The Quackometer

Part of the wonderful new world of regulated alternative medicine is the insistence that all registered practitioners undergo Continuous Professional Development. Just like in real professions, quacks will be expected to attend a certain number of hours per year in keeping their skills up to date and learning about the latest developments in their field.

The Prince of Wales and his new Complementary and Natural Healthcare Council are right behind this initiative and, with the government, there are going to be lots of shiny new 'training standards' for their members. Existing non compulsory 'regulators', such as the Society of Homeopaths also insist in Continuous Professional Development.

So, what do we expect homeopaths to learn? The latest meta analyses and why scientific results do not support homeopathy? Basic chemistry lessons and why no atoms means no effect? No.

Let me show you an example. This evening, homeopaths can earn on of their CPD certificates by going to a talk in St Albans given by Myriam Shivadikar. The talk is entitled, MEDICAL ASTROLOGY FOR HOMEOPATHS.

Every ancient civilisation used astrology for forecasting events, promoting health and in the prevention of disease. The alchemists used astrology and based prescriptions on the patient’s planetary constitution. As a physician, we need to understand patients in order to treat them. The best physician can predict a disease before it occurs- Why wait for a person to get sick?

This simple yet effective system of astrology is based on ancient wisdom using Planetary Cycles and popularised by Robin Murphy. You do not need to have prior knowledge of ‘Western Astrology’ to use this system.

Western Astrology? I thought 'Western' was bad and allopathic? Fortunately, you do not need prior knowledge of anything before attending this course. Trainees need not have prior knowledge of the differences between their arse and their elbow.

What new skills will homeopaths pick up?

• Your constitutional 3 main planets based on your date and time of birth

• The 7 sacred planets

• 7 year cycles – How to predict and prevent diseases.

• Diseases and remedies associated with each planet

Marvelous. This is for real. Adults appear to believe this stuff.

The event is being put on by Gala Homeopathy (slow load). Gala appears to specialise in charging homeopaths to attend events in exchange for their CPD certificates. In a few weeks, you can hear a talk by Lionel Milgrom who believes quantum mechanics explains homeopathy. It's utter nonsense of course, but the homeopaths lap it up. You can also learn about Live Blood Analysis, a technique that I have discussed recently and has been described as 'High-Tech Hokum' and a 'money making scheme'.

This event simply demonstrates that the whole approach of regulation by 'box ticking' is deeply flawed. The Complementary and Natural Healthcare Council (Ofquack) appears to believe that simply ensuring that homeopaths and other quacks are properly trained will protect the public. The important question is; what are they being trained in? No one wants to address this question. All Ofquack will be doing is endorsing nonsense. Once you have accepted that it is quite alright to accredit training in the nonsense foundations of most alternative medicine you loose the ability to sensibly decide what is good training and bad training. Offering training in delusion can only make quacks more efficient at fleecing their customers and engaging in meaningless or even dangerous practices.

I now think that the only way to tackle regulation of alternative medicine is by using prosecution under trading standards legislation. Everything else appears to legitimise the nonsensical, deluded and even fraudulent. Fortunately, despite the best efforts of Prince Charles and the many bodies representing alternative medicine, this is going to be the regime we will get. Time will tell if it is effective.

Labels: BPSDB, Natural Healthcare Council, ofquack, pseudoscience, regulation

 

Figure1. The Quackometer Quackery Quadrants

Let's call this the Quackometer Quackery Quadrants - of course. How would we divide the scales to use on each axis? For ‘evidence’, this is not too hard. There are accepted measures of the degree of evidence available for a treatment. A heirarchy of medical evidence can be constructed as follows:

1. Systematic Reviews of well controlled Randomized Controlled Trials (meta-analysis) or single RCT with narrow CI (confidence interval)
2. Systematic review cohort studies or lesser quality RCTs
3. Case controlled studies (non randomized)
4. Case series (no control group)
5. Expert opinion (GOBSAT - Good Old Boys Sat Around Table)

Can we construct a similar hierarchy of plausibility? That is possible too. We could, for example, take a mathematical approach and assign the axis a Bayesean prior probability scale. This might be the most desirable approach, but largely impractical in that it is difficult to assign meaningful probabilities to hypotheses, such as the homeopathic one, that 'like-cures-like'. How likely is it that homeopathy will overthrow all that we know about biology? It is vanishingly small, but difficult to be quantitative about it. We can, put a more qualitative scale and grade a treatment according to how well it conforms to well tested knowledge or how much it relies on speculative knowledge or even magical thinking.

1. Proposed mechanism of action based on similar well understood treatments.
2. Consistent with well established biochemistry
3. Consistent with accepted biology and chemistry
4. New biological mechanisms required
5. New chemistry and physics required
6. Inconsistent with accepted physics/chemistry/biology.
7. Requires magical mode of operation/inconsistent with natural laws

You may well come up with your own scale. For the sake of my argument, constructing a definitive and absolute scale is not important. A qualitative approach like the above will do.

So now we have a set of four quadrants that we can use to broadly classify medical interventions according to their plausibility and evidence base. The top right quadrant contains treatments that are well understood in terms of their modes of action and have a good evidence base to support them. The lower left hand quadrant contains interventions that are not based on known science, or rely on pseudoscientific explanations, or even at the extreme magical and supernatural thinking. This is truly the quadrant of quackery.

We would like to think that our medical interventions are all nicely housed in the top right hand quadrant, but this is not the case. For example, the Cochrane methodology, in solely looking at the clinical evidence base will allow us to draw a line of ‘evidence based medicine’ that runs horizontally across the quadrants as shown in Figure 2.

Figure 2. The Realm of Evidence Based Medicine

Everything above the line can be considered as evidence based and, therefore, worthy of public funding and likely to form effective treatments.

However, the problem with this approach can be illustrated with the quackery quadrants. Such a demarcation could possibly allow treatments that have an evidence base, but that are based on highly implausible mechanisms. Can this situation arise? Of course it can.

When medical evidence is evaluated, it is usually of a statistical nature. An arbitrary cut of point is decided where the confidence limits for acceptance becomes defendable. If we get better statistical results than this cut off then we can say we have a significant result. Usually, this cut-off is set at a 95% confidence limit. You may see this written in papers as the p=0.05 threshold. Any test with a p value of less than 0.05 is determined to be of ‘significance’. Unfortunately, the p values in themselves are not enough to tell us if a particular experiment is giving us reliable information about a medical intervention. The p value merely tells us that if the test was fair and unbiased, then what is the probability that the result was merely due to chance and not due to the effects of the intervention? For a p value of 0.05 this means that 1 in 20 fair tests will give the wrong answer.

It is worse than that though as it can be very difficult to construct fair tests. Experiments and reviews can have flawed methodology, incomplete controls and blinding, unpublished results, and, in the worse cases, even be subject to fraud and dishonesty. As such, the proportion of experiments and reviws that give the wrong answer will be much worse than 1 in 20. The upshot of this is that for a highly implausible, but popular alternative medical treatment, then many trials will generate a significant fraction of results that show positive results. If we were to plot the distribution of the various elements of homeopathic evidence on our quackery quadrants, we might end up with something like figure 3.

Figure 3. Where Homeopathic Treatments lie in the Quackery Quadrants

With homeopathy, as we are repeatedly told by the homeopaths, there is an evidence base for supporting the efficacy of their treatments for at least some conditions. This is indeed true, but it is insufficient to convince sceptics that homeopathy is anything other than a placebo. We can see that these positive results, such as the small positive effect in the Oscillococcinum result in the Cochrane review, try to force us to accept that we have a genuine effect from a highly implausible treatment. In other words, we are being forced to accept a miracle. The top left quadrant is indeed the quadrant of miracles in that we are being asked to accept something that appears to be against natural laws.

