Homeopathy4health

5 January 2014

Skeptic persecution via Ben Goldacre BadScience Forum leads to patient suicide and medic perpetrator prosecution. GMC fails to act.

http://childhealthsafety.wordpress.com/2014/01/02/patient-committed-suicide-after-his-doctor-was-hounded-by-dr-ben-goldacres-badscience-forum-internet-bullies-perpetrators-mild-two-year-cautionary-sentence-only-just-ended-december-2013/

Perpetrator: Stuart Jones

Causing a patient to commit suicide by vicious bullying of the patient’s treating doctor specifically to “increase anxiety levels” in the victim doctor’s patients is apparently not a sufficiently serious crime to warrant more than a 2 year “caution” for the Health and Care Professions Council.

Although no charges were brought against the patient’s doctor by the GMC and the doctor was never called before the GMC, aborted investigations in 2006/07 cost the GMC £136,692.12 in solicitors’ fees and disbursements and a possible further £500,000 on internal costs – according to a report on a website set up to support the patient’s doctor by patients and wellwishers.

The GMC is funded by a levy paid by all medical doctors registered in the UK.

It appears also no action has been taken by the GMC regarding Dr Goldacre’s BadScience Forum activities.

The GMC is meant to act on patient complaints.  To complain to the GMC you can contact them on:

Email: gmc@gmc-uk.org.”

29 June 2013

Why hounding homeopaths is both batty and arrogant.

“Ultimately what Nightingale is attacking is the intelligence and judgement of people who are trying to find an effective way to heal themselves. If homeopathy, which even its most virulent critics cannot claim is remotely likely to be harmful, works for you, then someone needs to combine serious arrogance with real battiness to believe they have the right to stand in the way.”

 Body of Evidence

There is no shortage of villains in the world. Psychopaths – domestic and national – whalers, toxic waste dumpers, global eavesdroppers, billionaire tax avoiders and their army of accountants –  all well worth campaigning against with the aim of getting them banged up or forced to cough up.

There is also an infinite supply of people who are mildly irritating who misplace apostrophes, wear Croc shoes, do crochet, litter their sentences with “you know” and text using their middle finger.

However most of us can tell the difference. In fact mixing the two categories up is a pretty reliable indicator of a serious level of battiness . Picketing shops that sell Crocs or campaigning to forbid the sale of mobiles to clumsy texters puts you firmly in the mild-to-fairly-irritating and definitely-a-bit -potty class.

Step forward the Nightingale Collaboration, earnest and self-styled defender of rationalism, whose seriously potty members have got…

View original post 986 more words

23 July 2010

Observations on Homeopathy Evidence Check

(my emphases)

Observations on the report Evidence Check 2: Homeopathy by the House
of Commons Science and Technology Committee, February 2010

1. Background

1.1. The report Evidence Check 2: Homeopathy was the second to be produced with
the purpose of examining how the UK Government uses evidence to
formulate and review its policies
. It was not an inquiry into homeopathy as
such
. The House of Commons Committee asked two principal questions:
What is the Government’s policy? And on what evidence is that policy
based?
The point was whether the scientific evidence supported the provision
of homeopathy by the NHS and the licensing of homeopathic products
by the MHRA.

1.2. The report received much publicity because of its firm rejection of evidence
for homeopathy’s efficacy on its way to answering these questions. The aim
of this paper is to focus on this one aspect of the Committee’s work, in view of
doubts voiced about the validity of its findings
. Sections 2 – 5 below address
this question.

1.3. The author served on the House of Lords Science and Technology Sub-
Committee which in 1999-2000 inquired into complementary and alternative
medicine (CAM). He was Co-Chairman of what used to be called the Parliamentary
Group for Alternative and Complementary Medicine during the
1990s, and also served on the advisory board to the systematic review of water
fluoridation which was conducted in 1999-2000 by the NHS Centre for
Reviews and Dissemination (CRD) at the University of York. As a user of
homeopathy he has failed to derive much benefit from it, but has supported
its use and development in the UK.

2. The scientific evidence for efficacy

2.1. There have been a number of systematic reviews and meta-analyses in this
field, which as the Committee states are the best sources of evidence. The
most recent review of substance is that by Shang et al in 2005, which it
considered “the most comprehensive to date” and which compared 110
placebo-controlled trials of homoeopathy [authors’ spelling] with 110 trials of
conventional medicine matched for disorder and type of outcome. The
Committee cited a conclusion by the authors [paragraph 69] that “when
analyses were restricted to large trials of higher quality there was no convincing
evidence that homeopathy [sic] was superior to placebo”. They did not
also cite the authors’ interpretation which followed these findings in the
Lancet summary, which stated: “When account was taken for these biases
[common to trials of both homoeopathy and conventional medicine], there
was weak evidence for a specific effect of homoeopathic remedies
, but strong
evidence for specific effects of conventional interventions. This finding is
compatible with the notion that the clinical effects of homoeopathy are
placebo effects.”

