The Quackometer

Some of you may be under the mistaken impression that the Quackometer is a blog. No, it was originally an engine for automatically determining if web pages were quackery or not.

That functionality has been offline for a little while now after a run in with a quack who was upset about a few things. Joseph Obi threatened my web hosts, Necetera, who were shown to be gutless worms. Fortunately, Positive Internet (Yeah!) came to the rescue and re-hosted my site. Obi is now back to his bizarre blogs, today shouting how he is not accountable to the GMC, whilst neglecting to mention the reason he is not is because he was struck off as a doctor by them.

So, it took a little work to get it back up and running. (For the technically minded I had to do some ASP to PHP conversion, poke holes through firewalls, set folder permissions and reverse the polarity of the neutron flux.)

What has been rather amazing over the past few months is how quite a lot of you appear to have missed the quackometer. I have had frantic emails from University Lecturers who have been using it as a teaching tool. With it gone, they had to think up something else. I know how hard this can be. My profound apologies. However, some people in Universities have been taking the quackometer far too seriously and I will be discussing this soon.

The main functionality is now back. You can type in a URL or a name and get an analysis done for you. There is a 'Top Ten' page where you can see what people have been typing in.

Don't forget to download the quackometer google toolbar button. This gives you 'one-click' access to analyse the current page you are on. Also, highlight a name in a web page with your mouse and the press the button to get an analysis. Type something into the Google Search box and hit the Quackometer button to get a QuackSafe search on any subject.

Have fun and remember it is just for fun. Hopefully a few more features will be back up and running soon. Maybe even a Facebook application.

Labels: quackometer

 

There is a claim by many sceptical writers that we live in a new age of endarkenment. Our public lives, whether in politics, universities, businesses and health, face an onslaught of irrational thought. However I have uncovered some remarkable evidence to suggest that interest in homeopathy is declining rather aggressively. I am not sure I believe it, and I want to encourage comments and interpretations to see if this might be real.

All this came about because Google have unveiled the latest part of their rather splendid toolset that allows researchers to look at search trends and see how this might be used to monitor and predict all sorts of behaviour. As a showcase for their techniques, they have developed flutrends that shows how people are searching about flu across the United States. They believe this correlates very closely with incidence of the disease and thus can be used as a near real time monitor of the severity of outbreaks. Standard reporting techniques mean that reporting lags two weeks behind and so this technique may be a much more timely and accurate measurement. Fascinating stuff. And very useful if you want to deploy resources effectively.

So, I decided to play around myself and naturally wanted to see if people were looking for stuff about homeopathy on the web. The graph below shows the relative incidence of the search term in the United Kingdom over the past few years. (The lower part of the graph shows results for news items.)

 

 

This is remarkable. Interest in homeopathy is only about 40% now of what it was at the beginning of 2004. if this is true it shows a devastating collapse in interest that surely must be reflected in the businesses of homeopaths.

(as a side note the letters above the graph refer to the following events:

B) The Lancet meta analysis published

C) The letter to PCTs asking them to reconsider funding NHS homeopathy

D) Degrees in homeopathy criticised as being unscientific)

Can we trust this curve?  Is this just an artifact of Google? Are people getting more sophisticated in how they use Google rather than relying on blunt and simple searches? Let is compare with France. Is a similar trend seen? Lets see the curve for homeopathie searches in France.

Much flatter. In France, homeopathy has a very different cultural dynamic. There are no lay homeopaths. Medical doctors prescribe pills or people self-'medicate' in large numbers from their local pharmacie. The largest homeopathy company in the world, Boiron, is French with a turnover of half a billion euros. There is no significant sceptical community as far as I can tell.

Does this result correlate with any other evidence we have about interest in homeopathy? We know GPs are prescribing fewer homeopathic prescriptions. Is this because interest is waning or do fewer prescriptions mean fewer web searches as patients find out what the hell their doctor has given them. The Society of Homeopaths has occasionally published memberhip figures. The last graph was in 2005 and shows a peak membership in 2004 and that it was then in decline. They have not published similar figures since. Are they embarrassed? Their membership income has increased but they say this is due to their better efforts at moving members up the grade scheme with higher fees due. I have reason to believe, albeit anecdotally, that few lay homeopaths are able to make a full time living and most do it as part of a portfolio, part time or as a paid hobby. Will members be renewing through the coming recession? We also know that NHS funding for homeopathy is decreasing as PCTs refuse to fund referrals and hospitals. There are definitely threats to homeopathy, but this severe?

