The Quackometer

I do find the Bible disappointing in one or two areas. For a work supposedly divinely inspired, it is remarkably lacking in handy life enhancing tips like how to cure nasty diseases and relieve common aches and pains. There really is little in the way of pharmacology and medicine in the Bible. Not even basic lifestyle, exercise and nutrition tips. "Do not smoke" should have made it into the commandments, you would have thought.

In the earlier parts of the big book, we are told at great length about how menstruating women, homosexuals and shellfish are unclean, but it is very short on details about why this should be so, and how we can generalise from these nuggets of wisdom to better understand the world. In the later parts of the book we find illness being described as caused by demons, and that possession can be cured by wandering prophets who can also just simply command people to get better. Very few of us are blessed with such talents, and so these stories do not help a great deal. Wouldn't it be great if there were just a few little health pointers: say to using willow bark to ease toothache, or even better, how certain moulds can kill infections. Imagine the Roman Army with penicillin. They might have taken over the world!

And so, it would be fair to say that nothing of modern medicine owes its origins to the Bible. What is even more remarkable is we see little quackery derived from these ancient religious texts. The Society of Homeopaths do not go around casting demons into swine. (Maybe the Alliance of Registered Homeopaths do, but I have not studied them so much.) We do not see Patrick Holford calling the children to him and turning a few fish into a multitude of miraculous brain pills. Or maybe we do.


But I would contend there is one story that features some quackery quite prominently - the nativity and the three wise men. They bring gifts of gold, frankincense and myrrh. We are told that these gifts have symbolic meaning - kingship, priestliness and death. An odd gift set for a child born in an animal stable. As wags have put it, sugar, soap and candles might have been more useful from genuinely wise men. But for me, these were gifts representing the three strands of quackery: the idiotic and dangerous, the potty and harmless, and the avaricious and cruel.


As a kid, I always found frankincense and myrrh a little tricky to understand. What the hell are these gifts? Now gold, I did understand. It was a good gift then and it is a good gift now. If you are still undecided about what to send le canard noir this Christmas, then gold will do. Weight is more important than artistic merit.


And what has gold got to do with medicine? Well, if you can rely on one set of quacks to turn any old substance into a miraculous cure you can count on the homeopaths. Yes, aurum metallicum is a homeopathic preparation made from diluted gold. You can buy it from all reputable homeopathic pharmacies, but remember, you will not be getting any real gold. All the atoms have gone away. Aurum is good for:

• Depression and suicidal thoughts


• Congestion of blood in various organs associated with heart and vascular problems


• Over sensitive to smells, touch, taste and music


• Mental exhaustion


• Digestive problems

So, with no actual gold in the remedy and it being used for serious depressives with digestive problems, its probably not the best gift for the baby Jesus. Nelson's non-individualised homeopathic Teetha might have been better. Homeopathy is idiotic and dangerous. There are homeopaths out there now, loose in the world, who think that non-existent gold in water can prevent someone commiting suicide. And that sugar-free powder can ease baby's teething pains.


Frankinsense is not used quite so idiotically. It is a common ingredient for the aromatherapist. You can go into Neil's Yard and buy some Organic Frankincense Toning Body Cream. Great Xmas gift. Especially for post-natal mums. It's potty and probably harmless. The beauty industry is full of daft claims for their ingredients - but no-one is claiming that their frankincense and lavender massage rub oil will cure AIDS or protect you from malaria. Its tolerable quackery. And it smells nice.

And so to myrrh - a resinous and bitter plant extract used for centuries in all sorts of healing rituals. The Chinese have used it for massaging your spleen meridian. In India, its usages have been for circulation and arthritis. It has been used as an antiseptic, as a rejuvenator and to induce labour (the wise men were late on this one). There is talk of using myrrh for study as a archeopharmaceutical - drug research based on ancient texts, but I am sceptical of this. The wide range of uses and wildly different ascribed properties may mean that its usage has been more cultural in its significance rather than strictly medical.

With such a deep cultural significance, and widespread historical medical uses, myrrh would appear the perfect substance to use as a modern quack product. Egyptian pharmaceutical company Pharco has leaped on the potential and produced a myrrh derived pharmaceutical called Mirazid. It is marketed as a antihelminthic drug , "derived purely from a natural botanical source", and has been registered by the Egyptian ministry of health as a treatment for schistosomiasis (bilharzia).

