the media, these findings may be important.2,3
25 years later, the call on journalists to behave more responsibly when reporting about so-called alternative medicine (SCAM) is as loud and clear as it is neglected and ignored.
Use of so-called alternative medicines (SCAM) is, as we have frequently discussed on this blog, associated with an anti-vax attitude or vaccine hesitancy. However, the nature of—and reasons for—this association are not entirely clear, not least because both SCAM and vaccine hesitancy are complex, heterogeneous phenomena.
A recent study aimed to determine which aspects of SCAM predict vaccine hesitancy and to probe the psychological roots of their association. In a two-stage survey (N1 = 1905, N2 = 1443), participants from Argentina, Germany and the USA reported vaccine/SCAM health behaviors, intentions and beliefs. They also responded to scales probing attitudes to science, individual differences in cognitive styles, and anomalous beliefs.
An Item-Response Theoretic model of vaccine responses revealed that, outside of either total acceptance or outright refusal of vaccines, hesitancy reflected a gap between past vaccination behaviors and future behavioral intentions. More than SCAM-use, vaccine hesitancy was predicted by SCAM-relevant health beliefs. An oppositional view of natural vs. biomedical care was central in this regard. Unscientific mindsets—both in attitudes to expertise and in anomalous beliefs—underpinned the psychological similarity of SCAM beliefs and vaccine hesitancy.
The authors concluded that the relationship between SCAM and vaccine hesitancy is primarily a matter of health-relevant beliefs centered on natural vs. scientific medicine. This relationship—and in particular, a gap between past vaccine behaviors and future be havioral intentions—reflects fundamentally unscientific mindsets. Thus, a key challenge in addressing this form of vaccine hesitancy is one of perspective taking: Scientists must find persuasive reasons to vaccinate which appeal to people who do not see science as the main route to medical knowledge.
These findings should seem fairly obvious to those of us who have followed the discussions on this blog and elsewhere around vaccines and vaccinations. In the present study, belief in ‘naturalness’ predicted vaccine acceptance – and did so consistently across countries – more than other health beliefs. The associations between vaccine acceptance and SCAM were not strongly related to sociodemographic factors. The only regular pattern was for gender, with women being both more vaccine resistant and more pro-SCAM than men.
Negative attitudes towards vaccines and belief in ‘naturalness’ were associated with a cluster of ‘anti-expert’ variables including distrust in science. Vaccine resistance was also associated with a range of anomalous beliefs or biased belief updating styles. These negative attitudes to scientific sources of information and unscientific belief contents are different aspects of an unscientific mindset.
I think, this makes sense and seems to confirm previous findings about the association between SCAM-use and vaccine hesitancy: the two are linked indirectly by a common denominator.
So-called alternative medicine (SCAM) is, according to the authors of this paper, gaining popularity among patients experiencing pain, alongside traditional treatments. Their survey aimed to explore the views of pain clinicians and researchers on SCAM interventions.
An anonymous, online survey was distributed to 46 223 authors who had published pain-related research in MEDLINE-indexed journals. The survey included multiple-choice questions and open-ended sections to gather detailed opinions.
A total of 1024 participants responded, most identifying as either pain researchers (43.59%) or both researchers and clinicians (39.88%). Many held senior positions (61.55%). Among the SCAM modalities, mind-body therapies such as meditation, yoga, and biofeedback were viewed as the most promising for pain prevention, treatment, and management, with 68.47% of participants endorsing these approaches. While a majority (43.89%) believed that most SCAM therapies are safe, only 25.55% expressed confidence in their effectiveness. There was broad agreement on the need for more research into SCAM therapies, with 45.88% agreeing and 42.53% strongly agreeing that further investigation is valuable. Additionally, many respondents supported the inclusion of SCAM training in clinician education, either through formal programs (46.40%) or supplementary courses (52.71%). Mind-body therapies received the most positive feedback, while biofield therapies were met with the most skepticism.
The authors concluded that these findings highlight the interest in SCAM among pain specialists and emphasize the need for more research and education tailored to this area.
It is not often that I come across an article that makes me laugh out loud. Here are some of the reasons for my amusement:
- Since when is 44% a majority?
