Thursday, November 27, 2008

ASA: Three strikes and you to carry on.

I've written about unregulated arthritis product Artrosilium on a number of occasions. The Advertising Standards Agency has just upheld the third complaint this year against Intramed Ltd, the company that markets Artrosilium in the UK.

The first in May 2008 was for selling herbal pills that purported to sort out prostate problems and raise your sexual game; the second in Sept 2008 was promoting more herbal pills (more specifically gingko biloba) which claimed:
By taking just two capsules of Ginkgo Biloba each day you will cope better with stress; your blood pressure will return to normal, a little more each day; your cholesterol level will fall, your short term memory will improve; after just a few days, you'll feel as though you've fallen into a real fountain of youth

The third, that came out this week, was for Vitasvelt, another herbal pill that:
is currently the only slimming product that can give you these amazing results thanks to the powerful action of Negative Calories, Lose 22lbs easily! 100% natural! Each capsule is packed with all the goodness found in 7 1/2 lbs of fresh cut vegetables! VitaSvelt - Lose weight fast eating your favourite foods
All three are unsubstantiated drivel.

Three wrist slaps in one year and there is nothing anybody can do about it. Intramed Ltd are free to continue selling their outlandish snake oil and I have no doubt it'll only be a matter of time before they do it again.

Their online shop, Health & Harmony Direct is a textbook study on the business of quackery.

The ASA have asked the Committees of Advertising Practice (CAP) to inform its media members of the problem with IntraMed. I'll not hold my breath.


Wednesday, November 26, 2008

£1 million for your 100% chemical free products

A long time ago, when I was an angry young blogger, I wrote about Sarah Beany and her nonsense 'chemical-free' cosmetics.

The Royal Society of Chemistry has taken this one step further and recently announced that they'll give £1,000,000 to anyone who can furnish them with 100% chemical-free material.

Part of the riot has been caused by Miracle-Gro who have longed claimed (to the derision of anyone with basic chemistry understanding) that some of their products are:
Made from 100% naturally occurring materials. 100% chemical free.

The Advertising Standards Authority have been unusually backward on this and according to a Guardian report by Frank Swain at the time, they stated:
When there is a colloquial understanding of a word, we can take this into account when reaching our decision. In this case, we believe that most viewers are likely to understand the term 'organic' as meaning no man-made chemicals have been used to manufacture, or are present in this product.

I wonder if the Royal Society of Chemistry will amend the remit of its Organic Division accordingly.

I spoke briefly to Jon Edwards at the RSC to see if anyone had taken him up on the offer, apparently a few smart arses had offered him a vacuum or lightning or similar.

So will the companies claiming 100% chemical free status come forward? I doubt it. I'd like to see the RSC approach them directly (and the ASA for that matter) and see where that takes them. A brief google search gives two major arenas - coffee and cosmetics. Coffee, because of the Swiss-water method of decaffeinating coffee (fancy some Colombian Supremo?) and cosmetics, because nasty, evil, vindictive, malevolent chemicals are not good advertising when you're trying to persuade someone to plaster their face in order to hide their natural ugliness. So we have products like The Lip Pencil, 100% organic and chemical free. Oh, luckily it lists the ingredients:
Hydrogenated palm kernel glycerides, Talc, Hydrogenated vegetable oil, Caprylic/Capric triglyceride, Hydrogenated palm glycerides, Rhus succedanea fruit wax, Tocopherol (vitamin E), Ascorbyl palmitate. [May contain: +/- Titanium dioxide (CI 77891), Mica (CI 77019), Manganese violet (CI 77742), Iron oxides (CI 77491, CI 77492, CI 77499), Red 30 (CI 73360), Carmine (CI 75470)]

Should be a straightforward phonecall to the RSC and pick up the cheque, I would have thought.


Friday, November 21, 2008

RNLI - Saving lives at sea, funding quackery on land

The Royal National Lifeboats Institute (RNLI) is the charity that saves lives at sea.

As required by the Charity Commission, it defines its objects as:

When I'm not laid low I like to go scuba diving and instructing around the UK coast and have one occasion been involved in an RNLI operation. They are an amazing service and save myriad lives per year through sheer bravery by volunteers. The Charity Commission webpage on the RNLI shows them to have 42400 volunteers compared with 1332 staff. I feel it is my duty to donate to them on a regular basis, given that I may need their assistance one time in the future.

What I don't want them to do is to spend any money funding quackery - it turns out that they appear to have been funding a 'trial' into the homeopathic treatment of weaverfish stings.

