Updated Edition!
This randomised, double blind controlled trial compared the efficacy of curcumin versus omeprazole in improving patient reported outcomes in people with dyspepsia.
The interventions were:
- curcumin alone (C),
- omeprazole alone (O),
- curcumin plus omeprazole (C+O).
Patients in the combination group received two capsules of 250 mg curcumin, four times daily, and one capsule of 20 mg omeprazole once daily for 28 days.
Main outcome measure was unctional dyspepsia symptoms on days 28 and 56, assessed using the Severity of Dyspepsia Assessment (SODA) score. Secondary outcomes were the occurrence of adverse events and serious adverse events.
A total of 206 patients were enrolled in the study and randomly assigned to one of the three groups; 151 patients completed the study. Demographic data (age 49.7±11.9 years; women 73.4%), clinical characteristics and baseline dyspepsia scores were comparable between the three groups. Significant improvements were observed in SODA scores on day 28 in the pain (−4.83, –5.46 and −6.22), non-pain (−2.22, –2.32 and −2.31) and satisfaction (0.39, 0.79 and 0.60) categories for the C+O, C, and O groups, respectively. These improvements were enhanced on day 56 in the pain (−7.19, –8.07 and −8.85), non-pain (−4.09, –4.12 and −3.71) and satisfaction (0.78, 1.07, and 0.81) categories in the C+O, C, and O groups, respectively. No significant differences were observed among the three groups and no serious adverse events occurred.
The authors concluded that curcumin and omeprazole had comparable efficacy for functional dyspepsia with no obvious synergistic effect.
This study, which was funded by the Thai Traditional and Alternative Medicine Fund, has been picked up by the press and is being lauded as a solid proof of efficacy. Its authors too are not half proud of their splendid trial:
This multicentre randomised controlled trial provides highly reliable evidence for the treatment of functional dyspepsia. PPIs, widely used and approved for over-the-counter use, were compared with curcumin, a popular herbal remedy. The study design, including double blind randomisation, minimised biases. Participants met strict criteria, underwent endoscopy and were tested for H pylori infection. Furthermore, we implemented measures to minimise biases by ensuring that the individuals administering the drugs, participants receiving the drugs and individuals conducting the assessment remained blinded to the type of medications administered to the participants. The trial was carried out in hospitals, and certified individuals used standardised questionnaires for assessments. Statistical methods were appropriate and followed accepted principles.
Two follow-up appointments were scheduled, and blood tests showed no abnormal symptoms or liver function abnormalities. However, participants with high body mass index indicated a trend towards liver function impairment in the curcumin group, suggesting the need for larger studies. Some participants did not provide follow-up information, which is a study weakness. However, the number of participants who provided this information was sufficient for statistical analysis and the majority of the participants attended the follow-up visit. Therefore, it can be deduced from the results that even if the number of participants followed after drug administration increased, the study findings would not be significantly different. Another limitation of this study was the absence of long term follow-up data for all patients after treatment. This is a question that will require further investigation.
The strength of the study lies in its relevance to daily clinical practice, providing additional drug options in addition to PPIs alone, without added side effects. The study was unbiased, partially funded by government organisations and the first well designed trial comparing curcumin with PPI for functional dyspepsia, with confirmation through endoscopy and ruling out H pylori infection. Limitations of this study included the small number of patients who were lost to follow-up and the lack of long term follow-up data.
However, I am far less impressed.
Why?
Curcumin is bright yellow and has a very distinct taste/smell. Even though curumin was given in capsules, patients can easily tell what they are taking. I therefore doubt that they were adequately blinded. In fact, the authors seem to agree when they state the following:
We observed that despite improvements in pain and non-pain scores, there was no significant improvement in the SODA satisfaction scores in the O and C+O groups (table 3). A possible explanation for this observation could be related to the taste and/or smell of curcumin, which might have caused reduced pleasantness for the participants while ingesting it. This potential discomfort could offset the improvements in pain and non-pain symptoms, leading to the non-significant change in satisfaction score. Further studies may be needed to explore this hypothesis as well as to improve the palatability of curcumin.
Sadly, the success of blinding (which under such circumstances should always be tested) was not reported and probably not even quantified. If many patients were de-blinded, it seems inevitable that their expectation influenced the results. In other words, the much-lauded effect of curcumin might just be due to placebo and curcumin might be entirely useless. Or, to put it bluntly, the trial was not nearly as good as many made it out to be.
PS
Sad to see that the reviewers of a reputable journal failed to pick up on this significant flaw.
The aim of this systematic review was to update the current level of evidence for spinal manipulation in influencing various biochemical markers in healthy and/or symptomatic population.
Various databases were searched (inception till May 2023) and fifteen trials (737 participants) that met the inclusion criteria were included in the review. Two authors independently screened, extracted and assessed the risk of bias in included studies. Outcome measure data were synthesized using standard mean differences and meta-analysis for the primary outcome (biochemical markers). The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was used for assessing the quality of the body of evidence for each outcome of interest.
There was low-quality evidence that spinal manipulation influenced various biochemical markers (not pooled). There was low-quality evidence of significant difference that spinal manipulation is better (SMD -0.42, 95% CI – 0.74 to -0.1) than control in eliciting changes in cortisol levels immediately after intervention. Low-quality evidence further indicated (not pooled) that spinal manipulation can influence inflammatory markers such as interleukins levels post-intervention. There was also very low-quality evidence that spinal manipulation does not influence substance-P, neurotensin, oxytocin, orexin-A, testosterone and epinephrine/nor-epinephrine.
