NOVEMBER 2022 NEWS
Featured topic: coronavirus
On Science-Based Medicine,
David Gorski posted:
“The appeal of being a medical 'apostate'.” “There has long been a huge appeal in medicine that derives from being an ‘apostate.’ Since COVID-19 hit, apostasy has become like a drug among too many doctors, and social media has amplified the popularity of ‘medical apostates’ beyond anything I’ve seen previously.”
“What does 'antivaccine' really mean since the pandemic hit?” “Sadly, as much as certain aspects of what “antivaccine” means have changed, such as the politics and the global infrastructure that promotes distrust of vaccines, the central core has remained largely the same, and that core was a variant of a conspiracy theory in 2010 and remains so in 2022.”
Jonathan Howard posted:
“Was closing schools an obvious and colossal mistake?” Had schools remained open, “nearly all children would have gotten COVID, as would everyone they live with, and most school employees…It’s reasonable to assume that several thousand children would have died had no mitigation measures been taken…There would be many more COVID orphans…More educators would have been out sick had no mitigation measures been taken. Who would have taught the students?” Those who claim that closing schools was a mistake “should honestly grapple with what would have happened had nothing been done rather than indulge an absurd, revisionist fantasy that everything would have been fine and dandy.”
“Letter to a medical student: you errored. You are owed an apology.” Howard responded to an article by medical student David Allely entitled “Failing our kids: Myocarditis in young boys.” Howard quoted David Brin: “If an outsider perceives ‘something wrong’ with a core scientific model, the humble and justified response of that curious outsider should be to ask ‘what mistake am I making?’ before assuming 100% of the experts are wrong.”
“Was New York’s spring 2020 COVID wave an illusion?” “Asking for ‘evidence’ that New York City got hit hard by COVID makes as much sense as asking for ‘evidence’ that New York City exists in the first place.” “…we again have the opportunity to witness a pernicious medical myth being created in real time. Despite abundant evidence to the contrary, sheltered disinformation agents will successfully convince many Americans that COVID’s threat was always overblown.”
Steven Novella posted:
“Risk of myocarditis following COVID-19 vaccine.” The risk “is real but tiny, and far outweighed by the benefit of vaccines.”
On Respectful Insolence, “Orac” posted:
“'Amnesty' according to Emily Oster: ‘Admit you were wrong!’” “Economist turned COVID-19 contrarian Emily Oster recently published an article in The Atlantic about offering amnesty and forgiveness over the pandemic.”
“Criticism and quality control ≠ ‘censorship and defamation’.” “Minerva published an op-ed disguised as a ‘study’ decrying ‘censorship and defamation’.”
“It’s still always about the grift – and the grifters.” “Early in the pandemic, America’s Frontline Doctors made a splash promoting hydroxychloroquine. They then turned to running an ivermectin prescription mill. Now they’re suing each other. It’s always about the grift.” Edzard Ernst also reported the story: “An anti-vax organisation sues its co-founder.” In a related article, Stephen Barrett published “A skeptical look at Simone Gold and America’s Frontline Doctors” on Quackwatch.
“To Nuremberg or not to Nuremberg? That is the antivax question.” “Punishing public health officials for their ‘crimes’ has long been an antivax fantasy. The Brownstone Institute has a question and can’t decide if it agrees, even as it echoes the same rhetoric.”
“Dr. Vinay Prasad whines about the ‘misinformation police.’ Hilarity ensues.”
“’Died Suddenly’: resurrecting the old antivax lie of depopulation.” “Died Suddenly resurrects the old antivax conspiracy that vaccines kill, the plan being to cause ‘depopulation’ that would allow ‘global elites’ to control the world.” Jonathan Jarry also wrote about the movie. “Take-home message: The anti-vaccine ‘documentary’ Died Suddenly alleges that the COVID-19 vaccines are bioweapons meant to depopulate the world by creating clots that kill people suddenly. The clots shown by the embalmers in the movie seem to medical experts to be no different than the clots that commonly occur in life and also after death. Many of the people the movie wants us to believe suddenly died are not actually dead.”