2.2. This was no endorsement of homeopathy. But it was some way removed
from the Committee’s conclusion in paragraph 70 of their report, “In our view,
the systematic reviews and meta-analyses conclusively demonstrate that
homeopathic products perform no better than placebos.” It also provides
little support for that part of Professor Ernst’s evidence to the Committee
where he “pointed out that: . . . Shang et al very clearly arrived at a
devastatingly negative overall conclusion
” [67].

2.3. The exaggeration by the Committee of Shang’s conclusions is worrying. It is
difficult to see how a weakly supported positive effect, for which one
explanation (possibly well-founded) is a placebo effect, can be translated into
a conclusive demonstration of this effect, with a “devastatingly” negative
finding
. No such firm claims can be found in Shang, who writes of finding
“no strong” evidence, or “little” evidence, and who ends his paper with
cautions about methodology and about the difficulty of detecting bias in
studies, as well as the role of possible “context effects” in homeopathy.

2.4. The Committee’s overstatement is not helped by claiming Government support
for its interpretation in paragraph 70, based on the Minister’s concession
of no “credible” evidence that homeopathy works beyond placebo. If he
meant persuasive evidence – and his guarded support for further research [75]
supports this – that shows a confusion by the Committee between absence of
evidence and evidence of absence
. If however he was saying that all evidence
was negative, this as Prof. Harper correctly stated [71] runs counter to the
message from most reviews up to and including Shang, which is one of primary
studies of insufficient quantity, rigour, size, homogeneity and power to
give clear-cut answers.

2.5. It is the absence of reliable evidence that remains the problem, and this
includes evidence of an absence of specific effects
(while acknowledging the
problem in proving a negative, an obstacle which did not deflect the
Committee from its conclusive verdict in 70). The Committee itself writes in
69 of no “convincing” evidence from Shang, from higher-quality trials, which
is not consistent with a claim of conclusive (dis)proof. Care with words can
be as important as with figures, and can just as easily mislead.

2.6. In a search for best evidence in the early 2000s this author relied on the bulletin
on homeopathy produced by the NHS CRD at York in 2002, one of an
Effective Health Care series on “the effectiveness of health service
interventions for decision makers”. This bulletin made a systematic
assessment of the evidence to date. It advised “caution” in interpreting this
evidence, and warned that many of the areas researched were “not
representative of the conditions that homeopathic practitioners usually treat”,
and that “the methodological problems of the research” should be considered.
It found “insufficient evidence of effectiveness . . to recommend homeopathy
for any specific condition”. At the same time it could not conclude that
homeopathy performed no better than placebo.

2.7. That was eight years ago. But it is notable that the more recent review by
Shang, on which the Committee relied quite heavily, cited no reference to any
placebo-controlled trial (i.e. of reasonable quality) subsequent to the CRD’s
bulletin, in arriving at a suggestion, but not a conclusion, of a placebo effect.

The House of Commons Committee’s verdict in 70 stands on its own in going
beyond what either review found from the evidence before it.

2.8. In seeking an up-to-date assessment from the NHS CRD, this author was referred
to the German researcher Klaus Linde as among the best of the
objective sources of current evidence on homeopathy. Linde, who was the
lead author of a major review in 1997 cited by the Committee, in turn
recommended the statistician Rainer Lüdtke as an expert with a good
overview of the current literature. Correspondence ensued with both
researchers, who were aware of the Committee’s recent report.

2.9. Both Linde and Lüdtke hold that the Committee’s conclusion in 70 that
reviews “conclusively demonstrate” a placebo effect is overstated and
unsustainable on present evidence. They have further criticisms of the way in
which evidence has been addressed.

2.10. Both are critical of Prof. Ernst’s evidence to the Committee as highlighted in
67. Prof. Linde confirms that his own 1999 re-analysis weakened the findings
of his 1997 review and probably “at least overestimated the effects of
homeopathic treatments”, but that his paper was “not ‘negative’” as stated by
Ernst
. He writes that “A more accurate interpretation is that the ‘re-analyses’
[by himself and 5 others, referred to by Ernst] show that the (positive)
evidence is not fool-proof. This applies still today (for example, to the Shang
analysis)”. Lüdtke draws attention to his own paper in 2002 which criticised
many statistical errors in Ernst’s 2000 re-analysis in the same journal, vitiating
Ernst’s negative conclusion, a published criticism which received no mention
in Ernst’s own evidence to the Committee
. Ernst was correct to state in
evidence elsewhere that the re-analyses of Linde came to a “less than positive”
conclusion, and that further reviews “failed to conclude that homeopathy is
effective”. The Committee, while adopting Ernst’s more absolute
conclusions, has not resolved the contradiction between his statements.

