The Quackometer

Just a day after I write about Dr James Colthurst and the Fenzian device (see Turning A Pint of Tea Leaves into Pure Gold), The Telegraph publishes a business story about how Dr Colthurst plans to raise a pot of gold in pre-IPO cash to help develop the company.

Dr Colthurst's company, Eumedic, has developed a new treatment called Fenzian that uses painless electrical impulses to encourage the body to heal itself.

Following a successful pilot study on the use of this treatment to alleviate the symptoms of asthma sufferers, Dr Colthurst is seeking around £20m in pre-IPO funding before a possible flotation 18 months to two years down the line.

Now that is a lot of money. My previous analysis suggested that there was scant evidence to suggest that the Fenzian device did anything at all and that it appeared to be very similar to a whole range of suspect devices that have been characterised as pure quackery.

So, should Quackometer Venture Capital be investing in this product? Let's go into the Dragon's Den.

As a potential Dragon Investor, I want to ask some pretty simple questions. I want to know if there is a market for this device that is large enough to accommodate the investment. I want to ensure that the device can be made with sufficient margins to make me a profit. I want to know how this device is innovative and compete against alternatives. I want to know what the risks are associated with my investment. In short, I want to establish how I can get my money back with a sufficient return to justify the risk I am taking.

So what is innovative about this device that claims to cure asthma and a whole host of other things? As I noted on my last post, it looks rather similar to the SCENAR - a dubious device that claims similar things - invented by Secret Russian Cosmonauts and encourages the body to 'heal itself'. Dr Colthurst has previously dabbled with this device.

DeviceWatch notes.

In a recent review of Internet websites touting these devices, the Attorney General's Office was able to find the following numerous examples that are indistinguishable in their ineffectuality from the EPFX: NES, E-Lybra, LSA Biofeedback, QXCI/SCIO, Life System, CoRe, Oberon, Mars, Quantec, Metascan, Etascan, SCENAR, ACUSEN, Interx: VEGA, Prognos, Biomeridian, Rife, Bicom, BioPuslar, Mitosan Therapy, Bodyscan, Zappers, F-Scan, Q2, Syncrometer, Magnagraph, Merid, NES, Acusense, Listen, EQ4, Orion, Explorer, Computron, Elision, Interro, Interactive Query System, MORA, Matrix Physique System, Propylene, Punts III and Vitel.

The Fenzian claims to be different by using 'short wavelength AC' rather than direct current'. Is this the key breakthrough? Now, if the Fenzian works, that would be a real innovation in this market. A government public insurance body in New Zealand looked into the Fenzian and concluded,

There is currently a lack of evidence with which to assess the effectiveness of Fenzian treatment. ACC should await the findings of the ongoing trials, particularly those involving sports injuries, and carefully assess the methodologies used.

The review looked at the same paper we examined in my last Fenzian post (Colthurst J, Giddings P (2007). ) and came to similar conclusions,

The findings of the case note review are described as "highly encouraging", but they do not in themselves constitute strong evidence for the effectiveness of Fenzian treatment; the treatment outcomes were not clearly defined, there was insufficient information about the patients and their complaints to make judgements about generalisability, and the authors were both involved with Eumedic Ltd.

The review does note some trials in progress. And the Telegraph reports that there has been a successful pilot study of asthma sufferers. Except I cannot find any reference to it. I doubt it has been published yet. I have written to the lead researcher, a Dr Cooper who studied medicine at the same place as Dr Colthurst, St Thomas's London, to ask where I may find the results. I have not had a reply so far.

Until this, or any other study is published, Quackometer Venture Capital will not be investing as I can see no other market differentiation for this product. But even if something is published, the trial is only a pilot study which is unlikely to give any sort of definitive answer. Indeed, pilot studies are, by their very nature, weak in statistical power and are more prone to bias. As the New Zealand researchers say, I will have to carefully assess the methodologies used in any trial.

So, is there a market for this device, even if it does work? Time for some back-of-the-envelope calculations. A pre-IPO investment of £20m puts a very high valuation on the company. Assuming Dr Colthurst wants to retain any control, this puts a current post-investment value of over double this amount. As this is pre-IPO investment, I am wanting to see my money double or more in a couple of years. For such a risky venture, I do not want building society rates of returns. Most investments like this do not get a return. When they do, they have to be big. So, My guess is that this puts a target IPO valuation at over £80m. That is a big sale.

Could it be worth it? Again, any potential share holder in the post-IPO company is going to want to see rates of return towards to top end of 10-20%. Let's be pessimistic and we see a 10% profit in the first year - that means we need to see £8m generated in cash.