An early trial by the 'discoverers' showed a miraculous cure rate of 91.7%. However, this trial looks like it needed careful attention: this trial had no control group and the participants described it as "a marvelous clinical cure without any side-effects". Sound familiar? The results had not been replicated by an independent team and the result was controversy, not least because there is already an effective treatment for this nasty condition on the market. Praziquantel has been tested thoroughly for safety and efficacy and does well, but it is not without its drawbacks. It does not prevent re-infection in areas where the disease causing snails are endemic.

Concerns that Mirazid was being used by private doctor's throughout Egypt when its efficacy had not been properly established led to a new study that directly compared Mirazid with Praziquantel. They concluded, " The cure rate with myrrh was very low, 15.6% after the first treatment, and 8.9% after the second treatment" and with "Praziquantel [the] cure rate was 73.7% and 76.3%"

The discrepancies between the first and second study are hard to explain, although the authors of the second report are highly critical of the methodology of the first. They conclude that "Mirazid is not in fact antischistosomal".

Nasty Big Pharma. Only science and legislation can stop them now.

 

There is nothing new under the quackery sun...

Labels: fun

 

Homeopaths claim that their pills can induce predictable and distinct sets of symptoms in healthy people. That is how they prove their powerful medicine. This is basic stuff for homeopaths and my simple test asks them to prove it because I do not believe it for a minute. If this claim is not true then everything else they say falls apart. So, far no-one has the courage to come forward.

But I want to extend my offer. I have given homeopaths almost complete freedom in how they do this test. The only real basics I ask for is that the test is verifiably blinded and they do the test publicly, that is, say what they are doing in advance. I do not need to be involved.

Homeopaths are claiming that us sceptics are behind the times and there is now research from material scientists that show that homeopathic preparations are different from normal diluted solutions. I do no believe this too. I think the experiments so far can be explained by bad experimental design: either contamination or instrumentation problems. No chemist can reliably show how homeopathic water is different from ordinary water.

So, the extended challenge: exactly the same as before; any six remedies; some third party swaps the labels around; tell us which remedy is which when the labels are not on the bottle. You can use any experimental equipment you like, any conditions you like - you just have to be blinded. Simple.

As this is analytical chemistry, I think I would one further condition over the original challenge. The remedies must be 12C, or more potent. The claims of homeopaths are that post-Avogadro dilutions are recognisable.

Let's see it.

Any homeopathic friendly chemists want to do this? Your chance to punch this smart alec sceptic on the nose.

Labels: $100 challenge, homeopathy

 

There can be few comment-enabled web pages left in the world that do not testify to the fact that Dana Ullman has published his latest book: The Homeopathic Revolution: Famous People and Cultural Heroes Who Chose Homeopathy. His claim for the book is that,

It is a project that may actually change the face (and the heart) of medicine and may make homeopathy a household word.

Dramatic stuff.

I have written about the book before, a few months before publication. This was because Ullman was making claims that I found incredible. Wherever you find a promotion for the book, you will find the claim that Charles Darwin was saved by homeopathy and this allowed him to publish the Origin. Ullman goes further and says that Darwin was an advocate of homeopathy. This was going to be easily verifiable, as all of Darwin's letters and writings are available online at the Cambridge Darwin Correspondence Project.

So, I did check, and I wrote about my findings at some length. And what I found was that Darwin did nothing but ridicule homeopathy and made it very clear that he thought it was nonsense. Darwin did, at times, take homeopathic remedies. But only when convalescing at a spa near Malvern where the resident doctor made all his patients take the pills. But Darwin did this 'without an atom of faith'. It was quite clear that it would be difficult to reconcile Ullman's statements with Darwin's own stated beliefs, and it looked like we were seeing nothing but the usual homeopathic propganda.

As you might expect, Dana Ullman took exception to my analysis and claimed I had missed many references, that I was superficial and undertook inadequate scholarship, that I was partial in my quotations, and my analysis contained misinformation. He emailed me to say "my research on Darwin [has] surpassed yours by a significant degree" and,

I sincerely hope that you are a good enough man (or duck) to admit that you MAY have been a bit too rash in your previous comments. People will TRUST you more if you admit that you were wrong about something. I realize that this tends to be rare amongst quackbusters, but perhaps you are different.