Weaverfish are a small spiny-backed fish that annoyingly like to hang around just under the sand in shallow water with their fins sticking up. Weaverfish snacks and small children end up getting stung which can bring up to 30 mins of pain, which is remedied against by placing the sting site in hot water.

Now, the Cornwall College Camborne are investigating as to whether a 200c preparation (remember that's diluted 1:1,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,
000 or 1:10^400) of bee sting given in tablet form would have any effect. The homeopathic treatments were provided by Helios Homeopathy (Avid readers will no doubt remember that Helios were quite happy to sell homeopathic remedies and prophylactics for Malaria - potentially fatal, of course - without a shred of evidence to show efficacy, because none exists. The MHRA have since forced them to remove the offending products from their shelves).

The website links to any results for 2006 and 2007 give you a 'bad link' result, so I tried phoning a few people. Firstly, RNLI (BeachGuards) PR HQ - they had never heard of the study, secondly the chap who was running the 'trial', David Retford, was not for answering his phone. His webpage in the College Cornwall website does have some results though, from 2007.

We find out that n=24 for 2007 with 59 in 2006, so at any rate the result is not worth a whole lot. His results state:
the time to it took for participants to leave was less in group A: an average of 18.19 minutes (homeopathic group), as opposed to 19.71 minutes in group B (placebo group).

He claims that the 'rate of pain relief' is significant at p=0.051. I claim that with n=24 the whole thing is pointless and one and a half minutes is neither here nor there.

As with the Natural History Museum getting involved with Homeopathic databases, the RNLI is lending its very good name to be associated with quackery who will no doubt wear the badge with pride. The RNLI is there to save lives (their own mission statement) not to fund quackery.

David Retford also requests:
We need further funding from both the College and the RNLI to continue.

I will be writing to the RNLI and to try and make sure this doesn't happen.

Thanks to David Barratt and other Bad Sciencers for the heads up on this.


Thursday, November 20, 2008

There's one born every minute - Homeopathy & Pain-free child birth

Exactly. Pain free. That's what the article says - Pain free.

I am willing to put this down to an over-sycophantic headline writer, but the article in this week's Carlisle News & Star is a textbook case of what's wrong with the media, in particular, local media.

The article describes local homeopath Janine Whitfield MLCHom, MARH from New Path Homeopathy and her quest for the perfect childbirth.

Uncritical, sycophantic, factless, un-researched and vacuous, the feature takes us through Janine's plan for (I assume) her first childbirth experience. Now, we have been reproducing pretty successfully in one form or another since the primordial soup, and it's fair to say that we are getting better at it.

This graph is taken from Inequalities in infant mortality: trends by social class, registration, status, mother’s age and birthweight, England and Wales, 1976–2000, the .pdf of which can be found here. (I tried to find a suitable one on Perinatal mortality but time didn't permit). I was surprised to see even such a dramatic change in the 25 years or so the graph covers - so despite Janine's insistance on using quackery to safeguard her from the spills of modern childbirth, her chances are pretty good already, which is lucky given that she is giving everything over to sugar pills; even her independent midwife who will be present at her homebirth, is a homeopath.

Janine "understand[s] the way they work" which puts her ahead of every other person in the world (including other homeopaths) who can't agree on why they think it works, despite being continually demonstrated to be no better than placebo.

Then we get into the sticky ground - the ailments. Janine believes that the following, experienced during childbirth, can be relieved by homeopathic remedies:
nausea, low energy, swollen legs and high blood pressure

Well, the sugar in the pill might help with the low energy, but apart from that it's all looking pretty dodgy. Indeed her website goes further claiming
[Homeopathy] has also been used effectively with people suffering from severe illnesses such as cancer or HIV and AIDS, where it can help to treat the often distressing associated symptoms, and provides much-needed mental and emotional support for patients and their families.

But homeopathy doesn't treat symptoms, it treats the person, I thought? Up is down, black is white, square is round, same old nonsense.

Next we get to (admittedly, a new one on me) Biochemic Cell Salts. These are from the same stable of quackery as Hahnemann's homeopathy, but not quite as dilute:
The tissue salts are prepared in dilute form, are non toxic and safe to use during pregnancy.
The month by month programme can help circulation, reduce the chances of heartburn, help prevent swollen ankles and help prevent stretch marks.
They also have post natal benefits, helping with speeding up the recovery, healing, problems during breastfeeding and post-natal depression.