How many units do we have to sell to achieve this sort of profit? The SCENAR device retails for about $5,000. What is the margin on such products? Difficult. Training is thrown in which may be expensive. The cost of sale is going to be higher than retail sales as devices are mainly sold to 'professionals'. Let's use a typical figure of 50%. That means we have to sell about 6400 units to make our target profit.

As we are in a competitive market and say we go for a market share of 20% - which may be hard given the established brands - that means we have to have a global market of 32000 units per year. Can there be enough chiropractors and sports therapists willing to dish out the dosh?

The product, so far, has no uniqueness in the marketplace, the evidence for efficacy is very poor, it relies on implausible modes of operation, and we are going to have to shift a huge number of units year on year.

For those reasons, I am out.

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So, what has this story been about? The promise of a London IPO does not look good. The amount of money just looks daunting given the nature of the product. In my opinion, we are seeing something else here: a way of getting column inches about a product in a national newspaper. It is marketing. And effective marketing. As always, uncritical pieces in the newspapers give the alternative medicine crowd free advertising.

Labels: fenzian

 

The advert begins...

 

Dr James Colthurst and the Fenzian Machine


No, I haven't gone all Daily Express on you. There is a genuine Lady Di connection here. But first, the Daily Telegraph.

We are told (May 10, 2008) how a man had a bad knee and how 'laser acupuncture' made it better again. Time for the Quackometer to investigate.

So, why do alarm bells ring? The Telegraph reports,

Last year I heard about a new treatment, called Fenzian, and decided to give it a go. Pioneered by Eumedic, a Berkshire-based company, it involves a hand-held electronic device that is passed across the afflicted area imparting low-level electromagnetic impulses into the skin. It has been likened to a non-piercing form of acupuncture.

'Electronic devices' that look really scientific and impart 'electromagnetic' things to the body are readily found in the world of quackery. They usually do nothing but allow practitioners to take hefty fees from customers. Is the Fenzian one of these devices? We must look more.


Apparently, the machine works by,

open[ing] a dialogue between the damaged part and the central nervous system, enabling the body to target its own healing powers more effectively.

Now that could be just flowery journalistic uncomprehending language. But if it is what Eumedic claim, then we could be in a spot of bother. One thing I would like to know is what is being said in the dialogue and what language is being used. Unfortunately, I doubt we will find out.

The next worrying aspect is that Eumedic appear to be relying on testimonials. An over-reliance on testimonials ought to alert us to the possibility that quacks are using anecdotes to convince people that their treatments work. (Check out the All-American Sports Stars.) But things look better when it appears that there is an actual written-up study of the treatment with 600 patients involved. There might be real evidence that the Fenzian works. The Telegraph reports,

[The study] showed that most felt they had been “cured”, though this was less evident among the older ones and those who had had symptoms for more than six months.

And hopes may be dashed. If the Fenzian was useless then we might expect those with new symptoms to get better soon anyway, but those with more drawn out problems to continue to have them. Is this paper for real?

The paper, entitled A retrospective case note review of the Fenzian electrostimulation system: a novel non-invasive, non-pharmacological treatment, is by J. Colthurst and P. Giddings. The study was of 600 case notes from one clinic. It was asking if the patients seen at this self-referred, private clinic felt better after a visit. As such, we cannot tell from the study if the Fenzian had any effect whatsoever. It is perfectly possible that people got better anyway. There is no control group, so we simply do not know what the Fenzian did. The criticisms you could make of this paper are exactly the same as those made of the Bristol Homeopathy Study. Funnily enough, both papers report a 70% satisfaction rate.

The authors themselves note that "conclusions that can be drawn from the findings are limited." However, they go on to rather optimistically conclude, "these preliminary results are highly encouraging". I would add that if all 600 patients had paid the initial £350 as the Telegraph correspondent, followed by 15 follow up visits at £150 a pop, a more justified conclusion of this paper might be, "these preliminary results are highly financially encouraging".

My doubts grow even stronger when we note that the lead author of the paper, J. Colthurst, is the owner of the clinic and inventor of the Fenzian. So, the paper can hardly be looked upon as an independent review of the technique. More troubling aspects arise when I note that a Professor Kim Jobst helped with the paper. Jobst has turned up on the quackometer before as an advocate of the highly dubious qlink magic pendant.

More scary things are in the paper, such as the appeals to NASA/Military/Russian/Secret authority,

Research by the Soviet aerospace and military scientists found that rapid changes in skin electrical properties occurred during acupressure, and that the sites of valuable response often correlated with known acupuncture sites. Regrettably, because of the secretive culture of the Soviet military, none of this research was published.

Such claims are always highly doubtful and impossible to verify - but sound very impressive.

So, who is the inventor of the Fenzian and author of this paper? Dr James Colthurst MBBS; BSc; MBA; MFHom; FRCS(Ed) is an ex surgeon, educated at Eton and St Thomas’s Hospital Medical School, University of London. He is the second son of Sir Richard la Touche Colthurst, 9th Baronet Colthurst of Blarney Castle, and a capped English rower.

