survey
Individuals with large followings can influence public opinions and behaviors, especially during a pandemic. In the early days of the COVID pandemic, US president Donald J Trump endorsed the use of unproven therapies. Subsequently, a death attributed to the wrongful ingestion of a chloroquine-containing compound occurred.
This paper investigated Donald J Trump’s speeches and Twitter posts, as well as Google searches and Amazon purchases, and television airtime for mentions of hydroxychloroquine, chloroquine, azithromycin, and remdesivir. Twitter sourcing was catalogued with Factba.se, and analytics data, both past and present, were analyzed with Tweet Binder to assess average analytics data on key metrics. Donald J Trump’s time spent discussing unverified treatments on the United States’ 5 largest TV stations was catalogued with the Global Database of Events, Language, and Tone, and his speech transcripts were obtained from White House briefings. Google searches and shopping trends were analyzed with Google Trends. Amazon purchases were assessed using Helium 10 software.
From March 1 to April 30, 2020, Donald J Trump made 11 tweets about unproven therapies and mentioned these therapies 65 times in White House briefings, especially touting hydroxychloroquine and chloroquine. These tweets had an impression reach of 300% above Donald J Trump’s average. Following these tweets, at least 2% of airtime on conservative networks for treatment modalities like azithromycin and continuous mentions of such treatments were observed on stations like Fox News. Google searches and purchases increased following his first press conference on March 19, 2020, and increased again following his tweets on March 21, 2020. The same is true for medications on Amazon, with purchases for medicine substitutes, such as hydroxychloroquine, increasing by 200%.
The authors concluded that individuals in positions of power can sway public purchasing, resulting in undesired effects when the individuals’ claims are unverified. Public health officials must work to dissuade the use of unproven treatments for COVID-19.
Trump is by no means the only politician who misled the public in matters of healthcare through ignorance, or stupidity, or both. Other recent examples that we previously discussed include, for instance:
- Kirsty Adams (UK) – UK politician dabbles in faith healing
- Andrew Bridgen (UK) – British politician punished for calling COVID-vaccination the “biggest crime against humanity since the holocaust”
- Norbert Hofer (Austria) – When politicians become snake-oil salesmen
- Penny Mordaunt (UK) – Penny Mordaunt, defender of homeopathy
- Jeremy Corbyn (UK) – Jeremy Corbyn and homeopathy
- David Tredennick (UK) – David Tredinnick: perhaps the worst example of scientific illiteracy in government?
Yes, Trump is not the only, but he is the most influential and might well be the most ignorant one:
- Words of wisdom from Donald Trump on science and related matters
- The ‘Trump-Effect’ on vaccination attitudes
- Trump seems to think that UV might be the answer to the corona-pandemic – could he mean “ultraviolet blood irradiation”?
- Andrew Wakefield, Donald Trump, SCAM, and the anti-vaccination cult
- Unbelievable: ‘THE TRUMP WELLNESS-PLAN’
For this reason alone – and there are many more – I hope he will not soon become merely a dark and scary chapter in the history of the US.
This retrospective audit aimed to assess the clinical effectiveness of telehealth interventions in an out-patient, individualized homeopathy clinical setting for 305 individuals with symptoms of positive or probable COVID-19
by a team of professional homeopaths working together in the United States during spring and summer of
2020.
The audit lasted from March to August 2020. It examined the merits of the initiative considering accessibility, effectiveness, safety, efficiency, and appropriateness of the care model.
Positive intervention outcomes were found in every measure:
- individual remedy prescriptions (83.4% positive),
- final outcomes of interventions (76.2% positive),
- degree of recovery following homeopathic interventions (74.4%).
Additionally, ease of access for a range of users, a high level of safety of the interventions, and efficiency of care and team resources indicated consistently positive outcomes.
The authors concluded that, given the significant strain on conventional healthcare systems during the early stages of the pandemic, the complementary medicine interventions studied here offer important considerations for meeting the demands for COVID-19 acute care with agile and adaptive complementary medicine models.
