DECEMBER 2022 NEWS

Other topics

Best of the blogs, December:

Science-Based Medicine is now 15 years old.

Steven Novella reviewed 15 years of SBM.
David Gorski reviewed “Lessons learned and what the future holds.”

In other posts:

Mark Crislip:

Discussed serologies. “The most problematic way to make a diagnosis is serologies: measuring antibodies in the blood directed against an infection.” Tests for Epstein Barr Virus and Lyme disease were discussed. “When the incidence of a disease is low, most serologic positives are false positives…The take home: A positive serology for an infectious disease may be meaningless.”

Scott Gavura:

Asked “Does xenon gas improve athletic performance?” “In terms of athletic performance, xenon’s asphyxiant properties appear to activate production of HIF-1α [hypoxia-inducible factor 1-alpha], which is a consequence the resultant oxygen deprivation. A secondary effect is erythropoietin stimulation, which promotes the production of red blood cells and consequently the oxygen-carrying capacity of the blood…Not snake oil, but unclear effectiveness…Since xenon was banned by WADA [World Anti-Doping Agency] in 2014, some evidence has emerged that painted a mixed but not clearly compelling case that inhaling the gas actually does enhance athletic performance. There is certainly no evidence that xenon has any recreational use, nor is there any evidence that it can help injury recovery. I’m not putting it in the same category as kinesio tape, but it’s probably fair to say that the potential benefits are not worth the risks and the cost, compared to legal (and safer) methods of boosting erythropoietin.”

Harriet Hall:

Posted “Is meat poison? Is fat the antidote?” “Conclusion: the carnivore diet is not healthy. A lean-meat-only diet can kill through protein poisoning. Fats and carbs are essential to providing all the nutrients and energy we need. A balance of protein, fats, and carbs is ideal, and that’s exactly what standard diet advice recommends.”
Asked “Should you take vitamin D supplements?” “Recent research found that supplemental vitamin D doesn’t prevent fractures or have any effect on the diseases it has been claimed to help, and blood tests for vitamin D are useless.” (However, “Blood tests might be useful for some patients who might have severe deficiency, such as people living in residential settings with no sun exposure, patients with malabsorption, or those receiving treatments for osteoporosis that might cause hypocalcemia and may benefit from vitamin D.”)

Clay Jones:

Posted “The Washington Post takes on baby chiropractic.” “Unfortunately the article, which overall was better than most I’ve read from the mainstream press on alternative medicine, ends with a believer in abject nonsense, who can present no legitimate evidence to support their belief in such a thoroughly implausible notion as baby chiropractic, getting the last word.”

On Respectful Insolence, “Orac”:

Posted “After their COVID success, antivaxxers are going old school on MMR.” “They see their success repurposing old antivax tropes against COVID-19 as their opportunity to pivot back to old vaccines like MMR and use these arguments for their original purpose before the pandemic: To attack childhood vaccines. The difference, unfortunately, is that now that they’ve established these arguments against a new pathogen, they might well succeed in using them against the old pathogens against whose vaccines they were originally developed.” See also related stories below (December 16).

Edzard Ernst:

Posted “More compelling reasons for distrusting Chinese research papers.” A study of retracted papers produced by paper mills found that 97% came from Chinese institutions. “While such fraudulent papers may have a relatively small impact in many areas of healthcare, their influence in the realm of TCM [traditional Chinese medicine] (where the majority of research comes from China) is considerable. In other words, TCM research is infested by fraud to a degree that prevents drawing meaningful conclusions about the value of TCM treatments.”

