MARCH 2024 NEWS

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On Science-Based Medicine,

Mark Crislip:

Posted “Best hospital eye roll.” Websites of hospitals on the US News and World Reports Best Hospitals honor roll were examined for their offerings of alternative medicine.

David Gorski:

Posted “Fenbendazole is fast becoming the laetrile of the 2020s.” “Antivaxxers who ‘repurposed’ deworming drugs like ivermectin and fenbendazole are peddling cancer ‘miracle cure’ testimonials that remind me of laetrile and Stanislaw Burzynski.”
Wrote “Mark Sircus and 'natural allopathic medicine'? Now I’ve heard everything from quacks.” “The term ‘allopathic medicine’ was invented by homeopaths in the 19th century as a disparaging term for medicine. So to see a quack like Mark Sircus try to coopt it as ‘natural allopathic medicine’ is quite something.”

Steven Novella:

Discussed parasite cleanse. “A recent trend on Tik Tok (and within the wellness community generally) is the parasite cleanse. The idea is that many people are walking around with GI parasites and don’t know it, and so a regular parasite cleanse should be part of a healthy routine. These claims are false and potentially dangerous…The potential benefit of a routine parasite cleanse is negligible, because the risk of actually having a parasite for those living in developed nations is incredibly low. You are far better just not engaging in risky activity. The parasite cleanses out there also have unproven efficacy, with good reason to think that they are likely ineffective. They also carry some risk of direct harm through toxicity.”

Edzard Ernst:

Posted “A comparative randomised controlled trial of homeopathy versus allopathy in acute otitis media.” “Let me just mention these three facts: The journal ‘Homeopathy’ never publishes negative results. Indian researchers of homeopathy publish as good as no negative results. As far as I can see, the Central Council for Research in Homeopathy, New Delhi, has never published a negative result. These points do, of course, not necessarily mean that the study is false-positive, but they do not inspire me with confidence.”
Wrote “If you design a clinical trial badly, you might get an invalid result: Laser- vs electro-acupuncture.” “The trial certainly does not show what they claim and neither had it ever the chance to show anything relevent...The efficacy of EA and LA for dysmenorrhea are both unknown. A comparative study with two unknowns cannot produce a meaningful result...What caused the improvement was not the treatment per se but the ritual, the placebo effect, the TLC or other non-specific factors. The maginal [sic] differences in other parameters are meaningless; they are due to the fact that – as an equivalence trial – the study was woefully underpowered and thus open to coincidental differences.”
Posted “Homeopathy ‘can completely cure the worm infection’ - believing the advice of homeopaths is foolish and dangerous.” “Most worm infestations are easily treated with effective conventional therapies. Untreated, they can have serious consequences. To advocate homeopathy – which is of course ineffective – is irresponsible, unethical and arguably criminal, in my view.”
Discussed “Effect of acupuncture on ischemic stroke in patients with rheumatoid arthritis: a nationwide propensity score-matched study.” “What the study does, in fact, show is an association between acupuncture and stroke. This association might be due to dozens of factors that the ‘propensity score matching’ could not control. To conclude that the results prove a cause effect relationship is naive bordering on scientific misconduct. I find it most disappointing that such a paper can pass all the hurdles to get published in what pretends to be a respectable journal.”
Wrote “Pneumothorax after dry needling is not rare.” “The evidence is clearly mixed and unconvincing. I am not sure whether it is strong enough to afford a positive risk/benefit balance. In other words: dry needling is a therapy that might best be avoided.”
Posted “The SCAM [so-called alternative medicine] market will grow from currently $148 to $1489 billion by 2033.”
Updated his paper from 30 years ago finding a shortage of clinical trials of herbal remedies. Using 2023 data, “I thus estimate that only around 200 clinical trials of herbal medicine are conducted each year. Considering that we are dealing with thousands of herbs and ten thousands of herbal products, this figure is an embarrassment for the sector...”
Wrote “No one should see a chiropractor thinking they are seeing a doctor,” discussing an article with the same title by Ranjana Srivastava.
Discussed his own review, “Is craniosacral therapy effective? A systematic review and meta-analysis.” The review is: Ceballos-Laita et al. Healthcare (Basel). 2024 Mar 18;12(6):679 Paper. “We concluded that the qualitative and quantitative synthesis of the evidence suggest that CST produces no benefits in any of the musculoskeletal or non-musculoskeletal conditions assessed. Two RCTs suggested statistically significant benefits of CST in children. However, both studies are seriously flawed, and their findings are thus likely to be false positive. So, CST is not really an effective option for any condition. Not a big surprise! After all, the assumptions on which CST is based fly in the face of science. Since CST is nonetheless being used by many healthcare professionals, it is, I feel, important to state and re-state that CST is an implausible intervention that is not supported by clinical evidence.”
Posted “Spinal manipulation and mobilisation among infants, children, and adolescents: an international Delphi survey of expert physiotherapists.” “The authors of this paper concluded that consensus revealed spinal manipulation should not be performed on infants regardless of condition, impairment, or spinal level. Additionally, the panel agreed that manipulation may be recommended only for adolescents to treat joint pain and joint hypomobility (limited to thoracic and/or lumbar levels). Spinal mobilisation may be recommended for joint hypomobility, joint pain, muscle/myofascial pain, and muscle/myofascial stiffness at all spinal levels among children and adolescents.”
Wrote “The question to ask during 'Acupuncture Awareness Week': DOES ACUPUNCTURE WORK?” “IT’S COMPLEX, BUT THE MOST RELIABLE EVIDENCE IS FAR FROM CONVINCING.”
Posted “Acupuncture for postoperative gastrointestinal recovery in patients undergoing thoracoscopic surgery.” “Yes, I agree, acupuncture appeared to have an effect. But did it? I doubt it! It could have been the expectation of an acupuncture benefit…that did the trick…It could have been all manner of influences. We will never know! And because we cannot know, we should design studies better such that they lead to a conclusive result, they are not a waste of precious resources, they cannot mislead us into thinking that acupuncture is more than a theatrical placebo.”
Discussed the “Efficacy of kinesio tape added to lumbar stabilization exercises on adult patients with mechanical low back pain.” “The authors leave us in no doubt that the KT was the cause of the positive outcome. However, they might be entirely wrong. Here are some other possibilities: the extra attention might have done the trick; the ritual of applying KT must have an effect; the expectation of the patient could have influenced the outcome; verbal or non-verbal communication between the patient and the therapist would have had an effect.”