Woah! Post natal depression? Stretch marks? The journalist shows no incredulity and accepts this nonsense as perfectly reasonable. No questions, just resigned acceptance - any nonsense this woman said will be unreservedly copied and pasted to the readership. Post-natal depression - sure just take this useless pill and get on with life! This isn't a self-limiting minor problem, someone in this state needs care, support, help - not quackery.

There is an argument going on in meeja circles about the future of regional media outlets. The BBC is expanding its local online news services much to the chagrin of the local newspapers' owners. One would hope that whatever happens, local newspapers would be forced to raise their game a touch - printing uncritical nonsense like this does no-one any favours (except, perhaps giving the homeopath a few extra clients), does nothing for the public understanding of science and (at least in this case) some competition from a (usually) more thorough news outlet would serve the local population an awful lot better.

Earlier in the week, I blogged about the Tragic Case of Russell Jenkins, a man whose belief in alternative medicine and shunning of modern medicine appears to have led to his death. I hope in the extremely unlikely event of a problem during the birth, both Janine and her homeopath midwife have the sense to revert to real medicine and forget the quackery.


Wednesday, November 19, 2008

Natural History Museum gives homeopathy undue scientific credibility

The Natural History Museum is one of the most amazing attractions in London. That's not opinion, its evidence-based fact. The science made available to the public in the NHM is outstanding and world-class - I haven't seen the new Darwin Exhibition but if past exhibitions are anything to go by, it will be top notch historical science.

Why, then, is the NHM dedicating valuable research time and effort to create a homeopathic database of the various plants, fungi, lichens and algae used by quacks to make useless sugar pills?

From the website:
The homeopathy database is a standard reference system for homeopathic practitioners, and other users of plant remedies. It reconciles the old homeopathic codes with the current botanical code. The information is based on long established remedies in the Homeopathic Materiae Medicae that are now revised and updated and the online access means it can be maintained and updated easily in line with current concepts of botanical nomenclature.

For such a reputable and outstanding source of science education to be involved with quackery at this level is to denigrate the good name of the NHM and to give homeopathy a scientific acceptability that it does not deserve.

Indeed, are they include other things that homeopaths have made provings of? I would be interested to see if they will have the proving of the shipwreck, which was inferred to somehow provide prophylaxis against traffic jams. Such is the bonkers world of the homeopath.

Finance for the project came in part from Ainsworths, Waleda & Helios, all UK purveyors of homeopathic quackery. (Avid readers will no doubt remember that Helios were quite happy to sell homeopathic remedies and prophylactics for Malaria - potentially fatal, of course - without a shred of evidence to show efficacy, because none exists. The MHRA have since forced them to remove the offending products from their shelves).

The NHM is doing itself and science a huge disfavour by giving research effort and webspace to quackery. I can see how the databases of flora used in medicine can be worthwhile from a historical and taxonomical point of view, however there is no need to give any credence to homeopathic magical sugar pill-ery along the way.

The value of a visit to NHM in terms of science understanding is well appreciated. Sally Collins and Andy Lee co-wrote a consultative study into how Natural History Museums can support secondary science teaching and learning (.pdf here). A brief quote from the Foreward by Sir Mike Tomlinson:
The importance of science in our lives has never been more obvious, yet we continue to grapple with the challenge of enthusing students with science at school and its study post-16.

Teachers readily acknowledge the need to ‘bring science alive’ and to enable students to understand how science and scientists work. Teachers cannot do this on their own, which is where natural history museums can be so important.

This report clearly reveals the positive and lasting benefits of visits to natural history museums and engagement with scientists working there.

Why put this in jeopardy by introducing students to blind quackery while trying to teach them about science?


Tuesday, November 18, 2008

Failed by Complementary Medicine - The Tragic Case of Russell Jenkins

From time to time, I get asked why I bother putting the screw on various complementary therapies - my usual first response is as someone who finds science interesting, overwhelming, incredible and at times barely believable (but always based on rigorous experiment), I get frustrated at people inventing non-sensical waffle that is often demonstrably wrong, and passing it off as science (usually to make money).

Further on in the conversation, the phrase "well, it's fine as long as you don't take it too seriously" rears its fence-sitting little head. If that's the case, why no just ditch it now and be done?

Also from time to time, something happens that demonstrates clearly, tragically and painfully that you ignore conventional medicine at your peril and there are occasions where no placebo, no therapy, no energy, no matter how theatric will affect your situation. These have been collated at What's The Harm? and the story that follows will no doubt be added to that list in the near future. The Lay Scientist has written up the story here.

The inquest of Russell Jenkins took place this week, following his death in April 2007. The Coroner recorded a Narrative Verdict, meaning the cause of death is not attributable to anyone.