Now science is not well known for its casual acceptance of miracles, and we should definitely not be accepting the evidence of homeopathic trials as evidence of a medical miracle. The philosopher David Hume (1711-1776) was one of the first to describe the conditions by which we should accept the occurrence of a miracle and that is that the probability that the evidence for the miracle is good evidence should be greater than the probability that the evidence is flawed in some way, such as by mistaken testimony, chance or deceit.

In Hume's words,

When anyone tells me that he saw a dead man restored to life, I immediately consider with myself whether it be more probable, that this person should either deceive or be deceived, or that the fact, which he relates, should really have happened. I weigh the one miracle against the other, and according to the superiority, which I discover, I pronounce my decision, and always reject the greater miracle. If the falsehood of his testimony would be more miraculous than the event which he relates; then, and not till then, can he pretend to command my belief or opinion.

With clinical trials, we have a pretty good idea of what the confidence a trial gives us – typically a 95% confidence level. How confident are we that our basic science of matter is correct? Would you take a 1 in 20 bet that the properties of matter were not to do with atoms? I would suggest that our confidence in basic physics is a lot better than 95% and that homeopathy is in direct contradiction with this knowledge. We have around two hundred years of good research into the properties of matter, collected by thousands of researchers. One little homeopathy study is very unlikely to threaten that body of knowledge. It is much more likely that the positive results of homeopathy are due to statistical chance, poor experimental methodology and even fraud, than showing contradictory evidence for the refutation of fundamental physics.

On our quackery quadrants then, we can draw a line that can tell us when we should accept the result of the evidence before us for any particular treatment. That line will run from the top left to the bottom right. What we are doing here is simply graphically illustrating the mantra of sceptics that extraordinary claims require extraordinary evidence. The corollary to this is that mundane, highly plausible and, dare I say, ‘common sense’ claims require a lower standard of evidence.

Figure 4. The Realm of Scientific Medicine. The evidence base for homeopathy is now excluded from scientific medicine, although may well sit within 'evidence based medicine'

Figure 4 then gives us a quite different view of how to accept the health claims of medicine from the standard one adopted by Cochrane and such bodies as NICE. We are describing scientific medicine as opposed to purely evidence based medicine. Scientific medicine takes into account the scientific context of the evidence and says that we should interpret that evidence in light of what we know about the world. It forbids us from casually accepting light evidence for treatments that are not plausible from what we know about physics, chemistry and biology. We can now only accept the evidence of a treatments efficacy when that evidence is greater then prior probability of that treatment being ineffective. This approach has a number of important implications.

Firstly, and most importantly, to all intents and purposes, clinical trials of highly implausible treatments, such as homeopathy, can never be used as evidence of their efficacy. No matter how good the statistical result of a trial, or how much data is analysed in a meta-analysis, the probability will always be greater that we are just analysing flawed data rather than there being a real effect. Homeopaths complain that sceptics never accept that trial data is proof of the effectiveness of homeopathy. This approach shows that homeopaths are quite right in their fears, although sceptics ought to be careful to point out that it is not because there is no evidence, but rather than the available evidence falls far short of any meaningful threshold of acceptance. Without a degree of plausibility, homeopaths are asking scientists to believe in the daily occurrence of miracles, and that will not do.

This answers my question as to whether Cochrane should be calling for more clinical research. What good would it do if more research was done in Oscillococcinum? More positive results for homeopathy might allow treatments to slip by simplistic ‘evidence based’ criteria for determining effectiveness, but will never satisfy broader scientific scepticism of homeopathy. There is a possible split that exists at the moment where many clinicians working in the NHS provide homeopathy to their patients whilst many academics and scientists are shouting what a nonsense this is. The hospitals are accepting a degree of evidence that is far too weak for real confidence to be expressed in the efficacy of homeopathy. Rather than use a simplistic evidence based approach to deciding which treatments to use in the NHS, a scientific approach needs to be adopted where the prior plausibility of a treatment is first evaluated so that it is possible to decide the degree of evidence required to support that treatment. Not all proposed treatments are the same and can be judged by the same criteria.

By conducting more research, we allow more anomalous evidence to creep in and that can only add to the difficulty of making health care decisions in our hospitals and governments. Rather than clarifying the position, clinical research into highly implausible treatments runs a very high risk of obscuring the truth. It is not that I do not accept that one day a highly implausible treatment will be shown to be effective, but rather there is a far higher chance of producing a nonsense result that just obfuscates the discussion. I will discuss how implausible research should be conducted shortly.

This brings me onto the second point. Homeopaths often accuse sceptics of double standards where low standards of evidence appear to exist for many routine hospital procedures whereas strong evidence is demanded for homeopathy. We can now see that this is not hypocrisy, but an inevitable consequence of scientific thinking. It is perfectly rational to accept treatments as effective if they have very high plausibility but little in the way of good objective evidence. Taking a trivial example, we all know that putting pressure on a wound stops bleeding. But I bet no randomised controlled trials exist to support such a procedure. Would anyone want to doubt that? For many surgical procedures, little in the way of high quality trial data may exist, the evidence may be at worst of the GOBSAT variety. But, many procedures may be inherently less susceptible to biases and subjective measurement errors. Death is a hard measurement point and is not easy to fudge. If a surgical procedure appears to prevent a quick death then we may well be quite right to accept largely anecdotal and case-based evidence. In fact, to insist on randomised controlled trials might well be highly unethical given the high degree of plausibility of the procedure.

This is, of course, in stark contrast to homeopaths claims that their pills can prevent or cure malaria. There is absolutely no good reason to think that this might be true. The plausibility of such a treatment is as near to zero as makes no difference. And yet many homeopaths insist that this is a bedrock of their practice (Hahnemann’s first homeopathic experiments were on malaria). Furthermore, some homeopaths insist on doing their own trials, often in Africa. Such experiments must be totally unethical, because their results, even if positive, could never be sufficient to demonstrate the efficacy of their treatment. Trials such as these put patients at risk with no prospect of any enlightenment to come from that risk.

So, my third point is what sort of research should homeopaths be doing, if any? Well, the only ethical and constructive research that could be done is research that could move homeopathy along the plausibility axis. This would be fundamental research that sought to uncover potential models of how the treatment might work. Before embarking on using real patients as test subject, confidence must be established that a treatment may be effective. That is not just good science but good ethical behaviour.

Figure 5. Direction of Investigations into implausible treatments

Homeopathy has a long path to go along here. Some homeopath supporters recognise this fact and see the importance of both demonstrating their fundamental tenets are true and also trying to show how homeopathy might be integrated into science. (My homeopathy challenge is a simple test to ask homeopaths to demonstrate that their beliefs about the preparation of homeopathic remedies are not just wishful thinking. So far, no one has agreed to the test.) There are some researchers who are looking into so-called ‘memory of water’ effect, that might add a smidgen of plausibility into their claims. So far, the experimental evidence for water memory is woefully inadequate, even if it was in itself a plausible hypothesis.

The utter degree of implausibility is so staggering that I believe it would be difficult to justify public expenditure on fundamental homeopathic research. The only reason it is given any credibility is because so many people have staked their livelihoods in believing it. If Hahnemann had not been born two hundred years ago, but turned up at an NHS hospital today asking them to buy his pills, he would be unceremoniously thrown out for being an utter crank. And that is how we ought to treat homeopaths today.