2.11. Lüdtke, like Shang, has also drawn attention to the pitfalls in research into
homeopathy, in a chapter in ‘New directions in homeopathy research’ (Witt C,
Albrecht H, eds.) published in 2009. He counsels against including all types
of homeopathy trials of reasonable quality in one review (such reviews tend to
suggest that homeopathic medicines are not efficacious), since the pooling of
so many different kinds of trial and type of homeopathy makes findings
unreliable
. He advocates restricting systematic reviews to clearly defined
health conditions or to single homeopathic medicines, concluding that “the
heterogeneity of trials is high and the meta-analysis results are not robust
against small changes in study design or statistical analysis”. In a paper
published in 2008 he has argued that Shang’s conclusions do not hold when
slightly different selection criteria are applied, e.g. by redefining how large is a
“large” study, or by including treatment trials but excluding prevention trials.
Size is not the only factor in arriving at robust conclusions.

2.12. Context effects may play a part, according to both Shang and Lüdtke.
Shang’s “powerful alliances” between patient and carer, based on “shared
strong beliefs”, may not be as distinctive or as peculiar to homeopathy as the
nature of the homeopathic consultation, with its wider range of questions than
are addressed in a conventional context, and the lifestyle recommendations
referred to by Lüdtke that often flow from it. There is overlap here with the
placebo effect (see 4 below); but homeopathy as “a complex medical system
of its own” may be responsible for some broader effects.

2.13. Linde writes that the “undecided fraction” to which he belongs is confused by
“the notorious lack of predictable reproducibility” on the one side, and by
“too many anomalous results in high quality studies to rule out a relevant
phenomenon”
on the other.

3. Other evidential considerations

3.1 A conventional argument against CAM treatments is often that they are risky
because they deny or delay a proper diagnosis and the adoption of tried and
tested conventional treatments [105; 108; Ev 26-27]. But this is not an
argument about (as here) homeopathy per se, and its side-effects which at such
high dilutions are as implausible as its efficacy is claimed to be. The potential
for harm however is real enough: but only if patients have not been in contact
with their own doctors, which happens in a minority of cases; if homeopaths
are not adequately trained to recognise ‘red flags’, and give bad advice; and if
conventional treatment is likely to be successful and/or acceptably risk-free in
the particular case, and indeed more successful than a homeopathic approach
.

3.2. The argument for adopting one kind of treatment and not the other relates
therefore to issues of practice, communication and training as well as of
comparative efficacy (for patient choice see 6.1 below). These are highly
important; but it is not legitimate to deploy the argument as the Committee
did as a factor in the intrinsic risk/benefit ratio of a therapy
, which it is not,
adducing it as an additional negative element instead of as part of an efficacy
argument which has already been addressed. (Suppose high-quality trials
establish homeopathy’s superiority over conventional treatment for a
condition: this, with homeopathy’s negligible side-effects, would make the
conventional option the risky one.)

3.3. Nor is the argument even-handed if examination of true side-effects in homeopathic
and conventional treatment is not addressed when discussing the
comparative merits of the two approaches, patient satisfaction, and
government policy. Shang et al gave “the exclusive focus on beneficial effects”
as one of several limitations of their study. The extent of adverse
clinical effects is as much a part of the evidence base as is benefit. If the
Committee had looked at these it might have cast a different light on policy
towards homeopathy in the NHS, and would almost certainly have highlighted
public disquiet about some of the more aggressive conventional treatments
as a reason for many patients preferring a CAM approach. This is a
significant omission.

3.4. There may be no good conventional treatment for a condition. Alternatively,
the standard treatment may be contraindicated. The Committee has not
considered these reasons why some patients may welcome the continued
provision of homeopathy.

4. The placebo effect

4.1. The placebo effect, addressed at some length by the Committee (30–40), is not
in dispute. Yet much about it is unknown
. It may be premature to assume
that patient expectations of modern medicine, with its erudition, structures,
scientific approach and rituals which give it the intellectual and moral high
ground in Western society, are of lesser force than those of a treatment which
is commonly thought of as “implausible”, and not only by scientists. Belief in
white coats is not weak
. Furthermore patients are likely to resort to CAM on
grounds of principle or safety as well as efficacy. The placebo as an
explanation is sometimes reached for too readily off the shelf, when its applicability
to the relevant condition, treatment and patient population is poorly
understood. This gap in argument has not been closed by the Committee.
The placebo effect in homeopathy needs more work before conclusions can be
confidently drawn.

4.2. Empathy in a consultation is more than a matter of time given [81]: it also involves
personality and training. This author has on occasion felt better heard
in a ten-minute GP consultation than in an hour with a CAM therapist,
although the latter have generally shown up well. The better comparator in
CAM situations is probably the specialist consultation, since most patients will
have initially visited their GPs. Nor is it always the fluctuating or selflimiting
conditions [43, 81], as the Committee suggests, that send patients to
unconventional providers; claimed relief from chronic complaints after a long
period of failure with conventional treatment is not uncommon
.

4.3. The surveys of homeopathic patients referred to in 80 suggest that selfreported
benefit was not only at a high level but persisted beyond the limits of
any placebo effect which, as the Committee states, is usually short-lived
.

