The Quackometer

This year has seen a fantastic number of books about quackery, scepticism, complementary and alternative medicine and its effects on society. As part of my review of the year, I thought I would look back at some of the best new books.

The year started of really rather well with the publishing of Rose Shapiro's Suckers: How Alternative Medicine Makes Fools of Us All. It is the book that rather set the tone for all others. And it is probably the book I wish I had written or even been good enough to have written.

 

Shapiro tells us that there are two definitions of the word 'sucker' that she had in mind: one who lives at the expense of others, and a gullible or easily deceived person. The theme of this book is that society as a whole is being deceived and is casually accepting of nonsense and fraud in healthcare. She tells us the Alternative Medicine market is worth £4.5 billion in the UK. But it is not just financial damage that is being done, but great intellectual damage.

 

Suckers has great chapters showing how chiropractors have got away with the biggest fraud of being so closely accepted into the mainstream and the evils of how cancer patients are preyed upon by quacks. What is worse is how our government supports so much of this fraud and how our institutions appear to be so blind to the danger.

 

Shapiro writes with a passion driven by the anger and dismay of witnessing lives being shortened, unaccountable charlatans and our intellectual culture undermined by leaches on our fallibility. If this was the only book written this year, it would have been enough. The book deserves to be sent to very MP, every NHS administrator and every school. 


Damian Thompson has a broader remit in his book as he looks at the growing emergence of what he calls 'counterknowledge' in society. It is not just the sphere of medicine that is suffering from suckers who seek to profit from unproven and spurious theories. Thompson draws in the counterknowledge of the creationist movement and, in particular, says we should be shifting our focus from the American version of this to one much closer to home in the form of Islamic creationism, most prominently voiced  in Europe by the Turk, Adnan Oktar. He decries the publishing industry for its venal publishing of the works of pseudo-historians in the wake of the da Vinci code.

 

But Counterknowledge also tackles quackery and alternative medicine too. Thompson devotes  a chapter to the 'Counterknowledge Industry' and shows how the misrepresentation of knowledge can afford great profits. He discusses Patrick Holford's The Optimum Nutrition Bible and his other business interests and how he has infiltrated mainstream academia with his brand of nutritionism. (He also quotes me at some length, which was a surprise.)

 

In common with several of these books, it discusses how the result of this casual acceptance of nonsense is not just wasted cash for middle class Europeans, but often wasted lives in Africa. South Africa has suffered enormously with hundreds of thousand of HIV people dying unnecessarily because of government acceptance of counterknowledge.

 

Healing, Hype or Harm? is a collection of essays collated by Edzard Ernst. Many of the essayists in this book will be familiar to you. What comes across to me again, is the passion of the writers. Quacks like to dismiss so called 'Quackbusters' as mere shills of pharmaceutical companies. This is of course a lie and an absurdity. We see here people deeply concerned about the infiltration of quackery into the healthcare system and how it is undermining important advances in medicine and society.

 

We can read Les Rose on the importance of evidence in healthcare. When health and lives are at risk, why do we so easily accept anecdote as evidence when we never would in a court of law?

Michael Fitzpatrick explores how alternative medicine has hijacked the concepts of compassion in healthcare and then uses this to its advantages. He argues for the reclamation of compassion as an important part of moving forward. David Colquhoun looks at how Universities have bowed under the commercial pressures to teach quackery as if it were science.

 

Not all the essays here sing from the same hymn sheet. Bruce Charlton argues for a sort of medical apartheid where  healing and curing are seen as separate are are not integratable. He argues that alternative medicine is from a medical perspective worthless but that this does not mean that people cannot get value from them. Charlton calls for a separation between the 'New Age' medicine and 'orthodox medicine' and to allow alternative medicine to tackle more spiritual needs. My problem with this is that my guess is most doctors would be happy with this, but the quacks will not feel constrained to just being spiritual in nature. Whilst homeopaths claim to be able to prevent malaria with sugar pills and iridologists claim to be able to diagnose disease by looking in your eyes, then their side of this truce will remain broken.