Mr Jenkins was a spiritual chanting artist who set up the Quiet Mind Centre at his home in Southsea in 1992, offering Reiki Massage, reflexology and the like.

After standing on an electrical plug, Mr Jenkins ended up getting an infection in his foot, which given his condition as a diabetic, was quite serious. Unfortunately, his 'inner being' told him not to go to hospital and his partner, Cherie Cameron who lived with him and joined the Quiet Mind Centre in 2002 also did not seek medical help. Ms Cameron still works at the Quiet Mind Centre, and despite previously being a theatre nurse did not see the danger in what was happening.

Mr Jenkins called on the advice of a homeopath, Susan Finn. (There is no mention of a Susan Finn in the records of either the Society of Homeopaths or the Alliance of Registered Homeopaths). By this time the foot had become gangrenous and it appears Ms Finn did not offer a homeopathic solution, instead suggesting he cover it in manuka honey.

This for me is the gut-wrenching part of the story. Susan Finn, regardless of her training or background, had a terrible situation on her hands. Here was a patient who was quite clear that he did not want to go to a Doctor or hospital and wanted alternative treatment, yet I'm sure she must have pleaded with him to get medical attention, despite her alternative beliefs.
His condition deteriorated and on April 13 he was forced to take to his bed. When Ms Finn visited the following day, she saw blood on the bed sheets and described a foul smell in Mr Jenkins's bedroom. His foot was swollen and one of his toes was discoloured. Two days later Mr Jenkins's condition had rapidly worsened and his toes had turned black.
- The News,

Even at this stage, Mr Jenkins refused to seek medical help with the tragic consequences that about a day later, he died from a 'mixed bacterial infection'. Mark Pemberton, consultant vascular surgeon reckoned that even 2 hours before he died, he had a 30% chance of survival.

This is quite a disturbing story and in fairness, I'm not sure how I feel about it. Where does the point of allowing someone the choice to make their own decisions stop and the point of overriding their belief system for their overall good start? I guess parallels can be drawn with religious beliefs where a medical practice viewed as 'illegal' within the community will result in an unnecessary death - blood transfusions for Jehovah Witnesses are one such example.

One thing is clear, anything that can be done to solve the problem and counteract the pseudoscientific claims of well-meaning but misguided believers long before it gets to this stage has to be a Good Thing.


Monday, November 17, 2008

More Omega 3 child testing nonsense - this time, New Zealand.

"The outcome I would be really happy with is a better understanding of healthy eating", said teacher Paul Whitaker, from Auckland's Wellsford School, according to TV.NZ.

What I assume he meant is "The outcome I would be really happy with is a better understanding of the scientific method, placebos and possibly the Hawthorne Effect".

It appears that after watching a BBC documentary on Omega 3 fish oils, Mr Whitaker decided to run a trial of his own: 42 pupils, 21 with a fish oil pill and 21 without, otherwise, everything was the same. The story was also picked up (slightly, but only slightly more sensibly) in The New Zealand Herald.

Now, Mr Whitaker makes a big enough song and dance about his results to allow me to pilliory him as a bit of a fool. It would be unkind to say that not much happens in NZ, and indeed this is no excuse. History repeated itself in many ways with the ghost of the nonsensical Durham Fish Oil trial/experiment/initiative/trial (still being admirably hounded by MacCruiskeen) being resurrected - the pills were given free to the school by Good Health, a NZ-based 'natural health solutions' company, who are happy to tout the trial as a success (despite not being finished yet) and give a list of some of the media exposure gained. (Save lazy people like me having to do too much Google trawling).

In a very similar case to Durham, the trial was poorly designed scientifically and a waste of time, although excellently designed from a point of view of getting a false positive with which to spin to the media.

First of all, 42 people is never enough to get any meaningful results - at best it may give an inkling as to the next direction your research will take.

Secondly, the person running the experiment knows everything about who is getting what and how well they are expected to do etc etc. This is where blinding normally comes into it. The amount of personal bias put into this trial (both unwittingly and perhaps wittingly) makes any results valueless. Did Mr Whitaker bias the choice of pupils in each category so that the trial would be a success? Who knows and indeed who cares, because there is so much more wrong with this trial.

Thirdly, what about a placebo? No placebo makes the trial an investigation into the Hawthorne effect - people perform differently when they know they are under test. You remove the problem by using a placebo.

Fourthly, the results are interpreted by Mr Whitaker - again the bias is open to his perception.
He said the 21 students taking the capsules for two months [...] were now six months to one year above where they were before they began taking Omega 3.