The authors concluded that spinal manipulation may influence inflammatory and cortisol post-intervention. However, the wider prediction intervals in most outcome measures point to the need for future research to clarify and establish the clinical relevance of these changes.
The majority of the studies were of low or very low quality. This means that the collective evidence is less than reliable. In turn, this means, I think, that the conclusions are misleading. A more honest conclusion would be this:
There is no reliable evidence that spinal manipulation influences inflammatory and cortisol levels.
As for the clinical relevance, I would like to point out that it would not be surprising if chiropractors could one day convincingly show that spinal manipulation do influence various biochemical markers. Many things do! If you fall down a staircase, for instance, plenty of biochemical markers will be affected. This, however, does not mean that throwing our patients down the stairs is of therapeutic value.
The objectives of this randomized double-blind placebo-controlled clinical trial were to determine if there:
- (a) is an overall effect of homeopathic treatment (homeopathic medicines plus consultation) in the treatment of ADHD;
- (b) are any specific effects the homeopathic consultation alone in the treatment of ADHD;
- (c) are any specific effects of homeopathic medicines in the treatment of ADHD.
Children aged 6–16 years diagnosed with ADHD were randomized to one of three arms:
- Arm 1 (Remedy and Consultation);
- Arm 2 (Placebo and Consultation);
- Arm 3 (Usual Care).
The primary outcome measure was the change of the Conner 3 Global Index-Parent T-score (CGI-P T score) between baseline and 28 weeks.
The results showed an improvement in ADHD symptoms as measured by the CGI-P T score in the two groups (Arms 1 and 2) that received consultations with a homeopathic practitioner when compared with the usual care control group (Arm 3). Parents of the children in the study who received homeopathic consultations (Arms 1 and 2) also reported greater coping efficacy compared with those receiving usual care (Arm 3). There was no difference in adverse events among the three study arms.
The authors concluded that, in this study, homeopathic consultations provided over 8 months with the use of homeopathic remedy was associated with a decrease in ADHD symptoms in children aging 6–16 years when compared with usual treatment alone. Children treated with homeopathic consultations and placebo experienced a similar decrease in ADHD symptoms; however, this finding did not reach statistical significance when correcting for multiple comparisons. Homeopathic remedies in and of themselves were not associated with any change in ADHD symptoms.
In the discussion section, the authors make their findings a little clearer: “The findings are generally consistent with a recent meta-analysis that concluded that (i)ndividualized homeopathy showed a clinically relevant and statistically robust effect in the treatment of ADHD. Similar to the meta-analysis, the authors found individualized homeopathy (consultation plus remedy) resulted in improvement in ADHD symptoms. However, the data suggest that this effect is not due to the remedy component of the intervention.”
The authors do not cite the (to the best of my knowledge) only study that had a very similar aim, namely differentiating between the effects of the homeopathic remedy and the homeopathic consultation. It was conducted by the late George Lweith who certainly was not against homeopathy. The conclusions of this trial were as follows: Homeopathic consultations but not homeopathic remedies are associated with clinically relevant benefits for patients with active but relatively stable rheumatoid arthritis.
Both trials confirm what rational thinkers have been saying for many years: the effects that many people experience after homeopathic therapy are not due to the homeopathic remedy but to the usually long and empathetic therapeutic encounter, the placebo effect, and other non-specific effects. To put it bluntly homeopathy is a kind of amateur psychotherapy.
Before someone now claims that this means homeopathy is fine, let me tell you this: no, it is not fine! If someone needs psychotherapy, he/she should see not an amateur but a professional, i.e. a psychologist who is properly trained in what she can and cannot do.
Swedish researchers examined the relationship between cognitive ability and prompt COVID-19 vaccination using individual-level data on more than 700,000 individuals in Sweden.
The analyses were based on individual-level data from several administrative registers in Sweden. The study population consisted of all men and women who enlisted for military service in Sweden between 1979 and 1997. During this period, enlistment was mandatory for men the year they turned 18 or 19. Women could not enlist for military service before 1980 but were then allowed to do so on a voluntary basis.
The study population thus covered almost the entire population of Swedish men born between 1962 and 1979, in total 750,381, as well as the sample of women who enlisted during the period of 1980–1997, in total 2703. In addressing the role of confounders, the researchers analyzed the sub-sample of 6750 twin brothers (3375 twin-pairs) in the enlistment records (identified by shared biological mother and year and month of birth).
The results show a strong positive association between cognitive ability and swift vaccination, which remained even after controlling for confounding variables with a twin-design. Consistent with this, the researchers showed that simplifying the vaccination decision through pre-booked vaccination appointments alleviates almost all of the inequality in vaccination behavior.
The authors concluded that the complexity of the vaccination decision may make it difficult for individuals with lower cognitive abilities to understand the benefits of vaccination.
On this blog, we have repeatedly discussed similar or related findings, e.g.:
- What are the reasons for opposing COVID vaccinations?
- Intelligence, Religiosity, SCAM, Vaccination Hesitancy – are there links?
