AUGUST 2023 NEWS
This month, the McGill Office for Science and Society is added to the list of regularly covered web sites. The OSS “is a unique venture dedicated to the promotion of critical thinking, science communication, and the presentation of scientific information to the public, educators, and students in an accurate and responsible fashion. With a mandate to demystify science for the public and separate sense from nonsense, the Office has a history of tackling fake news in the world of science well before the term ‘fake news’ even existed."
Featured topic: coronavirus
On Science-Based Medicine,
Scott Gavura posted:
“Examining COVID-19 misinformation propagated by US physicians.” The paper discussed is Sule et al. JAMA Netw Open. 2023 Aug 1;6(8):e2328928 Paper. “...While studies like these are helpful to permanently document the misinformation propagated by health care professionals, what’s needed is action – and consequences. State medical regulatory boards owe a duty to protect the public. However, disciplinary action is rare, and regulators seem unwilling to enforce a standard of care, which may be influenced by legislative pressure. Institutions that may employ these physicians should also be examining the information that has been communicated by these individuals and evaluating the public health consequences (and reputational risk) of this misinformation. Regrettably, without any consequences, it seems reasonable to expect the dissemination of medical misinformation from physicians to continue.”
David Gorski posted:
“The American Board of Internal Medicine finally acts against two misinformation-spreading doctors.” “Last week, the American Board of Internal Medicine announced that it was going to permanently revoke the board certifications of two COVID-19 contrarian doctors, Drs. Paul Marik and Pierre Kory.”
“The Ohio State Medical Board has finally suspended the medical license of antivax quack Sherri Tenpenny.” “The only question is: What took them so long, and why did it take the pandemic for them to act?” Edzard Ernst also discussed the suspension.
“Quoth quacks, ‘The medical consensus has changed before, making my quackery science!’” Brave maverick doctors (i.e., quacks) have long tried to portray themselves as ‘innovators’ challenging an ossified medical consensus for the good of patients. This tradition continues among COVID-19 quacks, in particular the Frontline COVID-19 Critical Care Alliance and its founders.”
Jonathan Howard posted:
“Sensible Medicine: Medical misinformation and medical groupthink from the medical establishment.” “Sensible Medicine is a monetized Substack that spreads overt anti-vaccine misinformation... A recent article there by Dr. Marty Makary gives us an opportunity to delve into their more pernicious misinformation techniques.”
Steven Novella posted:
“Nasal sprays to prevent COVID.” “The big problem here is that these products are partly being marketed as an alternative to proven preventive methods, such as wearing an effective mask and social distancing. The concern is that use of a nasal spray, if they turn out to be ineffective (completely or in the dose and method of use), will essentially give people permission not to use a more effective preventive method, or to take excessive infection risks. An ineffective nasal spray can provide a false sense of security, and increase the overall risk and spread of COVID. Ideally clinical research will test each specific nasal spray formula not just to see if it has preventive efficacy, but also in comparison to other established preventive methods. One or more of these products may prove ultimately effective. The problem is that we currently just don’t know, the research is far too scant.”
On Respectful Insolence, “Orac” posted:
“’I’m a rational theorist, not a conspiracy theorist’.” Dr. Peter McCullough and Monica Smit are discussed.
“Pierre Kory: ‘Poor poor pitiful me! (And ABIM is corrupt!)’.” “Earlier this month, COVID-19 quack Dr. Pierre Kory was told that the American Board of Internal Medicine had recommended removing his board certification. Kory’s answer? ABIM is corrupt!... Basically, Dr. Kory is trying to confuse you and thereby convince you that you can’t know anything for certain. He’s attacking expertise, knowledge, and science themselves. To do that, he is co-opting reasonable criticisms of the ABIM’s maintenance of certification program and how the organization is run to imply that the only reason ABIM is coming after Dr. Marik and him is because it is in bed with big pharma, as well as casting the usual doubt that cranks try to cast on the very concepts of expertise, deep subject knowledge, and scientific consensus.”
Edzard Ernst posted:
“Political party affiliation is associated with excess deaths during the COVID pandemic.” Mark Crislip commented on the same study on Science-Based Medicine, in a post entitled “I reject your medical reality and I substituted death.”
August 14 – A Press release reported “Three year manhunt for an alleged fake doctor selling an unproven coronavirus cure ends with Utah fugitive behind bars.” “...At the beginning of the COVID-19 pandemic, before approved vaccines were available, [Gordon] Pedersen sold via the internet a ‘structural alkaline silver’ product which he claimed ‘resonates, or vibrates, at a frequency that destroys the membrane of the virus, making the virus incapable of attaching to any healthy cell, or to infect you in anyway’.”
