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

survey

1 2 3 8

‘Infodemics’ are outbreaks of false information including rumours, stigma, and conspiracy theories. All of these have been common during the COVID-19 pandemic. The detection, assessment, and response to rumours, stigma, and conspiracy theories in real time are a challenge.

An international team of researchers followed and examined COVID-19-related rumours, stigma, and conspiracy theories circulating on online platforms, including fact-checking agency websites, Facebook, Twitter, and online newspapers, and their impacts on public health. Information was extracted between December 31, 2019 and April 5, 2020, and descriptively analysed. The team performed a content analysis of the news articles to compare and contrast data collected from other sources.

The researchers identified 2,311 reports of rumours, stigma, and conspiracy theories in 25 languages from 87 countries. Claims were related to:

  • illness, transmission and mortality (24%),
  • control measures (21%),
  • treatment and cure (19%),
  • cause of disease including the origin (15%),
  • violence (1%),
  • and miscellaneous (20%).

Of the 2,276 reports for which text ratings were available, 1,856 claims were false (82%).

The authors concluded that misinformation fuelled by rumours, stigma, and conspiracy theories can have potentially serious implications on the individual and community if prioritized over evidence-based guidelines. Health agencies must track misinformation associated with the COVID-19 in real time, and engage local communities and government stakeholders to debunk misinformation.

These findings are as perplexing as they are frightening. On this blog, we have since the beginning of the pandemic focussed on the SCAM for COVID-19. We have seen that this health crisis provided an occasion for almost any quackery on the planet:

  • homeopaths,
  • supplement salesmen,
  • TCM-practitioners,
  • chiropractors,
  • anti-vaxxers,
  • Siddha-doctors,
  • Vitamin-peddlers,
  • politicians,
  • evangelists,
  • acupuncturists,
  • herbalists,
  • essential oil salesmen.

They all crept out of the woodwork. Their methods may differ, but their aim seems to be the same: to make a fast buck regardless of how many people their activities might kill.

On this blog, I have discussed the adverse events (AEs) of spinal manipulative therapy (SMT) with some regularity, and we have seen that ~ 50% of patients who receive SMT from a chiropractor experience some kind of AE. In addition there are many serious complications. In my book, I discuss, apart from the better-known vascular accidents followed by a stroke or death, the following:

  • atlantoaxial dislocation,
  • cauda equina syndrome,
  • cervical radiculopathy,
  • diaphragmatic paralysis,
  • disrupted fracture healing,
  • dural sleeve injury,
  • haematoma,
  • haematothorax,
  • haemorrhagic cysts,
  • muscle abscess,
  • muscle abscess,
  • myelopathy,
  • neurologic compromise,
  • oesophageal rupture
  • pneumothorax,
  • pseudoaneurysm,
  • soft tissue trauma,
  • spinal cord injury,
  • vertebral disc herniation,
  • vertebral fracture,
  • central retinal artery occlusion,
  • nystagmus,
  • Wallenberg syndrome,
  • ptosis,
  • loss of vision,
  • ophthalmoplegia,
  • diplopia,
  • Horner’s syndrome.

Considering this long list, we currently have far too little reliable information. A recent publication offers further information on this important topic.

The aim of this study was to identify beliefs, perceptions and practices of chiropractors and patients regarding benign AEs post-SMT and potential strategies to mitigate them. Clinicians and patients from two chiropractic teaching clinics were invited to respond to an 11-question survey exploring their beliefs, perceptions and practices regarding benign AEs post-SMT and strategies to mitigate them.

A total of 39 clinicians (67% response rate) and 203 patients (82.9% response rate) completed the survey. The results show that:

  • 97% of the chiropractors believed benign AEs occur.
  • 82% reported their own patients have experienced an AE.
  • 55% of the patients reported experiencing benign AEs post-SMT, with the most common symptoms being pain/soreness, headache and stiffness.
  • 61.5% of the chiropractors reported trying a mitigation strategy with their patients.
  • Yet only 21.2% of patients perceived their clinicians had tried any mitigation strategy.
  • Chiropractors perceived that patient education is most likely to mitigate benign AEs, followed by soft tissue therapy and/or icing after SMT.
  • Patients perceived stretching was most likely to mitigate benign AEs, followed by education and/or massage

 

The authors concluded that this is the first study comparing beliefs, perceptions and practices from clinicians and patients regarding benign AEs post-SMT and strategies to mitigate them. This study provides an important step towards identifying the best strategies to improve patient safety and improve quality of care.