- COVID-19 vaccinations: Prof Walach wants to “dampen the enthusiasm by sober facts”
- Thoughts on the bigotry of vaccination opponents
- More information on homeopaths’ and anthroposophic doctors’ attitude towards vaccinations
- The ‘Trump-Effect’ on vaccination attitudes
- The anti-vaccination movement is financed by the dietary supplement industry
- Andrew Wakefield, Donald Trump, SCAM, and the anti-vaccination cult
I know, it would be politically incorrect, unkind, unhelpful, etc. but is anyone not tempted to simplify the issue by assuming that people who are against (COVID) vaccinations are intellectually challenged?
The American Chiropractic Association Council on Chiropractic Pediatrics (CCP) announced a new diplomate education program focused on pediatric care. The program will include 300 hours of education covering topics such as pediatric development from birth to age 16, adjusting techniques, working diagnosis, clinical application, integrated care and more…
Development of the diplomate education program has been in the works for several years, with contributions from many members of the CCP, including council president Jennifer Brocker, DC, DICCP. At the helm of course development for this education program are Mary Beth Minser, DC, CACCP, and Kris Tohtz, DC, LAc, educational coordinators for CCP. They agreed that the goal of the new program is to provide education that furthers knowledge of chiropractic pediatrics in an evidence-based, integrative way. “We wanted to make sure that we had something that aligned with ACA’s core principles,” Dr. Tohtz said. “Chiropractic-forward, yes, but scientifically focused.”
Dr. Brocker added, “There was a need for more evidence-informed education [in pediatrics]. I felt like the Council was well positioned to take this on because we had the opportunity to build it from scratch, making it what students and practicing doctors need.” …
Drs. Minser and Tohtz are excited that the diplomate program will also include a research component. “There is some lacking information when it comes to pediatric chiropractic,” Dr. Minser explained. She recently participated in the COURSE Study, an international study seeking to fill knowledge gaps in research relating to pediatric chiropractic treatment. “It was a very easy project to do, and pretty exciting to be involved,” she said. “But you have to know how to treat pediatric patients in order to be involved in those research projects. We want doctors and students [in this program] to be able to go through a case study, to be able to extract information for their clinical application from that case study or from research, or, if they would like, to write up case studies so we can get more published.”
“We feel we could really push pediatric chiropractic to a whole new level having doctors that have this type of knowledge base,” Dr. Minser said. “We just want to be the best pediatric chiropractors that we can be, and this diplomate [education] program helps [us] do that.”
____________________________________
“There is some lacking information when it comes to pediatric chiropractic.”
Really?
I think the evidence is quite clear: chiropractic has nothing to offer for ill children that other, properly trained healthcare professionals would not do better.
“We feel we could really push pediatric chiropractic to a whole new level.”
Why?
“We just want to be the best pediatric chiropractors that we can be.”
In this case, please study the evidence and you will inevitably arrive at the following conclusion:
THE BEST A CHIROPRACTOR CAN DO FOR A SICK CHILD IS TO REFER IT TO A COMPETENT DOCTOR – A DOCTOR OF MEDICINE, NOT CHIROPRACTIC!
This study aimed to evaluate whether individualized homeopathic medicines have a greater adjunctive effect than adjunctive placebos in the treatment of moderate and severe cases of coronavirus disease 2019 (COVID-19). It was designed as a randomized, single-blind, placebo-controlled trial set in the clinical context of standard care. Patients admitted in a tertiary care hospital, suffering from moderate or severe COVID-19 and above 18 years of age were included. In total, 150 patients were randomly divided into two groups to receive either:
- individualized homeopathic medicines
- or placebos.
Both options were administered in addition to the standard treatment of COVID-19.
The primary outcome was time taken to achieve RT-PCR-confirmed virus clearance for COVID-19. Secondary outcomes were changes in the Clinical Ordinal Outcomes Scale (COOS) of the World Health Organization, the patient-reported MYMOP2 scale, and several biochemical parameters. Parametric data were analyzed using unpaired t-test. Non-parametric data were analyzed using the Wilcoxon signed rank test. Categorical data were analyzed using Chi-square test.
In total, 72 participants of the add-on homeopathy (AoH) group showed conversion of RT-PCR status to negative, in an average time of 7.53 ± 4.76 days (mean ± SD), as compared with 11.65 ± 9.54 days in the add-on placebo (AoP) group (p = 0.001). The mean COOS score decreased from 4.26 ± 0.44 to 3.64 ± 1.50 and from 4.3 ± 0.46 to 4.07 ± 1.8 in the AoH and AoP groups respectively (p = 0.130). The mortality rate for the AoH group was 9.7% compared with 17.3% in the AoP group. The MYMOP2 scores between the two groups differed significantly (p = 0.001), in favor of AoH. Inter-group differences in the pre- and post- mean values of C-reactive protein, fibrinogen, total leukocyte count, platelet count and alkaline phosphatase were each found to be statistically significant (p <0.05), favoring AoH; six other biochemical parameters showed no statistically significant differences.
The authors concluded that the study suggests homeopathy may be an effective adjunct to standard care for treating moderate and severe COVID-19 patients. More rigorous, including double-blinded, studies should be performed to confirm or refute these initial findings.