Other topics
Best of the blogs, August – on Science-Based Medicine,
Scott Gavura:
Posted “What’s really in that sports supplement?” “A new analysis of sports supplements shows that you cannot trust the label to tell you what’s actually in the bottle.” The article was by Cohen and colleagues (see JULY 2023 NEWS). “A lowered regulatory bar for dietary supplements has been a boon to the industry, but the same can’t be said for consumer protection. In the absence of regulation that puts safety ahead of manufacturer interests, we shouldn’t expect to see any meaningful improvements in product quality. This double-standard has made it harder, rather than easier, for consumers to use supplements safely. Until a single, rigorous standard is applied across all consumer health products, there will continue to be uncertainty and even safety risks for users of dietary supplements.”
Asked “Are 'keto supplements' necessary?” “I could locate no published clinical trials to show that BHB [beta-hydroxybutyric acid] consumption provides meaningful medical or health benefits to those in ketosis (on keto diets) or to those that are not in ketosis. If you’re ‘going keto’ with the intent of burning ketones from fat, then I’m at a loss to understand why you would consume exogenous ketones, which simply provide a source of external fuel – like any other energy source. And measuring your urine for the presence of ketones when you deliberately consume BHB makes no sense to me whatsoever. BHB looks like a supplement still in search of a purpose. Perhaps one will be identified someday. There is no convincing evidence to suggest that BHB supplementation is beneficial or necessary, regardless of your dietary choices.”
David Gorski:
Posted “The World Health Organization promotes quackery yet again.” “The World Health Organization held the First WHO Traditional Medicine Global Summit this weekend. Unfortunately, its claims of being ‘evidence-based’ aside, the conference followed the WHO’s usual pattern of serving as propaganda, not science. The summit was one-sided, organized by believers with the only speakers being believers, to promote a predetermined policy goal of promoting traditional medicine and justify ‘integrating’ it with science-based medicine... Let me suggest something that might seem a bit heretical to the WHO as it exists now. The $250 million spent on its quackery-promoting Traditional Medicine Global Centre would be much better spent on—dare I say?—more traditional public health programs in areas of the world that desperately need them, programs promoting clean water, vaccination, and better nutrition, as well as providing ‘on-the-ground’ public health workers and medical personnel to bring science-based medicine, rather than unproven woo, to the people who need it most. The WHO has done such good work in these areas over the decades, and it saddens me to see it slipping more and more into a mindset that promotes medicine based on mysticism and prescientific religious belief systems, such as TCM [traditional Chinese medicine] and Ayurveda, as somehow being co-equal with science-based medicine to the point that they should be ‘integrated’ with it. That is not promoting ‘planetary health and well-being for all.’ Rather, it is shunting precious global health care funds away from science-based public health and medicine to promote unproven and disproven ‘ancient knowledge’.” Edzard Ernst also discussed the issue in two posts. On Aug. 15 he wrote, “The WHO has a long history of uncritically promoting alternative therapies. The Indian government has recently advocated irresponsibly dangerous nonsense, such as the use of homeopathy for the prevention and treatment of covid infections. The two together make an ominous initiative when it comes to alternative medicine.” On Aug. 21 he discussed an article from The Spectator, which noted “… the WHO has achieved a massive amount by unashamedly exporting rigorous scientific inquiry to parts of the world which it had yet to reach. It wasn’t folk medicine that eradicated smallpox; it was western medicine, and the WHO should not be apologising for that. Promoting quackery seems an odd – and potentially disastrous – direction for the organisation to take.” Nicholas Little also commented for the Center for Inquiry: “WHO thought this was a good idea?” “Whatever the reasons behind this promotion of pseudoscience, the WHO needs to stop, and stop now. Elevating homeopathy and other forms of ‘alternative medicine’ to a par with real, science-based medicine risks encouraging many across the world to eschew scientifically proven treatment and instead to place their faith in quackery. That kind of thinking kills people, and the poor of the world deserve better than having sham cures foisted onto them in the place of real medicine. WHO also risks destroying the credibility of the organization itself.”
Frank Han:
Continued his series of critiques of the antivax book “Turtles All the Way Down.” Part 4 deals with basic concepts in epidemiology.
Steven Novella:
Discussed “Structural Energetic Therapy.” “SET appears to be another form of massage therapy with unsupported claims…A search on PubMed turned up no studies supporting any benefits for SET, or the existence of the spiral twist. General searches online also did not turn up any scientific studies. The SET website has their own library of articles – all commentary or case studies (i.e. anecdotal). If there were any well-designed scientific studies (positive ones, anyway) I imagine they would be listed there. SET seems to be unmoored to scientific evidence, which is consistent with the claim that it can treat a long list of problems and that anyone can benefit. Good for marketing – not for science-based practice.”