The news this week has been filled with reports of the relative ineffectiveness of many antidepressant medications. The real shocker is how important data has not been made available to properly establish their effectiveness. Taking this science based medicine approach allows us to clearly differentiate between the different demands of whether more research is warranted into various sorts of antidepressants. Homeopaths may try to seek some equivalence between their failed and partially successful trials and the disappointing evidence for the effectiveness of some antidepressants. Both may look like placebos. But with the conventional pharmaceuticals, plausibility may still be much higher. We may not understand detailed mechanisms for how these drugs affect mood, but at least chemical intervention has some plausibility. My current glass of wine proves that. And, these drugs do show some effect for more depressed people. Understanding why this is and how these effects might be improved would look to be imperative. Homeopathy can make no such claim on limited research money.

And so to summarise, the Cochrane Review should limit its calls for further research to situations where plausible hypotheses exist, as without this, clinical data can never be persuasive. And for sceptics, attacking homeopathy cannot be done by solely by attacking the clinical evidence base. That evidence may well be poor and fragmented but there will always be a constant trickle of positive results such as the Oscillococcinum review, no matter how minor, that allow homeopaths to claim they are part of the evidence based medicine movement and that sceptics are being hypocrites. Homeopathy is wrong because the the evidence that does exist is far too limited for us to accept its efficacy given the extreme implausibility of its action.

****************************************************************************

If you want to explore more of the ideas raised here, a new blog has recently started. ScienceBasedMedicine.org is being written by prominent sceptic bloggers such as Steven Novella, Wallace Sampson, Harriet Hall and David H. Gorski.

Labels: evidence based medicine, homeopathy, pseudoscience

 

As my own personal tribute to Homeopathy Awareness Week, and as promised in my last post, I would like to critique a paper that has appeared in this Summer's edition of the journal, Homeopathy in Practice.

The article is entitled "Hormesis, epitaxy, the structure of liquid water, and the science of homeopathy" and is by Domenico Mastrangelo. The paper has appeared elsewhere but is obviously so important that HiP sees fit to republish it. You can view the text here.

Mastrangelo's thesis is that homeopathy is a real science based on sound scientific principles and should not be derided as 'unscientific' and 'implausible' by the 'western medical establishment'. Now if Mastrangelo can really do this, then it would indeed be a major scientific breakthrough of unprecedented scale. The reason the 'establishment' has a problem with homeopathy is that it beliefs are in direct contradiction to most of chemistry, physics and biology. The abstract closes with the hope that

this hurdle will be overcome by opening academic institutions to homeopathy to enlarge the horizons of medical practice, recover the value of the human relationship with the patient, and through all this, offer the sick a real alternative and the concrete perspective of an improved quality of life.

Has Mastrangelo made the break through? Let's look at each section in turn.

What is Science?

Mastrangelo begins by reviewing what science is. And tells us the following,

The “scientific” method encompasses the following phases:

1. Observing and describing a phenomenon or group of phenomena.
2. Formulating a hypothesis to explain the phenomena.
3. Using the hypothesis to predict the existence of other phenomena, or to predict quantitatively the results of new observations.
4. Performing experimental tests of the predictions by several independent and properly conducted experiments

Now of course a full philosophy of science would take up much space more than this, but Mastrangelo quickly dismissed these points by saying that 'archaeology, psychology and geology' could not be considered sciences under this definition. Domenico does not say why or give references. It must come as a bit of a shock to people working in these professions. Are they not capable of doing experiments to collect data, forming hypotheses, testing the predictions of the hypotheses against observations?

This sort of distortion of science is seen in creationism where we are told that evolution cannot be a science because you cannot observe evolution in a laboratory. This is a very narrow view of what an experiment is. Geologists, and so on, are quite capable of the systematic and controlled collection of data (an experiment) although this may take place in the field rather than the lab.

Fortunately, Mastrangelo invites the geologists and psychologists back in by offering his own definition of science,

the field of study which attempts to describe and understand the nature of the universe in whole or part.

Now, this definition will definitely include geology and so on, and it will also include homeopathy within its fold. Homeopathists do say they are trying to understand 'healing' - that is a part of the universe worth understanding. However, under this definition we can just about let in anything that attempts to describe the universe and the we have to call it a science: creationism, Scientology, Greek mythology, literature, pastafarianism, voodoo, astrology, mithrasism, Christianity and just about any alternative medicine.

So, by adopting a ridiculously weak definition of science, Mastrangelo is begging the question. His premises for the paper make it inevitable that he will succeed in poving that homeopathy is a 'science', but only under his owen terms. What is of course missing from his definition is all the rigour that allows us to exclude astrology and reiki from science: observation, evidence, hypothesis, experiment.

Not a good start to the paper.

Homeopathy as a Medical Science

Next, the task is to show how Hahnemann founded homeopathy on firm scientific principles. We are treated to a biography of the founder of the practice and a history of the discovery. The argument of the paper is that because Hahnemann formed hypotheses (like cures like) and performed drug testing-like experimental practices (provings) that homeopathy is 'scientific'. Mastrangelo appears to be slipping around on his own definition of science here.

Hahnemann’s way of proceeding through hypothesis, observations, testing, validation, and formulation of principles leaves no room for doubt: he was using the “scientific method” to explore an entirely new medical and biological world…

However, this only works if one takes, again, a rather limited view of what science is.

If we were to take this at face value then we could also argue that phlogiston, the bodily humours and the ether are all scientific. All were part of scientific hypothesis at some point in the past and experiments were performed to detect these phenomena. But advances in observation and theory all show that these things are not real. To continue to say that fire is caused by phlogiston is not scientific, even though it might once have been. In the same way, to say that just because Hahnemann's techniques once appeared to be scientific does not mean that they are now. If you keep calling them scientific, and ignore subsequent findings, you are practicing bad science or even pseudoscience.

One needs to be careful with the word 'proving' when homeopathists use it. Their use does not have the same everyday use. A proving is the process by which homeopathists discover which substances create similar symptoms in suffers to those caused by illness. In this sense, Provings are only proving anything if the principle of like-cures-like holds. This is one of homeopathy's central weaknesses and Mastrangelo returns to this point.

In retrospect, it is easy to see where Hahnemann went wrong. At the time, most doctors may well have been doing more harm than good with their blood letting and quack remedies. Hahnemann was no different in administering poisons in the hope that like cures like. Hahnemann noticed that the more dilute the poison, the better his patients appeared to do (not surprising really). If he diluted his poisons into pure water then his patients did best of all because at least no harm was being done and perhaps a placebo response was being gained. What homeopathy is is a therapeutic placebo and this has been demonstrated many times in experiment. To cling to ideas of 'like cures like' and 'dilutions and succussions' is unscientific in the same way that clinging to ideas of alchemy is unscientific. Hahnemann mistook minimal intervention, a placebo response and allowing disease to take its course for a genuine therapeutic effect. Homepathists have been making the same mistake for over 200 years.

Hormesis

The next part of the paper tries to convince us that 'like-cures-like' has a sound scientific basis. It introduces the concept of hormesis; the idea that favorable biological responses can be gained from low exposures to toxins. Mastrangelo presents this as something that western science has a problem with and avoids using the term. At one level, the concept is trivial and accepted by all. Paracetamol is a rather deadly toxin that can destroy the liver. In small doses it acts as a analgesic and the body can readily deal with processing it so that it does not become a danger.

