MAY-JUNE 2018 NEWS
Best of the blogs, May – on Science-Based Medicine, David Gorski:
illustrated the problem of “garbage in, garbage out” with a critique of a meta-analysis of acupuncture for chronic constipation. (The paper was retracted on July 19.)
wrote a series of posts on “right-to-try” legislation. The May 21 post noted that “’Right-to-try’ laws are a cruel sham that purport to allow terminally ill patients access to promising experimental drugs. In reality, they strip away many protections and leave vulnerable patients on their own. After four years and a number of toothless state laws, a federal version of ‘right-to-try’ is poised to become law. A version passed by the Senate could be voted on in the House as early as tomorrow and is the worst version under consideration.” His May 29 post on Respectful Insolence noted that the bill had passed. The June 4 post reported the signing of the law. Back on Respectful Insolence, he posted “Some final thoughts (for now)…” on June 11. On June 22, he posted “As I predicted, the exploitation of desperate patients using right-to-try begins.” (See also June 20 item below.)
Harriet Hall:
wrote “A device called Living Water will convert your tap water into acidic or alkaline water that supposedly is ionized and has antioxidant properties. There is no evidence that it offers any health benefits.”
addressed reflex integration therapy, promoted for “autism, ADHD, brain injuries, pain, and more.” “The various reflex integration therapies are based on speculative ideas about retained primitive reflexes. We can’t know whether any of them are effective, because they haven’t been scientifically tested.”
critiqued Lisa Mosconi's brain food diet, “a plan to prevent and treat Alzheimer’s and maximize cognitive function in everyone…Some of what she says is good standard health advice, but the rest is speculative, not based on good scientific evidence, and sometimes demonstrably wrong.”
Clay Jones:
wrote “A Canadian Journalist Calls Out Pediatric Chiropractic, and a Chiropractor Responds.”
Steven Novella:
posted “Stem Cell Tourism Comes Home.” “You used to have to go to China to get ripped off by fraudulent stem cell clinics. Now you can get conned right here at home.”
wrote about an ambulance service using essential oils. “Aromatherapy with essential oils is pseudoscience, backed only with low quality studies guaranteed to show a placebo effect.”
described how “An Australian nurse dies of cancer while being treated by a cancer quack with a caustic substance known as black salve.” “Orac” also discussed the case on Respectful Insolence.
Grant Ritchey:
provided an update on TicTocStop, a dental appliance that supposedly would help with symptoms of Tourette Syndrome. “…the more we look at the whole set up, the shadier it appears to be.”
On Respectful Insolence, “Orac”:
wondered how is it that alternative cancer doctor Stanislaw Burzynski is “still preying on desperate cancer patients?” His May 3 post provided an update.
discussed criticisms of science-based medicine by alternative medicine promoter Gary Null.
refuted anti-vaccinationist claims concerning the increase in autism prevalence. “What is most likely happening is that we’re getting better and better at finding and diagnosing autism, including milder cases…”
discussed the case of a Chinese doctor persecuted for criticizing a traditional Chinese medicine remedy. “China is rolling back many regulations for TCM remedies…the formulations will be more likely to be free of pesticides and heavy metals, but there will be no evidence needed that they have any therapeutic effects or that they are safe.”
posted “The FDA brings the hammer down on two quack stem cell clinics.”
discussed a study that found no benefits of acupuncture for in vitro fertilization. “What really bothers me is how unethical this study was. There was no plausible scientific basis for it.”
refuted the arguments of Dr. Jason Fung’s Debunking the Debunkers.
Edzard Ernst:
discussed a study of “Intravaginal manipulations by (German) osteopaths.” “…this is a breathtakingly idiotic trial, and everyone involved in it (ethics committee, funding body, investigators, statistician, reviewers, journal editor) should be deeply ashamed and apologise to the poor women who were abused in a most deplorable fashion.”
found “zero evidence” for Zero Balancing, a “body-mind therapy that uses skilled touch to address the relationship between energy and structures of the body.”
promoted his new book, SCAM (so-called alternative medicine). Scott Gavura reviewed the book on Science-Based Medicine.
discussed a study purporting to show the benefits of osteopathy for reducing anxiety. Among many flaws, it had no control group.
praised a study that found no benefit of acupuncture for in vitro fertilization. However, he objected to the authors’ statement that “the evidence of efficacy is conflicting”: “the evidence that acupuncture is useless for IVF was already pretty clear when they started their study.”
criticized a JAMA study purporting to show the benefit of chiropractic when added to usual care for low back pain. “The results are in perfect agreement with the assumption that chiropractic care is a placebo.”