- In fact, the majority of respondents seems not to believe that SCAM is safe;
- only 26% were confident that SCAM is effective, yet we are made to believe that “many respondents supported the inclusion of SCAM training in clinician education”.
The biggest laugh needs to go to the response rate of this survey: 46 223 people received the questionnaire and 1024 responded to it! This gives a response rate of just over 2%! and seems to indicate that the vast majority of pain researchers are not bothered about SCAM. If that is so, should we not adjust the conclusion accordingly? Perhaps something like this would fit the data much better:
These findings highlight the disinterest in SCAM among pain specialists and emphasize that no more research and education tailored to this area are required.
The aim of this study was to review the deaths associated with chiropractic treatment in Australia. The National Coronial Information System (NCIS) was searched for cases in Australia for which chiropractic treatment was determined to have contributed to death. Closed, completed Australian cases between 1 July 2000 and 31 December 2019 were evaluated (approximately 356,000 cases).
The findings revealed only one case in which chiropractic treatment was considered to have contributed to death. The case was that of an adult male who died from a dissected left vertebral artery following chiropractic manipulation for neck pain.
In addition, postmortem records at Forensic Science SA (FSSA) were searched for similar cases over the same time period (approximately 30,000 cases). No cases definitely attributable to chiropractic manipulation of the neck were found, but a case with thrombus in the left vertebral artery would not be entirely excluded as being related to chiropractic treatment.
Deaths associated with chiropractic manipulation in Australia therefore appear rare. Although there is a reported incidence of stroke associated with vertebrobasilar artery system occlusion following chiropractic manipulation, stroke associated with vertebrobasilar artery occlusion has also been observed following a visit to a primary care physician. This could be explained by vertebrobasilar artery pathology causing neck pain that initiated consultation.
The authors concluded that the present study only demonstrates a rare temporal, but not causal, relationship between attending a chiropractor and vertebral artery dissection causing death. Non-lethal injuries were not assessed.
This is an interesting paper. Many chiropractors steadfastly deny that their manipulations can cause serious problems. This analysis clearly shows that this assumption is untrue. It also suggests that deaths are rare. The question is: how reliable is this conclusion?
The authors searched NCIS and the FSSA for cases for which chiropractic treatment was determined to have contributed to death. In other words, fatalities for which chiropractic treatment had not been determined to have contributed to death were not considered. Because the link between a person’s death and a spinal manipulation might often not be made, further cases of deaths might need to be added to the total.
A further question is this: even if – as we all hope – deaths are very rare, does that mean chiropractic manipulations are safe? Here the answer is clearly NO! Death is merely the most dramatic outcome. Spinal manipulations can cause strokes, and most of these events do result in neurological deficits but not death.
Finally, we need to consider the risk/benefit balance of chiropractic manipulations. As often discussed here, the benefits of spinal manipulation are, depending on the indication, small or uncertain. This means that even rare but serious adverse events weigh heavily and tilt the balance into the negative. In short, this means that chiropractors should be avoided.
In conclusion, this paper leaves no doubt that chiropractic manipulations can be deadly. One would very much hope that such fatalities are extremely rare events, however, the data provided are not convincing.
I was fascinated and horrified in equal measure to watch Donald Trump speaking at the CPAC talking about a medical topic – autism to be precise. Here are his words (minus the gibberish he always adds to disguise the stupidity of his phrases):
…15 years ago, there was one case per 10 000, some say 20 000 US citizens. Now the figure is 1 in 36. There’s something wrong. Bobby (Robert F. Kennedy Jr.) is gonna find it, working with Dr. Oz; by the way, working with Dr. Oz…
The audience of conservatives cheered blissfully!
What Trump said at the CPAC was not original. He uttered almost identical nonsense before (except he also claims the rate is now 1 in 34); it seems to be one of his set pieces for amusing the intellactually challenged.
A few days ago Trump signed an executive order (EO) calling for the creation of a ‘Make America Healthy Again’ Commission, which the White House says will be “tasked with investigating and addressing the root causes of America’s escalating health crisis.” In the EO, the figures are, however, a little different: “Autism spectrum disorder now affects 1 in 36 children in the United States — a staggering increase from rates of 1 to 4 out of 10,000 children identified with the condition during the 1980s.”
- 15 years ago was not the 1980s;
- 1 in 10 000 is not the same as 1 to 4 out of 10,000 children.