Now, to be fair, I was not reading from Ullman's book - it had not been published yet - only wondering how he came to such conclusions for his promotional material. So, out of courtesy, I got hold of a copy, read it, and now am in a position to give a fuller review and see if Ullman's own evidence stands up to scrutiny.

Charles Darwin

So, let's start off with Dana Ullman's coverage of Charles Darwin.

The first mention of Darwin is in the Introduction. Ullman obviously thinks Darwin is central to his thesis. He starts off by saying that Darwin had great admiration for his homeopathic doctor and his treatments, "though these facts are scandalously missing from the history of medicine and science". Later, in the chapter on Physicians and Scientists, Ullman devotes ten pages to Darwin and homeopathy. Now, given Ullman's denunciations of my analysis of Darwin, I was expecting a lot of significant material that I had missed. But, it is just not there. However, there is a lot of insignificant material, a lot of jumping to conclusions and unsubstantiated speculations. This appears to be the greater scholarship that Ullman alludes to.

So, Ullman readily admits that Darwin was openly scathing about homeopathy and that he never attributed any of his health improvements to homeopathy. The evidence for this is overwhelming. Nonetheless, Ullman claims that Darwin's healthier moments during his long illness could be attributed to homeopathy. Ullman provides no evidence for this assertion. Darwin did suffer a long standing illness. The illness was sometimes totally debilitating, and regularly he experienced periods of remission. One time he got better was when Darwin was recuperating at Dr Gully's hydrotherapy spa. Now because Dr Gully gave Darwin homeopathy remedies, Ullman then contends that the homeopathy caused Darwin's health improvements.

This is nothing other than the same systematic logical mistake that all homeopaths make - post hoc ergo propter hoc - "after this, therefore because of this". Just because one event follows another does not mean that one event caused another. The entire foundation of homeopathy is built on this logical fallacy, and Ullman makes no allowance for it. The nature of Darwin's illness is unknown; many have speculated as to what it was, from an illness picked up in South America to purely psychosomatic illness. Therefore, to make any assessment of how Darwin's illness should have progressed is to overstretch our knowledge of that illness. The fact that Darwin felt better after spending time at a relaxing spa should not surprise us. Ullman, however, finds it difficult to conceive of any explanation beyond a homeopathic cure.

One part of Ullman's analysis I thought was particularly misleading. He says,

After just a month of treatment, Charles had to admit that Gully's treatments were not quackery after all.

I emailed Dana to ask for a reference for this and to state how he came to this conclusion. He did have a reference, but it was quite clear that Darwin was talking specifically about the hydrotherapy treatments and made absolutely no mention of homeopathy. Darwin's opinions of the sugar pills appears to have been steadfast.

Ullman goes on to explore an area I did not; that is Darwin's research on the response of the insectivorous plant Drosera (sundew) to dilute ammonia salt solutions. Darwin was shocked at the response of the plant's tentacles to ever increasingly dilute solutions. Ullman pounces on this as proof of Darwin wanting to research homeopathic solutions. There are three things wrong with this: one, Darwin never says anything about his research being homeopathic in nature; two, homeopaths tell us that dilute solutions are not homeopathic - succussion is necessary (apparently); and thirdly, the solutions are still light by homeopathic standards - homeopaths dilute beyond the point that the original chemical will be present. Ullman makes a similar error on his own websites and elsewhere in his book when he calls homeopathy the science of nanopharmacology. Now diluting to the nano level (a billionth) is still well within the realms of standard analytical physical chemistry. Measuring dosages at the nano-mole level is now standard laboratory practice. Homeopathic dilutions make nano doses look positively gargantuan. I have no idea why Ullman wants to insists on such terminology when it is so obviously misleading.

Darwin was shocked at the results of his dilution experiments, not because he thought that it confirmed homeopathy, but because he did not expect such dilute substances to have such a dramatic effect. This was new science and he was instinctively cautious. Darwin wanted to replicate his own work and confirm his findings. He doubted his own experience, experiments and capabilities and made doubly sure he was not deceiving himself. This is something that homeopaths could learn from.