5. The Committee’s witnesses

5.1. The Committee in two sessions called twelve witnesses to give oral evidence,
all but one with relevant affiliations. Selection of witnesses can affect
outcomes in the same way as selection of written evidence
. It is therefore
legitimate to examine the choices made.

5.2. It is not easy to see why a journalist doctor was invited to appear in preference
to some other non-representative contributors to the inquiry. The written
submission by Dr. Goldacre [Ev. 8] was notably short on supporting evidence,
but contained unqualified statements on the ineffectiveness of homeopathy,
forcefully expressed (“extreme quackery” was mentioned)
. By contrast, the
submission by the Complementary Medicine Research Group from the
Department of Health Sciences at the University of York presented a wellargued
summary with 68 references [Ev. 143]. In this appears the statement
“To date there are eight systematic reviews that provide evidence that the
effects of homeopathy are beyond placebo when used as a treatment for [five
childhood conditions]”
. This claim from a mainstream academic centre, rated
joint first nationally for health services research in the latest Research
Assessment Exercise, stands in stark contradiction to Prof. Ernst’s referenced
claims, noted above, and to Dr. Goldacre’s unreferenced statements
. It would
have been illuminating if the Committee had probed the Group about this,
face to face as a witness, and attempted some resolution before agreeing in
unequivocal terms with the two witnesses who were invited to appear and
were quoted favourably. The Committee criticised the supporters of homeopathy for their “selective
approaches” to evidence [73]. They could fairly be accused of the same.

Unfortunately they did not (presumably) have the scope to solicit the views of
Dr. Linde from Germany, which would have differed from those of Prof. Ernst
with regard to the evidence.

5.3. Only one Primary Care Trust submitted a paper, and it was invited to give
oral evidence on its decision that homeopathy did not provide value for
money. Given the number of PCTs countrywide this is rather surprising. It
might be wondered if some form of publication bias was in play, with the
many PCTs who were happy with provision of homeopathy seeing no need to
defend the status quo
. At least one writer complained of the short timescale
for submissions [Ev. 128]. It would have been interesting to know what steps
the Committee took to obtain a range of views about the evidence
, and
whether West Kent was the only PCT to have done an assessment of the kind
referred to in Ev. 134. Only a negative PCT view was recorded; and despite
the Committee’s unequivocal conclusion even West Kent conceded “limited
evidence in favour of homeopathy”.

6. Societal questions

6.1. Since doctors exist for patients and not the other way round it is not selfevident
that scientific evidence, important as it is, should be the sole
determinant of what is provided to the public.
If the patient is ultimately in
the driving seat (s)he might wish on broader grounds than proven efficacy to
finance this type of treatment rather than that (or in addition to that) from the
public purse. This gives scope for political judgements which can set a
government at odds with its medical advisers. This should be no surprise to
a parliamentary scientific committee which sits at the border of these two
worlds.

6.2. In the purely scientific field it is interesting that the present Committee should
feel “troubled” [71] by two senior government scientists coming to different
conclusions about the weight of homeopathic evidence. Such disagreement
in interpretation is quite common in scientific debate, although life is
undoubtedly easier where there is consensus. Premature consensus,
however, has its own dangers, as is generally recognised. The Committee
appears to require the scientists metaphorically to retire to a jury room and
not come out until they agree [64, 72], presumably with the Committee’s view.
This seems a step too far.

6.3. Pre-existing structures have some de facto claims. It is reasonable to decide
that if something were not in existence one would not call it into being, but if
it is already there one would not abolish it. While theoreticians might debate
this, society as a whole can accept it. It is more easy to accept where the
institution claims a minuscule proportion of the health and research budgets,
which must be the case with homeopathy whatever precise figure the
government comes to at the Committee’s request.

7. Conclusion

7.1. The evidence for homeopathy is not impressive, except possibly in terms of
lack of adverse effects. The Committee however has been less than rigorous
in its approach to this evidence.
Its choice of witnesses favoured a medical
media opponent of homeopathy over a research centre of excellence. It was
unwise to rely heavily on the interpretations of one professor of CAM, some
of whose statements are unsound or in conflict with other statements of his,
and who is not without his critics in the worlds of research and academia
whose views were given less prominence.
The 2005 review by Shang et al has
been inaccurately represented as ruling out specific effects of homeopathy, in
a summary statement by the Committee that goes beyond present evidence.
The Committee’s own statements show confusion between unconvincing
evidence of a specific effect and disproof of it
. The true risk profile of
homeopathy, compared with conventional treatment, was not considered.

7.2. These limitations make the Committee’s report an unreliable source of
evidence about homeopathy.
The jury must still be regarded as out on its
efficacy and risk/ benefit ratio. Whether more research should be done, and
of what kind, is another question. But there can be no ethical objection to it
since the principal questions have not, as the Committee claimed, “been
settled already” [78].

Earl Baldwin of Bewdley.
June 2010.