However, Mastrangelo wants us to take a strict view of hormesis where in low doses substances have the opposite effect of that at high doses. In this world, paracetamol would not be a cure for headaches but for liver disease - like cures like. Substances may well have different physiological effect at different doses, but there is no mechanism that supposes they have the direct opposite effect and so support the like cures like hypothesis. Vitamins can have greatly beneficial effects a low doses, but can become highly toxic at high doses. The biological mechanisms for benefit and harm need not be the same and indeed most often are not.

There are several things wrong with taking the hormesis view of homeopathy. Firstly, it presupposes that the poison is the cause of the illness. Low doses somehow stimulate the body to respond better to high doses. Real biological mechanisms may well exist for some types of hormesis. Radiation has been studied with some interesting, if not controversial, ideas that somehow the immune system may become 'hardened' after exposes to low levels of gamma rays and so better cope with higher levels. However, for illnesses that are not caused by toxins (most) hormesis can play no part whatsoever. (It is worth noting that many homeopathists deny the discoveries of medicine that illnesses can have viral, bacterial, parasitical and genetic origin.)

Secondly, all this talk of hormesis can only really have any value if a low dose is actually administered to the ill person. But with homeopathy, all but the very 'weakest' doses have been diluted to the point where no dose is present and so no hormesis can take place. Mastrangelo notes this and tells us that his theories are applying to doses 'below Avogadros number' I think he is confused in his terminology here and I believe he is saying that most homeopathic preparations are not diluted beyond the Avogadro limit.

The Structure and Behaviour of Water

Next, rather confusingly, and despite saying in the previous section that homeopathy can be explained in terms of low doses and hormesis, Mastrangelo goes on to discuss the idea that somehow water contains a 'memory' of the active ingredient once it has been diluted beyond the Avogadro limit. So now, homeopathy needs two mechanisms - one for when the poison is present in the dose and one for when it is not.

The idea that water can maintain the physical properties of water through adopting some sort of semi permanent crystalline structure is very old. And the lack of any evidence for this hypothesis is very old too. The arguments in favour of structured water appear to rest on analogies and special pleading. Mastrangelo is no different here.

First, Mastrangelo creates a straw man where he paints scientists as ignorant of the special nature of water and how it can have unusual structural properties and be very important in many biological structural mechanisms in proteins and DNA. Of course, science is not ignorant of these fascinating properties as it was scientists who discovered them in the first place and they are now part of mainstream science. Of course, water is a vital ingredient of biological processes and of course water has interesting structural properties.

Mastrangelo then creates false analogies by saying that carbon can have different properties depending on its structure; diamond, graphite etc. Of course! What has this got to do with homeopathy? Then, epitaxy is introduced where crystals are grown on substrates and the crystal takes on structural properties of the substrate. All standard stuff. Semiconductor electronics depends on this phenomenon. However, Mastrangelo makes the extraordinary claim that epitaxial properties can have effects below the Avogadro limit. It is not explained what this means, but two references are given. The first to wikipedia (!) and the second to a paper entitled “The structure of liquid water; novel insights from material research; potential relevance to homeopathy”. This paper introduces 'subtle energies' pretty early on and looks like it is homeopathists in support of homeopathy.

All the pleading in this section to say that "to deny their value would be very inappropriate for official science: inappropriate and totally “unscientific". Well, most of what is presented is not in dispute at all. What is in dispute is if structural properties of water have any bearing on explaining homeopathy. Mastrangelo has failed to do this. Instead, the paper is just pleading to say 'there must be something in in it!' To really do a convincing job, there are real and significant questions about the structured water hypothesis that are unanswered:

1. Water does indeed appear to support stable micro structures. But these last for a microsmidgen of a second. How are these structures maintained for long enough to produce products with a reasonable shelf life, i.e. weeks?
2. Many homeopathic products are given in sugar pills or alcohol. Do these substances have the same properties of water that you claim prove the theory? The answer is of course no.
3. If stable structures are formed, what reason is there to suppose that these structures have the same physical properties as the agent that caused them. Remember, like cures like.
4. How does repeated shaking and dilution actually amplify these structures, rather than just dilute them like the original active ingredient?
5. What role for hormesis if structured water can explain everything?

The point here is that the structured water theory is not an explanation for homeopathy. It is clutching at straws in an attempt to maintain some sort of credible physical explanation for homeopathy without recourse to 'supernatural' explanations, like so many homeopathists do.

The Placebo Effect

Up next, is a bunch of relativism where 'western medicine' is supposedly blind to alternative philosophies. It gives an example where Chinese medicine has discovered a network of channels in the body called the meridians. This is given as an example of how no one has a 'global view'. This is of course nonsense. The key differentiator is of course evidence (something left out of Mastrangelo' s definition of science). There is not a shred of evidence for meridians whereas there is an inundation of evidence for say, nerves or blood vessels.

This argument is an attempt to place homeopathy on an equal metaphysical footing with 'western allopathy'. It is confusing as to whether Mastrangelo wants to see homeopathy as within science or as an 'equally valid' alternative to it. It looks like Mastrangelo is trying to have his cake and eat it.

And so on to the placebo effect. Mastrangelo again wants to paint mainstream science as ignorant of the true nature of the placebo. This is true to a certain extent in that the action of the placebo is not yet fully understood. However, Mastrangelo appears to be saying that because a placebo has no molecules of active ingredient present, then isn't that the same as homeopathy?

This is just bizarre. Does Mastrangelo want us to believe that homeopathy and the placebo are the same? What then for Hahnemann's like-cures-like and so on? However, he says that the placebo is 'less plausible' than homeopathy because 'no molecules are involved at all.' He appears to be ignoring the current scientific understanding that the placebo effect is a psychological response to the ritual of healing. He accuses the pharmaceutical companies of using 'the placebo effect of marketing' to fraudulently increase prices (?). He notes that many analgesics may well have a high placebo-like component of their action, but fails to note that in trials such drugs score over and above placebo in effectiveness.

In short, Mastrangelo appears to be pretty confused about the placebo and why drug companies compare their products against a placebo. It is true that the placebo is not well understood. It is not completely clear what sort of conditions are susceptible to a placebo and under what conditions. However, in a drug trial it is not too important if a placebo effect for the condition is real or not as the trial is looking for a response in excess of that given by a potential placebo effect. Perhaps, more trials ought to be three way(drug, placebo, no intervention) to see how the placebo differs from doing nothing, but this all costs.

If Mastrangelo wants homeopathy to be seen as scientific then the standards of evidence for it ought to be consistent with scientific medicine. Testing against a placebo is a key component of this. Without such commitment to such tests, homeopathy must remain outside of science.

Matter and Mind

The final section delves into a mish-mash of quantum quackery and semi-understood astrophysical developments. Quantum physics has many mysterious and counter-intuitive elements to it. But Mastrangelo appears to fall for the old fallacy that just because quantum physics is mysterious then any mystery can be explained by it.

The problem with trying to appeal to the mystery of quantum physics is that it is a horribly exact science. It is first and foremost a mathematical theory. Non mathematical descriptions of quantum theory are only an approximation to the true theory. Quantum theory is extremely good at predicting experimental results. One can use the mathematics to predict the structure and interaction of atoms, particles and light with mind-boggling degrees of accuracy. There is no room in quantum theory to slip in mysterious forces and energies. They would be spotted. Quacks use quantum theory to impress their ignorant adherents. Those that have really studied quantum theory have no truck with such mysticism hitching a ride on the incredible success of the theory. Physicists may use mysterious and quasi-religious metaphors to describe their wonder at this world, but we should not confuse their metaphors with their science.