And on to Ullman's worst crime in this chapter. Ullman insists that Darwin was a supporter of homeopathy despite all the evidence to the contrary and he does this by asserting that he was afraid of what this peers would think if he said such a thing. Ullman does not present any evidence to back this up. I find this a terrible besmirchment of Darwin's character. One thing that you cannot say about Darwin was that he was unduley cowered in the fear of what the establishment might think of him. He did not launch his theory of evolution into a compliant and accepting orthodoxy. Darwin had to win over his scientific peers, the establishments of church and state, and society as a whole, through sheer strength of argument alone. Darwin was well aware of the implications of his work and how that might threaten the established view of a natural world created by a benevolent god. It took courage and much deliberation to take on this worldview and it is inconceivable that Darwin would quibble over a trifle such as homeopathy even if he did believe in it. No, Darwin knew homeopathy was nonsense. All the evidence points to that. Any other conclusion is just perverse.

Adolf Hitler

For me, in his treatments of Darwin, Ullman looses all credibility in his analysis. It would be enough to stop here in this review, but his analyses of Adolf Hitler is in some ways even more perverse.

Now, Ullman's book is about famous people and cultural heroes. Obviously, Ullman does not see Hitler as a cultural hero and he makes this clear. But in doing so, he then feels it necessary to show that Hitler was not an advocate for homeopathy and never benefited from it. But again, this is in the face of contradictory evidence that Ullman himself presents.

In the chapter Politicians and Peacemakers, Ullman describes how Hitler took nux vomica and belladonna, two staples of every homeopath's pharmacy, every day for nine years up to his suicide. Unlike Darwin, Hitler was convinced that these pills were saving his life. Now, to get around the rather nasty conclusion that this supremely evil man was a supporter of homeopathy, Ullman tells us that it was unlikely that Hitler's pills had undergone the proper dilution and succussion process, and were therefore not properly homeopathic. This contrasts rather starkly with Ullman's insistence that Darwin's simple dilutions were part of some homeopathic experimentation.

But the rather nasty conclusion is, and at risk of invoking Godwin's Law, that the Nazi state was rather enraptured with homeopathy. It would be surprising if it was not. German nationalism latched onto all sorts of mystical and distinctly Germanic notions during these terrible decades. The fact that homeopathy was of German origin no doubt had some bearing on its adoption by the various Nazi doctors in attendance to Hitler. Ullman insists that the pattern of prescribing remedies to Hitler did not match standard homeopathic practice, but one must also take into account that Hitler's doctors would also have done anything the Führer desired. These were not standard prescribing times.

It is difficult to come away with any other impression that Ullman is twisting his own presented evidence to reach whatever conclusion he chooses. If there is any credibility left, it is dashed when you note that one of the sources that Ullman references for his information on Adolf Hitler is the discredited historian David Irving.

'No Smoke Without Fire'

After looking at these examples, it is difficult to take any of the biographical details and conclusions seriously. But in a very important regard, this is utterly immaterial because it does not matter one jot what Darwin or Hitler thought about their experiences with homeopathy. Their opinions do not prove or disprove whether homeopathy is nothing but nonsense.

In order to judge Ullman's book, we ought to see if Ullman succeeds in the task he sets himself. The subtiltle of the book is Why Famous People and Cultural Heroes Choose Homeopathy? Does Ullman answer this question? In short, no.

Ullman assumes the answer from the start, and it is the answer of the commited homeopath - that homeopathy is a powerful healing force. And so in doing so, he fails to address the obvious problems with taking a string of historially based anecdotes. In looking at peoples accounts of homeopathy, you have to take into account the various ways in which people might acquire mistaken beliefs. Ullman does not do this and so we have no way of weighing the importance of this mass of ancdotes.

Even homeopaths do not deny that people are subject to a placebo response when taking medicines. This can be personally interpreted as a positive healing response to an otherwise inert pill. Also, many illnesses, being cyclical in nature, allow natural disease remissions to be attributed to the cure. This is almost undoubteldy what was going on in Darwin's case. When he was at his worst, he went to see Dr Gully. Any subsequent improvement would be attributed to whatever Dr Gully was doing - Darwin thought it was the hydrotherapy; Ullman the homeopathy. There are other ways of being fooled, of course. There is no need to go into them here. The point is that Ullman should have considered them in detail in his book if he wants us to take his mass of anecdotes as serious evidence. The fame and celebrity of Ullman's cultural heroes make no difference to the importance of these subjects' beliefs. If one person can hold a mistaken belief about a healing experience then so can thousands of others. Mere numbers make no difference. It does not enhance the quality of the evidence in anyway. A common delusion can produce millions of the deluded.