26 November 2009

Parliamentary Science and Technology Evidence check for Homeopathy

Thanks to ‘Voice of (not so) Young Homeopathy’ for their comments on this week’s Parliamentary Science and Technology Evidence check for Homeopathy here:

http://vonsyhomeopathy.wordpress.com/2009/11/25/uk-parliamentary-science-and-technology-committee-evidence-check/ 

You can watch the whole meeting here:   http://www.parliamentlive.tv/Main/Player.aspx?meetingId=5221

Vo(ns)YH promises a transcript too.

Some funny moments: I thought Goldacre’s comment that he wasn’t interested in Physics quite hilarious given that homeopathy allegedly ‘goes against all its laws’, and Ernst saying that he thought it was the long consultation that helped homeopathic patients REALLY begged the question: ‘is there any evidence for that? and if there is then why does the NHS only allow 10 minutes?’ and David Colquhoun got a dishonourable mention about going around collecting anecdotal evidence.

I’m disappointed that no-one mentioned that only 13% of NHS treatments are backed by solid evidence: http://clinicalevidence.bmj.com/ceweb/about/knowledge.jsp

Update: Here is the evidence supplied to the committee:

http://www.publications.parliament.uk/pa/cm200910/cmselect/cmsctech/memo/homeopathy/contents.htm

27 March 2008

Wholesale scorn on complementary medicine is unscientific.

Madeleine Bunting (at my least favourite newspaper ‘The Guardian’ since ‘I’m a cuddly junior doctor/you’re-making-it-up-psychiatrist’ Ben Goldacre’s devoid of any twisted homeopathic facts propaganda piece) makes some pertinent points about the state of Sceptic-Woo wars in complementary medicine.  I disagree that homeopathy is ‘just placebo’ as the benefits of homeopathic treatment can be much more profound than just ‘feeling better’ or ‘removal of symptoms’ but otherwise I agree with her thinking:

“Suckers: How Alternative Medicine Makes Fools of Us All; Snake Oil Science; and next month sees another, Trick or Treatment: what these new books have in common is varying degrees of frustration at the seemingly inexorable rise of complementary medicine. It seems the aim of some of these authors is to finish off a burgeoning health industry that they believe is based on charlatans and quacks preying on the gullible and desperate.

The books reflect the growing exasperation in some quarters that public opinion is not as amenable to persuasion and scientific evidence as they would hope. The language gets lurid; the mood music to pronouncements on complementary medicine is increasingly alarmist – we are living in dangerous times, an unEnlightenment looms as tides of irrationality threaten to overwhelm the palisades erected by science. “Reason is a precious but fragile thing,” declared Richard Dawkins in his series, The Enemies of Reason, last autumn. “Reason has liberated us from superstition and given us centuries of progress. We abandon it at our peril.”

What so troubles these science warriors is that it is estimated a third of people in the UK now use complementary medicine, at a cost of £1.5bn a year. In the US, the figures are substantially higher; it has been calculated that more visits are made to healing therapists than to doctors. There is an extraordinary paradox here: a half-century of astonishing conventional medical advances has not succeeded in eliminating complementary medicine. Quite the reverse: the breakthroughs in conventional medicine have been accompanied by the proliferation of other forms of healing – many of which have little or no evidence base to prove their efficacy. Indeed, it only takes a short surf on the web to discover that the wilder shores of this burgeoning industry are, well, pretty wild.

To the science warriors, this bizarre state of affairs can only be explained by irrationality. They bemoan the state of science education and lament how, contrary to expectation, literacy and access to information have failed to eradicate superstition. Meanwhile, in this increasingly sharply polarised debate, complementary medicine practitioners are equally exasperated by what they see as blinkered scientific reductionism.

So it takes a brave scientist to launch into this territory and risk getting attacked from both camps by daring to ask a simple question: is there anything science can learn from complementary medicine? That is precisely what Kathy Sykes is doing in her current television series, Alternative Therapies (the second programme is on BBC2 tonight). As Bristol University’s professor of public engagement in science and the director of the Cheltenham Festival of Science, no one can challenge her credentials as a scientist, yet her scrutiny of particular therapies throws up serious challenges to conventional medicine.

Sykes is too good a scientist to give complementary medicine an easy run. Tonight she examines reflexology, and gives it pretty short shrift. There are 30,000 reflexologists working on a million British feet a year. They base their work on a theory that parts of the sole of the foot correlate to organs in the body. The only problem is that Sykes could find no one, reflexologist or scientist, who could explain how these correlations might work. Furthermore, it turned out that this “ancient” healing system seems to have originated with an imaginative American woman in the 1930s. But patients swear by it. One reflexologist points Sykes to her annual garden party full of babies and children as evidence of the success she has had with infertility problems. This is the point where most scientists snort with derision at the use of personal anecdote as evidence, but Sykes presses on and it takes her into two areas of scientific research. First, she digs up new research on the importance of touch, which can have a profound impact on the brain. Even the hand of a stranger reduces anxiety and that of someone with whom one has a close relationship is even more significant. In fact, Sykes finds some scientific underpinning which goes beyond placebo in many of the therapies she looks at. But it is placebo which emerges as a recurrent and crucially important thread in her quest, and it leads her to the work of several American scientists who are trying to identify what placebo is, who it works for, and why it works.