Really? They had moved a year ahead in 2 months? Read over that again - they had moved ahead by 1 YEAR in 2 MONTHS. That is a result. That is a HUGE result. Imagine the money that could be saved by shovelling fish oil down all these kids necks! IMAGINE! It's clear that this is just not the case.

Fifthly, why is the trial being touted as a success when it still has months to run?
Whitaker's experiment is expected to continue until the end of the academic year in December.
Why is this being treated as a media press release and not a scientific paper? The answers are pretty obvious, of course.

Now, you may think that this posting is an obsessive rant regarding a fairly small study in New Zealand, a bit of publicity and PR spin and not much more than a bit of fun. Well, I object to the following:

1. Children being tested on (especially when there is no possible knowledge gain, and only for a pill company to sell more pills)
2. The public's understanding of science to be further cheapened.
3. The media again showing no basic scientific criticism because they are scientifically illiterate and unable to carry out journalism as opposed to press release restructuring.
4. Lying to children by telling them the reason they have got good results is nothing to do with their hard work, but due to a pill and that's the way society works, so take your foot off the gas, kick back and get on the vitamins.
5. Lying to children by telling them the reason they are not progressing is because they aren't taking pills and not because they are not as smart as other kids or have some learning difficulties.
6. The medicalisation of "intelligence" as something which can be found in a bottle of pills.
7. Pill companies benefiting from all the above, and using the nonsense to pretend their brand of placebo is 'scientifically proven'.

No doubt this will prompt someone to do a formal trial of the fish oil pills. I wonder how meticulous they'll be? One can only assume that (especially with Durham) there is no interest in actually finding out whether or not there is an effect. A negative result would have too much of an impact on the bottom line.


Friday, November 14, 2008

Department of Health respond to Homeopathy Petition

Well, I say respond, but they don't really say anything.

The original petition is here with the following wording:
We the undersigned petition the Prime Minister to Immediately ban NHS funding of homoeopathy and redirect the resources to proven medicine.
to which the DoH replied:

Although the Department of Health provides strategic leadership to the NHS and social care organisations in England, it is for local NHS organisations to plan, develop and improve services for local people. These bodies are best placed to respond to patients’ concerns and needs, so it is their responsibility to commission healthcare services and treatments. The clinical and cost effectiveness, safety and availability of suitably qualified practitioners are all issues that have to be taken into account when deciding what treatment to provide.

The White Paper Our Health, our care, our say makes it clear that Primary Care Trusts (PCTs) will be holding GP practices accountable for the use of public money under practice-based commissioning, and that PCTs will be expected to support practices that are innovative and entrepreneurial, and which extend patient choice.

Now there are a few little tidbits to translate out of the bureaucratese and into english:

1. It is for Local NHS organisations to decide on clinical and cost effectiveness.

Fair enough. This phrase has to encompass non-efficacious quackery and efficacious-but-prohibitively-expensive treatments.

2. GPs are accountable to Primary Care Trusts for public money spending.

Again, no real drama.

3. "PCTs will be expected to support practices that are innovative and entrepreneurial, and which extend patient choice."

Hmmmm. I can't really get my head round this one. I would have liked to have seen a clause involving 'evidence-based' or 'science-based' in this statement. It's easy to increase patient choice and be entrepreneurial, but only if you are prepared to disregard the laws of biology and physics, lie to your patients and fleece them for placeboes.

Still, I'll take this in a positive manner, and hope that the statement is intended to promote new, evidence-based therapies and techniques which for whatever reason are not part of the historical GP surgery. Perhaps some increased dietician involvement to avoid future problems with obesity, diabetes etc.

What it doesn't say, however, is anything about homeopathy, which for a petition about homeopathy is rather strange. I would suggest that the government petition replies should adhere to following rule:

"A reasonable person should be able to guess the question, having got the answer".



Thursday, November 13, 2008

Be aware of who you believe and what advice you swallow ...

... so ends a pretty good section from BBC's Inside Out SouthWest program, which on 12th Nov ran a piece on The College of Natural Nutrition.

For those of you in the UK, the BBC iPlayer has the program here, it runs from about 1min 7secs to 11 mins 38 secs. (Unless some kind bod pops it onto YouTube, I'm afraid non-Brits will have access issues).

(As an aside, it was also BBCs Inside Out Southwest program that confronted Neal's Yard about selling homeopathic products for malaria and, along with a complaint from this site, managed to get the products withdrawn.)