If the trend continues, there will be no Google searches for homeopathy sometime around 2011-2012. Does homeopathy have two to three years left? Even if the trend is true, surely it must bottom out as we are left with a rump of True Believers.  I am quite sure that homeopathy's greatest threat is that people will find out what it is - magical witchcraft. Is the Internet allowing people to see through the homeopathic propaganda? All very tantalising.

So, how reliable is the Google trends programme? They say is a 'beta' and so not to write PhD theses on it. An hour of fun has produced the following trends that suggest it is at least getting something right...

Can you tell there was no Glastonbury festival during 2006?

Led Zeppelin has been very steady (bar their reunion show last year).

Barbeques show predictable trends. I will leave it as an exercise for the reader to correlate barbeque searches with daily temperatures/hours of sunshine. (You can download data into a spreadsheet.)

Searching for Majorca and the Maldives shows the results you might expect with an upsurge of interest for both over Christmas as people open their Radio Times and think about their holidays. Majorca shows a highly seasonal trend whereas the Maldives reflects its more all year appeal. (My guess is I do not need to spell out what the spike for the Maldives at the end of 2004 was all about).

Barack Obama and Sarah Palin have thoroughly predictable profiles.

Interest in sex appears to be pretty steady (with some surprising uplift at Christmas again)

And so back to topic. What about other quackery? We can compare searches for homeopathy (blue), osteopathy (red) and chiropractic. (orange)

The decline of homeopathy is much more marked than the spinal techniques. Maybe something is real here.

The Google tool has a number of other excellent facilities. We can find out where the most homeopathic searches are coming from. The result is...

India. It shows the highest infliction of homeopathy where the nationalist governments actively encourage 'Traditional' medicines as part of the Hinduisation of politics - even though homeopathy is German. I have written about the World Health Organisation's disgraceful role in this hoax on the vulnerable.

So, what do we make of this? The trend is not easy to explain away and yet appears to remarkable to be true. Will we see homeopathic companies going out of business soon? Will membership of the pretend regulatory bodies drop precipitously? Is this the end of the last few decade's resurgence in this quackery?

I welcome your thoughts.

Labels: Google, homeopathy

 

Criticising quackery and pseudoscience has its risks. Write a newspaper article or blog criticising someones scientific and medical ideas and you are likely to enter into sharp debate about evidence and its interpretation. Criticise a quack and you can be sure they will be thinking of ways to shut you up - maybe with lawyers. Vested interests and money are strong factors and there are none of the usual safety valves in quackery for critical debate - peer review is near non existent and membership regulatory bodies are broken at root. Inherent in much quack thinking is the mantra that evidence and the scientific method cannot be trusted or is entirely inappropriate for their 'special' art. There are no accepted objective mechanisms by which disputes, internal or external, about practice, philosophy and ethics can be resolved. Quacks have locked themselves away from critical debate for so long that they have no idea how to re-engage, and if they did, they would have a mountain to climb with so much garbage accumulated over years of dogma dominated discourse . Thus, to defend their trades and protect their income, the legal route appears to be the only route.

Simon Singh MBE is one of Britain's best science writers. He is now locked in legal proceedings with the British Chiropractic Association after he wrote in the Guardian about the lack of evidence for chiropractic practice and the dangers associated with spinal manipulation. It has been some months now and it appears that both claim forms from the BCA and a defense from Simon Singh have been filed with the courts. The legal blogger Jack of Kent has done an excellent job of explaining what these documents mean so that non legal numpties like me can understand. Jack of Kent explains that the chiropractors are objecting (as we thought) to Singh saying that there is 'not a jot of evidence' for chiropractors claiming that they can cure 'colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying'. Singh calls such treatments 'bogus'.

The defense has done two main things. It has said that Article 10 of the European Convention on Human Rights provides a right to freedom of expression. Writing as a science writer in a quality newspaper about a matter of public health regarding children should surely not be subject to legal intimidation because some people object to it. And secondly, the defense wants to show that the meaning of the alleged defamatory words is justified because the meaning put forward is factually justified and fair comment. I urge you to read Jack of Kent's analysis in full.