On McGill Office for Science and Society:

Hosna Akhgary:

Wrote “The chilled truth: debunking myths about icing your face for better skin.”

Jonathan Jarry:

Posted “Mozart's music doesn’t make baby geniuses.” “It’s called the Mozart effect, and both researchers and journalists are to blame for the creation of this legend…Take-home message: The Mozart effect is often portrayed as the idea that playing Mozart’s music (or simply classical music) to a baby will make them smart. The original study into this was done in a few dozen college students. The effect was short-lived and was not even a boost in general intelligence, but in a very specific type of mental exercise. Studies of studies have since shown that the effect was never real.”
Discussed the AG1 smoothie. “AG1 combines the ‘just in case’ marketing of the multivitamin industry and unproven wellness ingredients into an expensive cocktail for the worried well…Take-home message: AG1 is a very popular supplement powder used to make a one-a-day smoothie filled with 75 ingredients. The vitamins and minerals it contains are based on the idea that the average person doesn’t get enough of these nutrients through their diet, which contradicts scientific evidence. AG1 also contains a digestive enzyme, adaptogens, and probiotics, despite the fact that there is no robust evidence that they offer benefits to humans.”

Christopher Labos:

Posted “Intermittent fasting and the perils of fast facts.” “Here's why we should be wary of recent headlines linking the popular dietary strategy with an increased risk of cardiovascular death... Many critiques can be levelled against this conference poster. It is not peer reviewed, did not adjust for the quality of participants’ diet, and relied on only two days of self-reported diet history. But more importantly, the lone positive association is not really groundbreaking. It’s likely an outlier. In research, as in life, some things are just random.”