The main villain in the piece is Barbara Wren, who runs the College of Natural Nutrition. A quick hunt on Google shows that she is anti-vaccines:
Barbara Wren, Principal of The College of Natural Nutrition, regards the customary procedure of vaccination as having a considerable damaging effect on the health of the growing and adult individual. Throughout her twenty five years of practicing, Barbara was able to observe the unequivocable results that vaccinations have on long-term disease patterns, affecting the physical, mental and emotional being.

and the College of Natural Nutrition happily plays along with the 'WiFi causes cancer' hoax that pops up every so often. Luckily, Nicola Summers at The College of Natural Nutrition is on-hand to explain how:
In natural nutrition terms, the pulsing electromagnetic signal enters the body, disrupts the electron cloud that surrounds our cells, which impacts the way the cell behaves, alters the charge of the cell and ultimately influences how the cell reproduces. This will of course have an extremely stressful impact on the body leading to dehydration, mineral misplacement, congestion, lack of ability to break nutrients down fully and so on.

If I meet her, I must ask her more about the electron cloud that surrounds her cells - one can only assume that the phrase "In natural nutrition terms" means the same as "in made-up lala land". She also kindly provides a link to EmFields, which is the new incarnation of Alasdair Phillips of PowerWatch.

So, all in all, The College of Natural Nutrition is shaping up to be proper little microcosm of nonsense. Like so many areas of woo, water seems to be key. Keeping rehydrated will of course keep most diseases as bay, but not any old water.... oh no, you need special, fetishist water - allow Barbara to explain:

Some Helpful Hints on Drinking Water:

Nothing, no substitute liquid, replaces pure water.

I usually recommend using bottled water, in glass if possible. Look for 'empty water' i.e. for a low content of minerals, especially sodium (Na) and calcium (Ca). Of the bottled waters, Volvic is one of the best, as it has the lowest surface tension and is one of the "emptiest"; unfortunately it has the disadvantage of being in plastic bottles.

If you can distill [sic] water, and thus "empty" it, that is ideal. Reverse osmosis with the addition of an activated filter is quite a good alternative. In many areas it is possible to have distilled water delivered, quite inexpensively. The best solution is in fact to have a still, which I consider to be a good investment, and to distill into glass. Any other sources are a compromise to a degree, and we have to select what we can from among the options. I use a little still which does a gallon every 8 hours and there is no message in distilled water. If you use distilled water, you need to pour it from a height of about 15 ins, in order to oxygenate it (and "enliven" it). Also you may wish to use a crystal, for example placed in a water jug, to energize water.
My bold, purely through lack of comprehension what it means.

Crystal therapy box ticked. Not a surprise if you take a look at the company she keeps on MySpiritRadio.

One of the students of Wren's is Barbara Nash, whose insurance company paid out £800,000 without accepting liability for giving advice to a patient (interviewed in the InsideOut program) which when allegedly followed left the patient brain damaged. Ben Goldacre, who was also interviewed for the program, wrote about the Nash case in his Guardian column at the time.

Anyway, you can imagine that BBC Inside Out SouthWest didn't have to delve to far into the lectures of Barbara Wren before the alarm bells rang.

Firstly, Barbara Wren's claim to cure thyroid cancer by using a dressing of castor oil and urine was met with understandable incredulity by Catherine Collins from the British Dietetic Association. Obviously, given Barbara's distrust of WiFi, it shouldn't come as a surprise that she reckoned the cancer was caused by a computer under the person's bed - a 'huge electromagnetic disturbance'.

Secondly, Barbara Wren suggests (insists?) on her students taking 25 times the maximum recommended dose of Iodine in supplement form, which is only available from the petshop as a water treatment chemical for fishies.

The presenter makes a valiant effort to take Wren to task over these suggestions, but to no avail.

This leads her to finish up with the line "Be aware of who you believe and what advice you swallow", but that isn't easy when most of the Main Stream Media is uncritically pumping this kind of rubbish out, giving people like Barbara Wren a platform from which to spout this type of nutritionist bullshit.


Wednesday, November 12, 2008

Paul Dacre vs Real Journalism

Paul Dacre, Editor of The Daily Mail, addressed the Society of Editors in Bristol this week, and his speech was printed in Monday's MediaGuardian. Throughout the week, various commentators have responded to Dacre's uncharacteristically public outburst, including Max Mosely and Polly Toynbee.

His main gripe was that the "British press is having a privacy law imposed on it" by one man, Justice David Eady who has used the privacy clause of the Human Rights Act to stop various sordid details of famous private lives making it into the public domain. Dacre uses the case of Max Mosely who famously sued News of the World for printing details of his S&M fun and games.