Colthurst is an intriguing character. Having the double misfortune of being second in line to the Baronetcy and loosing a bundle on the Lloyds markets, he found himself studying for a business degree (MBA) and then setting up a private clinic in Berkshire. Beyond his medical career, we find out that he was a close childhood friend of Diana and he turned out to be the paid for 'middle man', supplying the Diana tapes to Andrew Motion for the book that 'blew the lid off' the royal marriage.

Colthurst has a history of investment in alternative medicine. He is proud to claim that he is only the second surgeon to train in homeopathy and join the Faculty of Homeopaths and he only surgeon with an MBA. The Telegraph lists him as one of their Top 20 health gurus, just above Patrick Holford.

He also looks as if he has been dabbling in electronic gizmos for a while now. It is claimed he was one of the fist people to use the SCENAR device in the UK - a box remarkably similar to the Fenzian. The SCENAR was

developed by Russian scientists to ensure that cosmonauts stayed fighting fit as they floated in the stratosphere[sic].

Another user of the SCENAR, claims to be trained by Colthurst and says the device was,

developed in Russia in the 1970s to get wounded Soviet soldiers back on the battlefield as quickly as possible.

Marvelous.

In April this year, the Washington State Attorney General, Rob McKenna, wrote a letter to the US FDA to urge them to curb bogus medical devices such as the SCENAR. He said,

The sale and use of untested medical devices is a national problem. We encourage you to ban the manufacture, distribution and use of these dangerous devices, to step up enforcement against those who are taking consumers' money and risking their health.

Colthurst has other electronic device interests too. He runs a web site called muststopsmoking.com. For this service, you will be charged £250 and plugged into a Bioresonance device that "recognises the echoes of toxins and asks your body to 're-set' itself."

I must let you see the "Medical Description of Bioresonance" that is used to sell the service...

All substances have a resonant frequency. Even cells have resonant frequencies. These vary with different types and state of cells. Healthy cells have 'clear' harmonic waveforms. Unhealthy or damaged cells have disturbed waveforms. Toxic substances will disturb the waveform emanating from cells.

The 'output' signal from a cell can be considered as a resultant of the healthy cell waveform and the frequency of the toxic substance.

Bioresonance aims to measure the waveforms and to be able to separate disharmonic (toxic) waveforms from 'healthy' signals. A process of phase-cancellation is then used to counter the toxic waveforms. In addition, another process is used to amplify the healthy waveforms, thereby re-setting the cellular harmonics.

Gold standard pseudoscience.

Now, we have seen the Blarney-stone-kissing, gift-of-the-gab, silver-spoon-in-the-mouth, side of the family, but on his mother's side there is a more interesting relative. He is the great-grandson of Sir Almroth Wright who is something of a medical hero. Wright was an early pioneer of immunisation, inventing the process of autogenous vaccination preparation and was probably responsible for saving millions of lives through the development of the typhoid vaccine before the First World War. He worked with Alexander Flemming on the treatment and cleaning of wounds to prevent infection and battled fiercely with the 'Harley Street Ethos'. He campaigned to set up a government centralised fund for performing medical research so that it could be taken out of the hands of private practice. This action led Lloyd George to set up the Medical Research Committee (which later beacme the Medical Research Council).

Wright found many detractors, not least in George Bernard Shaw who lamented the passing of the art of medicine to the emerging power of scientific medicine typified by the attitude of Wright. Wright formed the basis of the character of Dr Colenso Ridgeon in George Bernard Shaw's satire The Doctor's Dilemma.

In a biography of Shaw by Hesketh Pearson, it is reported that,

Bernard Shaw called upon Sir Almroth Wright - a noted allopathic physician - to look into homeopathy. Wright expressed complete incredulity. Shaw remonstrated with him. "Look here," exclaimed Wright, "the thing is absurd and impossible; let me put it this way. Would you, Shaw, trouble to get out of your chair if I called from the next room, 'Do come in here and see what I have done - I have turned a pint of tea leaves into pure gold.'?" "Certainly I would," replied Shaw. "

Shaw's credulity stands in stark contrast to Wright's sceptical attitude. Homeopaths see Shaw's response as being more 'open minded'. Sceptics see it as an over willingness to believe in anything in the face of illogical nonsense. Indeed, Wright was supposed to have proposed that logic was formally taught to doctor's as part of their training. His ideas were ahead of their time and rejected.

I wonder what he would make of his descendant? My guess is that science may well have advanced, but society has not.