On Respectful Insolence, “Orac”:
Posted “Vaccines and SIDS: Steve Kirsch amps up the stupid.” “Antivaxxers have long claimed that childhood vaccines cause sudden infant death syndrome (SIDS). Now ‘new school’ antivaxxer Steve Kirsch has resurrected this hoary old lie using the thinnest of evidence plus a lot of handwaving
Edzard Ernst:
Posted “Shakti Mats are all the rage! But do they bring you any health benefits?”
Discussed “The ‘Global Patient Safety Task Force’ of the World Federation of Chiropractic.” “At first, most people will think: WHAT A GOOD IDEA! After a bit of reflection, however, some might ponder: WHY ONLY NOW AND NOT DECADES AGO? And after reading the above text carefully, skeptics might feel that the exercise can already be classified as a PR gimmick that will not generate the needed information: The WFC has yet again failed to establish a monitoring system of adverse effects; without it ‘patient safety’ is not achievable. They claim that ‘we know that serious adverse events are rare.’ How do they know this? And if they already are convinced of this, the new task force is bound to be a pure ‘white wash’. They think an ‘existing safety culture’ exists in chiropractic. This is wishful thinking and far from reality. They speak of the ‘expectations of patients and the public’ but ignore the need for a monitoring system accessible to the public.”
Wrote “Selling bleach solution as ‘miracle’ cure? No, it’s a dangerous ‘snake oil’!” Mark Grenon and his sons were convicted in the sale of “Miracle Mineral Solution.”
Posted “Massage therapy for athletic performance?” Two reviews were discussed. One noted, “The direct usage of massages just for gaining results in sport and exercise performance seems questionable. However, it is indirectly connected to performance as an important tool when an athlete should stay focused and relaxed during competition or training and recover after them.” Ernst’s conclusion was: “So, on balance, I think massage therapy might be worth considering for athletes.”
Reported that Australia's National Health and Medical Research Council affirmed its earlier negative review of homeopathy.
Discussed “infertility clinics that exploit customers by offering acupuncture.” “...far too many health clinics that offer SCAM [so-called alternative medicine] for this or that indication operate way outside the ethically (and legally) acceptable norm. They advertise their services without making it clear that they are neither effective nor safe. Desperate consumers thus fall for their promises. In the case of infertility, this might result merely in frustration and loss of (often substantial amounts of) money. In the case of serious disease, such as cancer, this often results in premature death.”
Wrote “The threat of 'predatory journals': hard to estimate.” “Sadly, in the realm of so-called alternative medicine (SCAM), there currently are dozens of such publications. I believe their danger in polluting the medical literature is hard to over-estimate.”
Posted “Visceral osteopathy for low back pain? No thanks!” A new review found “a lack of high-quality studies showing the effectiveness of visceral osteopathy in pain, disability, and physical function in patients with LBP.”Ernst noted that the totality of the evidence “fails to show that visceral osteopathy works for any condition.” “The treatment itself seems to be safe, yet the risks of visceral osteopathy are nevertheless considerable: if a patient suffers from symptoms related to her inner organs, the therapist is likely to misdiagnose them and subsequently mistreat them. If the symptoms are due to a serious disease, this would amount to medical neglect and could, in extreme cases, cost the patient’s life. My bottom line: if you see visceral osteopathy being employed anywhere, turn around and seek proper healthcare whatever your illness might be.”
Wrote “Sleep restriction therapy for insomnia – a new rubbish trial in THE LANCET.” “I am frankly amazed that this paper was published in a top journal, like THE LANCET... the verum group received fairly extensive attention, while the control group did not. In other words, a host of non-specific effects are likely to have significantly influenced or even entirely determined the outcome. Despite this rather obvious limitation, the authors fail to discuss any of it... I suggest the conclusions of this trial should be re-formulated as follows: The brief nurse-delivered sleep restriction, or the additional attention provided exclusively to the patients in the verum group, or a placebo-effect or some other non-specific effect reduced insomnia symptoms.”
Posted “Cervical manipulation for neck pain: DON’T DO IT!” “If we extend our searches beyond RCTs [randomized controlled trials], we find many cases of serious harm caused by neck manipulations (also as discussed repeatedly on this blog). Therefore, the conclusion of this review should be corrected: Low certainty evidence exists supporting cervical SMT [spinal manipulative therapy] as an intervention to reduce pain and improve disability in people with neck pain. The evidence of harm is, however, substantial. It follows that the risk/benefit ratio is not positive. Cervical SMT should therefore be discouraged.”
Discussed “Yet another systematic review of randomized clinical trials of 'manipulative therapy' for chronic neck pain.” The review mainly dealt with Chinese massage (tuina). “What the abstract does not tell us is that the Tuina studies are of such poor quality that the conclusions drawn by the Chinese authors are not justified. What we do learn – yet again – is that Chinese papers need to be taken with a large pintch of salt. In the present case, the searches underpinning the review and the evaluations of the included primary studies were clearly poorly conducted. Rubbish journals publish rubbish papers. How could the reviewers and the editors have missed the many flaws of this paper? The answer seems to be that they did not care. SCAM journals tend to publish any nonsense as long as the conclusion is positive.”
