Best of the blogs, January – on Science-Based Medicine: Jann Bellamy:
continued her “Legislative Alchemy” posts with a discussion of 2017 state legislative actions relating to alternative medicine. One post dealt with chiropractic: “Chiropractors are promoting themselves as primary care physicians.” The American Chiropractic Association “wants to sell the public on the notion that chiropractors should be everyone’s first stop for general health advice as well as a diagnosis of what ails them, no matter what the disease or condition, trusting the chiropractor to refer the patient to a real doctor should the need arise.” Another concerned acupuncture. Bills were “filed in eleven states to license, or expand the practice of, acupuncturists during the 2017 state legislative sessions. Six were successful. Two bills were defeated; three remain pending.”
Scott Gavura:
described how “Georgian College in Ontario, Canada is now offering a 3-year advanced diploma in the pseudoscience of homeopathy.” (see also Feb. 9 item below)
David Gorski:
discussed “’Raw water’: The latest dangerous ‘natural health’ fad.”
wrote “The final push to pass a federal version of the cruel sham of 'right-to-try' is under way.” “It can’t be stated too often. The goal of right-to-try is not to help terminally ill patients. It’s to diminish and weaken the FDA.”
wrote two posts describing how integrative medicine advocates were using the opioid crisis to promote their approaches. The first dealt with trying “to persuade state Medicaid systems to pay for quackery like acupuncture.” The second discussed how they rebrand their methods as nonpharmacological treatments for pain. These tactics “tactics allow integrative medicine advocates to claim all nonpharmacological treatments of pain as their own, separate from science- and evidence-based medicine, even when such treatments have existed in that realm for a long time.”
Harriet Hall:
provided a critique of a promotional video by Nina Koduru about "Five Fatal Foods." The video “is misleading propaganda designed to sell a product. There is no evidence that those foods kill people or that avoiding them would result in better health. There is little published evidence for most of the many benefits claimed for probiotics. This specific product has not been tested for effectiveness or safety, nor has it been compared to other products on the market.”
discussed compounding pharmacies. While these have attracted attention due to safety issues, with some contaminated products killing patients, “The elephant in the room is the fact that compounding pharmacies are often used injudiciously by naturopaths, ‘integrative medicine’ doctors, ‘functional medicine’ doctors, and other providers who prescribe treatments that are not supported by credible evidence and that often involve risky IV administration.”
reviewed a video series by functional medicine doctor Mark Hyman entitled "The Broken Brain": it “is not a reliable source of medical information. Hyman includes standard advice about a healthy lifestyle, but he mixes it indiscriminately with advice that is based on speculation rather than on credible evidence. And he makes claims that defy belief (curing autism with cod liver oil) and many that are demonstrably not true.”
Steven Novella:
posted “Indian Doctors Fight Against Quackery.” “To address a doctor shortage, Indian health minister JP Nadda is proposing licensing practitioners of ayurveda and homeopathy. This would be a terrible mistake.”
wrote “Infiltrative Pseudoscience”: “CAM proponents seek to undermine the standard of care, to confuse how science works and the relationship between evidence and practice. They want to change the rules of evidence, to water down regulations or carve out exceptions, and to promote false ideas.”
critiqued "Vision Therapy Quackery": “Behavioral optometry claims to treat a wide range of disorders, including learning difficulty and attention problems. But these claims are not based on solid scientific ground, and are not supported by rigorous evidence.”
On Respectful Insolence, “Orac”:
wrote “The next frontier in 'integrative medicine': Getting Medicaid to fund quackery.”
discussed antivaccine efforts on Facebook.
wrote “Oprah Winfrey for President? Does anyone remember all the pseudoscience and quackery she’s promoted?”
wrote “More 'auricular' acupuncture: Our veterans deserve science-based medicine, not quackery.” “Steve Salzberg quite correctly points out that the form of auricular acupuncture touted by Col. Dr. Niemtzow and being adopted by the VA was ‘made up out of whole cloth’ in 2001 and not yet put under any significant review. He’s absolutely correct. The evidence base for battlefield acupuncture is weak, even by acupuncture standards.”
praised an article in The Surgeon on integrative medicine: “This is the sort of thing we need from physicians: Actual pushback in the peer-reviewed medical literature against the integration of pseudoscience and quackery with medicine.” On the other hand, he found an article in Richmondmag to be yet another example of the “Credulous promotion of 'integrating' quackery into medicine.”
critiqued the claims of antivaccine naturopath Henele E'ale.