After all of Mastrangelo's talk of quantum astrophysics, dark matter and vortices of energy, he utterly fails to show how any of this has any relevance to homeopathy. His argument is a hollow appeal - "Modern physics is strange and mysterious, surely there is some room in there for the mystery of homeopathy?'. This is not science, this is mysticism masquerading as profoundness. It is homeopathy knocking on the door of the frontiers of physics. Mastrangelo should be showing us why he should be let in.

Mastrangelo's Conclusion

In the final section Mastrangelo submits us to an appeal from 'popularity'. So many people use it, it must be true. Then, an appeal to the failings of modern medicine and its lack of personalized care. Yes, your GP may be busy. What does that prove about homeopathy? Then onto Big Bad Pharma. Yes, these companies make profits and do bad things. What does that prove about homeopathy's effectiveness? Next onto the side effects of conventional medicines. Yes, potent medicines can have side effects. They have benefits too. It is up to the doctor and the patient, in mutual agreement, to decide if the benefits outweigh any potential side-effects. What does this prove about homeopathy? Then some more misunderstandings of quantum physics and the uncertainty principle.

And then finally the conspiracy theories that science and the pharmaceutocal companies are preventing research into homeopathy. The contradiction here is obvious. If 500 million people are really using homeopathy, how come a tiny fraction of the money gained from these people cannot be used to do the research an stick it in the eye of the scientists?

Homeopathy is an outdated mode of thinking about the body. It may have had a smidgeon of scientific credibility in the early 1800's. But now the only interesting scientific question left is a sociological one - why does such quackery persists in the face of overwhelming evidence?

One way of course is through the publishing of scientific-looking papers like Mastrangelo's. It allows homeopathists to believe that what they are doing is truly supported by science and that its detractors are shortsighted or conspiratorial. This paper is preaching to the choir. No scientist will be swayed by such a collection of appeals. But the scientificaly illiterate homeopathist will undoubtely be impressed with lots of the long words here.

Journals, such as Homeopathy in Practice, look like they do not apply the same standards of refereeing as might be found in real scientific journals. Mastrangelo's paper contains elements of pharmacology, surface and solid-state physics, cosmology, quantum physics and the philosophy of science. Surely the best test of whether Mastrangelo had succeeded in showing homeopathy was a part of science would be to have real scientists in appropriate fields peer review this paper. What I would like to know is how many of the referees for the paper (if it was peer reviewed at all) were suitably qualified in the above subjects.

My guess is none. I shall be writing to find out.

Labels: homeopathy, pseudoscience

 

In this story, a supplement industry spokesperson resorts to Creationist 'Science' for their evidence to support the 'crucial' nature of supplement pills, shows how we should eat like Inuits, without the messy business of catching fish (or dying young), and has a pop at one of the UK's most respected academics when he dares to point out some herbal gobbledegook.

A quackometer refrain is that where you find people saying that you cannot get the nutrients you need through diet, you will find a supplement pill pusher. And a new pill pusher has come to light this week: Dr Ann Walker, spokesperson for the Health Supplements Information Service (HSIS), a body set up to be an,

educational programme to present facts about health supplementation in a simple, a straightforward way. We aim to empower consumers with knowledge about nutrients and their crucial role for a healthy living.

Crucial, eh? Given that the HSIS is made up of many large and small business that try to flog nutripills to us, then we might expect strong marketing language. Why take those disgusting little pills if they were not crucial?

So what evidence are we given for the 'crucial' nature of supplements? How does the science stack up and should we rely on such evidence? Let's see what Dr Walker has to say on the subject.

But first a bit of background: Dr Ann Walker looks like a busy person. As well as work with the HSIS, she runs a herbalist training school with her husband, has her own herbalist private practice open twice a week, and still finds time to supervise studies in Human Nutrition in the Hugh Sinclair Unit of Human Nutrition at The University of Reading.

However, the one of Britain's most eminent scientists, Professor David Colquhoun FRS, has pointed out that Dr Walker's association with the University counts as about one tenth of a full time job. He also commented that she signs herself as a Senior Lecturer at Reading when trying to comment on the negative effects of supplements without declaring her interests as a spokesperson for the industry. The straw on the camel's back was exposing her herbalist web site as touting 'gobbledygook' when it suggests that Red Clover is a 'blood cleanser'. The term has no scientific meaning. All this resulted in Dr Walker's husband complaining to the Provost of University College London about Professor Colquhoun and his web site. The complaint alleged defamation and breach of copyright. Ann and her husband had not complained to Professor Colquhoun directly and had not answered his request for them to explain what a 'blood cleanser' was and why this was not gobbledygook.

Threatening legal action and complaining to the University without addressing David directly is a bit unsporting. Why would you do this if your views on herbal treatments stood up to examination? A simple email to David, pointing out his errors, would surely suffice? The fact that this has not happened rings alarm bells. And so, I felt it worthwhile looking at some of the other claims that Dr Ann Walker makes to see if they too support the popping of supplement pills.

Dr Walker writes articles for the Healthspan web site, which claims to be the 'largest home shopping supplier of vitamins and supplements in the UK. Tax free prices. Free P&P (UK)'. Her articles for the site are linked to various supplements and give reasons why purchasing such products are 'crucial'. I am going to pick on the first article in her list and see if it contains good reasons to buy a supplement or two.

The article is entitled 'Did cavemen get arthritis?' and is an attempt to explain why we should be buying Omega-3 and Vitamin D pills. It starts off,

We often hear that the ideal diet to prevent all chronic diseases, including arthritis, is the Stone-Age Diet, which was believed to be based on the meat of hunted animals and the leaves, roots, seeds and fruits of gathered wild plants. Did the ancient Stone-Age diet really combine the best features of what we now call healthy eating? In this article, the links between evolution, nutrition, dietary change and arthritis are explored in relation to archaeological evidence.

It is not clear where we can hear that diet can prevent all chronic diseases. This sort of claim is typical of nutritional therapists and is highly controversial, mainly because there is little evidence for it.

Dr Walker continues,

The earliest known case of human arthritis was found in a cave at La Chapelle-aux-Saints, France in 1908. It was the bent-over frame of a Neanderthal Old Man, who lived 60,000 years ago. His ape-like spine was responsible for the myth that the Neanderthals were one of the missing links in human evolution. But subsequent finds suggest that they were regular humans who just looked a little different from us and that their skeletal deformities were due to diet.

The specifics of the dietary problems are explained as follows:

During the Ice Age, Neanderthals lived in dark caves and probably suffered from vitamin D deficiency due to a lack of sunlight. Hence, if their diet was low in fish, they not only missed out on its rich vitamin D content, but also on its omega 3 fatty acids, with consequent risk of the development of soft, deformed bones and arthritic joints.

The first word that springs out here is 'myth'. Now, the question of whether Neanderthals are our evolutionary ancestors, or our cousins, or even hybrids, has been the subject of much debate and research, But to call it a 'myth' is a bit odd. The next bit is even stranger. Dr Walker claims that subsequent finds now prove that Neanderthals were just plain old humans, maybe a little odd looking, but with dietary problems. Specifically, a lack of Vitamin D would have caused rickets and deformed their bones.

These sorts of arguments about Neanderthals are quite common on the web. However, you will not find them on science web sites but on web sites displaying the rantings of creationists and so-called Intelligent Design advocates. These arguments are important to the creationists. The existence of Neanderthal bones, along with fossils from other homo species, are excellent evidence that archaic forms of humans existed, quite distinct from ourselves, and that evolution can explain their development from earlier, more ape-like ancestors. This is bad news for creationists who like to pretend that no such 'missing links' exist. And so the dissemblers on such sites paint these bones as those of diseased normal humans. A good example of the type of argument can be found on the All About Creation web site. The phrasing and style of argument displayed here is remarkably similar to Dr Walker's site.