Labels: electromagnetic quackery, fenzian, qlink

 

The Society of Homeopaths have recently had their 30th Anniversary Annual General Meeting and Conference at Leicester University. Lots of pop and cake were undoubtedly consumed. Various guest speakers were there talking nonsense and various 'breakout' sessions allowed homeopaths to share their delusional experience with each other.

One session will be on "Perils and pitfalls in practice" given by Patricia Moroney the current Professional Conduct Officer. She says,

There will be an opportunity for you to assess the professional conduct issues that arise in a variety of situations. The workshop will be a fun and interactive way to engage with The Code of Ethics and Practice.

Now, undoubtedly 'Trish' has been having some fun with the code of ethics over the past year. A few months ago, the Society of Homeopaths produced the first documented expulsion of a member ever. The Quackometer has repeatedly criticised SoH for not taking action against members who obviously flout their rules and not being transparent and accountable in their approach to professional conduct. Could the Society be listening?


The Society claim in their Review of 2007 to have made only one formal investigation,

During 2007, The Professional Conduct Department responded to over a hundred logged telephone calls, letters and emails from members and the general public. Many of the queries arose from misunderstandings or lack of information. The majority were resolved swiftly through means of advice or where necessary mediation. During 2007 the department conducted one Adjudication Panel hearing. The complaint was upheld.

That is surprising given the fact that many bloggers have sent in complaints about members, fellows and directors of SoH who are blatantly breaching the Society rules. My own efforts to complain are well documented on this site. One complaint resulted in SoH taking legal action against me rather than address my concerns.

e.g. See

Homeopaths Through the Looking-Glass
The Society of Homeopaths: Truth Matters
Society of Homeopaths breach own Code of Ethics on website
Patricia Moroney Pwned

and so on.

So, the unlucky recipient of a Society of Homeopaths reprimand was a Mr David Evans of the North West College of Homeopathy.

What events resulted in this investigation?

We do not know.

All we know is the list of rules he was supposed to have broken. These range from "avoid disclosing any information concerning a patient to a third party without the patient’s written consent" and "Maintenance of appropriate records" to rather more disturbing rules such as "Maintaining appropriate boundaries Homeopaths, are responsible for avoiding exploitation of their patients financially, emotionally, sexually; or in any other way." and "Where a patient, student, or supervisee is expressing feelings towards the homeopath, tutor, or supervisor which cause problems for the maintenance of professional boundaries and the professional- for whatever reason- is unable to resolve the situation in an acceptable manner the professional relationship is to be ended"

The Society do not tell us what the defendant was supposed to have done wrong. Perhaps it is a new parlour game. Look at the list of rules breached and imagine the story that led to the hearing. What fun.

And what is the result of the hearing?

The Panel recommended to the Board of The Society of Homeopaths that Mr. David Evans be expelled from The Society with immediate effect. The Board ratified the recommendation of the Panel to be effective from 11th March 2008.

Now, the whole debate about regulation is how the public are best protected against dangerous practices and people who should, perhaps, not be in positions of trust. Is the Society of Homeopaths capable of fulfilling this role? What has the effect of this ruling been? To my best knowledge, the only effect has been the removal of the letters RSHom from the web site of the place where the subject of the investigation works.

So far, I have been complaining that organisations never use their code of ethics to protect the public from harm. Now that they have tried to do so, we are confronted with the obvious futility, uselessness and deceptive nature of the whole facade.

Such is the weakness of voluntary self-regulation. The government see this as the way forward for all of alternative medicine by setting up Ofquack, the new 'federal' register of all alternative healers. Just like the Society of Homeopaths, the code of ethics for Ofquack will be more about putting a veneer of professionalism on the indefensible rather than protecting the public.

Labels: regulation, Society of Homeopaths

 

The Advertising Standards Authority is one of the few regulatory bodies in the UK regularly prepared to tackle the untruthful and unsubstantiated claims made routinely in the alternative health industry. It is also one of the weakest regulatory bodies in the UK. Nothing could highlight that more than how Life Healthcare (trading under the url http://www.reverseageing.com/) dealt with an investigation.

Life Healthcare had made an advertising leaflet for a product called Thyroid Support Formula and had a heading on the front page that stated "New Scientific Studies Prove That There Is Hope, Read On, and You'll learn the Secrets That Your Doctor Might Not Be Telling You about an Under-Active Thyroid". Particularly worrying was the claim that,

But the truth is that conventional medicine does not have the best testing or treatment methods for an under active thyroid. Just because your test results have come back negative for an under active thyroid doesn't mean you don't have it.

A complainant to the ASA expressed concerns that a leaflet from Life Healthcare was

potentially harmful because it discouraged people from seeking proper medical treatment or from following the advice of their doctor

and doubted that,

the claims made in the ad for the product's efficacy could be substantiated

The ASA took a look a the advertisement and also challenged Life Healthcare if they had proper authorisations to market their products and whether the testimonials and photos included in the ad were genuine.