But, as we are often told, we must not take Trump literally; it’s the ‘BIG PICTURE’ that counts!
A little research reveals that the 1 in 36 prevalence figure originates from this survey. It was not focussed on autism but on autism spectrum disorder (ASD).
- Autism is a specific disorder within the broader category of ASD.
- ASD refers to a range of conditions that share some commonalities.
- Autism has distinct characteristics and symptoms.
- ASD includes conditions like autism, Asperger’s syndrome, childhood disintegrative disorder, and an unspecified form of pervasive developmental disorder.
Is it really too difficult for Trump to differentiate between autism and ASD?
Or is the reason that this would not fit his agenda?
The survey concluded that “findings from the ADDM Network 2020 surveillance year indicate higher ASD prevalence than previous estimates from the ADDM Network and continuing evidence of a marked shift in the demographic composition of children identified with ASD compared with previous years. Although earlier ADDM Network reports have shown higher prevalence among higher-SES White children compared with other groups, the latest data indicate consistently higher prevalence among Black and Hispanic children compared with White children, and no consistent association between ASD and SES. Furthermore, this is the first ADDM Network report in which the prevalence of ASD among girls has exceeded 1%. Since 2000, the prevalence of ASD has increased steadily among all groups, but during 2018–2020, the increases were greater for Black and Hispanic children than for White children. These data indicate that ASD is common across all groups of children and underscore the considerable need for equitable and accessible screening, services, and supports for all children.”
The authors of the survey caution that the findings in their report are subject to at least seven limitations.
- First, the methods rely on the availability, quality, and completeness of existing information and records to ascertain ASD cases and other indicators. Although all sites had access to special education classification data, certain sites did not have access to education records for their entire population, limiting the ability to identify children with ASD exclusively identified and served through their schools. Sites requested records from public school special education programs but did not review private school education records. Incomplete information could lead to misclassifying children’s cognitive ability, overestimating the age when they were first evaluated or when ASD was diagnosed, or failing to ascertain that the children were identified as having ASD. Sex information reflects what is represented in children’s records and might not reflect their gender identity.
- Second, the case definition for intellectual disability was measured using a child’s latest cognitive test or examiner statement of a child’s cognitive ability. Diagnostic and special education eligibility criteria for intellectual disability requires concurrent adaptive functioning deficits. IQ scores are not necessarily stable measures of intellectual ability over time, can increase among children with ASD in response to intensive early therapeutic interventions, and might be unstable during early childhood. The age at which children had their most recent test or examiner impression of cognitive ability varied by site.
- Third, the ADDM Network sites are not intended to be representative of the states in which the sites are located. ADDM Network sites are selected through an objective and competitive process, and findings do not necessarily generalize to all children aged 8 years in the United States. Interpretations of temporal trends can be complicated by changing surveillance areas, case definitions, data source access, and diagnostic practices.
- Fourth, small numbers result in imprecise estimates for certain sites and subgroups, and estimates falling below the selected threshold for statistical precision were suppressed.
- Fifth, the surveillance data system does not collect the number of ASD ICD codes a child received at a specific source, limiting comparability to analyses of claims/billing databases that consider number of ICD codes received.
- Sixth, the COVID–19 pandemic resulted in reduced access to records from some sources at certain sites; it was often possible to electronically obtain some data elements from these sources but not manually review the full contents of records. Disruptions in services and school closures during 2020 might have resulted in less documentation of ASD in records, which could decrease ASD ascertainment by ADDM sites.
- Seventh, the prevalence of undetected ASD in each community as well as false-positive ASD diagnoses and classifications are unknown.
So, Trump charged Robert F. Kennnedy Jr. to investigate why ASD is on the increase. As it happens, Kennedy already knows the conclusion of this investigation. He has often stated widely debunked claims that autism is caused by vaccinations. For instance, in a 2023 interview with Fox News, he squarely claimed that “autism comes from vaccines”. This theory was popularised by the discredited ex-doctor Andrew Wakefield based on a fraudulent paper that was later retracted by the Lancet. Multiple studies have subsequently demonstrated that there is no link between vaccines and autism.