I do agree with the authors that more rigorous studies are needed before we can accept these findings. As it stands, this study seems to have multiple flaws:
- I fail to understand why they did not design their trial as a double-blind study. The reason given by the authors makes little sense to me.
- I also have my doubts that the study was even single-blind. If I understand it correctly, the placebo group was did not benefit from the detailed homeopathic history taking that is necessary to find the optimal homeopathic remedy. If that is so, unblinding of patients is inevitable.
- The authors themselves point out that the relevance of many outcome measures is questionable
Generally speaking, I find the results suspicious, implausible, and frankly too good to be true. I might also point out that the authors’ afilitation do not inspire much trust in their objectivity:
- 1Central Council for Research in Homoeopathy, New Delhi, India.
- 2Central Council for Research in Homoeopathy, Ministry of AYUSH, Govt. of India, New Delhi, India.
- 3Rejoice Health Foundation, New Delhi, India.
- 4Department of Onco-Anaesthesia and Palliative Medicine, Dr. B.R. Ambedkar Institute Rotary Cancer Hospital and National Cancer Institute, All India Institute of Medical Sciences, Ministry of Health and Family Welfare, New Delhi, India.
- 5Department of Onco-Anaesthesia and Palliative Medicine, All India Institute of Medical Sciences, Ministry of Health and Family Welfare, New Delhi, India.
Neither do these statements:
Funding
The study was funded by the Central Council for Research in Homoeopathy, Ministry of AYUSH, Government of India. The funder approved the study through its review committees, delegated/recruited staff for conducting the study, and facilitated all collaborative procedures.
Conflict of Interest
None declared.
Lastly, I do wonder why the authors published their study in the 3rd class journal ‘Homeopathy’. Surely, such findings – if true – deserve to be published in a journal of a decent reputation!
King Charles III is an enthusiastic, albeit uncritical proponent of so-called alternative medicine (SCAM). Does that boost his popularity in the general population? Or does it have the opposite effect? I am not aware of reliable data on this issue, yet I suspect it is neither here nor there. So, his waning popularity is probably caused by other factors.
A survey of more than 2,000 adult Brits found that overall, 62% want to keep the monarchy and 59% of people thought Charles was “personally doing a good job”.. At first glance, this looks not too bad for Charles and William but a more detailed analysis is far less optimistic: among 18 to 24-year-olds, only 30% say the monarchy is “good for Britain”. This “remarkable difference between generations”, demonstrates that younger people are much less supportive on remaining a monarchy and more sceptical about the Royal Family representing good value for money.
A decade ago, the same YouGov tracking survey found 17% preferred an elected head of state, which in this latest survey has risen to 26%. On the question whether Britain should continue to be a monarchy or be replaced with an elected head of state, the poll found:
- 62% wish no change,
- 26% want an elected head of state,
- 11% don’t know.
On the question whether the Royal Family is good value for money, 75% of the over-65s believe they are, but only 34% of 18 to 24-year-olds feel the same. And while 80% of the over-65s want Britain to stay as a monarchy, that figure falls to 37% for the 18 to 24-year-olds. There is also less support for the royals in Scotland or Wales than in England, where London has higher levels of people against the monarchy than elsewhere in the country.
Historian and royal commentator Ed Owens says the lack of support among the young should “certainly be of concern” to the Royal Family. But he says it will be difficult for the royals to turn this around, when many of the factors are outside their control. Dr Owens says opposition to the monarchy is part of a wider sense of “disenchantment” for younger generations about issues such as unaffordable housing, stagnant wages and student debt. “The system doesn’t seem to be working for them, so why should they celebrate an institution that seems to be at the heart of that system?” says Dr Owens.
Graham Smith, chief executive of the anti-monarchy campaign Republic, said the survey showed a “general trend of falling support, and that younger people will not be won back to the monarchist cause. Sooner rather than later we’ll see support for the monarchy fall below 50%.”
When the 1st edition of my book about about Charles’ (at the time, he was still ‘Prince of Wales’) love affair with SCAM came out, it was reviewd by the Daily Mail. They courageously asked Charles’ press office for a comment on it. A Clarence House spokesperson then told the journalist: ‘The Prince of Wales believes in combining the best of evidence based, conventional medicine with an holistic approach to healthcare – treating the whole person rather than just the symptoms of disease and taking into account the effects on health of factors such as lifestyle, the environment and emotional well-being.’ I know this is not all that meaningful and just a (fairly daft and uninformed) formular for getting rid of a tedious request, yet – for what it’s worth – it does not indicate that, in the realm of SCAM, Charles is all that open to change. More recent activities of King Charles seem to support this impression.
With regards to his overall popularitiy in the UK, this might mean that Charles will continue to lose the support of skeptics, while gaining the one of SCAM enthusiasts.
And the net result of this?
I fear it will almost be negligible.
This study aimed to compare the effects of cognitive functional therapy (CFT) and movement system impairment (MSI)-based treatment on pain intensity, disability, Kinesiophobia, and gait kinetics in patients with chronic non-specific low back pain (CNSLBP).