In short, it would appear that Simon Singh wants to put the evidence base for chiropractic in the dock. This is quite stunning and I am sure there are very many chiropractors who are now very nervous about this development. My feeling is that this was inevitable. Chiropractors, no doubt, believe that they do have evidence that their bone crunching can work miracles like curing frequent ear infections. Undoubtedly they will have countless testimonials.

But what is interesting here is the likelihood that chiropractors will have to defend what is appropriate evidence for believing that a medical intervention can treat particular illnesses. This is fascinating for me as I constantly hear about how much evidence there is for highly implausible treatments such as homeopathy. When examined though, the evidence is terrible and utterly unconvincing given how implausible homeopathy is. Homeopaths tend to argue as if evidence is all or nothing. They find some evidence for their claims and then act as if there can be no further doubt.

But evidence exists on a scale. Depending on the quality of the evidence, how far it is along the scale, our estimate for the truth of various propositions can change. Science is never certain about anything. Science is provisional in its nature. All theories are subject to change, although some are much less likely to change than others given the enormous amount of high quality evidence available. We can find poor evidence for all sorts of weird propositions. We might say that the round holes we see on the Moon are evidence that it is made of cheese. We might suggest that the reduction in back pain experienced after chiropractic treatment as evidence for its success. But we could also be mistaken too. Back pain does get better on its own (I can testify to that). Children's ear infections do subside on their own. Children get over their sleeping and feeding problems and occasionally stop crying. Mere testimony is not really evidence but quacks love this sort of stuff. As I have said before,

Healing fools. The seemingly miraculous ability of our bodies to naturally fight and recover from illness, and our inquisitive brains that are eager to seek out causative patterns in all things, means that we all too readily attribute our healing moments to whatever magic beans we were rubbing at the time. Some are so impressed by their own healing stories that they start to make businesses selecting the appropriate beans for others' healing. And the rest of us listen to the tales of the healing fools, as a sincerely told story appears to hold such power over us. Without care, we all risk becoming healing fools.

If we are to accept evidence for chiropractic efficacy we need a little more than stories. It is also worth pointing out that chiropractic treatment for anything that is not to do with muscles and bones is implausible in the extreme. Chiropractors believe they can cure many other things because the trade was founded on the idea that subluxations (chiropractors mysterious bodily malfunctions) were the cause of most (if not all) illness. Thus, by crunching bones you can clear subluxations and get the 'vital forces' moving again. Yes, chiropractic is founded on pre-scientific views of biology and medicine and thus any claims it makes must be subject to the highest forms of evidence. (Amazingly, some UK Universities, like the University of Wales, still underwrite such pseudoscientific gibberish.)

In discussing the nature of homeopathic evidence I have previously said,

Scientific medicine takes into account the scientific context of the evidence and says that we should interpret that evidence in light of what we know about the world. It forbids us from casually accepting light evidence for treatments that are not plausible from what we know about physics, chemistry and biology.

Chiropractors will need to demonstrate a high degree of plausibility before we can casually accept any light evidence from testimonials and other poor forms of evidence. They do not have that plausibility. They have a hard task ahead of them.

This task is made worse by the medical literature. The most recent review of the effectiveness of techniques such as chiropractic concluded,

Sixteen papers were included relating to the following conditions: back pain (n=3), neck pain (n=2), lower back pain and neck pain (n=1), headache (n=3), non-spinal pain (n=1), primary and secondary dysmenorrhoea (n=1), infantile colic (n=1), asthma (n=1), allergy (n=1), cervicogenic dizziness (n=1), and any medical problem (n=1). The conclusions of these reviews were largely negative, except for back pain where spinal manipulation was considered superior to sham manipulation but not better than conventional treatments. CONCLUSIONS: Collectively these data do not demonstrate that spinal manipulation is an effective intervention for any condition. Given the possibility of adverse effects, this review does not suggest that spinal manipulation is a recommendable treatment.

It looks like the Chiropractors are on a hiding to nothing. That does not mean that I think Singh will automatically win. The legal courtroom is not the place to decide scientific issues: it decides legal ones, and we all know that the law, at times, can be perverse. Rather, we have a game of high stakes now where, if the chiropractors go ahead, we are going to see lots of arguments like the above and the evidence for chiropractic put in the spotlight. Even if by some freak, the chiropractors win, they may well suffer many humiliations in the process. The world is watching, the press is watching and it is going to be a show.