The question that I have often asked before, and I am bound to ask again after seeing such results, is this:

If there were a drug that causes temporary pain/soreness, headache and stiffness in 55% of all patients (plus an unknown frequency of a long list of serious complications), while being of uncertain benefit, do you think it would still be on the market?

 

Steiner with his wife (right) and Ita Wegman, his lover (left).

Anthroposophic medicine was founded by Steiner and Ita Wegman in the early 20th century. Currently, it is being promoted as an extension of conventional medicine. Proponents claim that “its unique understanding of the interplay among physiological, soul and spiritual processes in healing and illness serves to bridge allopathy with naturopathy, homeopathy, functional/nutritional medicine and other healing systems.” Its value has repeatedly been questioned, and clinical research in this area is often less than rigorous.

Anthroposophic education was developed in the Waldorf school that was founded by Steiner in 1919 to serve the children of employees of the Waldorf-Astoria cigarette factory in Stuttgart, Germany. Pupils of Waldorf or Steiner schools, as they are also frequently called, are encouraged to develop independent thinking and creativity, social responsibility, respect, and compassion.

Waldorf schools implicitly infuse spiritual and mystic concepts into their curriculum. Like some other alternative healthcare practitioners – for instance, doctors promoting integrative medicine, chiropractors, homeopaths and naturopaths – some doctors of anthroposophic medicine take a stance against childhood immunizations. In a 2011 paper, I summarised the evidence which showed that in the UK, the Netherlands, Austria and Germany, Waldorf schools have been at the centre of measles outbreaks due to their stance regarding immunisations.

More recently, a study evaluated trends in rates of personal belief exemptions (PBEs) to immunization requirements for private kindergartens in California that practice alternative educational methods. The investigators used California Department of Public Health data on kindergarten PBE rates from 2000 to 2014 to compare annual average increases in PBE rates between schools.

Alternative schools had an average PBE rate of 8.7%, compared with 2.1% among public schools. Waldorf schools had the highest average PBE rate of 45.1%, which was 19 times higher than in public schools (incidence rate ratio = 19.1; 95% confidence interval = 16.4, 22.2). Montessori and holistic schools had the highest average annual increases in PBE rates, slightly higher than Waldorf schools (Montessori: 8.8%; holistic: 7.1%; Waldorf: 3.6%).

The authors concluded that Waldorf schools had exceptionally high average PBE rates, and Montessori and holistic schools had higher annual increases in PBE rates. Children in these schools may be at higher risk for spreading vaccine-preventable diseases if trends are not reversed.

As the world is hoping for the arrival of an effective vaccine against the corona virus, these figures should concern us.

This recently published survey aimed to investigate the use of so-called alternative medicine (SCAM) among long-term cancer survivors and its links with healthy behaviour. Data was used from the VICAN survey, conducted in 2015-2016 on a representative sample of French cancer survivors 5 years after diagnosis.

Among the 4174 participants, 21.4% reported using SCAM at the time of the survey, including 8.4% who reported uses not associated with cancer. The most frequently cited reasons for using SCAM were:

  • to improve their physical well-being (83.0%),
  • to strengthen their body (71.2%),
  • to improve their emotional well-being (65.2%),
  • to relieve the side effects of treatment (50.7%).

The SCAM users who reported using SCAM to cure cancer or prevent relapses (8.5% of the participants) also used SCAM for other reasons. They had more often experienced cancer progression, feared a recurrence, and had a poorer quality of life because of sequelae, pain, and fatigue. They also consulted their general practitioners more frequently and had changed their lifestyle by adopting more healthy practices.

The authors concluded that the use of SCAM is not an alternative but a complementary means of coping with impaired health. Further research is now required to determine whether the use of SCAM reflects a lifestyle change or whether it assists survivors rather to make behavioural changes.

The 2012 data from the same survey had previously reported that, among the participants, 16.4% claimed to have used SCAM, and 45.3% of this group had not used SCAM before cancer diagnosis (new SCAM users). Commonly, SCAMs used were:

  • homeopathy (64.0%),
  • acupuncture (22.1%),
  • osteopathy (15.1%),
  • herbal medicine (8.1%),
  • diets (7.3%),
  • energy therapies (5.8%).