In the March/April issue of Skeptical Inquirer:

Katie Suleta and Emily Hemendinger wrote “Fitspiration, pseudo-healthcare professions and the First Amendment.” “There have been a handful of recent court cases against people operating in healthcare despite dubious qualifications and defending themselves by asserting their right to free speech.”
Fred Abramson wrote “Why you will never know what 'healthy eating' is.”
William London reviewed “The Gospel of Wellness,” by Rina Raphael. “The Gospel of Wellness is the book I most strongly recommend to those who are invested in making themselves as healthy as possible through trendy products, practices, or services.”

March 4 – Trisha Pasricha wrote “Should I take ashwagandha for sleep? Here’s what the science says.” “Ashwagandha may adequately induce sleep. But it shouldn’t be viewed as a long-term solution.” Other topics discussed are effects on stress and anxiety, effects on testosterone, and adverse effects.

March 5 – Caroline Hopkins discussed hydrogen water. “The science backing the health claims of hydrogen-infused water is shaky at best... Few studies supporting the drink’s benefits have been performed in humans. And they are small and often contradictory.”

March 11 – Antonio and others published “Common questions and misconceptions about caffeine supplementation: what does the scientific evidence really show?” (J Int Soc Sports Nutr. 2024 Dec;21(1):2323919 Paper).

March 14 – Omkar Khandekar wrote “Indian judge says billion-dollar ayurvedic company has taken the public ‘for a ride’.” Patanjali Ayurved is “one of India’s biggest manufacturers of traditional ayurvedic products.” The Indian Medical Association claimed that “Patanjali and its brand ambassador Baba Ramdev made a series of false claims against evidence-backed modern medicine and its practitioners, and spread misinformation about COVID-19 vaccines.” Its advertisements also claimed “that ayurvedic products could cure chronic conditions like diabetes, high blood pressure, heart diseases and autoimmune conditions.” Edzard Ernst commented on the article.

March 14 – Hoffman and others published “The DTC [direct-to-consumer] microbiome testing industry needs more regulation” (Science. 2024 Mar 15;383(6688):1176-1179 Abstract). “…Companies’ claims of having the ability to detect ‘abnormal’ microbiomes are not substantiated by research; the testing processes lack analytical validity, and the results have no demonstrated clinical validity. As a result, consumers may be financially exploited or harmed by inappropriate use of test results that neither they nor their doctors understand.”

March 18 – Two studies of patients suffering from “Havana Syndrome” did not find evidence of brain injuries (Chan et al. JAMA. 2024 Mar 18:e242413 Paper; Pierpaoli et al. JAMA. 2024 Mar 18:e242424 Abstract). Their conclusions were disputed in an editorial by Relman (JAMA. 2024 Mar 18), who had reported evidence of injuries. The new studies were described in articles in The New York Times and Washington Post.

Additions to February news

February 15 – Rees and others (including Edzard Ernst) published “Meditation for the primary and secondary prevention of cardiovascular disease” (Cochrane Database Syst Rev. 2024 Feb 15;2(2):CD013358 Abstract). “Overall, we found very little information on the effects of meditation on CVD clinical endpoints, and limited information on blood pressure and psychological outcomes, for people at risk of or with established CVD.”

February 26 – The American Medical Association published an article by Timothy Smith, “What's the difference between physicians and naturopaths?” “Even the most highly educated naturopaths get only a fraction of the training that physicians get. Lawmakers should therefore exercise extreme caution when considering legislation that would expand the scope of practice for naturopaths…there is no guarantee that a naturopathic student completing a clinical rotation will see patients who are actually sick or hospitalized, and they may not be exposed to infants, children, adolescents or the elderly. It has been said that naturopaths tend to treat the ‘worried well’.” Edzard Ernst commented on the article. “The AMA is clearly cautious here. A less polite statement might simply stress that naturopaths are taught a lot of nonsense which they later tend to administer to their unsuspecting patients. On this blog, we have repeatedly discussed the danger naturopaths present to public health in the US and elsewhere…Claims that naturopaths are a viable alternative to evidence-based medicine are wrong, irresponsible and dangerous.”

February 26 – Nick Tiller wrote “Why are we still ice bathing?” While it may reduce pain, “regular immersion in cold water markedly inhibits recovery from strenuous exercise.”

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