So, pretty serious charges. How did Life Healthcare respond? They didn't. They completely ignored requests by the ASA to explain themselves. The ASA upheld all complaints and said,

The ASA was concerned by Life Healthcare's lack of response and apparent disregard for the Code, which was a breach of CAP Code clause 2.6 (Non-response). We reminded them of their responsibility to respond promptly to our enquiries and told them to do so in future.

Their action was,

We told Life Healthcare not to repeat the claims in future advertising. We urged them to seek guidance from the CAP Copy Advice team before advertising again and asked CAP to inform its members of the problem with Life Healthcare.

I, for one, am not convinced that this direction will be adhered to.

Life Healthcare appears to make a business from evading legal restrictions on its practice. The from page of its website informs us,

With draconian EU legislation pending for the UK marketplace your right to buy optimum dose nutritional supplements may be limited, and some ingredients may no longer be available. Fortunately as we are based outside the EU (in the Channel Islands), Life Healthcare can continue to supply these high potency supplements that may have to be withdrawn from the UK and Europe in the coming months and years.

The current weakness of consumer protection laws in the UK will indeed be strengthened in the next few weeks as vastly improved consumer trading legislation comes into force. Whether this makes any difference to companies such as Life Healthcare remains to be seen.

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Postscript

It would appear that fleeing to the channel island might not be the get out of gaol free ticket Life Healthcare hope for. Yesterday in parliament, the Minister for Health Dawn Primarolo, responded to a question asking what the Government was doing about such loopholes. She replied,

The FSA continues to work with the Ministry of Justice, the Department responsible for the Crown Dependencies, and the administrations in the Crown Dependencies regarding implementation of the food supplements directive and Nutrition and Health Claims Regulation to prevent trade in food supplements that would be illegal in the United Kingdom.

Labels: ASA, regulation, vitamins

 

Professor Jayney Goddard is the president of the Complementary Medical Association (CMA), "the world's largest professional membership body for complementary medicine" and has been elected a Fellow of the Royal Society of Medicine. She studied homeopathy at Imperial College for five years and has won numerous awards. According to various sites, she is "considered to be among the world’s leading experts in complementary and integrated medicine."

Impressive stuff. No wonder she was invited onto today's The Wright Stuff to debate with Simon Singh on the subject "Homeopathy: A Waste of Money". Indeed, Jayney Goddard is a regular guest on the show and boasts an impressive appearance list in other shows, including being resident 'Expert' on Discovery TV. But Jayney appeared to state a number of surprising factual errors and have some over optimistic interpretations of the research literature (and I will come onto these). How could such a eminent expert make such mistakes? I thought a little background research might be in order.

So, President of the CMA, "the world's largest professional membership body for complementary medicine". What is the CMA? Well, the CMA web site does not appear to be what I expected. It offers some articles, sells a few books and food supplements and offers marketing services for members. Looking at Company House records, the CMA is registered address is Chase Bureau Services, a supplier of 'off the shelf companies' and other company secretarial services. So, no 'head office' for the CMA then. The web site for the CMA is registered to a private individual with an address given in a residential block of flats in Wandsworth. I'm disappointed. The CMA is not sounding so grand as I first thought. However, the CMA does usefully offer viewers of the Wright Stuff options to buy products that Jayney mentions on air. It looks to me like Jayney Goddard is president of a shop.

So, what about being Professor Jayney Goddard? We are told that Jayney was "recently awarded a Professorship from Mahendra Sanskrit University in Kathmandu, Kingdom of Nepal". The university was set up to promote the Sanskrit language in Nepal. However, when I tried to contact the University to find out more about Jayney's Professorship, I found their website is permanently down. Unfortunately, it would appear that in 2002, a hoard of women Nepalese Maoist rebels reduced the University 'to cinder' and destroyed all the ancient Sanskrit texts, University buildings, furniture, and all university records. The rebels had previously planted a 'crude but powerful bomb' there too. It is not clear if Jayney Goddard makes frequent visits to fulfil her Professorial duties.

And what of these claims to have studied homeopathy at Imperial College? The University is one of Britain's most prestigious degree level teaching and research institutions. It does not offer a degree in homeopathy. Elsewhere we are told that her qualifications are "diploma in hypnotherapy and is a Licentiate of the London College of Classical Homeopathy". No qualifications from IC then? This is a puzzling one.

And finally, Jayney says she has been elected a Fellow of the Royal Society of Medicine. What does it take to become a Fellow of the Royal Society of Medicine? The answer looks to be about £356 for a London resident. You can join online. I filled in the form and elected myself to become a Regional Fellow for £287. Bargain! Le Canard Noir, Fellow of the Royal Society of Medicine. Magnificent! My mum will be so proud. It looks like Jayney could become a Fellow as her 'presidency' of the CMA is obviously a 'senior management' role in healthcare.