Edzard Ernst:
wrote “Detox is bunk; save your money for something useful, fun or pleasant!” “To the best of our knowledge, no randomised controlled trials have been conducted to assess the effectiveness of commercial detox diets in humans.”
concluded that “Chiropractic is not the best treatment for back pain !!!”
discussed an anecdotal report of cancer remission due to curcumin (a substance in turmeric).
analyzed a paper on Chinese herbs for Alzheimer’s. “…which journal would publish such rubbish?... Ahhh, it’s the BMC Complement Altern Med!”
discussed the Dorn Method, a relatively new German therapy for back pain and spinal disorders. “…we cannot possibly escape the conclusion that the Dorn Method is pure nonsense.”
criticized a paper on the use of acupuncture for headache associated with traumatic brain injury. The study design, which does not control for placebo effects, was characterized as being “deceptive to the point of being unethical.”
found a review of manual therapies for colic to be “uncritical and biased.”
reported on a paper dealing with “Liver damage after Chinese herbal treatments,” and felt that the incidence could be much higher.
January – In 2009, an Italian surgeon, Paolo Zamboni, proposed that multiple sclerosis is caused by chronic cerebrospinal venous insufficiency (CCVI), a narrowing of the veins draining blood from the brain. He developed a therapy which came to be known as liberation therapy. However, scientists were skeptical, and further investigation showed that there was no association between CCSVI and MS. Now a group including Zamboni has performed a study showing that the method is ineffective (JAMA Neurol. 2018 Jan 1;75(1):35-43 Paper) Editorial comment (1st page) News story.
January – The Good Thinking Society has published a guide to "Cancer and alternative therapies."
January – Mathews reviewed “Prohibited Contaminants in Dietary Supplements” (Sports Health. 2018 Jan/Feb;10(1):19-30 Paper). “Poor manufacturing processes and intentional contamination with many banned substances continue to occur in dietary supplements sold in the United States. Certain sectors, such as weight loss and muscle-building supplements, pose a greater threat because they are more likely to be contaminated…Athletes will continue to be at risk for adverse events and failed doping tests due to contaminated dietary supplements until legislation changes how they are regulated.”
January – Claflin, van der Mei, and Taylor reviewed “Complementary and alternative treatments for multiple sclerosis” (J Neurol Neurosurg Psychiatry. 2018 Jan;89(1):34-41 Paper). “Overall, we found little evidence of efficacy for CAM treatments of MS and class I [good quality randomized controlled trial with little evidence of bias] evidence was almost universally lacking…there are dozens of studies showing a positive effect of a particular CAM on a particular health outcome, but there is little overlap or consistency between studies, making it impossible to draw meaningful conclusions about treatment efficacy…This is not to say that CAMs have no effect on MS, but that there is currently no rigorous scientific evidence to support their use.”
January – Sposato and Bjerså reviewed “Osteopathic Manipulative Treatment in Surgical Care” (J Evid Based Integr Med. 2018 Jan-Dec;23:25 Paper). They found a lack of good quality papers in the field, and argued that “there is an urgent need to evaluate OMT in this context.” Edzard Ernst, in evaluating the review, noted that “There is no plausible reason why OMT should be beneficial in this setting. Osteopaths are not well-trained for looking after surgical patients. Physiotherapists, however, are and therefore there is no need for osteopaths on surgical wards. The evidence is extremely scarce. The available trials are of poor quality. Their results are contradictory. Therefore there is no reliable evidence to show that OMT is effective.” The correct conclusion of the review should be that “this approach cannot be recommended.”
January – A review by Lanhers and others (Sports Med. 2017 Jan;47(1):163-173 Abstract) concluded that “Creatine supplementation is effective in upper limb strength performance for exercise with a duration of less than 3 min, independent of population characteristics, training protocols, and supplementary doses or duration.”
January – Parker et al. reviewed the evidence from Cochrane Collaboration reviews on probiotics for gastrointestinal conditions (Nutrition. 2018 Jan;45:125-134 Paper). They concluded, “The results of the present overview of Cochrane systematic reviews of probiotics for GI disorders suggests that probiotics can have a beneficial effect on diarrheal conditions and related GI symptoms. Although encouraging, additional studies are needed to make conclusive inference on the efficacy of probiotics for colitis, Crohn's disease, and liver disorders.”