If one were to look for ridiculously poor studies in the realm of homeopathy, one would be spoilt for choice. Amongst the many such papers, this one would achieve a very high ranking. The investigation is nonsensical in:
- concept,
- design,
- endpoints,
- write-up,
- conclusion.
The paper prompts me to ask a few questions (and some answers):
Whoever had the notion that an audit can “assess the clinical effectiveness” of a therapy?
Do the authors even know what an audit is?
What institutions are behind such embarrassingly poor work? They are:
- ‘HOHM Foundation’, New York,
- the ‘Academy of Homeopathy Education,
- HOHM Foundation, Philadelphia.
Which journal publishes such rubbish?
It’s INTEGRATIVE MEDICINE REPORTS, a publication that claims to be a “high-quality open access journal”.
And who sponsors such idiocy?
This study was funded by donations to HOHM Partners and to Homeopathy Help Network by clients and community members.
Say no more!
A new market report predicts that the worldwide market for so-called alternative medicine (SCAM) will grow from $100 billion in 2022 to $438 billion by 2032.
According to the report, the SCAM market is expected to see innovation and expansion through mergers, acquisitions, and partnerships among large companies. Companies that are capitalizing on these trends include health supplement companies, companies that specialize in Ayurvedic health, those that offer TCM solutions, and those that offer more general holistic solutions to health. Major supplement brands include Herb Pharm LLC, Gaia Herbs, NOW Foods, Life Extension, Pure Encapsulations, Douglas Laboratories, Nordic Naturals, Nordic Nutraceuticals, Quality of Life Labs, Nature’s Bounty Co., Valensa International, Herbo Nutra, and Emerson Ecologics.
Other major players mentioned in the report are:
- AYUSH Ayurvedic Pte Ltd, Dabur India Ltd., Himalaya Global Holdings Ltd., Banyan Botanicals, and Arya Vaidya Pharmacy offer Ayurvedic health and wellness products while aiming to advance the science behind Ayurveda.
- Sheng Chang Pharmaceutical Company produces traditional Chinese medicines and herbal products that is one of the largest TCM pharma companies.
- All and One Medical provides healthcare solutions that combine conventional medicine with complementary and alternative therapies to promote overall wellness and preventive care.
- The John Schumacher Unity Woods Yoga Center is another that focuses on enhancing physical and mental well-being through the practice of Iyengar Yoga and offers classes and workshops.
- New Life Chiropractic aims to improve overall health and well-being by providing comprehensive chiropractic care that focuses on spinal health and preventive wellness.
- The Chicago Body Works offers a range of therapies and treatments designed to enhance physical and mental well-being, including massage and bodywork services.
- Weleda AG aims to connect people with nature by producing natural organic products that support health, beauty, and overall wellness while practicing sustainability and social responsibility.
- Quantum-Touch Inc. teaches energy healing techniques that promote physical, emotional, and spiritual health.
- Spectrum Chemical Manufacturing Corporation focuses on delivering high-quality chemicals and laboratory supplies to support scientific research and innovation across various industries, including health and wellness.
I must admit, I do like these market reports. They never fail to amuse me – for two main reasons:
- They are as reliable as reading tea leafs.
- The only reliable info they do provide is that the SCAM proponents’ often-voiced argument, “we are very different from BIG PHARMA” is pure nonsense.
People living with HIV (PLWH) are common users of so-called alternative medicine (SCAM). The main objective of this study was to study the frequency and patterns of SCAM natural products use in a large cohort of PLWH and to identify potential drug–drug interactions (DDIs) and the impact on their antiretroviral treatment (ART) adherence and efficacy.
This was a cross-sectional multicenter survey including 420 PLWH from different Spanish hospitals. Participants completed a face-to-face questionnaire on SCAM consumption and different sociodemographic and clinical data were collected. DDIs between SCAM and ART were identified and classified according to the Liverpool University Database and patient factors related to SCAM consumption were assessed.