There is so much more on Jayney's CV that we could explore. But enough for now.

So, what of these errors she made on the Wright Stuff? Simon Singh was arguing that the totality of scientific evidence for homeopathy showed that it was ineffective and a placebo based therapy - unsurprising given that it is just plain sugar pills. Jayney tells us though that 'outcome trials' are the way to measure homeopathy. These trials almost always give you positive results for homeopathy - they are just not very good as they do not compare homeopathy against any control group. It is impossible to know if the effect was caused by homeopathy or it was just people getting better on their own. Simon argues this, so Jayney went into animal experiments and this is where she lost the plot.

There is just some research printed recently, I think it was actually in Immunology which is one of the worlds leading scientific journals and it showed that mice exposed to something causes Chagas disease (guffaws) ... these mice were treated homeopathically, prior to being infected. It was a properly run double blind placebo controlled trial - the gold standard that Simon is actually talking about - and what actually happened was the untreated mice died, the mice that were treated did not get the disease.

Wow. But is it true? Well, no.

The research was done, but not published in Immunology. It was published in the in-house comic of the Faculty of Homeopaths, Homeopathy - a rag with as much scientific integrity as the Beano. The paper, "Effects of homeopathy in mice experimentally infected with Trypanosoma cruzi ", did not say that the untreated mice died or that the treated mice did not get the disease. It reported that more mice died in the control group but that this was not statistically significant. But the main criticism would be that the statistical certainty of effects were low (only p<0.05) and that multiple measurements were being made in five groups that would undoubtedly result in many false positives. If Professor Jayney Goddard thinks this is the best evidence for homeopathy, then we can be pretty sure it does not work. What is certain, is that this TV show was not the right forum for discussing p-values.

But Jayney went on to discuss homeopathy for childhood diarrhoea. She talks of trials 'all over the world, in developing countries' where children with diarrhoea have been treated with homeopathic medicines and also placebos and Jayney claims that the children who have been treated homeopathically had shorter periods of diarrhoea. Jayney tugs the heartstrings and tells us that the poor children of Burma, after the recent cyclone, could benefit enormously from such treatment. Undoubtedly, it is the sceptic scientists like Singh who get in the way of saving the children. Again. Is this true? Again, no. Diarrhoea and homeopathy is really just one researcher's passion - Jacobs. She has been involved in a number of trials in places such as Nepal and Nicaragua. Individually, these trials did not show a strong significant effect for homeopathy. But when Jacobs did her own meta analysis on three trials, she claims to be able to show a statistically significant effect. Jacobs suggests that "larger sample sizes be used in future homeopathic research to ensure adequate statistical power".

As meta analyses go, doing your own analysis on just three papers that you have been involved with is not really showing multiple independent confirmation of your result and is unlikely to be sufficiently self-critical of the work and take adequate precautions usually found in competent meta-analyses. Tellingly, Jacobs did go on to do another larger trial in Honduras in 2006. The conclusion was,

The homeopathic combination therapy tested in this study did not significantly reduce the duration or severity of acute diarrhea in Honduran children.

Showing his own biases, the paper did not discuss the possibility that homeopathy could not work, but rather that the homeopathic pills had been stored incorrectly and so on.

In discussing the Chagas and diarrhoea trials, Jayney Goddard misled her TV audience. It would have taken half an hour for Singh to untangle that lot, even if he had the relevant papers to hand. Given the the show host was acting like a moron pretending him and his friends did not need protection in malarial areas, Simon Singh did not have a chance of getting clear science across.

The most telling moment came when one of the other guests asked,

Simon, you've got trials that prove your case, Jayney, you've got trials that prove your case, which makes it very difficult for us to know where the truth lies.

Well, if Simon's colleague, a real professor of complementary medicine from Exeter University, Edzard Ernst, had come on, then perhaps there could have been a rational and fruitful discussion about the role of homeopathy in the NHS. But instead of Professor Ernst, we had to have a Professor from a long-since burnt down Nepalese Sanskrit University who runs a web site selling homeopathic books and pills. That, in my opinion, creates the obvious confusion shown on this show.

Labels: BPSDB, homeopathy, Jayney Goddard

 

In a recent post, I described how Neal's Yard Remedies had withdrawn their Malaria homeopathy pills. Their press release said,

as this is obviously a contentious issue which is causing customer concern, we have decided to withdraw the product, Malaria Officinalis 30c from sale with immediate effect.

I described this as bullshit, just like the rest of their press release. The much more likely cause was that they were being investigated by Trading Standards and the MHRA - the medicines regulator in the UK - after a BBC investigation had 'stung' one of their branches.