Luckily Kennedy has Dr. Oz – yes the very Dr. Oz who has featured many times on my blog (see for instance here, here and here) – to help him get to the bottom of what Trump believes to be a mystery. Those two will be quite an unbeatable team (neither of them has ever done proper research in this area; Oz promotes any quackery that fills his pockets, and Kennedy would not recognise reliable science, if it bit him in his behind)! Perhaps they could start their investigation by reading the many papers that have already found at least some of the plausible reasons for the above-cited figures, e.g:
- The Real Reasons Autism Rates Are Up in the U.S. | Scientific American
- Is Autism Really Increasing?
- Factors Causing an Increase in Autism | Psych Central
- Autism: Cases on the Rise; Reason for Increase a Mystery
- Recognising autism in healthcare – PubMed
Oh, I almost forgot: they don’t need to read such demanding papers. They already have the answer to the autism mystery!
PS
- acupuncture (39%),
- aromatherapy (35%),
- creative arts (20%),
- massage therapy (5%)
- hypnosis (1%).
After SCAM treatments, heart rate decreased and symptom scores improved for anxiety, fatigue, nausea, pain, and sadness (Cohen’s d effect sizes 0.22-0.99). Adjusted mixed-effects models suggested that the Faces Scale scores improved over time (b= -0.19, p<.01).
- after SCAM treatments, heart rate decreased and symptom scores improved for anxiety, fatigue, nausea, pain, and sadness;
- adjusted mixed-effects models suggested that the Faces Scale scores improved over time.
Of note is that they formulate these findings cleverly. Yet, the language nevertheless implies that SCAM was the cause of the observed effects.
To this I object!
In fact, I postulate that the findings show that SCAM treatments :
- delayed improvements in heart rate decreased, symptom scores, anxiety, fatigue, nausea, pain, and sadness.
- hindered the Faces Scale scores from improving over time.
On what grounds, you ask?
As the study had no control group, the basis for my claim is just as solid as the suggestions of causality made by the authors!
Today is World Cancer Day. It is an international day observed every 4 February to raise awareness about cancer, encourage its prevention, and mobilise action to address the global cancer epidemic. Cancer and so-called alternative medicine (SCAM) are closely linked, for instance, through the fact that large proportions of desperate cancer patients use SCAM, many in the hope to cure their disease. I have therefore often tried to instill some rational thought into the debate by discussing the emerging, largely negative evidence on SCAM for cancer. Here are just a few recent examples:
- Homeopathy as a therapy for cancer? A new review from India
- Geopathic stress allegedly can cause health issues such as arthritis, multiple sclerosis and cancer – BUT, PLEASE, DON’T BELIEVE SUCH NONSENSE!
- Homeopathic Cancer Therapy? No, no and no!
- Medicinal Mushrooms for Cancer?
- Bioenergy therapies for cancer: implausible, ineffective, and an unethical waste of money
- Camel urine as a treatment for cancer patients?
- Homeopathy for cancer? Unsurprisingly, the evidence is not positive.
- When an undercover journalist tests alternative cancer healers
To mark the day, I had a look at what people post on ‘X’ about SCAM and cancer cure. Here are some of the more amazing assumptions, claims and comments that I found (warts and all):
- The Princess of Wales, Kate Middleton has been diagnosed with Cancer – there is a high probability she has Turbo Cancer, caused by COVID-19 mRNA Vaccines she took in 2021.
- Blue butterfly pea flowers (Clitoria ternatea) is one of the best CANCER KILLING and CANCER PROTECTIVE plants available to man.
- Dandelion root far more effective in fighting cancer cells than chemotherapy.
- In Kenya, research shows 76% of cancer patient who turn to traditional medicine instead of chemotherapy have drastically improved.
- I’ve just been diagnosed w cancer and will approach it with nutrition, suppl,and cont’d exercise… other alternative therapies as well. Been an RN for decades and have witnessed the horrors and pitfalls of modern medicine. Must b your own best advocate.
- I had a niece, a cousin and a friend die same week of the big C. was an eye-opener for me cause chemo did not help them at all….so looked at the alternative medicine….down in Mexico. but it was too late. cancer spread like wildfire.
- I pray to God that no one has to suffer through cancer but I agree with you 1000% alternative medicine as a matter fact we already know that there are three that can cure cancer. I ivermectin is one and I can’t remember the other two.