In total, 420 participants were included (82.6% male, mean age 47 years); 209 patients (49.8%) were taking at least one SCAM. The most consumed SCAM were:
- green, black and red tea (n=146, 25.4%),
- ginger (n=26, 4.5%),
- fish oil (n=25, 4.4%),
- cannabis (n=24, 4.2%).
An ART based on integrase inhibitors was the only factor independently associated with SCAM consumption (OR 1.54, 95% CI 1.04 to 2.26). 50 potential SCAM–ART interactions in 43 (20.6%) patients taking SCAM were identified, being clinically significant in 80% of the cases. SCAM products most frequently involved with a potential significant DDI were supplements containing divalent cations (n=11) and garlic (n=7). No differences in ART efficacy and adherence were observed between patients with and without SCAM consumption.
The authors concluded that almost 50% of patients were taking at least one SCAM product and its use was associated with an integrase inhibitor based ART. One out of every six patients was at risk of presenting with an interaction between a SCAM and their ART, confirming the need to review continuously the use of SCAM as part of the medication review process.
So, the authors found that half of all PLWHs use some form of SCAM (whether I would classify tea as a SCAM is a different question). They also point out that this might put many PLWHs at risk. What I don’t understand is why they do not take the next logical step and ask what the benefits of the SCAMs for PLWHs are.
Allow me to answer this question: they are zero or very close to zero!
And this means that SCAMs generate a risk for PLWHs without creating any meaningful benefit. In other words the risk-benefit balance fails to be positive.
I think that this is an important point which needs to be stressed clearly in the conclusions. Therefore, I suggest to re-formulate them as follows:
Almost 50% of patients were taking at least one SCAM product. One out of every six patients was at risk of presenting with an interaction between a SCAM and their ART. The SCAMs used convey no appreciatable benefit. Therefore, SCAM use fails to generate more good than harm. It follows that responsible healthcare professionals should discurage SCAM use.
I am sure that I am not the only one who has occasionally wondered what political orientation is associated with a high level of SCAM-use. Surprisingly, there is very little research on this question. This study is one of the rare ones (if not the only one) that has looked into the issue. It investigated whether individual political orientation (PO) predicts the use of conventional (CM) and SCAM across Europe.
Cross-sectional samples representative of persons aged 15 and over from 19 European countries were used (ESS 2015; round 7; N = 35,572). PO assessments were based on participants’ vote choice in the most recent national election, using expert ratings of party positioning along five political-ideological dimensions: left-right general; left-right economic; Green/alternative/libertarian vs. Traditional/authoritarian/nationalist; anti-elite; and anti-corruption. Use of CM was defined as having consulted a general practitioner or specialist, and use of SCAM as having used acupuncture, acupressure, Chinese medicine, homeopathy, herbal treatment, hypnotherapy, or spiritual healing.
The results suggested that individual political orientation predicted not only the use of SCAM treatments but also the use of CM. While the traditional left-right axis did not predict either category of service use, the political orientation that was relevant was one focused on corruption. People who voted for political parties with salient anti-corruption agendas were less likely to seek CM and more likely to use SAM. In addition, voters of parties that prefer expanded personal freedoms—such as access to abortion, same-sex marriage, greater democratic participation—were more likely to use SCAM than other Europeans. People in poor health tended to use CM regardless of their political leanings: a relationship between anti-corruption and CM usage was observed onlu among people who were in good health. By contrast, health status did not affect the links between political orientation and SCAM.
The authors concluded that their study shows that the political dimensions relevant for health behaviors do not align primarily along the traditional left-right axis in Europe. The results suggest that the lay public may not necessarily see conventional healthcare as a politically neutral enterprise, and that SCAM providers may be serving needs that are unmet by conventional medicine. The results further suggest that perceptions of corruption among the lay public are more relevant for healthcare usage than has been acknowledged. An important question for future research is how the association between concerns about corruption and reluctance to seek conventional biomedical care is best explained.
I must admit I am surprised by some of these findings. Before we seek an explanation, I feel, we ought to have an independent replication of the results.