In a single-blind randomized clinical trial, the researchers randomly assigned 91 patients with CNSLBP into CFT (n = 45) and MSI-based treatment (n = 46) groups. An 8-week training intervention was given to both groups. The researchers measured the primary outcome, which was pain intensity (Numeric rating scale), and the secondary outcomes, including disability (Oswestry disability index), Kinesiophobia (Tampa Kinesiophobia Scale), and vertical ground reaction force (VGRF) parameters at self-selected and faster speed (Force distributor treadmill). They evaluated patients at baseline, at the end of the 8-week intervention (post-treatment), and six months after the first treatment. Mixed-model ANOVA was used to evaluate the effects of the interaction between time (baseline vs. post-treatment vs. six-month follow-up) and group (CFT vs. MSI-based treatment) on each measure.
CFT showed superiority over MSI-based treatment in reducing pain intensity (P < 0.001, Effect size (ES) = 2.41), ODI (P < 0.001, ES = 2.15), and Kinesiophobia (P < 0.001, ES = 2.47) at eight weeks. The CFT also produced greater improvement in VGRF parameters, at both self-selected (FPF[P < 0.001, ES = 3], SPF[P < 0.001, ES = 0.5], MSF[P < 0.001, ES = 0.67], WAR[P < 0.001, ES = 1.53], POR[P < 0.001, ES = 0.8]), and faster speed, FPF(P < 0.001, ES = 1.33, MSF(P < 0.001, ES = 0.57), WAR(P < 0.001, ES = 0.67), POR(P < 0.001, ES = 2.91)] than the MSI, except SPF(P < 0.001, ES = 0.0) at eight weeks.
The authors concluded that this study suggests that the CFT is associated with better results in clinical and cognitive characteristics than the MSI-based treatment for CNSLBP, and the researchers maintained the treatment effects at six-month follow-up. Also, This study achieved better improvements in gait kinetics in CFT. CTF seems to be an appropriate and applicable treatment in clinical setting.
To understand this study, we need to know what CFT and MSI exactly entailed. Here is the information that the authors provide:
Movement system impairment-based treatment
The movement system impairment-based treatment group received 11 sessions of MSI-based treatment over the 8 weeks for 60 min per session with a supervision of a native speaker experienced (above 5 years) physical therapist with the knowledge of MSI-based treatment. The researchers designed the MSI-based treatment uniquely for each patient based on the interview, clinical examination, and questionnaires, just like they did with the CFT intervention. First, they administered standardized tests to characterize changes in the patient’s low back pain symptoms, and then they modified the treatment to make it more specific based on the participant’s individual symptoms. Depending on the participant’s direction-specific low back pain classification, they performed the intervention following one of the five MSI subgroups namely [1] rotation, [2] extension, [3] flexion, [4] rotation with extension, and [5] rotation with flexion. Finally, Patients treated using the standardized MSI protocol as follows: [1] education regarding normal postures and movements such as sitting, walking, bending, standing, and lying down; [2] education regarding exercises to perform trunk movements as painlessly as possible; and [3] prescription of functional exercises to improve trunk movement [32].
Cognitive functional therapy
Cognitive functional therapy was prescribed for each patient in CFT group based the CFT protocol conducted by O’Sullivan et al. (2015). Patients received supervised 12 sessions of training over the 8-week period with 60 min per session provided with another physical therapist who had been trained in CFT treatment. In this protocol, a physical therapist with more than 5 years of experience conducted an interview and physical examination of the patients to determine their own unique training programs, considering modifiable cognitive, biopsychosocial, functional, and lifestyle behavior factors. The intervention consists of the following 3 main stages: [1] making sense of pain that is completely reflective, where physical therapist could use the context of the patient’s own story to provide a new understanding of their condition and question their old beliefs [2] exposure with control which is designed to normalize maladaptive or provocative movement and posture related to activities of daily living that is integrated into each patient’s functional impairments, including teaching how to relax trunk muscles, how to have normal body posture while sitting, lying, bending, lifting, moving, and standing, and how to avoid pain behaviors, which aims to break poor postural habits; and [3] lifestyle change which is investigating the influence of unhealthy lifestyles in the patient’s pain context. Assessing the individual’s body mass, nutrition, quality of sleep, levels of physical activity or sedentary lifestyle, smoking, and other factors via video calls. Identifying such lifestyle factors helped us to individually advise and design exercise programs, rebuild self-confidence and self-efficacy, promote changes in lifestyle, and design coping strategies.
I must admit that I am not fully convinced.
Firstly, the study was not large and we need – as the authors state – more evidence. Secondly, I am not sure that the results show CFT to be more effective that MSI. They might merely indicate 1) that the bulk of the improvement is due to non-specific effects (e.g. reression towards the mean, natural history of the condition, placebo) and 2) that CFT is less harmful than MSI.
My conclusion:
we need not just more but better evidence.
The ‘ALTERNATIVE MEDICINE HALL OF FAME’ is my creation amd is meant to honour reserchers who have dedicated much of their professional career to investigating a form of so-called alternative medicine (SCAM) without ever publishing negative conclusions about it. Obviously, if anyone studies any therapy, he/she will occasionally produce a negative finding. This would be the case, even if he/she tests an effective treatment. However, if the treatment in question comes from the realm of SCAM, one would expect negative results fairly regularly. No therapy works well under all conditions, and to the best of my knowledge, no SCAM is a panacea!