SCAM use was found to be significantly associated with younger age, female gender and a higher education level. Previous SCAM use was significantly associated with having a managerial occupation and an expected 5-year survival rate ≥80% at diagnosis; recent SCAM use was associated with cancer progression since diagnosis, impaired quality of life and higher pain reports.

In nearly half of the SCAM users, cancer diagnosis was one of the main factors which incited patients to use SCAM. Opting for SCAM was a pragmatic response to needs which conventional medicine failed to meet during the course of the disease.

These surveys mostly confirm what has been shown over and over again in other countries. What I find remarkable with these results, however, is the increase in SCAM use over time and the extraordinary high use of homeopathy by French cancer patients (more recently, the reimbursement of homeopathy in France has changed, of course). As homeopathy has no effects beyond placebo, this suggests that SCAM use by French cancer patients is far from being driven by evidence.

So, what then does determine it?

My best answer I can give to this question is this: relentless promotion through pharmacies, advertisements and journalists. These have all been very powerful in France in relation to homeopathy (hardly surprising, as the world’s largest homeopathic producer, Boiron, is based in France).

This leads me to the conclusion that SCAM is far more commercially driven than its enthusiasts would ever admit. They think of the pharmaceutical industry as the evil exploiter of the sick. It is now time to realise that the SCAM industry is, to a large extent, part of the pharmaceutical industry and often behaves just as badly or even worse: because what could be more unethical that selling placebos to desperate and vulnerable cancer patients?

When I discuss published articles on this blog, I usually focus on recent papers. Not so today! Today I write about a small study we published 17 years ago. It was conducted in Canada by researchers whom I merely assisted in designing the protocol and interpreting the findings.

They trained 8 helpers to pretend being customers of health food stores. They entered individually into assigned stores; the helpers had been informed to browse in the store until approached by an employee. At this time they would declare that their mother has breast cancer. They disclosed information on their mother’s condition, use of chemotherapy (Tamoxifen) and physician visits, only if asked. The helpers would then ask what the employee recommend for this condition. They followed a structured, memorized, pretested questionnaire that asked about product usage, dosage, cost, employee education and product safety or potential for drug interactions.

The helpers recorded which products were recommended by the health food store employees, along with the recommended dose and price per product as well as price per month. Additionally, they inquired about where the employee had obtained information on the recommended products. They also noted whether the employees referred them on to SCAM practitioners or recommended that they consult a physician. Full notes on the encounters were written immediately after leaving the store.

The findings were impressive. Of the 34 stores that met our inclusion criteria, 27 recommended SCAMs; a total of 33 different products were recommended. Here are some further findings:

  • Essiac was recommended most frequently.
  • The mean cost of the recommended products per month was $58.09 (CAD) (minimum $5.28, median $32.99, maximum $600).
  • Twenty-three employees (68%) did not ask whether the patient took prescription medications.
  • Fifteen (44%) employees recommended visiting a healthcare professional; these included: naturopaths (9), physicians (5) and nutritionists (1).
  • Health food store employees relied on a variety of sources of information. Twelve employees (35%) said they had received their information from books, 5 (15%) from a supplier, 3 (9%) had formal education in SCAM, 2 (6%) had in-store training, and 12 (35%) did not disclose their sources of information.

Since our paper has been published, several other investigations have addressed similar issues. Here are a few excerpts:

But why do I mention all this today?

The answer is that firstly, I think it is important to warn consumers of the often dangerous advice they might receive in HFSs. Secondly, I feel it would worthwhile to do further research, check whether the situation has changed and repeat a similar study today. Ideally, a new investigation should be conducted in different locations comparing several countries. If you have the possibility to plan and conduct such an experiment, please drop me a line.

Anyone who has followed the comments’ section of this blog knows that science communicators don’t always have it easy. In fact, they have to endure regular attacks. Now, this phenomenon has (as far as I know, for the first time) been investigated systematically.

The objective in this survey was to establish a taxonomy of common negative experiences encountered by those communicating medical science, and suggest guidelines so that they may be circumvented. A total of 142 prominent medical science communicators (defined as having >1000 Twitter followers and experience communicating medical science on social and traditional media platforms) were invited to take part in the survey. One hundred and one responses could be analysed.