 

In other essays we see John Garrow ask why we do not see more  CAM in court, Edzard Ernst looks at the ethics of CAM, Terry Polevoy on the support insurance companies give to chiropractors and James Randi on the daftness and flummery of quackery.

In perhaps the most moving essay we read Michael Baum looking at the concepts of holism in medicine and  the vapidness of CAMs view of holism. He looks at the examples of young women with breast cancer and how their complete lives play crucial roles in deciding what are the best courses of treatment. Baum does this in a way that no quack could ever come close to and tells us how, "alternative versions of holism are arid and closed belief systems, locked in a time warp, incapable of making progress yet quick to deny progress in the fields of scientific medicine'.

Next we had the long awaited Bad Science by Ben Goldacre. Readers of his column in the Guardian and his blog will be familiar with the themes. However, we can now read Goldacre without the limitations of a word length in a newspaper column. As such, we can explore in full why MMR was a hoax and why Gillian McKeith is an absurdity. Homeopathy is used as an exemplar for the teaching of evidence based medicine and Patrick Holford (again) gets a thorough systematic review of his claims by his 'crazed stalker'.

 

Goldacre has created many enemies in his column - mostly, homeopaths, nutritionists and anti-vax protesters. If any of them were intellectually honest enough to read this book, they may well be in for a shock. Although on the surface the book is telling us why various forms of quackery are nonsense, it has a far more important theme - how pharmaceutical companies can deceive us about real medicine. Indeed, we are regularly told how quacks and Big Pharma use exactly the same tricks to convince us their treatments are real. Finding out what is real is the important step and the book guides us through the process. Goldacre is often portrayed by his detractors as a shill for commercial pharmaceutical companies. This book shows the shallowness of this claim. In the chapter Is Mainstream Medicine Evil? we are talked through the process of how drugs hit the market and how this can go wrong - sometimes through the deliberate corruption of evidence by the drug companies.

 

Throughout, Goldacre carefully explains the importance of evidence, how to interpret it and how this process can go wrong, to the benefit of quacks and drug companies, and the harm of us as individuals. But, for me, what came through was his deep seated and proud nerdiness of enjoying science, and his lament that the media either ignore science or deliberately corrupted it to create sellable stories and controversy.


Perhaps, one of the most important chapters in Goldacre's book was one that was left out. As it was going to press, the Guardian and Goldacre were being sued by arch-quack Matthias Rath for an article that pointed out his role in exploiting people with HIV  in South Africa. For legal reasons, the chapter in Bad Science could not appear. (I understand this will be corrected in the forthcoming paperback version.)

 

There were no such restrictions on Richard Wilson in his book Don't Get Fooled Again: The Sceptic's Guide to Life where he devotes most of a chapter to the evils of Dr Rath. Whereas Goldacre looked at the dangers of nonsense more from a personal and UK point of view, Wilson takes on a more global and political perspective. He tells us how the whole areas of Russian science was hijacked by fake experts during the Soviet era who were more adept at playing political games than honestly seeking truth. Lysenko was the master at this as he held back Russian and Chinese biology and agriculture for decades as ideology became more important than evidence. The consequences of this were the death of millions through starvation.

 

Rath is portrayed as a modern Lysenko as his ideas have enraptured South African politicians. Again hundreds of thousand have died as a result of ideological AIDS denialist nonsense.

 

Wilson offers a partial solution to some of the problem by suggesting that the regulation of politicians is too light and that we should be holding them to account through the law not just the ballot box. The self regulation of politicians fails. Lying to us should be punishable in court. In the UK, this suggestion was put forward to MPs, most of whom thought is somehow naive. Only 37 out of 646 MPs backed a proposed law saying that it would be an offense for a politician to knowingly lie or deceive.

Heavy weight science writer Simon Singh wades in next in a partnership with Britain's only professor of complementary medicine, Edzard Ernst. In Trick or Treatment: Alternative Medicine on Trial, Singh and Ernst take a systematic approach to evaluating the evidence for a wide range of alternative medicines. In doing so, they again show us how evidence works, why it is important and why we can reliably know whether a treatment works or not. The result is a near rejection of almost all forms of alternative medicine. They take pains to point out when the evidence suggests that some things do work, but I am sure that the surprising thing for many people new to this sort of book is just how little alternative medicine comes through unscathed.