This is why researchers who defy this inevitability must be remarkable. If someone tests a treatment that is at best dubious and at worst bogus, we are bound to see some studies that are not positive. He/she would thus have a high or norma ‘TRUSTWORTHINESS INDEX‘ (another creation of mine which, I think, is fairly self-explanatory). Conversely, any researcher who does manage to publish nothing but positive results of a SCAM is bound to have a very low ‘TRUSTWORTHINESS INDEX‘. In other words, these people are special, so much so that I decided to honour such ‘geniuses’ by admitting them to my ALTERNATIVE MEDICINE OF FAME.
So far, this elite group of people comprises the following individuals:
- Tery Oleson (acupressure , US)
- Jorge Vas (acupuncture, Spain)
- Wane Jonas (homeopathy, US)
- Harald Walach (various SCAMs, Germany)
- Andreas Michalsen ( various SCAMs, Germany)
- Jennifer Jacobs (homeopath, US)
- Jenise Pellow (homeopath, South Africa)
- Adrian White (acupuncturist, UK)
- Michael Frass (homeopath, Austria)
- Jens Behnke (research officer, Germany)
- John Weeks (editor of JCAM, US)
- Deepak Chopra (entrepreneur, US)
- Cheryl Hawk (chiropractor, US)
- David Peters (osteopathy, homeopathy, UK)
- Nicola Robinson (TCM, UK)
- Peter Fisher (homeopathy, UK)
- Simon Mills (herbal medicine, UK)
- Gustav Dobos (various SCAMs, Germany)
- Claudia Witt (homeopathy, Germany/Switzerland)
- George Lewith (acupuncture, UK)
- John Licciardone (osteopathy, US)
Today, it is my great pleasure to admit another osteopath to the HALL OF FAME:
Helge Franke
Helge is a German Heilpraktiker and Osteopath. On his website, he lists his publications (kindly saving me the effort of doing a Medline search):
- Osteopathic manipulative treatment for nonspecific low back pain: a systematic review and meta-analysis. BMC Muskuloskeletal Disorders, 2014
- Effectiveness of osteopathc manipulative therapy for managing symptoms of irritable bowel syndrome: a systematic review. Journal of the American Osteopathic Association, 2014
- Why reservations remain: A critical reflection about the systematic review and meta-analysis “Osteopathic manipulative treatment for low back pain” by Licciardone et al. Journal of Bodywork & Movement Therapies, 2012, Elsevier
- Osteopathic Manipulative Treatment (OMT) for Lower Urinary Tract Symptoms (LUTS) in Women. A Systematic Review and Meta-analyses. Journal of Bodywork & Movement Therapies, 2012, Elsevier
- Comment: Is a postural-structural-biomechanical model, within manual therapy, viable? A JBMT debate. Journal of Bodywork & Movement Therapies (2011) 15, 259-261, Elsevier
- Die manuelle Behandlung des Kniegelenks – veraltetes Verfahren oder alternative Option? Naturheilpraxis mit Naturmedizin 9-2010, 1019-1026, Pflaum Verlag
- CRPS und Osteopathie – Grenzen und Möglichkeiten DO – Deutsche Zeitschrift für Osteopathie 3-2010, 6-8, Hippokrates Verlag
- Research and osteopathy: An interview with Dr Gary Fryer by Journal of Bodywork & Movement Therapies. 14, 304-308, Elsevier
- „…there is not much we can say without any doubt“ DO Life about Gary Fryer DO – Deutsche Zeitschrift für Osteopathie 1-2010, 4-5, Hippokrates Verlag
- Fred Mitchell und die Entwicklung der Muskel-Energie-Techniken DO – Deutsche Zeitschrift für Osteopathie 2-2009, 4-5, Hippokrates Verlag
- A randomized trial of arthroscopic surgery for osteoarthritis of the knee. Commentary Forschende Komplementärmedizin 2008 Dec 15(6), 354-5, Karger
- Evidence-informed management of chronic low back pain with spinal manipulation and mobilization. Commentary Forschende Komplementärmedizin 2008 Dec 15(6), 353-4, Karger
- Interview mit Prof. Eyal Lederman Teil 1 Osteopathische Medizin, 2/2007, S.15-21, Elsevier
- Interview mit Prof. Eyal Lederman Teil 2 Osteopathische Medizin, 3/2007, S.22-27, Elsevier
- Artikel über das 3. Internationale Symposium über die Fortschritte in der osteopathischen Forschung. Osteopathische Medizin, 1-2007, S.23-24, Elsevier
- Die richtige Haltung des Behandlers Osteopathische Medizin, 4-2006, S.8-10, Elsevier
- Interview mit Laurie Hartman Osteopathische Medizin, 4-2006, S. 11-16, Elsevier
- Herausgeber des Sonderheftes „Functional Technique” Osteopathische Medizin, 2-2006, Elsevier
- Harold Hoover, Charles Bowles, William Johnston und die Geschichte der Funktionellen Technik Osteopathische Medizin, 2-2006, S.4-12, Elsevier
- Interview mit Harry Friedman Osteopathische Medizin, 2-2006, S.25-30, Elsevier
- Funktionelle Technik – Praxis Osteopathische Medizin, 2-2006, S.17-23, Elsevier
- Osteopathische Diagnose und Behandlung des Hüftgelenks Naturheilpraxis mit Naturmedizin, 10-2006, S.1383-1393, Pflaum-Verlag
- Bericht über das 2-Tage Seminar von Prof. Laurie Hartman in München Naturheilpraxis mit Naturmedizin, 5-2006, S.754-755, Pflaum Verlag
- Bewusstsein für Bewegung. Die minimale Hebeltechnik und das Behandlungskonzept von Laurie Hartman Osteopathische Medizin, 4-2006, S.4-7, Elsevier
- ICAOR 6 / Interview mit Florian Schwerla Osteopathische Medizin, 3-2006, S.15-17, Elsevier
- Muscle Energy Technique – Geschichte, Modell und Wirksamkeit Teil 1 Geschichte Osteopathische Medizin 2-2005, S.4-10, Elsevier
- Muscle Energy Technique – Geschichte, Modell und Wirksamkeit Teil 2 Modell Osteopathische Medizin 3-2005, S.4-10, Elsevier
- Muscle Energy Technique – Geschichte, Modell und Wirksamkeit Teil 3 Wirksamkeit Osteopathische Medizin 4-2005, S.4-10, Elsevier
- Die Behandlung der Rippen mit Muskel-Energie-Techniken Naturheilpraxis mit Naturmedizin, 10-2005, S. 1353-1359, Pflaum Verlag
Yes, I agree! The list is confusing because it contains all sorts of papers, including even interviews. Let’s do a Medline search after all and find the actual studies published by Franke:
- Osteopathic manipulative treatment (OMT) for lower urinary tract symptoms (LUTS) in women. Franke H, Hoesele K.J Bodyw Mov Ther. 2013 Jan;17(1):11-8. doi: 10.1016/j.jbmt.2012.05.001. Epub 2012 Jun 17.