Other topics
Best of the blogs, November – on Science-Based Medicine,
Mark Crislip:
Discussed bee sting therapy.
Scott Gavura:
Posted “Facebook promoting dangerous and even banned supplements.”
Wrote “Liver damage associated with turmeric ingestion.” “Turmeric supplements have medicinal promise but their role is not well established. Combining turmeric with black pepper demonstrably increases the absorption of the drug. Liver damage is a rare but seemingly-real risk of consumption. If consumption as a supplement is considered, use with or without piperine should be held consistent. Research into genetic risk factors for liver damage from supplements like turmeric are still preliminary but have the potential to identify those at greater risk of harm. Until then, whether it’s turmeric or any other dietary supplement, carefully monitoring for signs and symptoms of liver damage or other harms is important.”
David Gorski:
Wrote “Aromatase inhibitors and acupuncture in breast cancer: Spinning a negative study, four years later.” The paper discussed is Hershman et al. JAMA Netw Open. 2022 Nov 1;5(11):e2241720 Paper. “This study, although barely ‘positive’ for some measurements, was, due to lack of blinding and the low effect size observed, functionally, clinically, and practically a negative study. TA [true acupuncture] didn’t result in any functional improvement. It didn’t decrease the percentage of patients who had to stop their AI [aromatase inhibitor] therapy. It only barely showed any improvement in a subjective pain score, and even then that effect varied wildly at different time points and was at most time points not statistically significant…Because of the lack of blinding and the very low prior scientific plausibility of acupuncture as a treatment for AI-induced joint pain, the SBM [science-based medicine] conclusion is that acupuncture didn’t work in this study for the outcomes studied.”
Posted “ASCO endorses 'integrative oncology' quackery for cancer pain.” “Last week, the American Society of Clinical Oncology and the Society for Integrative Oncology published guidelines for treating cancer pain. These guidelines endorsed quackery like reflexology and acupuncture. The infiltration of quackademic medicine continues apace in oncology.”
Harriet Hall:
Wrote “The advice to breathe 'in through the nose, out through the mouth' appears to be based on superstition rather than science. Nose breathing is preferable.”
Discussed “GOLO for weight loss.” “Conclusion: based on testimonials, not science… if you’re looking for scientific evidence that GOLO is effective, there’s nothing to be found.”
Steven Novella:
Posted “Study: for lowering cholesterol, statins work, supplements don’t.” A study by Laffin et al. (J Am Coll Cardiol. 2022 Oct 19:S0735-1097(22)07125-X. Epub ahead of print. Paper) was discussed. The study concluded “Among individuals with increased 10-year risk for ASCVD [atherosclerotic cardiovascular disease], rosuvastatin 5 mg daily lowered LDL-C significantly more than placebo, fish oil, cinnamon, garlic, turmeric, plant sterols, and red yeast rice.”
On Respectful Insolence, “Orac”:
Wrote “America’s quack Dr. Oz and the failure of medical academia revisited.”
Edzard Ernst:
Criticized a new study that “suggests that craniosacral therapy produces complete resolution of symptoms of infantile colic.” “…this new study demonstrates three things many of us already knew: Colic in babies always resolves on its own but can be helped by a placebo response (e.g. via the non-blinded parents), by holding the infant, and by paying attention to the child. Flawed trials lend themselves to drawing the wrong conclusions. Craniosacral therapy is not biologically plausible and most likely not effective beyond placebo.”
Posted “High velocity, low amplitude techniques are not superior to no treatment in the management of tension-type headache.” “Due to a placebo effect, almost any treatment should be better than no therapy at all. ALMOST, because high-velocity, low-amplitude techniques were not superior to no treatment in reducing the intensity and frequency of pain. This, I feel, is an important finding that needs an explanation. As it is only logical that high-velocity, low-amplitude techniques must also produce a positive placebo effect, the finding can only mean that these manipulations also generate a negative effect that is strong enough to cancel the positive response to placebo. (In addition, they can also cause severe complications via arterial dissections, as discussed often on this blog.)”