This point is noted by the writer of Ullman's foreward, Dr Peter Fisher, Clinical Director of the Royal London Homeopathic Hospital, when he says,

Of course, the fact that the extraordinary range of talented, intelligent, and independent-minded people depicted in this book benefited from homeopathy does not represent a scientific argument.

I would agree fully, but maybe just caveat that these people believed they benefited. But rather bizarrely, Fisher then immediately says,

"but, it is a strong 'no smoke without fire' argument".

This sounds so out of place for a man who considers himself to be a man of science. It is the talk of gossiping schoolgirls in an unsupervised playground. Of course there can be smoke without fire. It is entirely possible for large numbers of people to hold entirely mistaken beliefs, even intelligent celebrities and politicians. And so, this book has the significance of the nauseating and suffocating mobile wedding disco smoke machine, designed to hide the balding uncoolness of the past-it DJ. The book is a 400 page fig-leaf and Ullman is using his celebrity gossip and bizarre interpretations to obscure the embarrassing lack of convincing evidence that would show us homeopathy is nothing but a discredited philosophy, practiced by scientifically illiterate narcissists, using inert sugar pills.

As such, this book is not going to 'change the face and heart of medicine'. It is of interest only to those who want their prejudices confirmed and their delusions massaged. To really understand why so many people can so easily be sucked into the irrationality of alternative medicine is going to take another book. There may be a few of those along soon.

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

See also Orac's review of excerpts from the Homeopathic Revolution.

Labels: celebrity quackery, dana ullman, homeopathy

 

Well, I have had two conversations with homeopaths now about taking the challenge. Recap: its a simple challenge to see if a homeopath can determine which remedy is which out of a sample of six when they do not already know which remedy is which. If the claims of homeopaths are correct, it ought to be easy.

First up: Sarah K, who left comments on my blog to say she was up the challenge. Fantastic news. Unfortunately, quite quickly she appeared to get rather defensive and say she would not be rushed into things. And ultimately decided that she did not want to do it. A huge shame.

Some of her excuses were that remedies could take a long time to take effect and might interfere with each other. Fine. But she has the choice to decide which remedies to use. For example, I suggested Nelsons Insomnia remedy. Customers of Nelsons might expect their insomnia to be reduced in a few hours, not over several weeks, and they would expect no lingering side-effects too, which homeopaths claim do not happen. Oh well. So close.

Another homeopath appeared to contradict Sarah K in the most striking terms. Soroush Ebrahimi was up for the challenge, but unfortunately not mine - he had his own ideas. He wanted to give me a remedy and be able to seal an envelope with a prediction of what the remedy would do to me - a 'reproving'. I think it best to allow the IM chat to speak for itself...

(for explanation, Soroush has already challenged Ben Goldacre to a similar test. This is IM, so spelling and sentence order may be erratic)


SE: Hi - did you want me for something? Welcome to my group of friends

LCN: Just wanted to know if you were prepared to take the quackometer $100 challenge. If you claim you could guess ben g's symptoms from taking a single remedy, then this test ought to be a walk in the park and great public proof of homeopathic claims.

SE: Hi - I did explain that the quackmaster test involves to elements:

SE: 1- Is the homoeopath any good?

SE: 2- Does a potentised substance work?

LCN: yes i am happy with that - do you think you are good homeopath?

SE: So if the result is a fail you do not know whetehr the homoeopath was poor in his selection or whether potentised substance have no effect

LCN: sure. but if you succeed then you win!

SE: So my 'reproving' exercise is better, because it elliminates the uncertainty about the ability of the homoeopath

LCN: no it does not. it relies on both the homeopath to interpret the symptoms correctly and the subject to report them correctly - both subjective and so unlikely to yield a good result for anyone. Eitgher side could cry foul. With my test, no one can cry foul.

SE: Neither with my test - when they are in agony and asking for help, then we will know for sure!

LCN: well frankly - if you are prepared to inflict agony on someone then you are not fit to conduct such tests. and ben was quite right to refuse.

SE: Oh - so dilute potentised substance do have an effect?? Make up your mind

LCN: so, you want to induce agony in someone and then claim that homeopathy is right? I think you do not understand anything about obtaining objective evidence

LCN: you are telling me they do. i think ben was quite right to worry tha tyou might poison him. i would be. my test involves no such risks.