That is unless, the BCA see some sense and decide to try to slink away from this one.

In the meantime, if you care about what is going on here, you can keep up to date on this facebook group...


http://www.facebook.com/group.php?gid=33457048634

Labels: chiropractors

 

Sense about Science, a UK charity who aim to assist and campaign for better science reporting in the media, have today launched a new pamphlet design to help people understand how medical claims on the Internet may be misleading. The report entitled "I've got nothing to lose by trying it" explains "how to tell the beneficial from the bogus in the face of the miracle cure stories, new wonder-drugs and breakthrough therapies that are increasingly promoted" on the Internet. In particular, they focus on how quacks and charlatans may exploit people with long term chronic illnesses into trying unproven alternative treatments - usually at a significant cost.


This is something the quackometer cares about. The quackometer was set up to help people think critically about health claims on the web (and I am pleased to announce that the original quackometer engine should be restored to full working status within days.)


Tracy Brown of Sense about Science describes the reason for producing the guide as follows:

We’ve been contacted by so many people exhausted from the pressure they feel to try advertised treatments, dietary regimes and exercises. One person told us how the last years of his wife’s life were spent endlessly pursuing new treatments, from goats blood serums to unlicensed stem cell treatments abroad, all to no avail. This guide aims to help patients and their families to evaluate the treatment claims they are bombarded with.

Giving people false hope may well provide some temporary relief from whatever fears and frustrations they may suffer. However, the realisation that you have been patronised, deceived and fleeced of money must be devastating. The realisation that you could have been spending your time concentrating on more fruitful and meaningful parts of you life must be terrible. In my last post, I described how the World Health Organisation are actively promoting government funded quackery around the world. Often the justification is that because poor people cannot afford real medicine then it is alright to offer them unproven and nonsensical treatments. Alternative medicine is so often a cruelly deceiving distraction from what really matters in life. For that reason, I support what Sense about Science are doing here.


The MP Phil Willis puts it very well,

The cruelest deception for a patient with chronic illness is the promise of a cure based on empty hope not evidence. The publication of ‘I’ve got nothing to lose by trying it’ is an inspired attempt to empower patients to evaluate so called ‘miracle cures’ with evidence based advice.

Empowerment is such a key word. Quacks often talk of giving patients choice and condemn people like me for trying to restrict choice. But there can be no meaningful choice without being accuratly informed. It is therefore highly amusing to see how the Society of Homeopaths respond to this development from their arch-rivals at Sense About Science. Today, they issued a rare press release. They have not issued too many this year, probably after learning that keeping a low profile is the best way to avoid criticism of their actions.

They say,

The Society of Homeopaths, the UK’s largest regulator of homeopaths, welcomes the call by Sense About Science today for tighter regulation of the internet, to ensure that vunerable people are not exploited by dangerous treatments.

Whilst there is a large body of published evidence to show that homeopathy is both safe and effective, The Society considers it important that people consult a qualified and registered homeopath.

Registered members of The Society of Homeopaths are clearly identifed by the designation RSHom, which reassures the patient that they have met the required education standards, have undergone The Society’s registration process, are fully insured and have agreed to abide by a strict Code of Ethics & Practice.

Regular readers of this blog will know what a crock this is.

We know exactly how the Society fail to condemn homeopaths who exploit vulnerable people. We know how little evidence there is of homeopathic effectiveness and just how bonkers the whole process is. And we know just how little their code of ethics actually mean. The SaS pamphlet is design to see through the hogwash on the net dished out by almost all homeopaths.

I too look forward to greater regulation of quacks and when irresponsible homeopaths are in court trying to explain themselves. You really have to hand it to the Society for the sheer temerity of this press release. Bravo!

Labels: sense about science, Society of Homeopaths

 

The World Health Organisation is this weekend holding a Congress on Traditional Medicine to be held in Beijing, and will be evaluating how far governments around the world are following a previous WHO directive to integrate 'traditional' medicine concepts into their healthcare systems.


According to the WHO, traditional medicines (TM) are defined as:

the knowledge, skills and practices based on the theories, beliefs and experiences indigenous to different cultures, used in the maintenance of health and in the prevention, diagnosis, improvement or treatment of physical and mental illness.