This is one of the most common charges made against complementary medicine – that most of it is no better than placebo. But there is a way of turning that accusation around: perhaps complementary medicine is an effective way to harness placebo as one of the most powerful – and cheapest – of healing processes. Rather than being derogatory about the phenomenon as “just” placebo, perhaps we should see it as one of the most remarkable and little understood aspects of the human body.

That line of inquiry has taken Sykes to the US several times over the course of the two series she has made. There placebo has become a new frontier in medicine. In a range of studies with startling results – even sham knee surgery can be as effective as the real thing – many factors contribute to placebo: the confidence of the doctor; the social, cultural expectations around the procedure; the empathy and warmth of the patient-doctor relationship; the patient’s degree of faith. Get all these right, and the outcome can be remarkable. Harvard professor Ted Kaptchuk is publishing a study this week which shows that placebo is as good as any conventional treatment available for irritable bowel syndrome. Given that the eight most industrialised nations spend $40bn a year on medication for this condition, that’s revolutionary stuff.

This kind of research into placebo gives some insight into why complementary medicine has boomed and why there are so many people who cite their own experience to passionately defend it. The average consultation with a GP is 4.6 minutes, while the complementary therapist can devote an hour to taking detailed personal histories. That time and relationship provide a context and an opportunity for the ritual and recasting of personal experience which Kaptchuk believes are the crucial elements of placebo.

Complementary medicine is most popular where conventional medicine fails, such as with musculoskeletal conditions and mental health – stress, depression, anxiety (the recent revelations about the inefficacy of Prozac were another reminder of how shaky the science is in a large area of conventional medicine). Several complementary therapies are particularly effective at pain relief – you had to see Sykes’s footage of hypnotism helping a woman to have teeth extracted without anaesthetic to believe it. Kaptchuk argues that pain is not a static given but can be experienced dramatically differently.

Conventional medicine prolongs life but is less successful in prolonging good health – we can expect to spend more years of our life in poor health, as a government report showed last week – and in producing wellbeing. So people are voting with their feet, trying to find other ways to fill the gaps left by conventional medicine. We need scientists to help to identify what they are looking for and why, rather than pouring scorn indiscriminately on the whole field and on the relations between belief, mind and body, of which science still has such a fragmentary understanding.”

20 January 2008

Fact or FLACT?

Sceptics like to twist things around, notably Ben Goldacre (junior liaison psychiatrist, of the ‘it’s all in your head’ school of medicine), according to twisted logic.

It feels like this:

I might say ‘I like yellow’.

A sceptic might then claim ‘H4H doesn’t like white, red, blue, green, orange, purple, pink, black or brown.’  This would not be true as I also like blue and purple and I can tolerate all the other colours too.

I have a new term for such logic-derived ‘facts’: ‘FLACT’.

*4th February 2008.  Updated* to incorporate my justification of including Ben Goldacre from responses to Andy Lewis (aka le canard noir):

https://homeopathy4health.wordpress.com/2007/12/03/forced-vaccinations-because-conventional-medicine-is-not-effective-in-treating-infectious-disease/

The low cholera mortality rates under homeopathic treatment: When Cholera finally struck Europe in 1831 the mortality rate (under conventional treatment) was between 40% (Imperial Council of Russia) to 80% (Osler’s Practice of Medicine). Out of five people who contracted Cholera, two to four of them died under regular treatment. Dr. Quin, in London, reported the mortality in the ten homeopathic hospitals in 1831-32 as 9%; Dr. Roth, physician to the king of Bavaria, reported that under homeopathic care the mortality was 7%; Admiral Mordoinow of the Imperial Russian Council reported 10% mortality under homeopathy; and Dr. Wild, Allopathic editor of Dublin Quarterly Journal, reported in Austria, the Allopathic mortality was 66% and the homeopathic mortality was 33% “and on account of this extraordinary result, the law interdicting the practice of Homeopathy in Austria was repealed.’

Ben states:‘Homeopathic pills won’t do anything against cholera.’

So by his logic (and yours) most of the people treated with homeopathy just got better anyway: ‘the homeopaths’ treatments at least did nothing either way’

So logically: If people just got better anyway, by this evidence they should just have been left alone when they got cholera and the death rates would have been much lower. And his other part of Ben’s logic is that cholera death rates were so high because allopathic medicine made them much worse: ‘high allopathic mortality rate was due to dangerous practices’

So my point is why would the population worry so much about cholera then?