The results show that:

  • 92% of the participants has experienced abusive behaviour (91.9%), including persistent harassment (69.3%) and physical violence and intimidation (5.9%).
  • 39% had received vexatious complaints to their employers, professional bodies or legal intimidation.
  • 62% reported negative mental health sequelae due to public outreach, including depression, anxiety and stress.
  • 20% had been obligated to seek police advice or legal counsel due to actions associated with their outreach work.
  • the majority targeted with vexatious complaints felt supported by their employer/professional body and 32% reported neutral, poor or non-existent support.

Here is a selection of the responses from the participants:

  • Accusations—including by one Senator—that [we are] uncaring, dismissive, neglectful, arrogant, or paid by pharma companies when advocating for vaccines. (Misrepresentation)
  • I find my expertise is questioned—this often seems to be when men find it difficult to accept women with intelligence and qualifications. Sexist insults are a typical go-to response. (Discreditation)
  • The worst one that hurt me professionally and personally was that activists gathered my emails using [Freedom of Information Requests] and handed chosen packets of them with a story to different reporters. (Misrepresentation/Discreditation/Dubious Amplification)
  • Persistent negative comments on twitter; usually it doesn’t last long but it can feel very intense while it’s happening! (Intimidation)
  • I have been served with a SLAPP lawsuit in order to silence my outreach work. Frequently receive harassing emails, malicious comments made on blog. (Malicious Complaints)
  • Social media co-ordinated intimidation, implied threats of legal action (for defamation). Mocking, undermining, condescension and attacks for being an industry shill, although. I am just a patient advocate. Being called a liar, that I never had cancer, that I deserved cancer due to my attitude, that I have been mutilated by conventional medical treatment, and that I am no longer a woman (having had mastectomy for cancer). That my cancer will return and I deserve that. (Dubious Amplification/Misrepresentation/Discreditation)
  • I have had anti-vaccine organizations and individuals attempt to prevent my public appearances and have been the subject of numerous online smear campaigns accusing me of being ‘a shill for Big Pharma’ etc. (Discreditation/Dubious Amplification)
  • Those who attack me very frequently try to do it by targeting me at my job, sending bogus complaints to my bosses and the university. From my observation, that is the go-to attack, the first thing these groups do. (Malicious Complaints)
  • I had to contact the police, who visited the person who was harassing me. I also involved social services. We bought a CCTV to monitor our front door after a strange envelope was hand delivered. The person involved has targeted several people before and continues to target individuals who advocate vaccination. (Intimidation)
  • Abuse and accusations of corruption are the most common adverse reaction I get. Sometimes a particular group petition one’s employer and try to create trouble for them. I have been lucky in the past when this happened to have had supportive universities who appreciate my outreach work. I have in the past had slightly unhinged individuals writing rambling, implicitly threatening letters to my office which ultimately required police intervention. (Discreditation/Malicious Complaints/Intimidation)
  • The worst are gendered insults (being called a cunt, etc.) and rape/death threats. I have had one empty legal threat that was widely publicized. (Intimidation/Malicious Complaints)
  • Regular threats to sue for defamation. (Malicious Complaints)
  • Attempts to get me fired, public records act requests for emails, verbal attacks on my children. (Malicious Complaints, Intimidation)
  • One of the most unpleasant things is that certain people or groupings will use very underhanded tactics to respond to perceived criticism. If they can’t refute the science, it isn’t uncommon for them to go after you personally, alleging all manner of things to anyone who’ll listen; that you’re incompetent, or unethical, or perverted. It seems they throw things wildly to see what sticks, but it can be extraordinarily unpleasant to endure. (Dubious Amplification/Discreditation)
  • My main concern has been obsessed individuals who declare their enmity and seem to be unconstrained by civil norms. (Intimidation)
  • Homeopathy advocates looked up my LinkedIn profile and called my employer to complain about my comments on the radio. My employer did not support me and I ended up having to stop the activity I had been planning. (Misrepresentation/Malicious Complaints)
  • Being threatened with physical violence. (Intimidation)
  • A delusional supporter of [an individual] I wrote about accused me and my lawyer of stalking him and killing his in-laws. He sent accusing emails to the faculty of my school and all the police departments in my state. [They] also accused me of being a terrorist and complained about me to the FBIs Terrorism Joint Task Force. That gave me many nervous, sleepless nights. (Discreditation/Malicious Complaints)
  • Death threats received, employer unhelpful, sorted myself. (Intimidation)
  • I haven’t experienced many negative encounters because I would say I am only lightly involved in public engagement. However the reason I don’t become more heavily involved in this area is fear of this kind of abuse and vexatious complaints to my employer or regulatory body. (Malicious Complaints)