January 1 – A paper by Johnson and others (J Natl Cancer Inst. 2018 Jan 1;110(1)121-124 Paper) found that “AM [alternative medicine] utilization for curable cancer without any CCT [conventional cancer treatment] is associated with greater risk of death” Press release. Edzard Ernst discussed the paper.
January 3 – C. Aschwander wrote “ Tom Brady is Drowning in His Own Pseudoscience.” Claims in Brady’s book “The TB12 Method,” including recommendations for water and electrolytes, diet, and “muscle pliability,” were analyzed.
January 11 – The FDA took action against CellMark and its CEO for “Making Deceptive Claims about Products’ Ability to Mitigate Side Effects of Cancer Treatment” Press release. The products were “CellAssure, to treat cancer-related malnutrition, and Cognify, to treat ‘chemo fog’.”
January 13 – H. Mehta posted “This is Why Naturopathic ‘Doctors’ Should be Avoided.” Included is a link to Britt Hermes’ talk at CSICon 2017, entitled “The Bloody Work of ‘Naturopathic Doctors’.”
January 25 – The Genetic Literacy Project updated its Profile entitled “Mike Adams: Natural News, ‘everyone’s favorite über-quack #1 anti-science website’.”
January 28 – J. Gunter attended and reported on the GOOP Health event. “’I’ve never been to such a dull conference. There was nothing constructive. This was not the place or space to find even three things to do or change heath wise. It was a place to come and steep in the cult of GP [Gwyneth Paltrow] and to be told that death is cool and that love cures everything.” “Orac” also discussed the conference on Respectful Insolence. “What surprised me wasn’t so much how bad In Goop Health was, but rather how obviously fraudulent some of the featured speakers were.”
Best of the blogs, February – on Science-Based Medicine: Jann Bellamy:
published “Cleveland Clinic genetic experts call out functional medicine on worthless genetic testing and supplement prescribing.” However, such testing is recommended by the functional medicine doctors associated with the Cleveland Clinic.
Scott Gavura:
wrote “Are we all contaminated with chemical toxins?” “While there is evidence supporting the claim that there are synthetic and other environmental toxins in humans and in our food supply, there is a lack of evidence to show that (with some exceptions) there is specific cause for concern. Serious toxicity and poisonings are managed in hospital emergency rooms: That’s where the only effective detoxification interventions occur. Detoxification ideas promoted in the popular press, including anything sold as a kit or diet, or promoted by alternative medicine practitioners, lack evidence they do anything beneficial at all.”
David Gorski:
posted “ Quackademic medicine and the delusion of being ‘science-based’.” The article dealt with papers by Deepak Chopra in collaboration with academic researchers, as well as the integrative medicine program at Georgetown University.
wrote that “In the online echo chamber promoting alternative medicine, there are varying degrees of deception. There are true believers (who are often victims), entrepreneurs (who are often true believers who found a profitable business), and scammers. The categories are not mutually exclusive.”
Harriet Hall:
wrote “MyMedLab Offers Expensive, Useless, Nonstandard Lab Tests”: “…in my opinion, this kind of testing is likely to do more harm than good, sometimes at great expense for unnecessary tests. And insurance will not pay for lab tests that were not ordered by a doctor. There is a reason we have doctors: they have expert knowledge and are better equipped than patients to make decisions about what to test and when to test.”
published "Answering Our Critics – Again!". “Critics of Science-Based Medicine keep making the same old tired arguments, despite the fact that their arguments have been repeatedly demolished. Here is a list of recurrent memes, with counterarguments.”
discussed the use dangerous escharotics treatments in the article “Chiropractor Lost His License; Patient Lost Her Uterus.”
Joel Harrison:
wrote “The So-Called Vaccine Debate: False Balance in The San Diego Union-Tribune.” “A recent article in The San Diego Union-Tribune presents a pair of articles that gives a false balance regarding vaccinations. Those who oppose vaccination do so on the basis of ideology rather than science, thus placing the public’s health at risk.”