Wrote “Dire news for acupuncture fans,” discussing a review by Allen and others (JAMA Netw Open. 2022 Nov 1;5(11):e2243665 Paper). “The authors concluded that despite a vast number of randomized trials, systematic reviews of acupuncture for adult health conditions have rated only a minority of conclusions as high- or moderate-certainty evidence, and most of these were about comparisons with sham treatment or had conclusions of no benefit of acupuncture. Conclusions with moderate or high-certainty evidence that acupuncture is superior to other active therapies were rare…Considering such findings, some people (including the authors of this analysis) feel that we now need more and better acupuncture trials. Yet I wonder whether this is the right approach. Would it not be better to call it a day, concede that acupuncture generates no or only relatively minor effects, and focus our efforts on more promising subjects?” Steven Novella also discussed the review on Science-Based Medicine. “Given that there are several thousand published clinical trials looking at acupuncture, over decades, if acupuncture actually worked for anything I would think that by now we would be seeing a clear signal in the data – but we are not. As this review demonstrates, most of the evidence is low quality, and almost none is deemed high quality evidence. Only two subsets had high quality evidence of acupuncture showing an effect, and these suffered from small numbers and methodological issues that were overlooked by the reviewers. Further, if you do enough studies for enough conditions, you’re going to come up with some positive evidence just by chance alone, especially if you throw in a little publication bias. The overall pattern of the acupuncture literature, therefore, is clearly negative. It is consistent, I would even argue highly predictive, of a null phenomenon. We see this same pattern with other scientifically implausible claims, such as ESP and homeopathy. It’s likely not a coincidence.”
Discussed “Onion water for viral infections?” “…compelling trial evidence that preparations from onion are effective against viral infections does not exist…So, no good evidence for onion, potentised onion, onion water, or any other preparations of onion.”
Wrote “So-called alternative medicine (SCAM) for heart failure,” discussing a Statement from the American Heart Association. “No doubt, this assessment is a laudable attempt to inform patients responsibly. Personally, I am always a bit skeptical about such broad statements. SCAM encompasses some 400 different therapies, and I doubt that these can all be assessed in one single overview…attempts to provide comprehensive overviews of all SCAMs are problematic, and that incomplete overviews are just that: incomplete.”
Discussed cosmetic acupuncture. “It will cost you a lot of money because the therapist will persuade you that you need 10 treatment sessions or more. It can cause blotchiness and hyperpigmented spots…It has been reported to cause extensive facial sclerosing lipogranulomatosis. So, you want to improve your looks? I am not sure what therapies work for this purpose. But I do know that cosmetic acupuncture isn’t one of them.”
Posted concerning an updated Cochrane review of homeopathy for acute respiratory tract infections in children (Hawke et al. Cochrane Database Syst Rev. 2022 Dec 13;12(12):CD005974 Abstract). “The authors concluded that the ‘pooling of five prevention and six treatment studies did not show any consistent benefit of homeopathic medicinal products compared to placebo on ARTI recurrence or cure rates in children. We assessed the certainty of the evidence as low to very low for the majority of outcomes. We found no evidence to support the efficacy of homeopathic medicinal products for ARTIs in children…’ These findings are hardly surprising. Will they change the behavior of homeopaths who feel that: 1. children respond particularly well to homeopathy, 2. ARTIs are conditions for which homeopathy is particularly effective? I would not hold my breath!”
Wrote “Spinal manipulation or mobilisation for kids? No, stay away from both!” A review by Milne et al. (BMC Pediatr. 2022 Dec 19;22(1):721) was discussed. “The authors concluded that, whilst some individual high-quality studies demonstrate positive results for some conditions, our descriptive synthesis of the collective findings does not provide support for spinal manipulation or mobilisation in paediatric populations for any condition… Perhaps the most important findings of this review relate to safety. They confirm (yet again) that there is only limited reporting of adverse events in this body of research. Six reviews, eight RCTs and five other studies made no mention of adverse events or harms associated with spinal manipulation. This, in my view, amounts to scientific misconduct. Four systematic reviews focused specifically on adverse events and harms. They revealed that adverse events ranged from mild to severe and even death…In terms of risk/benefit balance, the conclusion could thus not be clearer: no matter whether chiropractors, osteopaths, physiotherapists, or any other healthcare professionals propose to manipulate the spine of your child, DON’T LET THEM DO IT!”
Posted “The first trial of homeopathic Hypericum C200 generates nothing but hilarity.” The trial was for pain management after surgery. “For a number of reasons, this is a remarkably mysterious and quite hilarious study…In the end, none of this matters, because the results of the study reveal that firstly the homeopathic ‘law of similars’ is nonsense, and secondly one homeopathic placebo (i.e. Hypericum C200) produces exactly the same outcomes as another, non-homeopathic placebo.”
Wrote “So-called alternative medicine (SCAM) for animals is not evidence-based and borders on animal abuse.” A review by Bergh et al. (Animals (Basel). 2021 Nov 24;11(12):3356 Paper) was discussed. “In essence, this review confirms what I have been pointing out numerous times: SCAM for animals is not evidence-based, and this includes in particular homeopathy. It follows that its use in animals as an alternative to treatments with proven effectiveness borders on animal abuse.”