Perhaps, the associations are much more complex. I have the impression, for instance, that they depend not only on the country but also on the specific SCAM in question. If I had to guess, I’d say, for example, that:
- German naturopathy is associated with conservative politics;
- British homeopathy is associated with liberal politics;
- French homeopathy is associated with conservative politics;
- US chiropractic is associated with right wing politics;
- Austrian acupuncture is associated with left wing politics;
But these are truly wild guesses!
If anyone has some factual information, I’d like to see it, please.
Yesterday, I received the email below. I almost deleted it because, at first glance, it looked like spam. Then I started reading it – perhaps you should do so too.
Dear Edzard Ernst,
We’d like to inform you that Research.com, a leading academic platform for researchers, has just released the 2024 Edition of our Ranking of Best Scientists in the field of Medicine.
We are sure you will be very happy to learn that you have ranked #819 in the world ranking and #86 in United Kingdom. You have also been recognized with our Medicine Leader Award for 2024. Congratulations!
The ranking is based on D-index (Discipline H-index) metric, which only includes papers and citation values for an examined discipline. The ranking includes only leading scientists with D-index of at least 70 for academic publications made in the area of Medicine.
The full world ranking is available here: https://www.research.com/scientists-rankings/medicine
The full ranking for United Kingdom is available here: https://www.research.com/scientists-rankings/medicine/gb
Feel free to also read an article summarizing the statistics and trends from our ranking here: https://research.com/careers/world-online-ranking-of-best-medicine-scientists-2024-report
Please accept our sincere congratulations. Being present in our ranking is definitely a great achievement for you and your university or research institution. Feel free to share and publicize your accomplishment in any way you see fit.
With Best Regards…
________________________
I am not sure how significant this all is. Nonetheless, I thought I share the email with my small fan club from my blog.
This study aims to appraise the utility, accuracy, and quality of information available on YouTube on acupuncture for chronic pain treatment. Using search terms such as “acupuncture for chronic pain” and “acupuncture pain relief”, the top 54 videos by view count were selected. Videos were included if they were:
- > 1 minute duration,
- contained audio in English,
- had > 7000 views,
- related to acupuncture.
Each video was categorised as either:
- useful,
- misleading,
- or neither.
Another primary outcome of interest was the quality and reliability of each video using validated instruments, including the modified DISCERN (mDISCERN) tool and the Global Quality Scale (GQS). The means were calculated for the video production characteristics, production sources, and mDISCERN and GQS scores. Continuous and categorical outcomes were compared using Student’s t-test and chi-square test, respectively.
The results show that, of the 54 videos,
- 57.4% were categorized as useful,
- 14.8% were misleading,
- and 27.8% were neither.
Useful videos had a mean GQS and mDISCERN score of 3.77± 0.67 and 3.48± 0.63, respectively, while misleading videos had mean GQS and mDISCERN score of 2.50± 0.53 and 2.38± 0.52, respectively. 41.8% of the useful videos were produced by a healthcare institution while none of the misleading videos were produced by a healthcare institution. However, 87.5% of the misleading videos were produced by health media compared to only 25.8% of useful videos from health media.
The authors concluded that their analysis of the highest viewed acupuncture videos for chronic pain reveals only about half provide useful information, indicating a significant misinformation challenge for viewers. This underscores the urgent need for more high-quality, unbiased videos from healthcare institutions and physicians on complementary health practices like acupuncture.
This new analysis confirms what we and others have shown numerous times before: information about so-called alternative medicine (SCAM), which is abundantly available on the Internet, needs to be taken with a healthy pinch of salt. Whenever we studied the issue, our conclusions were even less optimistic than those of the present authors. In fact, most of the time we concluded that following such advice is a risk factor to our health.