Samuel Homola:
wrote “Inside Chiropractic: Yesteryear and Today.” “In the 123 years since its inception, the core beliefs of the chiropractic profession have not changed. Chiropractic continues to exist as a form of alternative medicine that embraces a variety of questionable procedures and treatment methods. The chiropractic profession in the United States is still defined by the vertebral subluxation theory that gave it birth and independence as an alternative to conventional medical care. Chiropractors resist changes that would allow development of their profession as a conservative back-care specialty. “
On Respectful Insolence, “Orac”:
posted “Quackademic medicine triumphant (yet again): A defense of acupuncture on the Harvard Health Blog that misses the point.”
wrote “More naturopathic propaganda claiming lifestyle interventions as their own and adding quackery.”
asked, “Who cares what celebrities think about vaccines?”
wrote “The Academic Consortium for Integrative Medicine and Health: Exaggerating the evidence for acupuncture to make it appear to be more than an elaborate placebo.”
discussed “Miracle Mineral Solution” in a post entitled “Parents are still feeding their children bleach to ‘cure’ their autism.” “There are some forms of quackery that I’ve never been able to understand, quackery that is so bizarre, so without a reasonable scientific rationale, and so potentially harmful that it boggles my mind that anyone would think it is a good idea.”
posted “Idaho: The capital of the US for religion-inspired medical neglect of children, thanks to the Followers of Christ.”
asked “What’s more quackademic medicine than Harvard’s acupuncture course? Maybe Duke’s reflexology course!”
Edzard Ernst:
in response to a paper on physiochemical research into homeopathic solutions, wrote “My challenge to the homeopaths of this world.” He asked five questions concerning the “memory of water theory.
discussed kratom: “On balance, my conclusion is that we urgently need more data and meanwhile should avoid this ‘herbal drug'."
analyzed a review on cupping for athletes. “The authors even go as far as stating that the trials reported in this systematic review found beneficial effects of cupping in athletes when compared to no intervention. I find this surprising and bordering on scientific misconduct. The RCTs were mostly not on cupping but on cupping in combination with some other treatments. More importantly, they were of such deplorable quality that they allow no conclusions about effectiveness. Lastly, they mostly failed to report on adverse effects which, as I have often stated, is a violation of research ethics. In essence, all this paper proves is that, if you have rubbish trials, you can produce a rubbish review and publish it in a rubbish journal [The Journal of Alternative and Complementary Medicine]."
wrote "This RCT [randomized controlled trial] of a Chinese herbal mixture makes a mockery of science and medical ethics.” “I have seen too many flawed studies of alternative medicine to be shocked or even surprised by this level of incompetence and nonsense. Yet, I still find it lamentable. But, in my view, the worst is that supposedly peer-reviewed journals such as ‘BMC Complement Altern Med’ publish such overt rubbish."
analyzed a paper on craniosacral therapy: “This study has so many flaws that I don’t know where to begin."
responded to a trial of the East Asian herbal supplement, Sipjeondaebo-tang: “How turn a negative trial into a positive one? Simple, just cheat!...This level of scientific misconduct is remarkable, even for the notoriously poor Evid Based Complement Alternat Med. I strongly suggest that: 1. The journal is de-listed from Medline because similarly misleading nonsense has been coming out of this rag for some time. 2. The paper is withdrawn because it can only mislead vulnerable patients."
discussed naprapathy: “If you ask me, naprapathy is something between chiropractic (without some of the woo) and physiotherapy (without its expertise). There is no good evidence that it works. Crucially, there is no evidence that it is superior to other therapeutic options."
through guest blogger Norbert Aust, provided English translations of critiques from the German "Information Network Homeopathy."
found an analysis of adverse reactions to anthroposophic medicinal to be mysterious, because the reported frequencies were even lower than for placebos.
wrote that “ visceral osteopathy is not plausible and the best evidence available to date does not show it works. In my view, this means that we should declare it an obsolete aberration of medical history."
February – Liu and others reviewed “Dietary supplements for treating osteoarthritis” (Br J Sports Med. 2018 Feb;52(3):167-175 Paper). They concluded “supplements provided moderate and clinically meaningful treatment effects on pain and function in patients with hand, hip or knee osteoarthritis at short term, although the quality of evidence was very low. Some supplements with a limited number of studies and participants suggested large treatment effects, while widely used supplements such as glucosamine and chondroitin were either ineffective or showed small and arguably clinically unimportant treatment effects. Supplements had no clinically important effects on pain and function at medium-term and long-term follow-ups.”
February – A meta-analysis by Zhang and others concluded that acupuncture is effective in dealing with cancer-related fatigue (Support Care Cancer. 2018 Feb;26(2):415-425 Abstract).