Well today, the MHRA have issued their own press release, which I will reprint here...

The Medicines and Healthcare products Regulatory Agency (MHRA) has clamped own on a homeopathic remedy intended to be viewed as a treatment or preventive for malaria sold by the cosmetic chain, Neal’s Yard Remedies. The MHRA has received confirmation from the company that the remedy, Malaria Officinalis 30c, will be removed from sale immediately.

All homeopathic remedies are classed as medicines and require prior authorisation by the MHRA before being placed on the market. The MHRA was concerned that no record of an authorisation had been given for Malaria Officinalis 30c and therefore concluded that it was an offence to sell, supply or to advertise this product which had not been authorised.

David Carter, Head of the Borderline Team at the MHRA said, “This product was clearly intended to be viewed as a treatment or preventive for malaria, which is a serious and potentially life-threatening disease. We regard the promotion of an unauthorised, self-medicating product for such a serious condition to be potentially harmful to public health and misleading. We are pleased that Neal’s Yard Remedies have complied with our request and removed this product from the market.”

So, Neal's Yard ethical bullshit has been exposed.



Now, I emailed their MD, Jonathan Hook, to ask if he supported the claims made by his unmedically qualified Medicines Director, Susan Curtis. In her book Homoeopathic Alternatives To Immunisation she describes how similar remedies could prevent malaria. Some of them are still for sale. No reply so far.



The book is still for sale on Neal's Yard's website. It continues to make alarming claims...

An invaluable guide for all trevellers[sic]. This book contains practical
information on preventing and treating major infectious diseases, including hepatitis, flu, measles and whooping cough.

Only the claim for malaria has now been dropped.

It looks like Neal's Yard has done the absolute minimum to avoid prosecution. This is shameful and is contemptuous of its customers. When is Neal's Yard going to come clean and do the right thing?

And let us not forget, Neal's Yard were only acting as resellers for Ainsworths. Are the MHRA going to anything about that company too?

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The BBC have now picked up on this story. "Firm 'misled' over malaria drug". Of course, it wasn;t a 'drug' they were selling, but a plain sugar pill.

Labels: homeopathy, Neal's Yard Remedies

 

Edzard Ernst has accused practitioners of alternative medicine of lying to their patients. In last week's New Scientist he gave an interview where he described his childhood experiences with homeopathy, and his subsequent medical and homeopathic training, and his work in the only German homeopathic hospital. His conversion to doubt has been slow and guided by the evidence. He now believes that homeopathy is nothing more than a placebo therapy. That is what the science says. According to Ernst, the continued popularity of homeopathy is essentially due to homeopaths lying to their patients about the state of research into the subject. If they told the truth, their businesses may collapse.

Now, Dr Brian Kaplan, a medically qualified homeopath, has taken exception to Ernst remarks and thrown down the gauntlet - pistols at dawn. Kaplan says,

I have met hundreds if not thousands of homeopaths in my career. Some have indeed believed in some strange things, some have been very naive indeed in my opinion, but I have never met a homeopath whom I thought was lying to his/her patients. They may have said things to patients that Ernst thinks is untrue but that is very different from lying which is the deliberately not telling the truth.

Now, for once, I would pretty much like to agree with Kaplan. I think few homeopaths are out-and-out liars. Lying is not the word for what homeopaths do. The actual word that is most commonly appropriate is 'bullshitters'.

To explore this issue, I would like to draw on the work of renowned moral philosopher and Professor Emeritus of Philosophy at Princeton University, Harry G. Frankfurt. In 2005, Frankfurt published an essay entitled On Bullshit. This groundbreaking work explores the philosophical meanings of bullshit, why there is so much around and how it differs from other sorts of untruths.

Frankfurt argues that bullshitting is not the same thing as lying, but both are an abuse of the truth. In his words,

It is impossible for someone to lie unless he thinks he knows the truth. Producing bullshit requires no such conviction. A person who lies is thereby responding to the truth, and he is to that extent respectful of it. When an honest man speaks, he says only what he believes to be true; and for the liar, it is correspondingly indispensable that he considers his statements to be false. For the bullshitter, however, all these bets are off: he is neither on the side of the true nor on the side of the false. His eye is not on the facts at all, as the eyes of the honest man and of the liar are, except insofar as they may be pertinent to his interest in getting away with what he says. He does not care whether the things he says describe reality correctly. He just picks them out, or makes them up, to suit his purpose.

Homeopaths are renowned bullshitters. They do not care about the truth. They are extremely reluctant to say anything definitive that can be proven wrong. They do not test their ideas themselves in any meaningful way. They will say anything to make themselves look plausible in the face of sincere criticism. Instead of addressing the concerns raised by Ernst, they bullshit about conspiracy theories about how pharmaceutical companies are funding people like him to discredit them. There is not a shred of evidence for this - but that does not matter - they just bullshit away.