- Effectiveness of osteopathic manipulative treatment for pediatric conditions: A systematic review. Franke H, Franke JD, Fryer G.J Bodyw Mov Ther. 2022 Jul;31:113-133. doi: 10.1016/j.jbmt.2022.03.013. Epub 2022 Mar 24.
- Muscle energy technique for non-specific low-back pain. Franke H, Fryer G, Ostelo RW, Kamper SJ. Cochrane Database Syst Rev. 2015 Feb 27;(2):CD009852. doi: 10.1002/14651858.CD009852.pub2.
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Osteopathic manipulative treatment for nonspecific low back pain: a systematic review and meta-analysis. Franke H, Franke JD, Fryer G.BMC Musculoskelet Disord. 2014 Aug 30;15:286. doi: 10.1186/1471-2474-15-286.Effectiveness of osteopathic manipulative therapy for managing symptoms of irritable bowel syndrome: a systematic review. Müller A, Franke H, Resch KL, Fryer G.J Am Osteopath Assoc. 2014 Jun;114(6):470-9. doi: 10.7556/jaoa.2014.098.
- Osteopathic manipulative treatment for low back and pelvic girdle pain during and after pregnancy: A systematic review and meta-analysis. Franke H, Franke JD, Belz S, Fryer G.J Bodyw Mov Ther. 2017 Oct;21(4):752-762. doi: 10.1016/j.jbmt.2017.05.014. Epub 2017 May 31.
- Evidence-informed management of chronic low back pain with spinal manipulation and mobilization Franke H.Forsch Komplementmed. 2008 Dec;15(6):353-4
- Osteopathic manipulative treatment for chronic nonspecific neck pain: A systematic review and meta-analysis Helge Franke, Jan-David Franke, Gary Fryer, 2015 Int J Osteop Med.
Not a huge list, I agree. Yet it is respectable, particularly if we consider that Franke managed to squeeze out a little positive message even from cases where the data are fairly clearly negative. Another thing that I find noteworthy is the fact that Franke, as far as I can see, never published a clinical trial. He seems to specialize in reviews – and perhaps that is understandable: if one is compelled to spinning the message from fairly negative evidence to a positive conclusion, reviews might be better suited.
Altogether, I think Helge Franke deserves his place in the ALTERNATIVE MEDICINE HALL OF FAME!
As I mentioned before: it’s the season for awards and prizes:
- The ‘Golden Plank‘ – Austria
- The ‘Rusty Razor’ – UK
- And now the ‘Bent Spoon‘ – Australia
It goes all the way back to 1982 when the Australian Skeptics instituted an award to be presented annually at the National Convention to individuals or organisations who made the most outrageous claim of a paranormal or pseudoscientific nature in the preceding year. After conferring with leading American Skeptic and illusionist, James Randi, who had earlier instituted a Bent Spoon award, it was decided that the Australian version would also commemorate one of the less useful, though widely acclaimed, alleged paranormal claims; the psychic ability to distort items of cutlery. So was born the Australian Bent Spoon Award. Some years later, in a masterpiece of alliteration, it was decided that the preamble to the award should read “presented to the perpetrator of the most preposterous piece of paranormal or pseudoscientific piffle”.
For a nomination to be accepted it should include the following details:
- The name and contact details of the nominator (only the name will be listed on the website)
- The name of the person or organisation being nominated
- The reason for the nomination, including a clear explanation of the link to the paranormal or to pseudo-science
The ‘Bent Spoon’ is reserved for people who do their woo in Australia. The organisers also reserve the right to reject nominations that are deemed inappropriate. In particular, defamatory or frivolous nominations will not be accepted.
If you feel like nominating you favourite Australian anti-hero, use this link to email your nomination for 2023.
Click here to see the list of all current nominations.