February 1 – Stephen Barrett posted “A Skeptical Look at Respen-A and Its Promoters.” The product (which is promoted for autism) cannot work, since it is homeopathic, and there is no convincing evidence that it does work.
February 1 – Consumer Reports published “How ‘Natural’ Doctors Can Hurt You,” dealing with naturopaths.
February 2 – William London published “Some Success Against City of Hope's Cancer Miracle Mongering?” After London complained about ads from the cancer center, “City of Hope seems to have refrained from miracle mongering in its newspaper ads during 2017…But I do know that City of Hope has continued to promote itself as a place of miracles.”
February 3 – Stephen Barrett posted “A Skeptical Look at the AcuGraph and Stimplus Pro” on Device Watch. “The AcuGraph system…is claimed to determine health problems and make therapeutic recommendations based on measurements of skin resistance at so-called ‘acupuncture points.’ The Stimplus Pro is claimed to ‘harness the power of electro-acupuncture’." Barrett concluded, “I see no logical reason to believe that the AcuGraph or Stimplus Pro can work as advertised. I do not believe that the AcuGraoph [sic] can identify health problems throughout the body. I do not believe that auriculotherapy has any validity. There is no logical reason to believe that stimulating the ear can modify a disease process at a remote part of the body. Acupuncture points, meridians, and Qi are metaphysical concepts that are part of traditional Chinese medicine. I do not believe that have any anatomic or physiologic reality. I do not believe that acupuncture has any effect on the course of disease.”
February 6 – Cara Rosenbloom wrote “These skeptics are using science to fight a wave of bad nutrition advice on the Internet.” The efforts of David Gorski, Yvette d’Entremont (“SciBabe”), James Fell, and Timothy Caulfield are described.
February 9 – A News story by Joe O’Connor was entitled “In wake of criticism, Ontario's Georgian College scraps planned homeopathy diploma program.”
February 15 – Dave Roos profiled Britt Marie Hermes in “A Former Naturopath Blows the Whistle on the Industry.”
February 21 – Bryden and others published “Anti-vaccination and pro-CAM attitudes both reflect magical beliefs about health” (Vaccine. 2018 Feb 21;36(9):1227-1234 Abstract). “We conclude that vaccination scepticism reflects part of a broader health worldview that discounts scientific knowledge in favour of magical or superstitious thinking. Therefore, persuasive messages reflecting this worldview may be more effective than fact-based campaigns in influencing vaccine sceptics.”
February 22 – Mishori wrote “Pulling back the curtain on ‘The Doctors’ and ‘The Dr. Oz Show:’ What our analysis revealed.” “While it was common for the shows to make medical recommendations, these recommendations typically didn’t include discussions of the risks or costs of treatment…About 78% of statements made on the Dr. Oz show did not align with evidence-based medical guidelines, society recommendations, or authority statements. For The Doctors, this was about 80%...For both shows, about half of the literature supporting the claims made on the show television was statistically insignificant or required extensive extrapolation. No literature support could be found for about a third of the claims.”
February 22 – Joffe and Lynch published “Federal Right-to-Try Legislation - Threatening the FDA's Public Health Mission” (N Engl J Med. 2018 Feb 22;378(8):695-697 Preview). “..despite the claim that dying patients have nothing to lose, granting very sick patients early access to unapproved products may be more likely to harm patients than to help them…Are we prepared to abandon FDA’s gatekeeping role in favor of unfettered patient autonomy and market forces, risking precisely the problems that prompted Congress to grant FDA its present authority?”
February 28 – Murdoch and others wrote “Exploiting science? A systematic analysis of complementary and alternative medicine clinic websites' marketing of stem cell therapies” (BMJ Open. 2018 Feb 28;8(2):e019414 Paper). “Stem cell science, research and clinical application are very specialised, and it is highly unlikely that the broad array of CAM practitioners noted in this study each have the requisite expertise to work with stem cells in a safe and effective manner.” The authors also noted “the highly questionable nature of many of the claims” they found. “Orac” discussed the paper on Respectful Insolence. “So what we have here is a picture of clinics that don’t tell the truth. They regularly don’t point out that there is little or no evidence for the efficacy of their treatments. They regularly don’t mention potential risks and adverse reactions. They often don’t mention that a treatment is experimental and not FDA-approved.”
February 28 – David Warmflash wrote “Are consumer genetic tests misused by doctors and alternative health providers?”