December – As reported in Consumer Health Digest, “FDA announces enforcement priorities for homeopathic products. The U.S. Food and Drug Administration has issued a final guidance describing the agency’s approach to prioritizing regulatory actions for homeopathic products marketed in the United States…The FDA has developed a risk-based approach to enforcement that gives priority to homeopathic products that potentially pose a higher risk to public health.” However, “Most homeopathic products fall outside of these categories. No homeopathic products are FDA-approved, and there is no reason to believe they are effective.”

December – Pameijer and others published “What did we learn in 35 years of research on nutrition and supplements for age-related macular degeneration: a systematic review” (Acta Ophthalmol. 2022 Dec;100(8):e1541-e1552 Paper). They concluded “Research in the last 35 years included in our overview supports that a high intake of specific nutrients, the use of antioxidant supplements and adherence to a Mediterranean diet decrease the risk of progression of early to late AMD.”

December – Evans and others reviewed “Exogenous ketone supplements in athletic contexts” (Sports Med. 2022 Dec;52(Suppl 1):25-67 Paper). “Despite the mechanistic bases for potential beneficial effects of EKS, the evidence at present is overwhelmingly against EKS being an ergogenic aid for athletic performance. Yet questions remain about whether there are optimal dosing strategies (especially using ketone esters), specific athletic populations, or specific exercise challenges in which acute ingestion of EKS may provide a performance benefit.”

December 1 – Nick Tiller discussed backward walking or “retro walking.” “Based on the evidence, there may be some validity to backward walking exercises, mainly as an adjunct to a larger program of conventional physiotherapy for people with knee and gait abnormalities. But these potential benefits are at risk of being overshadowed by a slew of baseless claims regarding memory and energy expenditure, and the very rebranding of backward walking exercises as ‘retro walking’ signals the industry’s preference for marketing over science and style over substance.”

December 5 - Harriet Hall discussed “Kailo and other patches for pain.” Other products mentioned are Taopatch, Luminas, and Signal Relief. “The claims for these patches are all meaningless, nonsensical, pseudoscientific, energy-medicine jargon. They are not intended to make sense. They are intended to make you think you would understand if only you knew more about science.”

December 5 – Truth in Advertising posted “Nutrafol needs to shed its deceptive hair growth claims.” Claims to increase hair growth or prevent hair loss require FDA approval, “which Nutrafol acknowledges it does not have.”

December 7 – The FDA posted an article on non-invasive body contouring technology.

December 13 – Another FDA item was entitled “Protect your family from fraudulent flu products.” “There are no legally marketed over-the-counter (OTC, or non-prescription) drugs to prevent, treat, or cure the flu. But there are legally marketed OTC drugs to reduce fever and to relieve muscle aches, congestion, and other symptoms typically associated with the flu. Dietary supplements, conventional foods (such as some herbal teas), or devices (such as certain air filters and light therapies) that fraudulently claim to prevent, mitigate, treat, or cure the flu have not been evaluated by the FDA for safety and effectiveness…At your pharmacy and online, you may see products being sold and advertised as homeopathic. The FDA is not aware of any proven benefits of these products.”

December 16 – A press release from the Kaiser Family Foundation reports that “More than 4 in 10 Republicans and a third of parents now oppose schools requiring children to get vaccinated for measles and other illness, up since the COVID-19 pandemic began.” A related story from NBC News was entitled “Vaccine misinformation one of the biggest public health threats, CDC director says.”

Addition to previous months

September 20 – Hidalgo and others published “Complementary and alternative therapies in skin cancer a literature review of biologically active compounds” (Dermatol Ther. 2022 Nov;35(11):e15842 Paper). “There is emerging evidence for CAM use in skin cancer, but no human clinical trials support the effectiveness of any CAM in the treatment of skin cancer to date.”

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