 

Acupuncture is widely accepted as a treatment that does work. However, after reviewing its history and evidence one is left with the impression that it is little more than a scam. Homeopathy is easily dismissed. Although the authors go through rather useful review and history of all the meta-analyses on the subject - something homeopaths never do. Chiropractic is exposed as nonsense - and at times, dangerous nonsense that should be avoided at all costs. Common herbal remedies are tabulated and their evidence base rated. (Most are poor or medium.) Finally, the pair review reasons why alternative medicine might be so popular despite its appalling evidence base and point out who the real villains and culprits are in this state of affairs.

Between them, these books paint a consistent picture of a society that is enamoured with nonsense and how this can cause both personal harm and even catastrophic disaster to societies. However, if we are to overturn the tide of nonsense, it will not be sufficient to replace the day time television quacks with new authorities such as Singh, Ernst and Goldacre. The impact of nonsense and quackery on society will only really diminish when more people understand how their beliefs are manipulated and distorted by the tricks and canards of charlatans.

 

Although, we live in a scientific age, and almost all our children are taught science at school, few appear to come out of education with a deep understanding of how science works and how to recognise good arguments based on evidence. My final book is by the Philosopher Julian Baggini and is probably the one I might recommend giving to your family quack if you wanted to attempt to change their mind about things. In The Duck that Won the Lottery (And 99 Other Bad Arguments), Baggini dissects 100 logical fallacies and how they have manifested themselves in the media recently.  

This book would also be a good mental workout for the dedicated sceptic. The joy of this book for me was that each logical fallacy is presented in an accessible style but then pushed to see if it always applies. Is it always wrong to pursue ad hominem attacks? What about arguments from authority? At the end of each chapter Baggini poses a question or two in order to test the limits of the applicability of arguments. Good fun and not academic - and also, I must say, I disagree with some of the arguments. But I guess that is the point. Being a sceptic can never be formulaic. We cannot just simply repeat logical rules to expose truth and falsehood. We must always be alert and always thinking. That is the true nature of science and that is what separates it from the dogmas and ideologies of alternative medicine.

 

 

Happy New Year.

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

I have a spare copy of Suckers and Bad Science. Who should I send them too and why? Who do you think is most deserbing and/or in desperate need of each? Pleave leave answers below...

It looks like Magnopulse have been bad boys an girls by making claims about their products that really do not hold up, according to the OFT. And, it looks like Magnopulse do not agree with this finding. However, they have agreed a compromise with the OFT, and so Magnopulse adverts will change (just after the stock of old ones has run out). I guess the disagreement was over the evidence for the claims being made. After all, their web site is full of articles showing how effective magnetic bandages can be. Is this just down to an interpretation of evidence and an over-zealous regulator? Who is right here?

Now, as I have said many a time - the words 'magnet' and 'healing' do not belong together. Spotting these words near each other earns Canard points on the Quackometer. There is plenty written on this subject and I don't want to go over old ground. What caught my attention was the extent to which Magnopulse tried to publish 'research' on their web site. This obviously looks impressive and is a step up from the usual testimonials found on quack web sites. If this research is good then I will undoubtedly have to adjust the quackometer accordingly.

Let's look at one of the 'published' studies on the Magnopulse web site, Effects of 4Ulcercare on Leg Ulcer Recurrence and The Potential Cost Savings to The NHS.

How could the average person tell if this was good or bad research? At first pass, the results look quite interesting - a huge reduction in leg ulcers for people who have used the bandages.

But the reality is a lot more shaky. And in fact, there are a number of big give aways - and luckily, we don't have to get too technical, understand trial procedures in detail, or have a PhD in statistics.