But they did:

http://www.earlyamerica.com/review/2000_fall/1832_cholera_part1.html

‘New York was probably the most thoroughly scourged among the states. Each of the thriving towns along the Erie Canal suffered in its turn, despite quarantines and last minute attempts at ‘purifications.’ . . .Small villages, even isolated farms, were stricken. And here the disease was most terrifying; it had to be faced alone, often without friend, minister, or physician. The appearance of cholera in even the smallest hamlet was the signal for the general exodus of the inhabitants, who, in their headlong flight, spread the disease throughout the surrounding countryside.’

http://www.lib.rochester.edu/index.cfm?page=3353

‘Asiatic cholera is a very violent intestinal disease, usually running a short course to dehydration and death, often in a matter of hours. Its very violence ensured that it would not be the type of disease which could be overlooked or treated with little concern’

‘The social and economic consequences of cholera were quite significant. Community life was completely disrupted whenever a new pandemic arrived. Usually panic gripped the populace and all persons who could leave the affected area promptly did so. The spectacular deadliness of the pandemic of 1826-37, which was the first to strike Europe and America, set up a psychological conditioning which assured that all subsequent invasions would induce panic. Normal economic and social life came to an end. Governmental activities were carried out with difficulty. Even medical and nursing services were impaired–sometimes to the extent that the sick were left untended and the dead unburied. Travellers and strangers often were treated badly. Gradually, as an epidemic waned, normal routines were resumed. Practically every community added boards of health and sanitation, which were supposed to take preventive measures against new outbreaks of cholera.’

2 January 2008

Goldacre’s conflicts of interest exposed.

Cultural Dwarfs and Junk Journalism by Martin J Walker: free download available at www.slingshotpublications.com

Dr Ben Goldacre is the author of the Guardian’s Bad Science column and has authored ‘A Kind of Magic?’, in which:

“he produced what might appear to be a thoroughgoing, devastating critique of a bogus therapy, but the article is at best a farrago of truth, half-truth and downright dissembling. Given the lengths that the Guardian and other British newspapers go to be apparently objective on any vaguely radical subject, one can’t help wondering why the Guardian is happy to let Goldacre romp through, and tread down, all previous standards of fair debate.

Broadly speaking, the essay that follows is the latest addition to my ongoing analysis of the British corporate science lobby and its popular campaigning arms, skeptics and quackbusters. Specifically, the essay focuses on attacks on Patrick Holford, the independent nutritionist, while trying to place the quackbusting journalist Ben Goldacre, who began this round of attacks, in a social and political context.

Dr Ben Goldacre rarely draws attention to the fact that he is a medical doctor, nor does he ever discuss, even in the most general terms, patients with whom he has come into contact, in the way that, for example, James Le Fanu does in his intelligent Sunday Telegraph column.  In fact, nothing Goldacre says seems to be grounded in everyday life, the condition of ‘ordinary people’ or the public at large.

Despite claiming to spend most of his life working in the NHS, he is circumspect about which London hospital he works in and what kind of medicine he practises. For someone who spends considerable amounts of time criticising those who practice non-allopathic medicine, for example nutritional practitioners, he might, one would think, make more of his NHS position.

Despite his claim to be a serious academician, and despite the fact that a number of his PR puffs say that he ‘has published academic papers in neuroscience’, there is no record on the significant databases of his having co-authored more than one academic paper, apparently written while he was a visitor at Milan University. The only way in which academic status can be measured is by the number of peer-reviewed papers or other notable publications such as books. It should
be pointed out that the engorgement of un-provable academic credentials is one of the major points of criticisms he addresses when writing his quackbusting articles.

QUACKBUSTER OR JOURNALIST: DOES BEN GOLDACRE HAVE CONFLICT OF INTERESTS?

In 1999, two years after New Labour had come to power and Lord Sainsbury had been rewarded for his campaign donations, Goldacre was funded by the British Academy to do his Masters degree in philosophy at King’s College.

Today, the British Academy (BA) is funded by the Office of Science and Innovation (OSI), which sits within the DTI.28 In the past it has always been linked to both the Royal Society and the Royal
Institution. It claims to ‘maximise the contribution made by our science, engineering and technology skills and resources to the UK’s economic development, and to the quality of our lives’. Of course, one is bound to wonder how the quality of public life could be enhanced by Ben Goldacre gaining an MA in philosophy.

King’s College is the bastion and training ground for The Lobby. It is where Simon Wessely, the premier master of scientific spin, resides, working, mad-professor-like on endless projects to prove that organic environmental illness does not exist, and that anyone who suggests it does is deluded.

The most empathetic and forgiving of us were imagining that Ben was a junior doctor in a heavily pressed casualty unit in an inner City area. If Ben was dealing with the dirty life and death of motor accidents, shootings and drug-related deaths in north-east London for example, perhaps he might be forgiven his hard bitten views, and his anti airy-fairy concerns about people affected by electric air waves, chemicals and bad vaccines.

It appears, however, that he has always been a post-grad clinical research worker, now possibly studying for a Phd at King’s College, the home of the psychiatric school of ‘all-in-the-mind aetiology’. In all probability Goldacre has been at this University Hospital since taking his MA, and was probably attached to it when he was taken on by the Guardian.