discussed a review claiming that homeopathy is useful in dealing with epidemic diseases. “…such articles are highly irresponsible and frightfully dangerous: if anyone ever took the message that homeopathy has the answer to epidemic seriously, millions might die.”
noted a Cochrane collaboration review of acupuncture for hip osteoarthritis (Manheimer et al., Cochrane Database Syst Rev. 2018 May 5;5:CD013010 Abstract). The review found that “Acupuncture probably has little or no effect in reducing pain or improving function relative to sham acupuncture in people with hip osteoarthritis.” Ernst notes that “osteoarthritis has been THE condition for which even critical reviewers had to admit that there was at least some good, positive evidence. It seems therefore, that yet again a beautiful theory has been slain by an ugly fact.”
refuted some claims about essential oils and cancer. “Essential oils might be an interesting area of research, yet one has to tell consumers and patients very clearly: there is no evidence to suggest that using essential oils will change the natural history of any type of cancer.”
May – a meta-analysis by Vickers and others (J Pain. 2018 May;19(5):455-474 Abstract) concluded that “Acupuncture is effective for the treatment of chronic musculoskeletal, headache, and osteoarthritis pain. Treatment effects of acupuncture persist over time and cannot be explained solely in terms of placebo effects. Referral for a course of acupuncture treatment is a reasonable option for a patient with chronic pain.”
May 1 – Liu and others wrote “Which supplements can I recommend to my osteoarthritis patients?” (Rheumatology (Oxford). 2018 May 1;57(suppl_4):iv75-iv87 Abstract). They concluded, “Limited research evidence supports recommendations for the oral use of Boswellia serrata extract and Pycnogenol, curcumin and methylsulfonylmethane in people with OA despite the poor quality of the available studies.”
May 2 – Stephen Barrett published “Studies Show that ‘Liberation Therapy’ for Multiple Sclerosis Doesn't Work” on Quackwatch. The therapy had been promoted by Paolo Zamboni. (See our January news item.)
May 3 – A study found that n-3 (omega-3) fatty acid supplementation provided no benefit for dry eye disease (Dry Eye Assessment and Management Study Research Group et al. N Engl J Med. 2018 May 3;378(18):1681-1690 Paper). Scott Gavura discussed the study on Science-Based Medicine.
May 8 – Snyder, Turner, and Crooks wrote “Crowdfunding for Unproven Stem Cell-Based Interventions” (JAMA. 2018 May 8;319(18):1935-1936 Paper). Examining two crowdfunding platforms, the authors found 408 campaigns involving 50 stem cell businesses, with millions of dollars requested. In general these exaggerated the potential benefits and understated the risks. Jann Bellamy commented on the study on Science-Based Medicine. (See also June item below.)
May 8 – A review of acupuncture for essential hypertension (Chen et al. Med Sci Monit. 2018 May 8;24:2946-2969 Paper) found that “there is inadequate high quality evidence that acupuncture therapy is useful in treating hypertension, as the exact effect and safety of acupuncture therapy for hypertension is still unclear.”
May 11 – C. Dinerstein provided a critique of a paper allegedly showing that use of integrative medicine in the hospital is effective in relieving pain and will save money. “I am open to any treatments that can help my patients. But if you want to remove the term alternative and begin saying integrative medicine, then you have to publish data, with control groups and real understandable calculations.”
May 16 – A review by Ayers and others of coenzyme Q10 (Curr Atheroscler Rep. 2018 May 16;20(6):29 Abstract) concluded that “Current evidence does not support routine use of CoQ10 in patients with coronary heart disease. Additional studies are warranted to fully determine the benefit of CoQ10 in patients with heart failure before including it in guideline-directed medical therapy.”
May 29 – The College of Naturopathic Physicians of British Columbia, which regulates naturopaths in the province, issued “Changes to the College’s Immunization Standard and prohibition of CEASE therapy.” The standard directs that naturopaths should not provide anti-vaccination materials or counseling. Furthermore, they should not advertise CEASE (“Complete Elimination of Autism Spectrum Expression”) therapy, which is based on the false belief that most cases of autism are due to vaccinations. In their blog posts, "Orac" and Edzard Ernst explain that CEASE involves homeopathic treatments, and is unsupported by evidence.
Best of the blogs, June – on Science-Based Medicine, Jann Bellamy:
noted that “A study finds ‘delayed referral, misdiagnosis, adverse events and ineffective treatments’ in chiropractic management of pediatric orthopedic conditions.”
wrote “Can post-hoc data-dredging produce competent and reliable scientific evidence for Prevagen's claims of memory improvement? The FTC and consumer groups say ‘no’.”