First, how do we know that it was the bandage that caused the reduction in leg ulcers? There is no control group to see how people would do without magnetic bandages. This is fundamental. All experiments need a control of some sort. This has none. In fact, what is going in here is just a group of researchers ringing up customers and asking them if they feel OK and how their ulcers are ('Not too bad dear, mustn't grumble'). Were the patients receiving other treatments that might have cured them? We don't know. What if they had done nothing and just let them heal? Again, no idea. And so on.

Bizarrely, the study excludes people it rang up whose ulcers had not healed and then claims that "no subjects had ulcers that failed to heal or got worse whilst using the device". It should add of course, "apart from the ones we excluded because their ulcers did not heal." This is a bit like excluding all grey haired people and then claiming that magnetic bandages give your hair a natural rich colour.

The big giveaways are though that this 'paper' looks like a targeted mailshot to the NHS. It is concentrating on how much can be saved by buying these bandages. The paper is not published anywhere and ends with a URL of where you can buy the products. It is marketing.

Other studies have been published on the site and written up for journals. But it looks like their are some commonalities here in that the studies appear to all suffer from major methodological flaws which mean that it is impossible to draw conclusion from them. Even the NHS was compelled to issue a critical analysis in 2005 after several newspapers flaunted the companies products on the back of dodgy studies. (No prizes for guessing which paper...)

The writer of just about all these reports appears to be a Dr Nyjon Eccles BSc MBBS MRCP PhD. Nyjon runs a clinic in London that appears to offer all sorts of naturopathic and 'alternative' views on medicine.

Here is one example of Dr Nyjon Eccles fabulous pieces of pseudo-scientific, cancer-curing quackery:

LYMPH DETOXIFICATION - This is achieved by non-invasive scalar, oxygen-fed light beam therapy. This helps to detoxify the tissues by assisting the body in dissolving lymph blockages and restoring normal lymph flow using the Nobel quantum scalar technology coupled with oxygen for enhanced healing potential.

One has to ask why someone who promotes herbs for cancer patients, detoxification programmes, nutritional therapies and other dubious techniques is being used to look into the effectiveness of magnets in bandages? One possible explanation is that Dr Eccles may have 'alternative' standards of evidence and may not be quite so rigorous in his testing as would be expected, thus leading to good marketing material, even if the bandages are ineffective.

Now notice, I use the word 'may' in the above sentence. Dr Eccles may be a very thorough researcher with just one or two minor slips (we are all human). On the other hand, he may be thoroughly useless. For all I know, he may have two heads, and may be a baby murderer. And yes, I don't know for sure. I may just have unfounded suspicions.

'May' is a great word. And I am sure it the favourite word of Dr Eccles and all those at Magnopulse today. The Office of Fair Trading has allowed them to continue to advertise as long as they use this word in front of claims of effectiveness. For example,

The OFT's action was settled on the basis that Magnopulse Limited and its officers, Derek and Wendy Price, have given undertakings to the court that they will not make advertising claims stating or giving the impression that: magnetic products will produce a therapeutic effect for those who wear or use them (as opposed to saying that they may have such an effect and/or some trials have shown that there may be such an effect and/or some consumers have reported such an effect)

So, I wish I could get the quackometer to spot all these 'mays'. It is another good giveaway that something is not right with health claims. Magnopulse may go on making dubious claims and may continue to trade and may rip people off. I am rather left with the impression that the OFT may be a waste of space.

The Quackometer has been up and running for just about a year and has seen some serious traffic increases over the past six months. Starting off with just a few hits per day, the daily unique visits now stand in the many hundreds, with a peak recently of several thousand. Cripes! What started off as a bit of a bored joke has now grown into a proper web site.

So, a quick, tearful thanks to all the people who keep coming back. Thanks for all the correspondence, both encouraging and threatening. I hope 2007 will throw up richer, funnier and more useful functionality and content. Plus a few more innevitable threats.

So, to the main business. The quackometer scans various news sites twice a day on the look out for quack stories. I thought is would be good to review what has been found, where the stories are coming from and who is writing them. Awards will be made.