The WHO also generously include what is called Complementary and Alternative Medicine as Traditional Medicines. The WHO appear to believe that real medicine can benefit from the integration of traditional beliefs, quackery and charlatanism and is actively lobbying governments to assist this process. This is an appalling state of affairs and deserves some closer examination.



Hold on, you might say. Are you not just being a while male western chauvinist, privileging my own cultural perspective in so readily dismissing TM? Are you not just thinking it all must be witchcraft and voodoo? No. I would strongly respond. Let us look at what the WHO are really promoting here. And, let's get a few things out of the way. Yes, there may well be effective treatments amongst the many indigenous medical traditions around the world. We could all quote examples of herbs that have found to useful in some areas. But, that is not to say that we should just take indigenous medicines at face value and assume that because we are told they work, they do. It is quite clear that many local healing beliefs have more cultural significance than medical substance. The same herb might be use for completely contradictory purposes amongst different cultures. We cannot assume that some cultures have tapped into ways of discovering medical knowledge that somehow depends on tradition, intuition or mysticism and not objective evidence and the scientific method. By looking at the prevalence of things like homeopathy within our own country, we can see that complex and far reaching healing beliefs can be sustained, with institutions, government support, research and university courses, without the slightest reason to believe that it is an effective medical approach.



So, back to the WHO. Their stance is that they should be promoting and strengthening something called traditional medicine throughout the world. The objectives of WHO are threefold:

• To facilitate integration of traditional medicine into the national health care system by assisting Member States to develop their own national policies on traditional medicine.


• To promote the proper use of traditional medicine by developing and providing international standards, technical guidelines and methodologies.


• To act as a clearing-house to facilitate information exchange in the field of traditional medicine

Tellingly, the acquisition of evidence to support the use of TM is not high on their priorities.

In 2002, the WHO published a review of its strategy with regards to TM. It is littered with CAM bias. It uses the term 'allopathy' to describe real medicine and so betrays a pro-CAM bias. Allopathy is a term invented by homeopaths as a term of abuse for healers that did not subscribe to their own philosophy. In a giveaway paragraph, the WHO say,

Allopathic medicine is based on Western culture. Practitioners therefore emphasize its scientific approach, and contend that it is both value-free and unmarked by cultural values.

If I was an Indian medical researcher, I would find this very insulting. I would be quite capable of assessing evidence, collecting data and drawing rational conclusions without being part of 'western culture'. The statement is playing on a distasteful cultural relativism that assumes that somehow science is a western owned cultural phenomena and that other ways of knowing have equal validity.


Now, the WHO go on to describe TM as follows:

Their common basis is an holistic approach to life, equilibrium between the mind, body and their environment, and an emphasis on health rather than on disease. Generally, the practitioner focuses on the overall condition of the individual patient, rather than on the particular ailment or diseases from which he or she is suffering.

This is blatant pro-CAM propaganda ripped straight from the text books of any quack degree in a western university. First of all, it would be interesting to know how they know this? Are all indigenous healing beliefs holistic? - whatever that means. And are all 'western' medics not concerned about the patients total quality of life, their environment and their state of mind? It is insulting bullshit.

The report is full of such shallow minded nonsense. When discussing why there is little good evidence for many alternative therapies, the report says,

The reasons for the lack of research data are due not only to health care policies, but also to a lack of adequate or accepted research methodology for evaluating traditional medicine.

Again, bullshit. The scientific method is quite capable of evaluating health claims, no mater what the source. Admittedly, some techniques lend themselves more readily to testing. Homeopathy, with their little sugar pills, is straightforward. Acupuncture needs a little more thought as it is quite hard to produce a good sham therapy. People tend to know if you stick a needle in them. The reason that such research methodology is not accepted by practitioners of alternative medicine is that is shows their techniques are indistinguishable from placebo treatments. The evidence collated over the past decade has been enormously unfavourable to most alternative medicines.

So, what is going on here. There may well be a number of factors. Firstly, it might be worth noting that the current Director-General of the WHO is a candidate put forward by the Chinese government, Dr Margaret Chan. She has extensive experience in government support and regulation of alternative medicine. Chinese medicine is not quite so traditional as we might be led to believe. Chairman Mao is credited with inventing what we now know as Traditional Chinese Medicine as he cynically provided his population with cheap medical services after the revolution. When diplomatic relations with the West were resumed, delegates were shown patients undergoing surgery using acupuncture as an anaesthetic. These displays are now know to be hoaxes where the patient was heavily sedated and had large amounts of local anaesthetic applied. (The BBC were quite recently taken in by this again).