If this is the case, most probably he doesn’t see patients, except when he passes them in the corridor at the Maudsley as he makes his way to the Liaison Psychiatry Unit within the Institute of Psychiatry,where he is studying under the Prince of Spin Professor Simon Wessely, the head of the Liaison Psychiatry Department. Wessely is an advisor to the Science Media Centre and on the Advisory panel of the US American Council on Science and Health, one of the most heavily funded pro industry lobby groups in the world.

The really good thing about Liaison psychiatry is that you can blend all kinds of social issues with lots of mad-cap psychiatric ideas that work well for industry. Liaison psychiatry is a form of psychiatry in which the psychiatrist informs unsuspecting ordinary citizens who report to hospitals with organic illnesses that they are actually mentally ill. This diagnostic ability is particularly acute when the Liaison psychiatrist meets up with anyone who has suffered an environmental illness, a chemical insult, or any industry-related illness.

For some time now, King’s College has been deeply involved in the programme of spin designed by industry and the New Labour government. However, as is evident from the involvement of Goldacre there, the relationship between The Lobby, the University and the hospital, is not simple. As well as Wessely’s role, ex-Revolutionary Communist Party members have also played a part in bringing vested interests to the college. Together with pseudo-scientific research into mental illness and environmentally caused illness, King’s is deeply involved in risk analysis for various controvertial environmental factors.

CONFLICT OF INTEREST?

Can there be any doubt that the industry directed research at King’s, with which Goldacre is associated, or his association with Professor Wessely, whose research on ME, Gulf War Syndrome and EMF never benefits patients but always government or industry, constitutes a conflict of interest that should from the beginning have been declared by Goldacre, every time he says anything about science in the Guardian
or anywhere else?”

3 December 2007

Forced Vaccinations because conventional medicine is less effective in treating infectious disease

Some states in the US are making vaccinations compulsory:

Forced Vaccinations « What IS Going On?

Why? Conventional medicine does not have the tools to treat the strong symptoms that come with a vigorous natural response to infectious disease.

19th century homeopaths were effective in treating these infectious diseases: Read full article here

 “From its earliest days, homeopathy has been able to treat epidemic diseases with a substantial rate of success, when compared to conventional treatments

In 1900, Thomas Lindsley Bradford, MD, wrote a book called “The Logic of Figures” in which he collected the statistics he could find that would compare the conventional therapeutics with homeopathic ones. Many of the figures cited below are derived from Bradford’s work.

One of the earliest tests of the homeopathic system was in the treatment of Typhus Fever (spread by lice) in an 1813 an epidemic which followed the devastation of Napoleon’s army marching through Germany to attack Russia, followed by their retreat. When the epidemic came through Leipzig as the army pulled back from the east, Samuel Hahnemann, the founder of homeopathy, was able to treat 180 cases of Typhus– losing but two. This, at a time when the conventional treatments were having a mortality rate of over 30%.

In 1830 as the cholera epidemic was reported coming from the east, Hahnemann was able to identify the stages of the illness, and predict what remedies would be needed for which stages. When Cholera finally struck Europe in 1831 the mortality rate (under conventional treatment) was between 40% (Imperial Council of Russia) to 80% (Osler’s Practice of Medicine). Out of five people who contracted Cholera, two to four of them died under regular treatment. Dr. Quin, in London, reported the mortality in the ten homeopathic hospitals in 1831-32 as 9%; Dr. Roth, physician to the king of Bavaria, reported that under homeopathic care the mortality was 7%; Admiral Mordoinow of the Imperial Russian Council reported 10% mortality under homeopathy; and Dr. Wild, Allopathic editor of Dublin Quarterly Journal, reported in Austria, the Allopathic mortality was 66% and the homeopathic mortality was 33% “and on account of this extraordinary result, the law interdicting the practice of Homeopathy in Austria was repealed.”

Homeopathy continued to be effective in the treatment of Epidemic Cholera. In 1854 a Cholera Epidemic struck London. This was a historically important epidemic in that it was the first time the medical community was able to trace the outbreak to a source (a public water pump), and when the pump was closed, the epidemic soon ceased.

The House of Commons asked for a report about the various methods of treating the epidemic. When the report was issued, the homeopathic figures were not included. The House of Lords asked for an explanation, and it was admitted that if the homeopathic figures were to be included in the report, it would “skew the results.” The suppressed report revealed that under allopathic care the mortality was 59.2% while under homeopathic care the mortality was only 9%”

Note: Ben Goldacre would like you to believe (notice the word ‘believe’) that the low mortality rate of homeopathy was due to it’s ‘no effect’ effect and the high allopathic mortality rate was due to dangerous practices: ‘Homeopathic sugar pills won’t do anything against cholera, of course, but the reason for homeopathy’s success in this epidemic is even more interesting than the placebo effect: at the time, nobody could treat cholera. So, while hideous medical treatments such as blood-letting were actively harmful, the homeopaths’ treatments at least did nothing either way.’  Then why was there such fear of such epidemics, all everyone needed to do was ‘do nothing’?  Nonsense again, Ben.

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