The idea that Neanderthals were deformed and diseased ordinary humans has a long heritage, going as far back as the 19th Century German Anatomist Rudolf Virchow, who examined the skeleton of a Neanderthal and pronounced it a victim of rickets and a good bludgeoning around the head. By the beginning of the 20th Century, such ideas had been proved to be nonsense and now they are only to be found on christian literalist web sites (and the odd vitamin sales site).

We now have a much better view of what the Neanderthals were. Far from being backward, diseased and brutish, our cousins were in fact highly successful colonisers of Europe and the Near East. They thrived for hundreds of thousands of years and their remains have been associated with complex hunting and tool making, control of fire and cultural artifcats. Whereas the later arriving sapiens adapted to the harsher environments of Europe though technology, Neanderthals survived through physical adaptions. Their bodies were not diseased but strong and stocky in order to conserve heat and hunt effectively. Their bodies show no signs of rickets. Rather than having the grossly weakened and twisted bones of a rickets victim, their bones are 50% stronger than ours and show none of the usual symptoms of the disease. Why they finally died out, and our own ancestors survived, is still being hotly debated as more evidence comes to light. However, it might be worth noting that the natural assumption that modern humans were far superior in their adaptions for the modern world may yet turn out to be hubris. Neandethals may yet turn out to have a longer dominion over their world than we do.

To further the idea that we will become more Neanderthal like if we don't take our Vitamin D and Omega-3 pills, Dr Walker goes on to more theories about fish oil in the diet of earlier humans. She says that intakes of "vitamins, minerals and phyto-chemicals, such as flavonoids, would have been much higher than today" and this may have made possible brain growth. It is not clear why she believes this.

But, in support of at least part of this, she cites the work of Professor Michael Crawford who published a theory in a 1989 book that early humans would have had to eat large quantities of seafood in order to get enough omega-3 for brain growth. This idea has been incorporated into what is known as the aquatic ape theory, an interesting but controversial idea that early human evolution must have gone through a phase where our ancestors lived in water. The theory is supposed to explain various odd human features such as our ability to hold our breath and swim and our nakedness. The aquatic ape theory has not gained acceptance as so many of the features the theory tries to explain can be explained in other ways. In similar ways, the fish-eating ape theory of Michael Crawford has been argued to be unlikely. John Langdon recently published a paper in the British Journal of Nutrition that reviewed the literature to see what support there may be for the theory and found that there was probably no need for an extreme fishy diet.

Dr Walker goes on,

There seems to be little doubt that many current health problems result from a mismatch between our genetically determined nutritional requirements and our modern diet. According to numerous studies, the Stone-Age diet, high in fruit, vegetables and fish, is still the best for modern humans to reduce their risk of
chronic diseases

So, far Dr Walker has given us little to convince us of the idea that chronic problems such as arthritis are due to our deviation from a stone age diet. Indeed, the leap to the 'crucialness' of taking supplement pills is even more absent. Why not just advise people to have a diet high in the food stuffs our ancestors ate?

Finally, Dr Walker says,

Interestingly, glucosamine and chondroitin (now widely used as supplements to reduce the symptoms of arthritis) are both sourced from marine life. The health benefits of seafood may explain why Greenland Inuits have one of the lowest rates of arthritis in the world.

This article is getting far too long now to look into the glucosamine and chondroitin claim, so I am happy to pass over to Coracle on Science and Progress to see what weight this bears. However, Dr Walker tries to convince us that Inuits have low levels of arthritis and this may be caused by a high fish diet. However, others think that such disparities, if they truly exist, may well have genetic components. It is also worth noting that Canadian Inuits have a life expectancy 10-15 years lower than the average Canadian. Whilst there are many factors that will play a role in this, it has been noted that the Inuit diet must have one the lowest intakes of fresh fruit and vegetables in the world.

The whole hypothesis that our caveman ancestors had superb diets that we can only emulate by buying supplements from Dr Walker's sponsors must be ridiculous. Today's western consumer has access to year round fresh fruit and vegetables, a constant and predictable supply of grains, meat, fish, dairy products and jaffa cakes, and almost never goes through periods of shortages or restrictions. Diets do go wrong, with people eating too much, or eating in an unbalanced way. But, supplements are not the answer, in most cases. Daft tabloid dietary advice, nonsense from media nutritionists, fads and scare stories all confuse people into believing organisations like Dr Walker's marketing firm. Articles, like this Neanderthal one, are not helping.

Ironically, Dr Walker might be nearer the truth of advocating a Neanderthal lifestyle when she is promoting her herbal remedies. Human beings have a long tradition of using plants in therapeutic ways and this undoubtedly goes back into our prehistory. As our ancestors evolved, so their brains got better at fathoming causal relationships in the world. Tools and technology are the consequence of brains that can accurately model cause and effect relationships. To those emerging human minds, the instinct to find causal reasons for disease and to take action to cure must have been strong. After all, humans can influence and manipulate so much of their world, why not their bodies and their illnesses? It is interesting to speculate how humans' love of quackery comes from those primitive instincts and how our minds still seek patterns and explanations in illness. Is herbalism deeply rooted in our evolutionary past?

Did Neanderthals use herbs to heal? Tantalisingly, there is some evidence from a grave in Iraq. Maybe, our relationship with plants is even deeper than the Neanderthals. Last Christmas, I had the pleasure of meeting a researcher who was off to Borneo to study how Orang-Utans maybe self-medicated with various plants. She was going to be collecting Orang pooh for six months and studying it, and was obviously destined to become the Gillian McKeith of the Orang-Utan world. But with an accredited PhD. And even more matted ginger hair.

But to fall for the alluring idea of the 'wisdom of the ancients' and their 'natural' healing powers would be missing what was going on here. Maybe, some plants had a therapeutic effect. Maybe, the action of a social group using plants gave a strong placebo response in the ill. As we find today, many illnesses would be fought off by an immune response or be self-limiting in some other way. The act of healing rituals cemented social bonds and the plants used formed part of the groups' defining cultures. There is evidence that Neanderthals cared for their sick and elderly, however, the value of using plants in healing was probably more cultural and social than pharmaceutical.

We scientific humans, however, have developed skills that allow us to work out which plants really have beneficial effect, and we have technologies that allow us to refine the chemicals that cause the effect, how to minimize risks and side-effects and how to standardise doses. It's called modern, scientific medicine. Dr Walker's herbalism has more in common with our ancestors shamanic rituals than with what goes on in hospitals. If there is good evidence for the beneficial effect of a herb then it ceases to be herbalism and becomes part of the tools of real medicine. This does happen, of course. The majority of drugs now used have their origins in plants and other natural substances.

However, Dr Walker appears to be more rooted in our Neanderthal past using mystical and non-scientific explanations for herbal remedies. Professor Colquhoun was quite right to point out that using terms like 'blood cleanser' is just gobbledegook. Fortunately, I have just heard that his web site will be re-instated on the UCL servers and that the university consider the meat of the complaint groundless. So much for legalistic threats. Can we get back to the science now please?

So, why did Neanderthals not get arthritis? Was it fish oil? Is this the answer?

Perhaps, it had something to do with the probable life expectancy of a Neanderthal being just 20 years.