So what is the impact on journalism of this impinging privacy? According to Dacre:

[It] is undermining the ability of mass-circulation newspapers to sell newspapers in an ever more increasing market.
I hardly need write any more about what a nonsensical argument this is.

Dacre refers to the Human Rights Act as 'wretched' and maintains that Mosely was guilty of 'unimaginable depravity', which given that it appeared to be people engaging in consensual sexual practices, makes me wonder what hyperbole he would use to describe the recent stories of, say, alleged genocide in DR Congo, or the tragic death of Baby P.

Regular readers of this site will be aware of many shortcomings of the Mail, by uncritically touting PR releases multiple times, playing with statistics to give amazing headlines, or even repeatedly writing conflicting health information.

These are only limited examples that I've come across - I tend to agree with Polly Toynbee in that Dacre
probably does more damage to the nation's happiness and wellbeing than any other single person, stirring up hatred, anger, fear, paranoia and cynicism with his daily images of a nation going to hell in a downward spiral of crime and depravity.

So will the newspapers circulation keep falling if we can't find out about the legitimate sex lives of various glitterati? Perhaps Dacre would do well to start looking for some real stories. Stories that are bubbling in the background; stories that bloggers write about, unable to believe that bigger media outlets aren't already all over the story. Already this week we've had, amongst others:

- more news on the British Chiropractic Association suing Simon Singh for making comments in the Guardian regarding the efficacy of Chiropractic - should tick a 'free speech' box or two.

- information on the unholy alliance between Matthias Rath, Alliance of Natural Health & MEP Kathy Sinnott. (Matthias Rath was the vitamin pill salesman who dropped his courtcase with Ben Goldacre/The Guardian after Goldacre alleged that he was telling AIDS sufferers that AZTs were killing them and they should buy his vitamin pills instead). Again, another 'freedom of speech' box ticked.

- news that the World Health Organisation are investigating how much governments have been implementing their directive to integrate 'traditional' medicine concepts into their healthcare systems, lobbied heavily by vested interests with seemingly no importance placed on scientific method - the very misinformation that allows Matthias Rath and his ilk to carry out their pill selling under the guise of medicine.

These are huge stories that will no doubt remain untouched in the media, yet they are important stories that newspapers should be hounding down and publicising. These blogs are only in the pseudoscience genre, no doubt similar blogs exist in the arenas of economics and politics etc.

The real investigative journalism is being done for free by unpaid bloggers with no vested interests but a good story. If Mr Dacre wants to increase newspaper sales, he should do some real investigative journalism rather than whining like spoilt child.


Tuesday, November 11, 2008

Lies, Damn Lies and Statins

(By Guest Blogger, Sceptical Rogue)

What a great morning to wake up to!

The Daily Mail is telling me all about the new statin drug that slashes the risk of heart attacks and strokes for EVERYONE by up to 44 per cent.

I can't believe it.

How happy I am.

Even BBC Breakfast is having a go, promising that 'rarely have we seen such clear and dramatic results'.

But before we all rush to the doctor demanding prescriptions of Crestor to crush up and put in our morning cereal, I thought I'd take a slightly closer look.

So, this story is about the The JUPITER Study which was published online in the New England Journal of Medicine on 9th Nov 2008. The study looks at patients with relatively low levels of total (HDL+LDL) and 'bad' (LDL-C) cholesterol but with elevated C-reactive protein (a marker of inflammation), and looks at the effect on several cardiovascular events (notably Heart Attack and Stroke) when treated with rosuvastatin 20mg or placebo.

Now let's start with the good stuff - this trial does tick the Thinking Is Dangerous box of acceptable trial design. The trial is Double-blind, Randomised, Placebo controlled, Multi-Centre and Peer review published. Disclosure of the randomisation is pretty good and thorough with very low differences in risk factors across the groups.

The headline grabbing stuff tells me that if I take rosuvastatin I can slash my risk of heart attack by 58% and stroke by 48% even if I have normal levels of cholesterol. Well what could be wrong with that? Surely, a miracle has occurred here today?

Well, no. Not really.

There were 31 Myocardial Infarctions (Heart Attacks) in the treatment group compared with 68 in the placebo group. Each group had 8901 patients in it. There were 33 strokes in the treatment group and 64 in the placebo group.

In real, proper, everyday terms, this means that if I have normal cholesterol levels, but higher c-reactive protein levels, over 2 years:-

- My risk of heart attack goes from a rather disappointingly low 0.76% to an indistinguishably lower 0.35%.