Wrote “The most common conditions that chiropractors (cannot) help kids with.” “I have yet to hear of a single case where the chiropractor then checked out the child and concluded: ‘there is nothing wrong; your baby does not need any therapy.’ Chiropractors always find something – not something truly pathological, but something to mislead the parent and to earn some money. Often the treatment that follows turns out to be a prolonged and thus expensive series of sessions that almost invariably involve manipulating the infant’s fragile and developing spine. There is no compelling evidence that this approach is effective for anything. In addition, there is evidence that it can do harm, sometimes even serious harm.”
Posted “Shiatsu has positive effects on internal tension, sleep, social interaction, attention, etc. – true or false?” “I fear that these statements are not merely exaggerated but suspect they are also untrue. Testing them in properly controlled clinical trials would show whether my suspicion is correct.”
Wrote “Craniosacral therapy is effective for migraineurs … at least this is what a new study concluded.” “Sorry, but I disagree! And I have several reasons for it: The study was far too small for such strong conclusions. For considering any treatment as a therapeutic approach in migraine patients, we would need at least one independent replication. There is no plausible rationale for craniosacral therapy to work for migraine. The blinding of patients was not checked, and it is likely that some patients knew what group they belonged to. There could have been a considerable influence of the non-blinded therapists on the outcomes. There was a near-total absence of a placebo response in the control group. Altogether, the findings seem far too good to be true.”
Published “A slightly different perspective on 'INTEGRATIVE MEDICINE'.” “INTEGRATIVE MEDICINE can be a way for some doctors to delegate the art of medicine to quacks. Good doctors don’t need to do this because they are able to show compassion and treat their patients as whole human beings. Less gifted doctors, however, find INTEGRATIVE MEDICINE a practical solution to their own incompetence.”
Posted “Community pharmacists must be reminded of their ethical duty when advising patients about SCAM [so-called alternative medicine].” “By and large, pharmacists continue to go along with the double standards of a) evidence for conventional drugs and b) fairy tales for SCAM. In the interest of progress, patient safety, and public health, it is time that pharmacists wake up and remind themselves that they are not commercially orientated shopkeepers but ethical healthcare professionals.”
Stated that “Quackery is the biggest disease affecting India.” “…the fact that one website lists a total of 746 Alternative Medicine Colleges in India, leaves little doubt about it.”
Discussed a review of manual therapy for shoulder pain (Naranjo-Cinto et al. J Clin Med. 2022 Jul 28;11(15):4395 Paper). “The authors concluded that the addition of the manual therapy techniques applied in the present study to a therapeutic exercise protocol did not seem to add benefits to the management of subjects with non-specific shoulder pain.”
Posted “Acupuncture for low back and/or pelvic pain during pregnancy: another dodgy systematic review and meta-analysis.” “…here are a few points: many trials were of poor quality; there was evidence of publication bias; there was considerable heterogeneity within the studies… the analyses included studies that compared acupuncture to no treatment at all as well as studies that followed the infamous ‘A+B versus B’ design. Seven studies used no intervention or standard of care in the control group thus not controlling for placebo effects. Nobody can thus be in the slightest surprised that the overall result of the meta-analysis was positive – false positive, that is!” Steven Novella also discussed the review on Science-Based Medicine. His conclusion: “This meta-analysis should properly be interpreted as negative – as consistent with the null hypothesis that there is no specific effect of acupuncture in the studied intervention beyond placebo. I outlined above why this is overwhelmingly true. But again, the most damning evidence is the inverse relationship between study quality and effect size, with the best studies being negative. This evidence certainly does not justify rejecting the null hypothesis, and that’s all that really matters. This is especially true of an intervention with an extremely low prior plausibility, and lack of a known or plausible mechanism. No matter how you look at acupuncture, from a historical, basic science, or clinical evidence perspective, it is nothing but an elaborate placebo. This meta-analysis is perfectly consistent with that conclusion. And yet, studies like this are consistently misrepresented to falsely support acupuncture.”