The authors concluded as follows: The question of how we best communicate health science in the modern era is an area where more research is urgently required, especially on the role of social media, and optimum ways physicians, researchers and other public-facing figures can promote good medical science and mitigate falsehoods. The suggestions herein ought to be taken as a starting point, with discussion evolving as improved evidence materialises. There are wider problems implicit in all this that those communicating science cannot tackle in isolation; social media regulation particularly is a serious issue, both in regard to the spreading of misinformation/disinformation, and with respect to procedures preventing the potential weaponisation of social media platforms. Social media platforms must ultimately be made answerable to regulatory oversight, just as every other important aspect of life is; claims of innocence are unconvincing when their business model is so clearly dependent on advertising engagement at the cost of lives. The problem of poor reporting and false balance in conventional media outlets also must be considered, and there is significant scope for scientists and doctors to contribute to policy in these areas. There is ample evidence that physicians and scientists have an important role to play in combatting health disinformation, as has recently been argued by one of the authors in relation to vaccination for British Medical Journal opinion. But equally, it is crucial that those engaging in this vital work have the requisite support from their institutions, so that deleterious consequences of laudable outreach work might be circumvented. It is increasingly clear that disinformation about medicine and illness has become ubiquitous, with severe consequences for both our collective health and public understanding of medical science. Scientists and physicians must be at the vanguard of the pushback against these dangerous falsehoods—our societal well-being depends on it.

_______________________________________

This is an important paper, in my view. It is well worth reading in full.

I know many scientists who will no longer engage in science communication (other than publishing their papers and attending conferences) because they had one or two bad experiences. I certainly had hundreds of bad (some very bad) experiences, but I have taken the opposite decision.

Thus I started this blog, authored several books aimed at the consumer, give public lectures, etc. I have done this for many years despite the lack of support from my university and sometimes despite the opposite of support from my peers.

Why?

Why do I work tirelessly trying to inform consumers about so-called alternative medicine (SCAM)?

Because, in view of the plethora of (often dangerous) misinformation, it is hugely important to get the word out to the men and women in the street. I pity the ones who regularly allege that I do all this because of the money I earn from such activity (on the whole, it costs me money). In fact, I do what I do because I hope it might

  • stimulate rational thought,
  • help people to make wise therapeutic decisions,
  • make a small contribution to public health,
  • and perhaps occasionally even save a life.

And the threats which I continue to receive merely indicate that I might be doing this job well, and prove how important the task really is.

There has been plenty of research into the factors that determine the usage of so-called alternative medicine (SCAM). Yet, so far, not a single truly powerful predictor has been identified. The aim of this study was therefore to identify the most important predictors of the use and approval of CAM. The researchers performed a canonical correlation analysis on all 3480 records from the 2012 German General Social Survey (ALLBUS) with the lifetime use and opinion of SCAM as the dependent variables.

Approval of paranormal practices such as fortune-telling, dowsing or spiritualism explained 32% of the variance in the dependent canonical variate “approval of SCAM”, while sociodemographic variables explained only 2%. Experience with paranormal practices explained 17% of the variance in the dependent canonical variate “experience with SCAM”, and sociodemographic variables explained 10% of the variance. Traditional religiosity, attitudes towards science and post-materialist values showed no relevant correlations with the dependent canonical variates.

The authors concluded that paranormal beliefs and related measures are the most important known predictors of the use and approval of SCAM. Experience with paranormal practices not only indicates paranormal beliefs but also explains experience with SCAM that cannot be explained by approval of SCAM. Female gender and higher socioeconomic status predict experience with SCAM without predicting approval of SCAM, but their influence should not be overstated.

Let’s not worry for the moment about the fact that most of the methods employed here to quantify the variables in question were not adequately validated. Let’s instead just assume that the reported findings are reliable and real. In this case, we must ask what do these correlations mean?

The authors seem to think that their results are quite extraordinary and require elaborate explanations. I find the findings utterly unsurprising and think they are almost self-explanatory: SCAM use/approval and the belief in the paranormal are linked because, to a very large degree, SCAM is part of the paranormal. The two are associated via a common denominator: lack of rationality and critical thinking.