And here is the fascinating list of former winners that reads like a ‘WHO IS WHO IN AUSTRALIAN QUACKERY’:
- 2022: Maria Carmela Pau, for selling useless COVID vaccination exemption certificates, and claiming medical qualifications she did not have.
- 2021: Craig Kelly MP, for spreading misinformation about COVID and vaccinations, and offering dubious cures and conspiracy theories.
- 2020: Pete Evans for the promotion of the pseudoscientific non-medical BioCharger and continuing his anti-vaccination position.
- 2019: SBS-TV program “Medicine or Myth” for promoting certain alternative medical treatments as if they had scientific credibility as opposed to placebo effectiveness.
- 2018: Sarah Stevenson/Sarah’s Day for the promotion of questionable natural health remedies via her vast network of followers.
- 2017: National Institute of Complementary Medicine and the University of Western Sydney for the continued promotion of disproved and unproved alternative medicine practices.
- 2016: Judy Wilyman, Brian Martin, and the University of Wollongong for awarding Wilyman a doctorate on the basis of a PhD thesis riddled with errors, misstatements, poor and unsupported ‘evidence’ and conspiratorial thinking.
- 2015: Pete Evans, chef, for his diet promotions, campaigns against fluoridation and support of anti-vaccinationists.
- 2014: Dr Larry Marshall, Chief Executive, CSIRO for his support of water divining.
- 2013: Chiropractors’ Association of Australia and the Chiropractic Board of Australia for failing to ensure their own members – including some committee members – adhere to their policy announcements.
- 2012: Fran Sheffield of Homeopathy Plus! for advocating the use of magical sugar and water in place of tried and true vaccination for many deadly diseases, most notably Whooping Cough.
- 2011: RMIT University “for having a fundamentalist chiropractic education program – if the word education can be used in this way – and for endorsing the practice by targeting children and infants in their on-campus paediatric chiropractic clinics”
- 2010: the Australian Curriculum and Reporting Authority (ACARA) for its draft science curriculum.
- 2009: Meryl Dorey and the deceptively named Australian Vaccination Network, who spread fear and misinformation about vaccines
- 2008: Prof Kerryn Phelps
- 2007: Marena Manzoufas, Head of Programming at the ABC for her sterling work in authorising the television show Psychic Investigators, made worse by putting it to air in the Catalyst timeslot
- 2006: The pharmacists of Australia, who manage to forget their scientific training long enough to sell quackery and snake oil (such as Homoeopathy and ear candles) in places where consumers should expect to get real medical supplies and advice. Video of award here.
- 2005: The ABC television program Second Opinion for the uncritical presentation of many forms of quackery.
- 2004: The producers of the ABC television show The New Inventors, principally for giving consideration to an obvious piece of pseudoscience, the AntiBio water water conditioning system
- 2003: The Complementary Healthcare Council
- 2002: Gentle Heal Pty Ltd for the selling of fake (Homoeopathic) vaccine.
- 2001: The Lutec “Free Energy Generator”
- 2000: Jasmuheen who claims one can live without food and water.
- 1999: Mike Willesee for the ‘documentary’ Signs From God.
- 1998: Southern Cross University for offering a degree course in naturopathy, while also claiming to be conducting research into whether there was actually any validity to naturopathy.
- 1997: Dr. Viera Scheibner – Anti-immunisation advocate
- 1996: Marlo Morgan – American new age author who claimed in her book Mutant Message Downunder, that Australian Aborigines could levitate.
- 1995: Tim McCartney-Snape for his promotion of the Foundation for the Adulthood of Mankind.
- 1994: Commonwealth Attorney General for an enterprise agreement with its 2,400 employees that included a clause so any employee, who had taken sick leave, need not provide a medical certificate signed by a medical practitioner, but could provide one signed by a naturopath, herbalist, iridologist, chiropractor or one of assorted other “alternative” practitioners.
- 1993: Steve Vizard’s Tonight Live programme (Channel 7).
- 1992: Allen S Roberts, archaeological research consultant for a search for Noah’s Ark.
- 1991: Woman’s Day magazine for its coverage and support of the paranormal, in particular astrology.
- 1990: Mafu, multilifed entity, channelled by Penny Torres Rubin and who, despite millennia of experience, was remarkable for the banality of his/her pronouncements.
- 1989: Diane McCann who wrote that Adelaide was built on one of the temples of Atlantis.
- 1988: None
- 1987: Anne Dankbaar, Adelaide “psychic”, whose discovery of the Colossus of Rhodes created something of a media stir until it was shown to be modern builders rubble.
- 1986: Peter Brock, prominent racing driver, whose highly touted “energy polariser” generated more heat in the motoring media than it did energy in his car.
- 1985: The Findhorn Festival Group, which sponsored the visit to Australia of American “psychic dentist” Willard Fuller. “Brother” Willard left town just ahead of some injunctions from real dentists.
- 1984: Melbourne Metropolitan Board of Works for its payment of $1,823 to US “psychic archaeologist” Karen Hunt to use divining rods to detect an alleged “Electromagnetic Photo Field”
- 1983: Dennis Hassel, “medium” whose chief trick was to make his hand disappear.
- 1982: Tom Wards, self proclaimed “psychic”, whose predictions in the popular press were renowned for their inaccuracy.