Scott Gavura:
discussed a new study on the relationship of colon cancer to vitamin D. “This newest study does not show that there is a benefit to supplementation, however it does show a positive association with higher levels…At this time, there is little support in treatment guidelines for vitamin D supplementation to prevent colon cancer. However, it adds to the body of evidence about vitamin D and cancer. It would seem the safest things to do to avoid colorectal cancer would be to ensure that you’re getting adequate vitamin D in your diet, and, perhaps more importantly, you’re addressing the biggest factors for colorectal cancer prevention.”
David Gorski:
refuted the appeal to indigenous ways of knowing to justify some alternative approaches. “The appeal to other ways of knowing is basically a form of special pleading, in which it is claimed that your belief should be exempt from rigorous scientific evaluation.” Steven Novella also addressed the topic on the NeuroLogica blog: “…science and rigorous scholarship are not just cultural ideas, they are methods that have demonstrable value, and have been shown to work… it is possible to respect indigenous culture and history without pandering to pseudoscience.”
reported that “the most influential oncology society, the American Society of Clinical Oncology (ASCO), endorsed a 2017 update to the SIO [Society for Integrative Oncology] guidelines, thus endorsing the ‘integration’ of quackery with oncology and paving the way for insurance coverage.”
began a three-part series entitled “Clínica 0-19: False hope in Monterrey for DIPG patients.” June 25 July 2 July 9 “Drs. Alberto Siller and Alberto Garcia run Clínica 0-19 in Monterrey, Mexico, which has become a magnet for patients with diffuse intrinsic pontine glioma (DIPG), a deadly brain cancer. Unfortunately, their treatment is an unproven combination of 11 chemotherapy drugs injected into an artery feeding the brainstem, plus an unknown and unproven ‘immunotherapy’.”
Harriet Hall:
in a post entitled “Fake News about Fish Oil,” stated “An ad for the dietary supplement Omega Rejuvenol is disguised as a news story in my local newspaper. It makes claims that are not supported by evidence.”
Sam Homola:
wrote “Chiropractic vertebral subluxation theory breeds a variety of questionable diagnostic and treatment methods. Certification in use of a subluxation-based technique offers no assurance that the technique is effective or scientifically acceptable.”
Steven Novella:
wrote “What are the health effects of living close to wind turbines? The answer is, probably not much, but definitive data is elusive.”
reported that “Halotherapy, sitting in a salt room, is the latest spa trend, just as full of pseudoscience and false claims as we have come to expect from wellness spas.”
On Respectful Insolence, “Orac”:
discussed the bizarre claims of William Gray, who sells “eRemedies” that supposedly incorporate healing information from homeopathic products.
wrote “Just when I thought Dr. Oz couldn’t go any lower, he proves me wrong—with astrology!” “What this episode of The Dr. Oz Show tells me is that Dr. Oz has not changed. Despite his promise three years ago to stop promoting pseudoscience, he’s still at it, promoting pseudoscience every bit as ridiculous as psychic mediums, faith healers, and homeopathy.”
Edzard Ernst:
wrote that “Doctor homeopaths violate fundamental rules of ethics when practicing homeopathy” because they “cannot obtain adequately informed consent.”
refutes the argument that one should use homeopathic medicines on the basis of “first do no harm.”
argued against homeopath Dana Ullman's claim that evidence-base medicine can no longer be trusted.
discussed a case of “Ophthalmic Adverse Effects after Chiropractic Neck Manipulation.”
wrote “The HOMEOPATHY RESEARCH INSTITUTE: bringing unreliable information to a wide international audience.”
responded to a critique of his own homeopathy articles by Prof. R. Hahn.
criticized a paper alleging that shiatsu reduced depression in Alzheimer patients. “Accumulating so much nonsense in one research paper is, in my view, unethical.”
posted “Pro and Contra: should UK community pharmacists sell homeopathic remedies?” Ernst pointed out that the “Standards for Pharmacy Professionals” “preclude selling placebos, while pretending they are effective medicines.”
refuted arguments from the UK Faculty of Homeopathy that systematic reviews support the effectiveness of homeopathy.
discussed gua sha, a traditional Chinese treatment “sometimes referred to as ‘scraping,’ ‘spooning’ or ‘coining’.” Among other criticisms, he noted that “Gua sha lacks biological plausibility” and “The reviewed trials are too flawed to allow any firm conclusions.”
wrote “Individualised (traditional) herbalism: best avoided, in my view.” It is not evidence-based, potentially harmful, and costly.
posted concerning vaginal steaming. Ernst notes that “none of these claims are supported by anything we would recognise as evidence” and “the potential for harm is undeniable.”
wrote “Malpractice of chiropractors – just the tip of an iceberg?” “I fear that, if we were to count the lack of informed consent by chiropractors (and other alternative practitioners) as malpractice, the numbers would be astronomical.”