-

Labels: diets, nutritionist, pseudoscience, vitamins

 

Well, today's news has had lots of Wi-Fi scares being reported. Tonight's Panorama is going to look at the 'dangers' of bringing Wi-Fi into schools. Let's wait to see what they have to say, but early reports do not bode well as they are claiming that their 'independent tests' showed WiFi produces EM levels three times higher than mobile phone masts. It is difficult to think up a more meaningless statement. But such is the quality of debate at the moment in the hysteria being whipped up about the dangers of all things electrical. Will Panorama fuel or dampen the flames? We shall see.

But the news has prompted me to do a little more looking at the subject, and in particular, one campaign group that I have not looked at before, the EM-Radiation Research Trust. Campaign groups, like this one, crop up regularly and appear to be behind the spread of fears around mobile phones and radiation. The quackometer has already looked at Powerwatch and how it is selective in its use of evidence, and Electrosensitivity-UK and its rather shrill condemnation of anyone who dares to suggest that electrosensitivity symptoms might not be caused by radiation

The Radiation Research Trust is an interesting one though, in that it appears to have the support of several members of parliament and an MEP. The trustees of the charity include Andrew Mitchell, Conservative MP for Sutton Coldfield, Mark Oaten, MP for Winchester, Dr Ian Gibson, Labour MP for Norwich North and MEP Dr Caroline Lucas, of the Green Party. Its nice to know from the start that I cannot be accused of political bias for showing how this rabble of politicians has got itself involved with quackery. An organisation that has such cross-party support has surely has mustered some important clout and so it is worth delving a little deeper in Radiation Research to see what they are up to.

So, who are the other trustees and movers within the charity?

We have an Eileen O'Connor who contracted breast cancer whilst living close to a phone mast. How she knows the mast was the cause of her illness is not clear. But it looks like one of those modern equivalents of the village witch hunts. Everything from villagers' nose bleeds, headaches to cancer is blamed on the mast. Now, cancer clusters do happen, even just by chance. When clusters are spotted it is natural to look for a cause, whether it be the nuclear power station, mobile mast or old woman living with a black cat. It is easy to jump to the wrong conclusion here and personal testimony, although heartfelt, should be taken with a pinch of salt.

Next, we have Brian Stein, Chief Executive of Samworth Brothers Ltd., manufacturer of motorway service station staple, the truly miraculous Ginsters range of pasties. Brian suffers from electro-hypersensitivity and, as we have seen, by the very nature of the problem, the last people to have broad opinions about the causes of the condition are the suffers themselves. I wonder if Mr Stein refuses to microwave his pasties?

Mike Bell is the chairman of the organisation and is often seen reporting the groups views to HPA committees and the media. The only scientist in the group is Dr. Gerard Hyland, honorary associate fellow of Warwick University. Having a scientist is undoubtedly good as it gives credibility to the charity and a voice of authority.

Now, Dr Hyland is the poster pin-up boy of the electrosensitivity lobby as he is doing something most important for them. The problem with showing that Wi-Fi and mobile phones are dangerous is two-fold: first, the evidence for the range of problems associated with EM-fields is in many areas non-existent, and in others circumstantial and incoherent; the second, that there is little plausibility of non-ionising radiation causing the range of problems reported at the levels found in domestic settings. The 'plausibility problem' causes many scientists to dismiss the claims of the lobby out of hand. It places a strong burden of evidence on those making the claims and the evidence is not convincing.

So, Dr Hyland is working on the plausibility problem. Solving this plausibility gap is essential if the anti-Wi-Fi lobby is to make a convincing case. However, the idea that radiation from a Wi-Fi transmitter can cause damaging localised heating in brains and bodies is easily discounted - the emitted powers are usually far too small to have any meaningful effect. Hyland, is working on so-called 'non-thermal' explanations. An example of a non-thermal effect of a mobile phone is the stuttering interference you hear on your car radio. This 'pulsed' radiation does not heat the radio, but interferes with the electronic signals inside. If it can do this to a radio, can it do the same to the 'electrical' parts of the human body? That is essentially the non-thermal pulsed effect theory and it has been leaped upon by the anti-mobile, anti-wi-fi, anti-hi-fi lobby.

But, EM simply interfering with your neurons is not enough for plausibility. It is quite clear that mobiles do not induce something like epileptic fits, so a simplistic radio-interference type model is not enough. No, Dr Hyland, and similar researchers, propose that something much more subtle is going on at the cellular level, causing problems at the microscopic scale. And this is where it all starts to get a little strange.

One starts to get a sense of unease when Dr Hyland insists that his research is looking at 'aliveness', somehow implying that the fact that cells are alive is overlooked by other researchers. To the quackometer, this missing 'aliveness' starts looking like the talk of new-agers or energy quacks with their bonkers 'subtle energies', not that of a serious researcher. Dr Hyland comes from a theoretical physics background so we might forgive for strange biological language. However, a little more delving adds to the concerns. Dr Hyland is now retired from Warwick and has been for a while. But, his effort appears to be focused with a group called the International Institute of Biophysics based in Neuss-Holzheim, Germany.

The institute is researching into something called biophoton emission. This effect is supposedly different from bioluminescence, where bright light is created by living cells in creatures like fireflies and deep sea creatures. Biophotons are 'ultraweak photon emission[s] from living systems'. These photons somehow transmit information 'within and between' cells. And so, here we start to see the necessity of biophotonics to the anti-mobile lobby - a tentative but plausible mechanism of how non-thermal radiation effects can interfere with cellular processes. Can Emsignals of the right frequency interfere with the 'coherence' of inter-cellular biophotonic emission? Only, the problem is that the whole concept of biophotonics is extremely controversial and is treated as 'fringe' by most researchers. Indeed, biophotonics carries the many tell-tale signs of classic pseudoscience and pathological science. It pits itself against well established science such as the 'central dogma of genetics', that cellular communication occurs through the DNA-RNA-protein transcription and translation mechanism. It suggests that 'Russian science' has been aware of this for many decades, and we in the West have not woken up to it yet. (Look up Lysenkoism to see the problem with this.) Its 'subtlety' and 'ultraweakness' means that it deals with effects at the limits of detectability, where noise and poor experimental set-up can wreak havoc with results and interpretations. (Look up N-rays for a comparison).

Worryingly, the research interests of people associated with the Institute starts to make the quackometer get a little jumpy. They include:

• holistic concepts and the understanding of consciousness


• schrödinger's definition of food quality


• biophoton field reflecting biological rhythms


• molecular basis of stress and the concept of self-healing


• self-healing and the principles in homeopathy


• studies and medical applications of biophotons especially in connection with acupuncture and cancer


• anatomical structure of acupuncture meridians and its physiological significance

and so on...

In fact, the whole concept of biophotons is used by all sorts of quacks, from Professor Dame Mossop's Phytobiophysics, to homeopaths and energy healers to add a veneer of (pseudo)science to their musings. Biophotonics is used as a one-size-fits-all, off the shelf explanation for all sorts of outlandish quackery. It is so 'subtle' and ill-defined that it can be moulded to explain any freakish health theory. Is this really the sort of company that the Radiation Research Trust wants to keep? Is this what the 'research' in their name refers to? If plausibility is what you are after, then surely mechanisms that share explanatory powers for homeopathy and cancer-busting acupuncture may well end up back-firing on you?

But the Radiation Research Trust's associations get a little worse.

The group makes a big play of thanking their Cornish sponsor, a company called Ecoflow, for their generous financial support. In a mind boggling twist of irony, the company that campaigns against the harmful effects of electromagnetic fields is supported by a company that manufactures and distributes magnetic healing products.