Posted “My ‘Alternative Medicine Hall of Fame’ welcomes Terry Oleson.” “Oleson has published on auricular acupuncture and acupressure, at least one book and the papers listed below. This is an oddly dubious and biologically implausible so-called alternative medicine (SCAM). Terry Oleson... and his research are all the more remarkable: in his hands auricular therapy seems to work of just about everything...14 papers about a dodgy SCAM [so-called alternative medicine] without the hint of a negative finding! I hope we can all agree that this achievement makes Terry a worthy member of my ‘HALL OF FAME’, a group of people who, like Terry, have been able to publish nothing but positive findings about the most dubious SCAMs.”
Wrote “Health misinformation in the US: education plays a particularly important role.” Excerpts from the KFF Health Misinformation Tracking Poll Pilot were discussed.
Posted “Joe Dispenza: a chiropractor excells in pseudoscientific bullshit.” “‘Dr. Joe’ is not a medical doctor or neuroscientist but a chiropractor. He does not understand quantum physics. He has not published any meaningful scientific studies. His proclamations are nothing but platitudes or empty phrases.”
On McGill Office for Science and Society:
Jonathan Jarry:
Posted “Nattokinase's clot-busting promises sway scientists who should know better.” “Take-home message: Nattokinase is an enzyme secreted by bacteria when fermenting soybeans during the making of the traditional Japanese food known as natto; Nattokinase dietary supplements are claimed to help prevent and treat cardiovascular disease, although the studies done so far are not rigorous enough to support this claim and we still do not know with certainty what happens to nattokinase in the human body when taken by mouth; Anti-vaccine influencers are selling nattokinase supplements as a way to ‘detox’ from the spike protein contained in the COVID-19 vaccines, which is simply not based on good science.”
Wrote “Saffron for teenage moodiness? The evidence is immature.” “Take-home message: Saffron, the most expensive spice in the world, is claimed to help stabilize a teenager’s mood and to help control anxiety and depression; The evidence for this comes from very small clinical trials that lasted at most two months; The vast majority of these trials were conducted in Iran, one of the leading producers of saffron, and there is reason to believe that trials that do not show a benefit to saffron do not always get published.”
Posted “The microbiome and its myth-making machine.” “If you have heard something very specific about the microbiome, odds are it’s wrong.”
Wrote “Step right up! Essential oils boost your memory (maybe not)!” “Take-home message: Loss of or altered smell can be an early sign of neurological disease like Alzheimer’s disease and Parkinson’s disease, although it is also commonly seen with old age and can be triggered by other factors, like a respiratory infection. A study from UC Irvine claims to show that smelling essential oils at night dramatically improves memory, but the study was tiny and the improvement was only seen on the fifth trial of only one of four cognitive tests. The study was funded by the multinational Procter and Gamble, which is reported to be releasing an essential oil diffuser this fall based on these mediocre findings.”
Joe Schwarcz:
Posted “Sour grapes.” “By all means incorporate grapes in your diet, but don’t expect them to make you live longer.”
Wrote “Sour hype about apple cider vinegar.” “Apple cider vinegar may make for a tasty salad but claims about its health benefits are tough to swallow... as a medicinal substance, the hype is not backed by evidence, particularly for the tablets, capsules or gummies.”
August 1 – A review by Viswanathan et al. (JAMA. 2023 Aug 1;330(5):460-6 Paper) concluded that “New evidence from observational studies provided additional evidence of the benefit of folic acid supplementation for preventing neural tube defects and no evidence of harms related to multiple gestation, autism, or maternal cancer. The new evidence was consistent with previously reviewed evidence on benefits and harms.” As a result the US Preventive Services Task Force reaffirmed its recommendation that “all persons planning to or who could become pregnant take a daily supplement containing 0.4 to 0.8 mg (400 to 800 μg) of folic acid” (JAMA. 2023 Aug 1;330(5):454-459 Statement).
August 9 – Ijaz and Carrier published “Governing therapeutic pluralism: An environmental scan of the statutory regulation and government reimbursement of traditional and complementary medicine practitioners in the United States” (PLOS Glob Public Health. 2023 Aug 9;3(8):e0001996 Paper).
Additions to previous months
March 24 – Borkens and others published “Homeopathy – a lively relic of the prescientific era” (Wien Klin Wochenschr. 2023 Mar 24:1–8 Paper
July – Ordille and others published “Black salve: a dangerous corrosive disguised as an alternative medicine” (Cureus. 2023 Jul 1;15(7):e41248 Paper).
July 27 – Mary Chris Jaklevic wrote “‘Medical errors are the third leading cause of death’ and other statistics you should question.”