If you google ‘chiropractic’ you might get the impression that an unusual number of US chiros are outright perverts. Here are four current cases that I found instantly without any in-depth seraching:
A “Christian chiropractor” is facing several criminal charges after at least eight former clients have accused him of rape and sexual assault. Roc Byrd, 61, of Danville, who worked as a chiropractor for Cornerstone Chiropractic in Avon, is facing one felony count of rape, five felony counts of sexual battery and four misdemeanor counts of battery. He is accused of raping a client, touching clients inappropriately over and under their clothes during appointments without consent and pressing his genitals up against multiple patients. Byrd identified himself as a practicing Christian and reportedly began each of his chiropractic appointments by praying with clients.
A Warren chiropractor faces significant legal problems and a criminal investigation into how he allegedly treated one of his patients. Officials say he sells himself as one of only a handful of Michigan “Chiropractic Neurologists,” but the former patient claims he is a sexual predator and offers video as apparent proof. The case involves Dr. John Pispidikis of the Spinal Recovery Center. The complaint was filed Friday (April 19) morning, which surprised the doctor. The patient involved remains unnamed in the civil court documents, but she claims the doctor groped her during a physical exam last February. But she had no proof, so she claims she went out and got some.
The Oklahoma Board of Chiropractic Examiners (OBCE) has ordered the Back Stop’s only chiropractor, Mark Kimble to surrender his license by next Monday after several sexual impropriety allegations against him have surfaced. Oklahoma Board of Chiropractic Examiners confirmed with KFOR that there are seven alleged victims of Kimble’s who have come forward.
The Los Angeles County Sheriff’s Department is looking for possible victims of a chiropractor accused of sexual assault. Richard Carnow, 65, was arrested by authorities on March 13 on four felony counts of sexual battery. Carnow is a chiropractor in San Dimas in the San Gabriel Valley, the Sheriff’s Department says. He’s accused of sexually assaulting multiple adult women between June 2023 and August 2023. Officials did not say if his alleged victims were current or former patients. Investigators say the nature of the alleged crimes have led them to believe there may be additional victims and they are asking for the public’s help to find them.
Yes, I know, these are (according to chiros’ assurances) regrettable, isolated cases – nothing to worry about!
But perhaps these assertions are wrong and there is a problem after all?
I am reminded of my post from 2021; let me refresh your memory:
Two chiropractors conducted a retrospective review of publicly available data from the California Board of Chiropractic Examiners. Their aim was to determine categories of offense, experience, and gender of disciplined doctors of chiropractic (DC) in California and compare them with disciplined medical physicians in California. The DC disciplinary categories, in descending order, were
- fraud (44%),
- sexual boundary issues (22%),
- other offences (13%),
- abuse of alcohol or drugs (10%),
- negligence or incompetence (6%),
- poor supervision (2%),
- mental impairment (.3%).
The authors concluded that the professions differ in the major reasons for disciplinary actions. Two thirds (67%) of the doctors of chiropractic were disciplined for fraud and sexual boundary issues, compared with 59% for negligence and substance misuse for medical physicians. Additional study in each profession may reveal methods to identify causes and possible intervention for those who are at high risk.
The abstract of the paper does not provide comparisons to with the medical profession. Here they are; relative to doctors, chiropractors are:
- 2 x more likely to be involved in malpractice,
- 9 x more likely to commit fraud,
- 2 x more likely to transgress sexual boundaries.
________________________
Could it be, I askmyself, that there is something deeply wrong with the chiropractic profession? Could it perhaps be that chiro schools do not have a good hand when it comes to student recruitment? Could it be that chiro schools teach too little medical ethics, or none at all?
The Academy of Homeopathy Education is a US-based accredited teaching institution offering homeopathy education services to professional and medically licensed homeopathy students. This study reports on clinical outcomes from the teaching clinic from 2020 to 2021.
Data were collected using the patient-generated outcome measure, the Measure Yourself Concerns and Wellbeing (MYCaW). Mean MYCaW values for initial and subsequent consultations were analyzed for the degree of change across the intervention period in 38 clients. Each client listed up to two complaints. MYCaW scores between initial and subsequent consultations were analyzed for the degree of change (delta) across the intervention period.