SE: Ben was QUITE wrong - because if you read my post, you would have realised that he would have had the substance tested for himself and my half of the remedy would have been in a safe-box only to be opened with both of us present

SE: You guys have to put your body where your mouth is

SE: Either a potentised highly dilute material has powers or it does not

LCN: i am happy to take homeopathic remedes - but not from someone who promises to have me in agony! it shows a lack of ethics in the trial that you would be prepared to do so.

LCN: i have no doubt that the homeopathy would do nothing. I just would not be prepared to take a pill forom you.

SE: So tell me do potentised highly dilute substance have any power?

SE: if not - you are just taking a sugar pill as you lot claim

LCN: i believe they do not. but can i trust you to give me a potentised highly dilute substance ?

I hope you understand my reluctance to take part. The conversation went on for a while more. Mostly, me repeating a question to ask Soroush to take my test or work out a better protocol for his own.


For the record, I would take such a test, but Soroush needs to think up a protocol to take into account the following:

• S should not be allowed near any pill I would take.
• We need end measures that are not subjective - if the test fails I do not want homeopaths accusing me I was misreporting symptoms.
• We need a quantifiable result. At present, a success for S would not give us any idea of the significance of the result. Could it have been chance? We have no way of quantifying that.
• If it is going to cost more than my proposed test, I want to know why it is a better test and worth the money.

Without these things, Soroush's test is just a circus stunt. And, if I may say so, a very disconcerting circus stunts. Like a scary clown juggling sheep's hearts.

It is remarkable than no one else has come forward. This is a basic test of homeopathy. Something that ought to be easy and yet nothing quite like it appears never to have been done. It would show basic evidence that homeopathy is not a delusion. And yet, homeopaths feel no shame in taking on the responsibility for sick people. A responsibility that cannot be grounded in reason or evidence and instead relies on fragile anecdotes. Homeopaths' preference to counter criticism is to sue people rather than provide argument and evidence.

I am offering the chance for some homeopath to give me a metaphorical bloody nose, humiliate me, and prove me wrong - all for the cost of some postage and and few remedies.

So far, none of them have the courage of their convictions.

Labels: $100 challenge, Ben Goldacre

 

Today, the Advertising Standards Authority have upheld complaints against Equazen and their eye q™ products, finding them to have made untruthful and unsubstantiated advertising claims. This is about time. Their antics in promoting fish oil pills to school children have been well documented.

Equazen (now owned by Swiss pharmaceutical company Galenica) have been using local authorities to promote the idea that taking a daily fish oil supplement can boost children's' school performance. They call it the 'Clever Capsule' for your child. However, their evidence that could substantiate this has been hard to come by. Claims that the pills have been independently and scientifically tested in schools looked very weak with the only trials on record appearing to lack basic scientific controls, size or applicability. Nonetheless, the charge to sell loads of these pills to concerned parents has taken place in earnest.

Vitamin pill entrepreneur Patrick Holford has been pushing the pills on TV and through his Food for the Brain charity. Boots the Chemists have had displays extolling the virtues of the pills and their PR agencies have ensured that the credulous media, such as the Daily Mail, copy out the press releases as if it they were news.


All in all the message has been: you are an irresponsible parent if you are not shoving fish pills down your kids necks.


The ASA investigated whether the claim "A Hi-EPA fish oil formula that may help maintain concentration levels and healthy brain development" could be substantiated. Also they looked at the independence of the tests, the rigour of the test and whether the concentration and learning of all children would improve following supplementation. Equazen produced a huge amount of evidence to support their adverts but the ASA found that their claims could not be substantiated and they were misleading. The ASA instructed Equazen as follows:

We told Equazen to remove the claims "... may help maintain concentration levels and healthy brain development", "the Clever Capsule"Scientifically tested in schools", "proven in schools" and "proven by Science" from future advertising for eye q. We also told them to avoid implying in future that the advertised product could benefit the general population or that a trials results related to a product with exactly the same composition and dosage as the advertised product if that was not the case.

Now, I for one am mightily impressed by the ASA. This was quite a complex issue involving a lot of evidence and weighing of scientific viewpoints. This is something that many bodies wish to shy away from. We have seen the Guardian readers' editor this week talking about the difficulty of arbitrating readers disputes over scientific evidence. Some of the evidence was easy to dismiss, such as Equazen trying to pass off their adherence to the Food Labelling and Food Supplements Regulations as some sort of endorsement of the efficacy of their product. Other evidence required careful dissection of trial methodology to determine the applicability to their claims.