- Cancer has been proven to be eliminated with alternative medicine you denounce without a single study. I’m starting to think you hate the American people.
- Next time you or your loved one gets cancer, use “alternative medicine“.
- Most Doctors use drugs for treatment of symptoms because that’s how they are trained. No nutrition or alternative medicine is taught or encouraged. In cancer treat Drs are required to only recommend chemo because they could lose their license for alternative nedicine referrals.
- Spiritual causes of illness, including cancer, are often explored within alternative approaches to healing and holistic philosophies. Although traditional medicine does not recognize spiritual causes, many spiritual traditions and energetic practices.
- I pray that you look to alternative medicine, don’t listen to the current medical model as it is designed to keep people sick, western medicine does not heal. Chinese medicine does like others around the world. A primary cause of cancer is parasites. Western medicine doesn’t look.
- Chemotherapy is brutal, attacking both cancer and healthy cells. Alternative solutions do exist, but mainstream medicine often won’t offer them. Take control of your research, explore your options, and question everything.
- I cured my cancer symptoms using alternative medicine, including Ayurveda. Not drugs.
- I’m a double cancer survivor and I was in a clinical trial testing chemo in 2013-2014. Chemo is poison and big pharma. Alternative medicine is better. Changed must be made. I love that PresidentTtump has done this. And I can’t wait for RFKJr to lead HHS.
- Cancer kills you if you follow the advice of the medical establishment. There are many alternative cures for cancer and even more ways to prevent it in the first place. Do some research into naturopathic medicine if you truly want to be healthy.
- Maybe Trump should redirect that 500 billion to alternative medicine/supplement/ivermectin research that will eradicate cancer. And what is causing cancer. Don’t need a mRNA cancer vaccine. We already have the tools to stop cancer.
- Please get checked for parasites which is what cancer is. Try alternative medicine and see how that works – I bet it does.
- I have a friend who cured her own breast cancer with alternative methods. There are cures out there. Mainstream medicine just won’t recognize them.
- Everything is fake in medical field nowadays. Not only petition but also pathogen hypothesis medical academic papers about virus, cancer etc.. We need to build an alternative medicine field ASAP.
- …
- …
[I could have gone on almost for ever]
I had not expected to find much wisdom on ‘X’, but what I did find truly horrified me. For every sensible Tweet, there seem to be 10 imbecillic and dangerous ones. Imaging a desperate cancer patient reads these lies, misleading claims, nonsensical statements and conspiracy theories!
To set the record straight, let me state these two simple facts:
There is no SCAM that would change the natural history of any form of cancer.
What is more, there never ill be one! As soon as a treatment might look promising as a cancer cure, it will be investigated by mainstream scientists and – if it turns out to be helpful – integrated into conventional oncology. In other words, it will become evidence-based medicine.
You don’t believe me without evidence?
Ok, then please read my book on the subject.
PS
And yes, there are some SCAMs that might have a role in improving QoL, but that’s a different topic.
In the series of posts entitled WHAT HAPPENED NEXT, I pick up themes that I addressed more than a decade ago with the intention of finding out whether things have moved on or not. Today, allow me to tackle the thorny issue of the use of so-called alternative medicine (SCAM) for children.
The use of SCAM by adults is often problematic; employing SCAM for kids is almost invariably so. This has mainly two reasons:
- Children cannot give informed consent.
- The evidence that SCAM is doing more good than harm to children is missing, negative or unconvincing.
I have therefore long cautioned parents about their use of SCAM for their kids.
In June 2013 I published a blog post on the subject that ended with the following remarks:
Treating children with unproven or dis-proven therapies is even more problematic than treating adults in this way. The main reason is that children cannot give informed consent. Thus alternative medicine for children can open difficult ethical questions, and sometimes I wonder where the line is between the application of bogus treatments and child-abuse. Examples are parents who opt for homeopathic vaccinations instead of conventional ones, or paediatric cancer patients who are being treated with bogus alternatives such as laetrile.
Why would parents not want the most effective therapy for their children? Why would anyone opt for dubious alternatives? The main reason, I think, must be misinformation. Parents who use alternative medicine are convinced they are effective and safe because they have been misinformed. We only need to google ALTERNATIVE MEDICINE to see for ourselves what utter nonsense and dangerous rubbish is being promoted under this umbrella.