We saw Neal's Yard Remedies this week after they were caught dishing out useless sugar pills to prevent malaria bullshitting for England. Their PR department will undoubtedly be winning PR bullshit awards over that attempt to get-out of-gaol-free.

We have seen The Society of Homeopaths trying to bullshit their way out of similar accusations, issuing press releases that really did not appear to care if what they were saying was the truth. They claim to be consulting with the Department of Health over self-regulation. A freedom of information act request suggest otherwise.

We see their 'intellectuals' publishing papers on quantum mechanical explanations for homeopathy. It is utter bullshit of the highest order, but that does not matter, because the homeopaths lap it up.

When homeopaths, like Kaplan, only partially review the evidence for homeopathy, cherry picking the positive studies and ignoring the overwhelmingly disappointing, they are bullshitting. By continuously saying that meta-analyses are 'discredited' when they are not is just pure bullshit.

Bullshit may not cover all homeopaths abuses of the truth though. Some have seen Frankfurt's analysis of truth abuses as incomplete and in need of further revision and extension. It was therefore necessary for former Oxford Wilde Reader in Mental Philosophy and current Professor of Philosophy at the University of Miami to publish an essay entitled mindfucking.

McGinn's 2008 analysis notes that not everyone who engages in speaking without regard to the truth is a bullshitter. They may well be just telling stories, or singing a song, and is not making any claims to be either telling the truth or a lie. Defining a bullshitter cannot be done by just noticing a disregard for truth.

In examining the true nature of bullshit, we discover that in order to be a bullshitter you must intentionally represent yourself as competent and sincere and be trying to place this false belief in the listeners head that you are telling the truth. As such, a bullshitter is not completely indifferent to truth and falsehood as Frankfurt has suggested. We can see how homeopaths publishing papers on quantum mechanics gives the impression that they know what they are talking about in this area. There is the intention to come across as an authority. The fact that these papers are not published in quantum physics journals should set off loud alarm bells. There is no one in an alternative medicine journal capable of telling the authors that the paper is bullshit and so rejecting it.

But deeper into this new analysis of truth abuse comes the concept of mindfucking. Both liars and bullshitters are concerned with beliefs - that of what their listeners think. There are always two untruths for the liar and the bullshitter - the (possible) untruth of what is being said and the untruth of the belief in the listeners head that what is being said is sincere. The mindfucker, on the other hand, does not just care about their listeners beliefs and what the listener thinks of them, but about manipulating their emotions too. The intention is to disturb and abuse. The mindfucker seeks to raise emotions of alarm, confusion, insecurity, fear and hatred. At the very least, mindfucking is using emotion to manipulate thought.

And this is where we can see that homeopaths are most definitely mindfuckers. It is just not good enough to lie to you patients about the power of the pills. It is also not good enough to bullshit about evidence. Homeopaths find it necessary to fuck with people's minds. They tell them that the real enemy is their doctor. They scare them in one-sided stories about the harm that drugs and immunisations do. They tell them their medication will do them more harm than good. They talk incessantly about side-effects of drugs as if the actual effects of the drugs and the illness itself were secondary issues.

Is Kaplan guilty of a mindfuck in his criticism of Ernst? Instead of addressing Ernst's evidence of the ineffectiveness of the majority of complementary medicine, Kaplan accuses Ernst of ignoring the supposed lack of evidence behind conventional medicine. It is a mindfuck because it plays to the usual emotion of distrust in Big Pharma, it deflects from the issue and seeks to cause alarm about Ernst's motives. But of course, Ernst is Britain's only Professor of Complementary Medicine and it is a complete red herring to accuse him of ignoring a subject that he never intended to study. There are thousands of researchers in Britain studying and improving the evidence base of medicine and yet Kaplan wants to attack Ernst over it. The irony is of course is that Ernst is improving the evidence base of CAM - people like Kaplan do not like the answers coming out of his department. Let's fuck with people's minds instead.

So, I am not sure if Ernst is going to take up Kaplan's offer of a duel. My bets would be on the canny German. They still train people to duel there, you know. Kaplan has not made a case that a duel is necessary. Rather, it is up to Kaplan to state that homeopaths do not misrepresent the truth about the evidence base for homeopathy. If he is sincere about the truth, why is he not as concerned about his own profession as Ernst appears to be? Where is the condemnation of homeopaths running high street shops with dangerous beliefs about immunisations? Where is the concern that homeopaths do not practice within the knowledge of a sound evidence base?

I think Ernst was actually being rather kind in calling homeopaths liars. He should have called them all bullshitters and mindfuckers.

Labels: edzard ernst, homeopathy