There is a problem in the UK of finding the right authorities to help in tackling the claims of quacks. If someone is making dangerous or misleading claims about a quack product then it is quite difficult to know who can help. Trading standards were set up to deal with dodgy plumbers and are run from local councils. The ASA is an industry run organisation with limited sanctions. The ASA deals with adverts only, but not web adverts. Trading standards are based in regional offices and may or may not have the experience to deal with more complex scientific issues. It is a bit of a mess.


The harm that the ASA ruling will have on Equazen is not a monetary one in the form of a fine. It is not the threat of legal action - it is rather a smack on the wrist from their peers. What they undoubtedly really fear is bad publicity and that is what an ASA ruling often leads to.


Far from perfect, and limited in scope and powers, the ASA appears to be remarkably willing to take on difficult issues and act on complex issues. I just wish that this approach could be applied more uniformly to challenge the problems society faces from quackery.

Labels: ASA, equazen, Patrick Holford

 

In his Guardian article, Ben Goldacre wrote about how homeopaths respond to criticism:

Labels: Ben Goldacre, homeopathy, Society of Homeopaths

 

Jerry Addler has published his New Year's resolution in Newsweek,

Labels: journalists

 

One thing always puzzled me about Tony Blair (well in fact, many things) was when he rather suddenly came out in defence of homeopathy. Out of the blue, he told the detractors of this weird superstition to back off:

Labels: ARH, homeopathy, Society of Homeopaths

 

Homeopaths are feeling under threat at the moment and are scrambling around wondering what to do about it. I think there are a number of things they could do: most importantly, they should better manage their own business by showing that they respect the boundaries of what they can reasonably assume is good practice, e.g. stop the dangerous nonsense of believing that can do anything about dangerous conditions such as malaria and AIDS; they can be much more complementary and less alternative.

But there is something else that they can do too: start showing a desire to develop a base of data that can be relied upon, and respected, to support their methods. The focus to-date has been on clinical trials. Doubters say that trials show no evidence of efficacy. Supporters point to many positive trials. But it has been well documented that the many positive trials are most often poorly designed and reported, and are at best ambiguous in their results. There is not a compelling evidence base for homeopathy. If there was, there would be no argument.

So, let's take a step back. What sort of evidence would be required to convince me that there might be something in it? Fundamentally, my problem with homeopathy is its total implausibility - it contradicts what we know about the behaviour of matter. How can a plain sugar pill have any significant therapeutic effect on health? So, why not test the basic plausibility of homeopathy - can homeopathy pills do more than sugar pills in predictable way? There are a number of discussions about this going on in bloggerland and I would like to pick up on these and set a challenge...

Here is a rough outline of the sort of test I would like to see done...

1. A trained homeopath selects six homeopathic remedies of any type and strength.


2. The remedies are posted to an independent third party who removes the labels and replaces them with a code letter, A, B, C...F, and posts them back.


3. The homeopath takes each remedy in turn and notes the 'totality of symptoms'.


4. The homeopath writes down which remedy corresponds to which code letter.


5. The third party 'breaks the code' and we note how many are right.

1. Tell the world in advance that you are going to do this. Post your intention on a blog or web site, tell the world what you are going to do, be open to suggestions about how to simplify and make it a fair test. The more detail you publish, the more trust you will have. Remember, sceptics have a problem with trust of homeopaths.


2. State in advance what you think would be a successful result and any caveats you may have. Think of ways in which the trial may go wrong in advance, and make efforts to minimise those risks. None of us want excuses afterwards if it does not go well.


3. Find a genuine independent third party - someone with no stake in the outcome. Publish who they are and ensure they are happy to field questions from people after the trial. (People will want to know that protocol was followed).


4. Publish your results on the web before the code is broken to reveal how well you have done.

Labels: $100 challenge, homeopathy

 

Dr. Manish Bhatia of Hpathy.com has issued a new email newsletter entitled The Fight Back for Homeopathy. Apparently, there are a lot of anti-homeopathy bloggers and newspaper articles around at the moment. Get away? The impact of this, says Dr B, is devastating with homeopathy bleeding to death. Dr B is marshaling the troops for a come-back.

Labels: homeopathy

 

This, morning David Colquhoun was on the Radio 4 Today programme (listen again, 20 minutes in) making the charge that today's Society of Homeopaths Symposium on AIDS was deeply irresponsible.

Labels: homeopathy, Society of Homeopaths