- My risk of stroke goes from a most decidedly non-headline-grabbing 0.72% to a yippee-I'm-gonna-live-forever 0.37%.

Putting this into context, it was the Scandinavian Simvastatin Survival Study (4S) in the 1990's which really propelled the statins into the biggest selling drug class of all time. This study, also Randomised, Multi-centre, double-blind, placebo controlled and peer review published, enrolled patients with high cholesterol levels, compared Simvastatin to placebo and looked again at cardiovascular outcomes.

In this study, the risk of having one or more major coronary event went from 30% in the placebo arm to 19% in the treatment arm! Now these numbers are impressive.

It is worth noting that the Relative Risk Reduction in both trials is roughly similar, but that the real world Absolute Risk Reduction of JUPITER pales in comparison to 4S. And yet, have a look at the media outlets with their impressive numbers and listen as they demand that NICE start funding high doses of expensive statin in primary prevention to make, well, little difference to most people really.

In the interests of fairness it should be pointed out that these studies looked at different patients with different risk factors. It should also be pointed out that 4S had a follow up of 5.4 years whereas JUPITER was stopped early after median follow up of 1.9.

However, my point still stands - The Media, and let's not forget Astra Zeneca themselves - (bless them) will go for the big numbers and the huge claims and to hell with context - but then 'New Study Reduced Risk of Heart Attack from 0.76% to 0.35% for only some people' won't set the media world on fire.

Skeptical Rogue


Monday, November 10, 2008

Feeling hip!

Two weeks ago today I had an open hip debridement on my right hip. At 31, I was about half the age of most of the other people having similar operations, but I guess that's not too surprising. Cam impingement and subsequent treatment seems to be a reasonably new area of medicine and as such the techniques are still being developed. (Given the nature of this blog, I thought CAM Impingement was quite an ironic pathology for me to have)

Nonetheless, the above will explain the lack of blog activity over the past while, and indeed may explain the (anticipated) blog over-activity in the next few weeks! Sometime in the New Year I will be getting the same debridement on my left hip, so you may suffer the same famine and feast again then.

As it turns out, the consultant is confident that the pain I was experiencing before the operation won't get any worse, but couldn't say whether it would be less, so in reality I'm faced with potentially having the same chronic pain I had before the operation, but with the strong hope that it won't deteriorate.

In a timely manner, Sense about Science has published their latest guide "I've got nothing to lose by trying it" (the document can be downloaded from the top right corner of the SAS page). For this guide, SAS has teamed up with a number of charities including Multiple Schlerosis Society and Alzheimer's Society to provide some education and awareness of how, as consumers, we need to be incredibly alert to quacks offering us hope of symptom relief, usually in return for cash. Needless to say, the quacks generally take the money and leave the pain.

I have written on a number of occasions about Artrosilium, the arthritis gel aimed at the 5 million or so Britons who have arthitis or similar diseases. Despite having been slapped by Advertising Standards Authority in May 2004 and making the MHRA hitlist for unregistered medical products in 2003 and so not allowed to be sold in the UK, the product was still being sold via the website at, until a complaint to the MHRA from this site had the website closed. The website has since reopened at but at least it does not bear the web address, which gave a false feeling of UK regulatory legitimacy.

Searching for this product in Google brings 50% of Thinking is Dangerous' traffic, which shows that more and more people are using the net to try and get hold of fantasy quack medicines that somehow will prove to be the elixir they dreamed of. (I recently wrote a short piece for Sense About Science's Evidence-Based Medicine Matters project, along the same lines, and found myself (slightly embarrassingly) in very esteemed company!)

This is not to say that the purchasers of these products are stupid or uneducated, but more that when faced with chronic pain with no respite, people buy the dream, and don't give much thought to the evidence. The flipside of this is that there is a pretty penny or two to be made preying on these people, and this is where the unscrupulous quacks and marketeers are ready to pounce, pretending to be by your side offering you the solution, when in reality they are preying on your belief and hope of a so far impossible remedy.

The SAS guide is written to help people recognise quack treatments and is mainly concerned with neurological conditions, although it would have been great to see arthritis (rheumatoid & osteo) in there as well, as many of the same issues are experienced by arthrites. The BBC website has a brief video clip of arthritis/ME sufferer Daniella Muallem and her experience of quack remedies, which imparts rather well the importance of evidence-based medicine, as well as how non-conventional medicine can be purely an excercise in wallet-lightening.

So, as I sit here and recouperate, I'll mull over the fact that there is less cam impingement in my hip, and hopefully less CAM impingement in patient healthcare in general.