Amongst their products are the full range of quack and crank magnetic devices including magnetic bracelets, pet collars, water softeners, wine conditioners, car fuel conditioners, gas pipe energy enhancers and (of course) mobile phone protectors. In a satisfying inversion of the nutri-pill-peddler turned EM-crank (see Patrick Holford and his QLink pendants), these EM cranks also sell vitamin food supplements to help the magnets work better. No, its true. Follow the link.
Ecoflow reassure us that their products work though their patented 'Central Reverse Polarity' technology, which is not available elsewhere. I am reminded of the famous Doctor Who line, '"reverse the polarity of the neutron flow". Can you physicists reading this please stop laughing now? You are annoying the rest of us.

The company works through recruited independent sales agents who are given training in their products. One little insight is how they sell their fuel enhancer magnets. According to one report, they get their mark to see how long they can hold their hand over a gas lighter flame, with and without the magnet applied to the gas lighter. This is a fairly straightforward con. Pain is highly suggestible and as a result is very placebo responsive. Give someone the idea that a flame will hurt more than before and it will. A much more objective and easy way to demonstrate that a flame is hotter when a magnet is attached is by using a thermometer. But this company chooses Derren Brown style conjuring tricks.

As you might expect, Ecoflow has been slapped hard by the Advertising Standards Authority for its unsupported claims and sales approach.

So, why do MPs and MEPs lend their support to this charity? Maybe, if you live in their constituencies you could write to them and ask why they are wasting their parliamentary time on such matters. Maybe our politicians like dealing with frightening things that can't be detected like harmful wi-fi rays and Iraqi weapons of mass destruction. It saves having to deal with real and pressing problems like poverty, poor education and how to organise access to health care without destroying it in continuous re-organisations.

Email addresses below:

Mr Andrew Mitchell Sutton Coldfield

Mark Oaten Winchester

Dr Ian Gibson Norwich North

Dr Caroline Lucas MEP South East

Let me know what they say.

Labels: electromagnetic quackery, magnets, pseudoscience

 

A press release today from the Economic and Social Research Council talks about recent research on how the public evaluates the information on health websites. The concluding message is simple:

Labels: boots the chemist, NHS, pseudoscience

 

Those of you who have read my last blog entry might be under the impression that I believe the Daily Mail is a deeply ignorant and offensive paper that panders to its bigoted readers' prejudices and does nothing but promote its right wing individualistic nonsense. Furthermore, I may have left the impression that the Daily Mail is little more than a conduit for alternative medicine fraudsters who use the rag to promote their deluded and dangerous wares through a credulous and uncritical science editorial policy. I may have given the impression that I was gloating about how the paper picked up all three Quackometer Awards for Quackiest News Source, News Story and Journalist.

Well, today, the paper disproves any of these slurs by printing a rather enlightening piece about Professor Edzard Ernst, entitled, "Complementary medicines are useless and dangerous, says Britain's foremost expert".

The Professor is a real Professor, with a chair at a real, accredited higher education institution, with real academic degrees and a long list of research publications in real peer-reviewed journals. He has, however, trained in many complementary therapies, but is now embarked on a thorough evidence-based evaluation of the techniques and their claims. His summary is basically that a bit of acupuncture may work for some pain (but not through woo meridians), massage is good and some herbal stuff may be effective. Everything else is pretty much useless and even dangerous.

Not surprisingly, his approach and conclusions do not go down too well in the woo community. Evidence is to the homeopathist, reflexologist and reiki master as kryptonite is to Superman. Reason is to the crystal therapist, chiropractor and nutritionist as water is to the the Wicked Witch of the West.

So it is no surprise that Professor Ernst is attacked, or more commonly, totally ignored by CAM practitioners. If mentioned at all, the Professor's work is condemned as being irrelevant to the sorts of 'holistic' treatments that health charlatans engage in. It is a widely held belief in homeopathic circles that double blind, randomised, placebo controlled trials cannot be used to test the efficacy of their sugar pills. No substitute is offered as an alternative test measure - the homeopathist is quite happy to sit in the dark, in an anecdote rich smog and an evidence free vacuum, and use this canard to deflect away the negative results that come out of good, controlled trails. And a canard it is. As Professor Ernst is reported to say in the article, "You need to think a bit more - it's a challenge".

The sad thing is that not much thinking is really required. For a trial to be effective, all you need to do is blind both the practitioner and patient as to whether the 'real' sugar pill or a dummy pill is being taken. Let the homeopathist do whatever they like in their 'complex intervention' (long expensive chat), let them prescribe whatever combination of identical sugar pills is required to create the 'individualized treatment'. Just make sure that the dispensing of the actual pills is done through some sort of randomised, coded and blind procedure. This is surely not beyond even the wit of a homeopathist. In order to believe that such a trial would be ineffective, you would have to believe that the critical part of the homeopathy magic is in the actual physical handing over, from therapist to patient, of the content-free tablets - nothing to do with tinctures, succussions, dilutions and like-cures-like.

So, anyway. Why did the Mail publish this? If I was to get all conspiratorial, I would say that the Mail publishes such stuff knowing exactly how its readers will respond. The Mail tends to dislike experts and authorities, people who can dispute their nonsense with well reasoned debate. Maybe the Mail knows that its readers will just see Prof Edzard as just another out-of-touch, ivory tower elitist idiot. The readers 'know' that their woo-of-choice works and so the only conclusion is that this guy must be just out to spoil their fun. It is a pity that this article is not allowing comments on it at the moment as we could test out if this near the truth. Or maybe it is much simpler in that there is no real science editorial policy and that they will just publish anything that makes a good story regardless of its origin, accuracy or reliability.

Anyway, one thing I am quite proud of is that the Quackometer News Scanner did not pick up this story, despite is being riddled with alt med terms. This is what that the quackometer has to say about the piece,

0 Canards.

This web site has more quackery than my village pond. It is full of scientific jargon that is out of place and probably doesn't know the meaning of any of the terms. However, the black duck can spot a fellow sceptic!. The site is highly sceptical in language and is debunking. It also looks like this site is trying to sell stuff. Buyer Beware!

I am not going to argue.

Update - 13/12/06

Looks like my prediction is correct. The readers backlash has started in the comments section of the article.

Some highlights so far:

• Individuals should be free to judge for themselves the effectiveness or non-effectivenss of any therapy. We do not want or need authorities 'protecting us' at every turn.
• what we need is to preserve our freedom to choose what works for us.People have to become aware that our rights are eroding and refuse to accept it. Debate about the safety of natural medicine is ridiculous in light of the large number of people who die from drug side-effects.
• Often times prescription and non-prescription medicines do more harm than good.
• The popularity of homeopathy and other natural remedies is pretty strong 'evidence' in itself
• I'm not quite sure what this man hopes to achieve by such arrant nonsense. Indeed it is he who is irresponsible. Why, I wonder does he feel the need to make such a controversial public announcement?
• However, from my own experience, it would appear to me that there is absolutely no doubt that alternative medicine, along with the appropriate lifestyle changes, can make a major impact upon the health of those who choose to follow that path.
• Why is it that Professor Ernst et al never make any mention of thousands of allopathic (scientifically formulated) drugs that poison, kill and destroy many peoples lives every day?
• Wonder if something's happening in the allopathic world that the heat has to be taken off them and placed onto complementary medicine?

Blah blah blah.

Labels: daily mail, homeopathy, journalists, newspapers, pseudoscience