A total of 95 body system-related symptoms were analyzed for change in intensity following the homeopathic intervention. Statistically significant improvements in the intensity of main symptoms were observed between initial and subsequent follow-ups. The main symptom scores showed a mean change in intensity (delta MYCaW) of −0.79 points (95% confidence interval (CI), −1.29 to −0.29; p = 0.003) at first follow-up, a mean change of −1.67 points (95% CI, −2.34 to −0.99; p = 0.001) at second follow-up compared with the initial visit, and a mean change of −1.93 points (95% CI, −3.0 to −0.86; p = 0.008) at third follow-up compared with the initial visit. For clients with four or more follow-ups, the mean delta MYCaW was −1.57 points (95% CI, −2.86 to −0.28; p = 0.039).
The authors concluded that statistically significant improvements as well as some clinically meaningful changes in symptom intensity were found across a diverse group of individuals with a variety of long-term chronic conditions. The improvement was evident across different body systems and different levels of chronicity. There are limitations to the generalizability of the study due to the research design. Further research and investigation are warranted given the promising results of this work.
There are, of course, not just limits to the generalizability of this study! I’d say there are limits to the interpretation of any of its findings.
What was the cause of the improvements?
Here are just a few questions that I asked myself while reading this paper:
- Are the guys from the Academy of Homeopathy Education not aware of the fact that even chronic conditions often get better by themselves?
- Have they heard of the placebo effect?
- Are they trying to tell us that the patients did not also use conventional treatments for their chronic conditions?
- What about regression towards the mean?
- What about social desirability?
- Why do they think that further research is needed?
- Are these really results that look ‘promising for homeopathy?
To answer just the last question: No, these findings are in perfect agreement with the fact that highly diluted homeopathic remedies are pure placebos (to be honest, they would even be in agreement with such remedies being mildly harmful).
This study aims to assess the feasibility of a pragmatic prospective study aiming to report the immediate and delayed (48-hours post-treatment) AEs associated with manual therapies in children aged 5 or younger and to report preliminary data on AEs frequency.
Between July 2021 and March 2022, chiropractors were recruited through purposive sampling and via a dedicated Facebook group for Quebec chiropractors interested in pediatrics. Legal guardians of patients aged 5 or younger were invited to fill out an online information and consent form. AEs were collected using the SafetyNET reporting system, which had been previously translated by the research team. Immediate AEs were collected through a questionnaire filled out by the legal guardian immediately after the treatment, while delayed AEs were collected through a questionnaire sent by email to the legal guardian 48 h after the treatment. Feasibility was assessed qualitatively through feedback from chiropractors and quantitatively through recruitment data.
Overall, a total of 28 chiropractors expressed interest following the Facebook publication, and 5 participated. An additional two chiropractors were enrolled through purposive sampling. In total, 80 legal guardians consented to their child’s participation, and data from 73 children were included for the analysis of AEs. At least one AE was reported in 30% of children (22/73), and AEs were mainly observed immediately following the treatment (16/22). The most common AEs were irritability/crying (11 children) or fatigue/tiredness (11 children). Feasibility analysis demonstrated that regular communication between the research team and clinicians, as well as targeting clinicians who showed great interest in pediatrics, were key factors for successful research.
The authors concluded that their results suggest that it is feasible to conduct a prospective pragmatic study evaluating AEs associated with manual therapies in private practices. Direct communication with the clinicians, a strategic clinicians’ recruitment plan, and the resulting administrative burden should be considered in future studies. A larger study is required to confirm the frequency of AEs reported in the current study.
It is hardly surprising that such a study is ‘feasible’. I could have told the authors that and saved them the trouble of doing the study. What is surprising, in my view, that chiropractors, after ~120 years of existence of the profession, ask whether it is feasible.
I suggest to do the definitive study on a much larger sample, extend the observation period, and recruit a representative rather than self-selected sample of chiros … or – much better – forget about the study and establich a functioning post-marketing surveillance system.