But more worryingly, the conference in Beijing contains its own clues to distortion. In a Reuters news report we are told,

Revenue from traditional medicine in Europe reached more than 3 billion euros ($3.82 billion) from 2003 to 2004, according to Zhang Xiaorui, WHO coordinator on traditional medicine. The number for China was $8 billion, she said.

Yes. Vested interests appear to playing a huge role. At the conference, several groups have set up satellite symposia. The International Pharmaceutical Federation, a group representing 'pharmaceutical scientists ' is promoting 'self medication' of traditional, alternative and complementary medicines. The Ministry of Health of China and the State Administration of Traditional Medicine of China is also sponsoring a symposium on acupuncture that is organised by the World Federation of Acupuncture and Moxibustion Societies. The World Federation of Chiropractic is also in on the act with their own lobby. There is nothing non-western and traditional about chiropractic. It is a deluded and rather nasty cult like practice that aggressively lobbies for government regulation.

Behind this appears to be a justification from the WHO that it is right to promote TM because it is so widespread. They claim that,

• In China, traditional herbal preparations account for 30%-50% of the total medicinal consumption.
• In Ghana, Mali, Nigeria and Zambia, the first line of treatment for 60% of children with high fever resulting from malaria is the use of herbal medicines at home.
• WHO estimates that in several African countries traditional birth attendants assist in the majority of births.
• In Europe, North America and other industrialized regions, over 50% of the population have used complementary or alternative medicine at least once.
• In San Francisco, London and South Africa, 75% of people living with HIV/AIDS use TM/CAM.
• 70% of the population in Canada have used complementary medicine at least once.
• In Germany, 90% of the population have used a natural remedy at some point in their life.

and so on...

This is nothing but an argument from popularity. Just because something is popular does not mean that it is right. In fact it is disgraceful. Most people in India or Africa that use traditional medicine do so because they have no choice. And here is the heart of the problem. The United Nations should not be encouraging the of unproven, discredited and absurd treatments, just because they are 'popular'. They should be ensuring that governments make available effective and affordable treatments for all their populations.

The stance of the WHO and the United Nations here is shameful and unethical. They are pandering to local nationalistic irrational beliefs, commercial interests and a vague relativism. In doing so, they are promoting practices that will be a massive distraction and a waste of precious resources for those wishing to provide safe, effective and affordable treatments to the most vulnerable people of the world.

Babies in Kenyan slums do not need homeopathy to protect them against malaria. Thousands of them die every year. They need nets for their beds and mosquito control. South African people with HIV do not need Vitamin C and traditional medicine. They need cheap generic anti-retrovirals. Schistosomiasis devastates lives of 200 million and it is easily treatable with a single dose of the drug praziquantel. (The 'traditional' therapy, myrrh, fails.) TB kills thousands and can be treated with drugs. Clean water prevents cholera. Vaccinations prevent polio.

The prevalence of TM is not something that should be encouraged by the WHO but something that should be a world-wide cause for alarm and action. In India where the government actively encourages homeopathy, the WHO should be alerting the world to the plight of hundreds of millions of people denied access to effective medical treatment and subjected to exploitative quackery in the name of political expediency. In South Africa, the Mbeki government advocated the use of traditional medicines at the expense of 'colonial' drugs for the treatment of HIV. It has been estimated that 300,000 people died as a result and it allowed western quacks, such as Matthias Rath, to use the rhetoric of traditional medication to promote his useless vitamin pills as an AIDS cure.

The solution to so many terrible illnesses in the developing world are fairly straightforward. What is missing is political will and stability, education and fairly modest funding. The trillions that the West is now spending on bailing out banks is fantastically more than what is required to save the lives of millions from preventable illnesses. And while this is ignored, the United Nations is pandering to nationalistic nonsense, quackery and charlatanism that will benefit the deluded and fraudulent and kill hundreds of thousands unnecessarily.

The only more shocking thing is that this will go completely unreported in the world's news.

Labels: WHO, World Health organisation