The objective of this survey was to assess the prevalence and types of so-called alternative medicine (SCAM) usage as well as the participants’ spirituality/religiousness in an outpatient department for endocrinology and metabolic diseases. All individuals visiting the outpatient department at a German university hospital from April to June 2009 were offered a standardized questionnaire on the use of dietary supplements and other SCAMs as well as their religiousness/spirituality. Demographic and clinical data of 428 respondents were taken from the electronic health record.

Of the respondents, 16.4% (n = 66) classified themselves to be religious/spiritual and 67.9% (n = 273) as not religious/spiritual. The results show that:

  • 41.4% of the respondents used supplements and 27.4% additional therapies;
  • the use of supplements and other SCAMs was more frequent in people with higher religiousness/spirituality (p = 0.005 and p = 0.01,resp.);
  • there were no associations between religiousness/spirituality and the number of consultations, costs for drugs, appraisal of the physicians treatment methods, the perceived effectiveness of prescribed drugs, fear of late complications or of side effects.

The authors concluded that a higher religiousness/spirituality is associated with a more frequent use of supplements or additional therapies in individuals with endocrinopathies or metabolic diseases. As SCAM has been shown to be associated with worse outcome, addressing religiousness/spirituality which stresses the responsibility of the person for his life might offer an additional resource and should be further studied.

This survey has a dismal sample size and even worse response rate and must therefore be taken with more than a pinch of salt. Yet vaguely similar associations have been shown before. For instance, analysing data from the 1995-1996 National Survey of Midlife Development in the United States (n=3032), researchers examined the correlations between four aspects of spirituality/religiousness-i.e., spiritual only, religious only, both spiritual and religious, and neither spiritual nor religious-and six measures of SCAM. Compared with spiritual only persons, the odds of using energy therapies were 86% lower for spiritual and religious persons, 65% lower for religious only persons, and 52% lower for neither spiritual nor religious persons. Compared to spiritual only persons, spiritual and religious individuals were 43% more likely to use body-mind therapies in general; however, when this category did not contain prayer, meditation, or spiritual healing, they were 44% less likely. Religious only individuals were disinclined toward SCAM use.

There might be considerable cultural and national differences, of course, but if it is true that religiousness/spirituality is associated with a more frequent use of SCAM, we ought to ask what the nature of the link between the two might be. There are, as far as I can see, three possibilities:

  1. religiousness/spirituality causes SCAM use;
  2. SCAM use causes religiousness/spirituality;
  3. the two are related via one or several other factors.

I see no reason why 1 or 2 should be true. More likely there is a common denominator. The obvious one might be that both religiousness/spirituality and SCAM use are somewhat irrational, more a matter of belief than evidence, and revealing a lack of scepticism or critical thinking. In this case, religiousness/spirituality and SCAM use would simply be two different expressions of the same frame of mind.

What do you think?

 

 

During the last few months, I have done little else on this blog than trying to expose misinformation about COVID-19 in the realm of so-called alternative medicine (SCAM). However, the usefulness and accuracy of most viewed YouTube videos on COVID-19 have so far not been investigated. Canadian researchers have just published a very nice paper that fills this gap.

They performed a YouTube search on 21 March 2020 using keywords ‘coronavirus’ and ‘COVID-19’, and the top 75 viewed videos from each search were analysed. Videos that were duplicates, non-English, non-audio and non-visual, exceeding 1 hour in duration, live and unrelated to COVID-19 were excluded. Two reviewers coded the source, content and characteristics of included videos. The primary outcome was usability and reliability of videos, analysed using the novel COVID-19 Specific Score (CSS), modified DISCERN (mDISCERN) and modified JAMA (mJAMA) scores.

Of 150 videos screened, 69 (46%) were included, totalling 257 804 146 views. Nineteen (27.5%) videos contained non-factual information, totalling 62 042 609 views. Government and professional videos contained only factual information and had higher CSS than consumer videos (mean difference (MD) 2.21, 95% CI 0.10 to 4.32, p=0.037); mDISCERN scores than consumer videos (MD 2.46, 95% CI 0.50 to 4.42, p=0.008), internet news videos (MD 2.20, 95% CI 0.19 to 4.21, p=0.027) and entertainment news videos (MD 2.57, 95% CI 0.66 to 4.49, p=0.004); and mJAMA scores than entertainment news videos (MD 1.21, 95% CI 0.07 to 2.36, p=0.033) and consumer videos (MD 1.27, 95% CI 0.10 to 2.44, p=0.028). However, they only accounted for 11% of videos and 10% of views.