But first, an apology and admission. This is going to be very UK-centric - my time has very much concentrated on the UK press at the expense of many sources of potential quackery around the world. Maybe, I can get this working better next year for overseas news sources. I must say though, that the UK does look like its newspapers are particularly prone to printing quack nonsense. More research is needed to see if this true. Also, I must point out that the Quack News Scanner was only working from August - so not a full year yet in review.

And now for he disclaimers. This is not a scientific study! I make no bold claims to have conducted a comprehensive review of all the papers and I have not done extensive validity checking on all the spotted articles. Life is short and it is just for fun. Also, not all papers are represented. The Independent and Express are the big omissions (for technical reasons) and this is a shame since the indie spurred me on with a silly piece about electrosmog earlier in the year. Nor do I include the red-tops (bar the Mirror) partially for technical reasons, but mainly because they are different sort of beast where their readers engage with the paper in different ways than other more self-important titles. (My feeling is that papers like the Sun are not quite so credulous as one might naively suppose - I will be looking into this further). Finally, all the stories listed below, may not be quackery. As always, read and research and make up your own mind.

So, straight into the first award...

Quackiest News Source

The summary of scores for stories since the beginning of August 2006 is...

1) The Daily Mail with 38 stories and a total of 157 Canards
2) The Times with 30 stories and a total of 132 Canards
3) The Guardian with 15 stories and a total of 67 Canards
4) BBC with 8 stories and a total of 29 Canards
5) The Mirror with 6 stories and a total of 21 Canards
6) The Telegraph with 1 stories and a total of 3 Canards

(All papers include their Sunday equivalents)

So, hardly a surprise that the Mail (and Mail on Sunday) lead with 38 stories that scored over 3 Canards. The Times is not far behind. However, analysis of the data reveals a few interesting points. The Times score predominantly comes from its "Health alternatives" column. This is clearly flagging the stories as being 'alternative', or as we like to say here, 'not real'. The Mail on the other hand makes no such gesture to alerting its readers that bollocks may follow.

It is interesting to note, that the Guardian has the highest Canards per story ratio. Maybe this is because the Mail tends to let a bit of quackery slip into lots of stories rather than just concentrate on the big quack scoop. The Mirror's stories can be pretty much put down to one columnist, a Ms Gillian McKeith. No more to say there then - she has aggressive lawyers. And congratulations to the telegraph for only scoring 3 Canards for one story promoting osteopathy - but at least in an area where this technique has a chance of working.

So the winner of Quackiest News Source really has to be - The Daily Mail - Congratulations!!

A well deserved win. Its continuous commitment to publish rubbish health stories coupled with very few warnings to its readers that what is going to follow is complete nonsense mean that it was hard to beat this year. Furthermore, its commitment to give telephone numbers and web addresses of quack suppliers will undoubtedly result in many of its moderately wealthy, middle-class readers handing over their hard-earned dosh to the fraudulent and deluded. Despite the Mail's aversion to tax of all forms, this is undoubtedly the Mail's facilitated tax on the gullible.

Quackiest News Story

At the end of this blog, I have given a list of all stories the quackometer found that scored over 5 Canards.

A couple of smashing stories really stand out. Dr Danny Penman's remarkable story about the healing properties of prayer was quite special. Also, the Times mindless plug for that rather silly technique Bi-Aura stood out from the crowd. But, by a country mile, the most ridiculous and credulous story of the last four months has to go to Sarah Stacey for that outstanding piece of work Good vibrations in the Daily Mail. The Quackometer spotted it, gave it 10 Canards, and it is difficult to niggle with that analysis.

The story plugs several different 'therapies' - all for a made-up illness and, at least in the case of the QLink pendant, it is difficult to conclude anything other than it is fraudulent. The QLink is a classic piece of pseudoscience, invoking quantum theory to explain its non-existent properties. There is a cast of thousands in the story, all offering testimonials for the QLink trinket, including Dr Wendy Denning (who still cannot spell complementary), Professor Jobst and Dr Mark Atkinson. Oh, how I love titles.

The winner of Quackiest News Story is - Sarah Stacy with 'Good vibrations'.