Wrote “More evidence to suggest that spinal mobilizations for low back pain are ineffective.” “The authors concluded that both methods of lumbar spine mobilization demonstrated comparable improvements in pain and disability in patients with LBP, with neither method exhibiting superiority over the other. If this conclusion is meant to tell us that both treatments were equally effective, I beg to differ. The improvements documented here are consistent with improvements caused by the natural history of the condition, regression towards the mean, and placebo effects. The data do not prove that they are due to the treatments. On the contrary, they seem to imply that patients get better no matter what therapy is used. Thus, I feel that the results are entirely in keeping with the hypothesis that spinal mobilization is a placebo treatment.”
Posted “A new acupuncture trial with a positive result – alas, it seems too good to be true.” The trial was of electroacupuncture for insomnia and depression. Ernst listed seven reasons to be skeptical of the conclusions.
Wrote “Patients deserve greater clarity on who is a physician - and who isn’t.” “In SCAM [so-called alternative medicine], we have the problem that practitioners often call themselves doctors or physicians without having a medical degree. This confuses patients who might consult and trust these practitioners assuming they have studied medicine.”
November 2 – Catherine Davison wrote “Modi wants to export traditional Indian medicine to the world, but doctors warn against pseudoscience and quack cures.”
November 7 – J. Michael Menke wrote “What chiropractic research tells us about the replication crisis in science.” “In short, lower back pain is a problem where any treatment works at least for some sufferers, but none work particularly well, though the rest claim to work for everyone. When you think about it, the notion that every treatment works might actually mean its opposite – that none work because non-pathological pain eventually resolves on its own.”
November 10 – Nick Tiller published “Is sport a breeding ground for pseudoscience?” Among the topics discussed are Tom Brady and “muscle pliability,” Michael Phelps and cupping, and whole-body cryotherapy
November 17 – “FDA warns seven companies for selling dietary supplements with claims to treat cardiovascular disease” Press release.
Additions to previous months
July 5 – Tahreem and others published “Fad diets: facts and fiction” (Front Nutr. 2022 Jul 5;9:960922 Paper). “These diets are quite appealing due to the proposed claims, but the lack of scientific evidence is a big question mark. Such diets are often marketed with specific claims that defy the basic principles of biochemistry and nutritional adequacy. These diets may have protective effects against obesity and certain chronic diseases like cardiovascular diseases, metabolic syndrome, and certain cancers. Limited evidence exists to support the proposed claims; rather certain studies suggest the negative health consequences of long-term adherence to such dietary patterns.”
September 3 – Stanciu and others published “Kratom as an opioid alternative: harm, or harm reduction? A systematic review of literature” (Am J Drug Alcohol Abuse. 2022 Sep 3;48(5):509-528 Abstract). “With no reported controlled human clinical trials, in the light of rising concerns surrounding kratom’s liabilities, there is insufficient evidence to allow any conclusions to be drawn. Case reports and observational studies carry significant bias toward harm and efficacy, respectively. Existing animal studies are heterogeneous in methodology and ultimately findings, with concern for interspecies variability and human translatability. Further research should investigate the safety and efficacy of using kratom alkaloids as opioid substitutes.”
October 28 – “In support of public safety, and because some of these products may still be available on the market, FDA issued warning letters to Amazon, Walmart, and Latin Foods Market for distributing various ‘Artri’ and/or ‘Ortiga’ unapproved and misbranded drug products. Walmart and Latin Foods Market already issued voluntary recalls for these products.” The original warning was in April. “FDA laboratory analyses revealed certain Artri and Ortiga products contain the undeclared drug ingredients: Dexamethasone (a corticosteroid) that can cause serious adverse events, including infections, increased blood glucose (sugar) levels, changes in blood pressure, damage to bones, psychiatric problems, and adrenal dysfunction; Diclofenac sodium (an anti-inflammatory drug) that can lead to adverse cardiovascular events, such as heart attack and stroke, or serious gastrointestinal damage, including bleeding, ulceration, and fatal tears of the stomach and intestines, or liver toxicity including liver failure that can cause the need for a liver transplant or death; Methocarbamol (a muscle relaxant) that can cause sedation, dizziness, and low blood pressure. These drug ingredients, which are not listed on the product label, can also interact with other drugs a consumer is taking.”