June – Snyder and Turner published “Selling stem cell 'treatments' as research: prospective customer perspectives from crowdfunding campaigns” (Regen Med. 2018 Jun;13(4):375-384 Paper). They found that “these campaigners internalize, repeat and exaggerate claims found in these businesses’ marketing materials. Specifically, these campaigns repeat, exaggerate and broadcast to a wide audience claims that these businesses are engaged in legitimate scientific research…These findings provide evidence in support of existing concerns regarding misleading statements in these businesses’ marketing materials, the co-opting of scientific funding and regulatory agencies to legitimize their services, and a failure of their potential customers to make fully informed decisions regarding their purchase of these treatments.”
June – Also on stem cells: the International Society for Stem Cell Research (ISSCR) published “Nine Things To Know About Stem Cell Treatments.” “Many clinics offering stem cell treatments make claims that are not supported by a current understanding of science.”
June 5 – A review examined “Supplemental Vitamins and Minerals for CVD [cardiovascular disease] Prevention and Treatment” (Jenkins et al., J Am Coll Cardiol. 2018 Jun 5;71(22):2570-2584 Paper). The review “showed generally moderate- or low-quality evidence for preventive benefits (folic acid for total cardiovascular disease, folic acid and B-vitamins for stroke), no effect (multivitamins, vitamins C, D, β-carotene, calcium, and selenium), or increased risk (antioxidant mixtures and niacin [with a statin] for all-cause mortality). Conclusive evidence for the benefit of any supplement across all dietary backgrounds (including deficiency and sufficiency) was not demonstrated; therefore, any benefits seen must be balanced against possible risks.” Steven Novella discussed the study on Science-Based Medicine. “The bottom line message for the average person is this: There is essentially no benefit to routine supplementation, and there may be some risks…do not believe supplement hype (antioxidant or otherwise), do not believe nutrition gurus, do not take megadoses, and there is no such thing as a ‘superfood’.”
June 7 – Pandolfi and Carreras wrote “Why Current Statistics of Complementary Alternative Medicine Clinical Trials is Invalid” (J Clin Med. 2018 Jun 7;7(6). pii: E138 Paper). The authors wrote that “when the hypotheses under scrutiny have precarious scientific bases…it is mandatory to use inferential statistics, considering the prior probability that the hypothesis tested is true.” (Note: this is the approach of science-based medicine.)
June 8 – L. McGinley and K. Zezima wrote “Kratom is hailed as a natural pain remedy, assailed as an addictive killer. The U.S. wants to treat it like heroin.” “Bertha K. Madras, a professor of psychobiology at Harvard Medical School, said such claims that kratom is beneficial are not scientifically substantiated. There haven’t been any human clinical trials that show definitively how kratom acts in the body or how it interacts with other drugs.”
June 12 – T. Polevoy published “Complementary Medicine: Risks to Infants and Children” (J Clin Med. 2018 Jun 12;7(6). pii: E149 Paper). Polevoy reviewed several cases of death or serious injury due to unscientific treatments.
June 15 – The University of Northern Iowa drew criticism for hosting a conference on the discredited method of facilitated communication News story. “Orac” discussed the events with two posts on Respectful Insolence. The June 19 post stated that “This has been going on too long. It’s definitely time to stop exposing people, especially children, to this quackery.” Defenders of the conference responded to critics, and “Orac” dissected their arguments in his June 21 post.
June 20 – Two articles dealt with the new federal right-to-try law. A. Fuerstein wrote “Here come the right-to-try profiteers. The FDA is powerless to stop them” for STAT. M. Cortez wrote “The ‘Right to Try’ Could Cost Dying Patients a Fortune” for Bloomberg.
June 26 – MedPage Today published a Discussion with Steven Novella entitled “What Used to Be Fraud Is Now Alternative Medicine.”
Addition to Earlier Pages
December, 2017 – The American College of Medical Toxicology published a Position statement on post—chelator challenge urinary metal testing (J Med Toxicol. 2017 Dec;13(4):352-354). Such testing has been used by some alternative practitioners to assess alleged heavy metal toxicity, followed by recommendations for chelation therapy. “However, scientifically acceptable normal reference values for post-challenge urine metal testing have not been established…Scientific investigation to date has failed to establish a valid correlation between prior metal exposure and post-challenge test values…post-challenge urinary metal testing has not been scientifically validated, has no demonstrated benefit, and may be harmful…”