The authors concluded that over one-quarter of the most viewed YouTube videos on COVID-19 contained misleading information, reaching millions of viewers worldwide. As the current COVID-19 pandemic worsens, public health agencies must better use YouTube to deliver timely and accurate information and to minimise the spread of misinformation. This may play a significant role in successfully managing the COVID-19 pandemic.

I think this is an important contribution to our knowledge about the misinformation that currently bombards the public. It explains not only the proliferation of conspiracy theories related to the pandemic, but also the plethora of useless SCAM options that are being touted endangering the public.

The authors point out that the videos included statements consisting of conspiracy theories, non-factual information, inappropriate recommendations inconsistent with current official government and health agency guidelines and discriminating statements. This is particularly alarming, when considering the immense viewership of these videos. Evidently, while the power of social media lies in the sheer volume and diversity of information being generated and spread, it has significant potential for harm. The proliferation and spread of misinformation can exacerbate racism and fear and result in unconstructive and dangerous behaviour, such as toilet paper hoarding and mask stealing behaviours seen so far in the COVID-19 pandemic. Consequently, this misinformation impedes the delivery of accurate pandemic-related information, thus hindering efforts by public health officials and healthcare professionals to fight the pandemic.

Good work!

I suggest to critically evaluate the statements of some UK and US politicians next.

 

As we have discussed repeatedly, chiropractors tend to be critical of vaccinations. This attitude is easily traced back to DD Palmer, the founding father of chiropractic, who famously wrote about smallpox vaccinations: ‘…the monstrous delusion … fastened on us by the medical profession, enforced by the state boards, and supported by the mass of unthinking people …

In Canada, the anti-vaccination attitude of chiropractors has been the subject of recent media attention. Therefore, researchers explored the association between media attention and public dissemination of vaccination information on Canadian chiropractors’ websites.

In 2016, an international team of investigators identified all Canadian chiropractors’ websites that provided information on vaccination by extracting details from the regulatory college website for each province using the search engine on their “find a chiropractor” page. The researchers assessed the quality of information using the Web Resource Rating Tool (scores range from 0% [worst] to 100% [best]), determined whether vaccination was portrayed in a positive, neutral or negative manner, and conducted thematic analysis of vaccination content. Now the researchers have revisited all identified websites to explore the changes to posted vaccination material.

Here are their findings:

In July 2016, of 3733 chiropractic websites identified, 94 unique websites provided information on vaccination:

  • 59 (63%) gave negative messaging,
  • 19 (20%) were neutral,
  • 16 (17%) were positive.

The quality of vaccination content on the websites was generally poor, with a median Web Resource Rating Tool score of 19%. Four main themes were identified:

  1. there are alternatives to vaccination,
  2. vaccines are harmful,
  3. evidence regarding vaccination,
  4. health policy regarding vaccination.

From 2012 to 2016, there was one single Canadian newspaper story concerning anti-vaccination statements by chiropractors, whereas 51 news articles were published on this topic between 2017 and 2019. In April 2019, 45 (48%) of the 94 websites originally identified in 2016 had removed all vaccination content or had been discontinued.

The authors of this investigation concluded that in 2016, a minority of Canadian chiropractors provided vaccination information on their websites, the majority of which portrayed vaccination negatively. After substantial national media attention, about half of all vaccination material on chiropractors’ websites was removed within several years.

I find these findings encouraging. They demonstrate that media attention can produce change for the better. That gives me the necessary enthusiasm to carry on my work in putting the finger on the dangers of chiropractic and other forms of so-called alternative medicine (SCAM). At the same time, the findings of this investigation are also disappointing. About half of all the chiropractors had not removed their misleading content from their websites despite the 51 articles highlighting the problem. This shows, I think, how deeply entrenched this vitalistic nonsense is in the heads of many chiropractor.

This means there is still a lot to do – so, let’s get on with it!

1 2 3 8
Recent Comments

Note that comments can be edited for up to five minutes after they are first submitted but you must tick the box: “Save my name, email, and website in this browser for the next time I comment.”

The most recent comments from all posts can be seen here.

Archives
Categories