Misinformation is the foremost reason why well-meaning parents (mis-) treat their children with alternative medicine. The results can be disastrous. Misinformation can kill!
The question I am asking today is HAS ANYTHING CHANGED? Has the usage of SCAM for kids declined? Has the evidence that SCAM is effective for children become more solid?
Judging from my 2024 posts on the subject, the answer seems hardly encouraging:
- The altruistic chiropractor: free spinal checks for children
- Traditional herbal medicine use doubled the risk of multi-organ dysfunction syndrome in children
- Spinal manipulation and mobilisation among infants, children, and adolescents: an international Delphi survey of expert physiotherapists
- Homeopathy is reported to reduce the fatality rate of children with acute encephalitis by 15% – but I find this hard to believe
- “Overuse Injuries in Children: A Homoeopathic Approach”: SCIENTIFIC MISCONDUCT or FRAUD?
- Homoeopathy vs. conventional primary care in children during the first 24 months of life
Judging from recently published surveys, the answer seems convincingly negative. Here are just a few examples:
- 46% stated that their child currently used or had ever used some form of complementary and alternative medicine in their life
- Thirteen percent of respondents indicated CAM use by their child.
- 51% reported CAM use in the preceding year.
- 85.9% of parents was willing to use CAM in future.
- 79% had used complementary and alternative medicine.
I find such findings quite alarming. I fear they suggest that:
- Misinformation is powerful.
- Parents require responsible advice.
- SCAM practitioners need to learn about and adhere to medical ethics.
- There is much more work to do, if we want to improve the safety of vulnerable children.
The Internet is increasingly used as a primary source of information for patients. Many private physiotherapy practices provide informative content on low back pain (LBP) and neck pain (NP) on their websites, but the extent to which this information is biopsychosocial, guidelines-consistent, and fear-inducing is unknown. The aim of this study was to analyse the information on websites of private physiotherapy practices in the Netherlands about LBP and NP regarding consistency with the guidelines and the biopsychosocial model and to explore the use of fear-inducing language.
The content of all existing Dutch private physiotherapy practice websites was examined in a cross sectional study design. Content analysis was based on predetermined criteria of the biopsychosocial model and evidence-based guidelines. Descriptive statistics were applied.
After removing duplicates and sites without information, 834 (10%) of 8707 websites remained. Information about LBP was found on 449 (54%) websites and 295 (35%) websites informed about NP. A majority of websites (LBP: n = 287, 64%; NP: n = 174, 59%) were biomedically oriented. Treatment advice was given 1855 times on n = 560 (67%) websites. Most of the recommended interventions were inconsistent with or not mentioned in the guidelines. Fear-inducing language was provided n = 1624 (69%) times.
The interventions that were inconsistent with the guidelines included several so-called alternative medicine (SCAM) options, including:
- dry needling (for LBP),
- medical tape (for LBP),
- trigger point therapy (for LBP),
- dry needling (for NP),
- trigger point therapy (for NP).
The authors concluded that their study shows that most Dutch private physiotherapy practice website are not a reliable source of information for patients with LPB and NP. The Dutch physiotherapy community needs to take action to comprehensively review and update the information on their websites to align with high‐quality best practice recommendations and guidelines for LBP and NP. It is important to strive for better information for patients to reduce fear, to support them in making better recovery choices, to achieve less disability, and to improve their quality of life.
To be honest, I would never have expected Dutch private physiotherapy practice website to be a reliable source of information for patients with LPB and NP. In general, private websites from healthcare practitioners are not reliable sources for anything, as we have so often seen on this blog. They are promotional by nature and have the purpose of boosting business.
I fear that the only thing positive I can say about the private physiotherapy practice websites is that they are not nearly as bad as those of:
- acupuncturists,
- aromatherapists,
- chiropractors,
- energy healers,
- herbalists,
- homeopaths,
- naturopaths,
- osteopath,
- reflexologists,
- etc, etc.
(If you need evidence for these bold statements, please look through the last 3 000 posts of this blog.)
As misinformation can cause untold harm, we need to ask: what is the solution to this problem? I think it’s disarmingly simple: for health-related information, stay away from websites that are evidently promotional by nature!