I think Sarah would also deserve...

Quack Journalist of the Year

for her unwavering commitment to writing and promoting all manner of quackery in the Health Notes section of the You supplement of the the Mail on Sunday. She has written a string on quacktastic stories, always with a good plug for the source, most often, Victoria Health. (If you join the VH Club, you can get a free Sarah Stacey book!)

So, the Mail has done remarkably well this year. Any surprise? Not really. As was recently well put on the badscience blog, nutritionism (or nutriquackery) is a particularly right-wing pastime with an obsession for personal responsibility for your health rather than looking to the wider society for causes and solutions. Thus, it is only your own fault if you are fat and poor, unhealthy or have badly behaved and underachieving kids. Pop a supplement pill to improve kids GSCE results rather than support and send your kids to the local school. The Mail's whole point of view is based around a distrust of any authority that could challenge its small minded world view. Science and scepticism are direct challenges to the myths and delusions of its approaches to the problems of health, government, immigration and economics. No wonder quackery thrives.

Oooh. The little black duck got on his soap box for a moment. Back to a few more quick awards...

Most Blatant Piece of Dodgy Science Acting as a Marketing Press Release...

Dr David Thomas and the Mineral Depleted Food Scandal.

Jumping the Gun Award...

Gerry Potter, Professor of Medicinal Chemistry [de Montfort], and Dan Burke, Emeritus Professor of Pharmaceutical Metabolism for their work on salvestrols^TM.

Dodgiest Hawaiian Shirt...

Paul Pearsall for his work on Cellular Memory

Most Shameless High Street Quackery Supplier

Boots the Alchemist for their faithful pushing of homeopathic products to the public. Given that they publicly state, 'integrity in the community, environment, marketplace and workplace govern all our activities', pushing sugar pills as medicine is just not acceptable.

Most Distinguished and Ethical Quack...

has to be the Distinguished Provost of the Royal College of Alternative Medicine, Professor Joseph Chikelue Obi - although those are his words, not mine.


Finally, another plug for Sense About Science - a charity that I will urge you to make a small donation to. Their goal is to provide a source of contacts and information that the media can use to validate and research the science behind the headlines. I hope their work puts the quackometer out of business. It's not a homeless charity, or one for poorly puppies, but I think this is a cause well worth popping a few quid via paypal to.

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

those quack stories in full...

10 Good vibrations Daily Mail
8 Ear acupuncture is the latest celebrity fad but does it work? Daily Mail
8 The English patient The Times
7 Can you feel the force? The Times
7 Health panel: How can I cope with crippling migraines Guardian
7 Osteoporosis; human papilloma virus; boosting your immune system The Times
7 The facts about prebiotics Daily Mail
6 Anxiety; back pain; green tea The Times
6 Back-pain acupuncture 'effective' BBC
6 Carol Barnes: How alternative remedies helped me beat the menopause Daily Mail
6 Erectile dysfunction and low libido; ginseng; irritable bowel syndrome The Times
6 How toxic is your body Daily Mail
6 It works for me: McTimoney chiropractic The Times
6 Natural household cleaning products; eczema; using homeopathic arnica during childbirth The Times
6 Organic milk better for a healthy diet Daily Mail
5 A feeling for healing The Times
5 Cereal offenders Daily Mail
5 Could spiritual healing actually work Daily Mail
5 'Downward dog, Dad?' Guardian
5 Fairley and the chocolate factory The Times
5 Health shops give bad advice on depression Guardian
5 Health stores offer a cocktail of unproven depression drugs Daily Mail
5 Lesley sings the praises of osteopathy Daily Mail
5 Max H Pittler: Boosting your immunity Guardian
5 Max H Pittler: Exercise fatigue Guardian
5 Max Pittler: Natural remedy for gastro-oesophageal reflux disease The Times
5 Over-sixties advised to boost daily diet with 'good' bacteria The Times
5 Sitting straight bad for backs BBC
5 Speedy recovery Guardian
5 Warm milk and garlic It might sound vile - but itll beat the bugs Daily Mail