Alternatives to Evidence Based Medicine
I will detail these seven alternatives in forth-coming issues of the magazine. For now here is Eminence based medicine: The more senior the colleague, the less importance he or she places on the need for anything as mundane as evidence. Experience, it seems, is worth any amount of evidence. These colleagues have a touching faith in clinical experience, which has been defined as “making the same mistakes with increasing confidence over an impressive number of years.” New Zealand Medical Journal Vol 113 No 1122 p479
It’s most unusual to see published trials showing that homeopathy is ineffective. The common term for this is “publication bias” where trials tend to be published only when they show something positive. One of the authors is GT Lewith, a long time apologist for homeopathy and that makes it even more remarkable. Should we give them one of our awards?
A double blind, randomised trial evaluated the efficacy of homeopathic immunotherapy on lung function. The conclusion: homeopathic immunotherapy is not effective in the treatment of patients with asthma. BMJ 2002;324:520-3
An accompanying editorial comments: “we believe that new trials of homeopathic medicines against placebo are no longer a research priority.”
All responsible health professionals must ensure that homeopathy is never funded by the health system. It would be grossly irresponsible to waste public money on “dilutions of grandeur”.
Ministerial Advisory Committee on Complimentary and Alternative Medicine (MACCAH)
Have a look at their Website: www.newhealth.govt.nz/MACCAH/. I have been visiting from time to time in keen anticipation of the result of their deliberations and to see what quackery will be introduced into our failing health system. The committee comprises a sociologist (chairperson), iridologist, doctor of medicine, naturopath, acupuncturist, paediatric nurse (and massage therapist), and teacher. The iridologist is David Holden who organised the International Iridology and Sclerology Conference that I mentioned in an earlier column.
Certain members of the committee have asterisks alongside their names as a reflection of a possible conflict of interest. Readers will recall that our organisation was unsuccessful in getting any skeptics on this committee. Would such a putative member have warranted an especially large asterisk?
There is a similar committee in the USA. It has become a scandal that the National Institute of Health (NIH) has distributed (wasted?) hundreds of millions of dollars on testing what Americans refer to as CAM, or complimentary and alternative medicine. They spent $1 million testing “magnet therapy”. The majority of the studies have been inconclusive and have led to the need for more tests. This has tended to give such quackery a spurious degree of acceptability. As critics point out, how many studies have been published showing that CAM doesn’t work? Read a very good critique of this area at www.washingtonmonthly.com/features/2001/0204.mooney.html
It is quite clear, given the US experience, that the MACCAH will produce nothing of any value and furthermore I predict that they will never publish a single article stating that any CAM modality is useless. I sincerely hope to be proved wrong.
Laying on of Hands
Every doctor of medicine knows the importance of properly examining patients even when they do not expect to find anything wrong. The act of touching people in a therapeutic context carries a very powerful placebo effect. This is a legitimate part of the "art" of medicine and when coupled with good communication leads to a good outcome. This effect is sometimes referred to as the “laying on of hands”, itself derived from the concept of mediated divine healing. For example, the King’s touch was supposed to cure scrofula, a cutaneous form of tuberculosis.
The extreme version of this is the absurd delusion of therapeutic touch where the patient is not actually touched but their energy fields are "corrected". Don’t laugh; this is part of mainstream nursing at Wellington Hospital!
The laying on of hands effect explains the apparent success of many physical treatment modalities such as osteopathy and chiropractic. They all do exceptionally well out of ACC-provided funding and it is no wonder that a recent provider survey found a high level of satisfaction from chiropractors (79%) and physiotherapists (76%). I once asked an ACC Colleague why they funded quackery such as osteopathy and chiropractic and his reply was that ACC didn’t care about anything except getting people back to work. Applying that logic I could set up a military consultancy (Boot Camp Rehabilitation Inc) and get people back to work by threatening them with military-style discipline.
Here is an extract from an advertisement from my local paper: "cranial osteopathy for babies and children to help with poor sleeping patterns, restlessness, crying and poor concentration". This quackery involves allegedly manipulating the bones of the skull to regulate the flow of cerebrospinal fluid. It is complete and utter nonsense that relies for its effect on the touching, a plausible patter and a gullible consumer.
ACC News October 2001 Issue 39
Bye, Bye, Bivalve
Trials of green-lipped mussel extract have been stopped after it was found that “the extract didn’t work.” (Marlborough Express March 11, 2002). Green-lipped mussel extract was marketed in NZ as Lyprinol and more than $1 million of the product was sold after it was claimed that it was a cure for cancer. Successful prosecutions were taken against those responsible for the scam.
The media frenzy showed that journalists had learned nothing from the Milan Brych affair.
I feed our cat (Gilgamesh) on green-lipped mussels, and as well as a lustrous coat he has shown no sign of developing cancer. I rest my case. In order to satisfy the most sceptical of journalists I enclose this picture as proof as he and Claire read the Lyprinol story.
This is the title of a magazine that contains some of the most nonsensical rubbish I have ever seen. The editor is the woman responsible for promoting the Hoxsey quackery in Tauranga, which led to dozens of desperate cancer suffers taking one-way trips to Mexico to receive treatment. Tauranga travel agents made a killing in every sense of the word. This magazine should be read by all Skeptics in order to get a taste of what could be inflicted on the health system by the MACCAH. One ray of hope however – they mentioned www.quackwatch.com and stated that “this leads the public to believe that natural medicines are a fraud.” Well-enough said!
Is this delusion never going to go away? How many trials does it take to show that burnt possum testicles do not deter possums from eating vegetation sprinkled with said preparation? The Green party are already a bit of a joke and this latest nonsense makes me wonder whether they have all been partaking of ganja while worshipping with Nachos Tandoori. However, there is more to this than meets the eye, or testicle. I tried sprinkling some of a late relative’s ashes around our garden and I haven’t seen the mother-in-law for months. I rest my case. It must also be horribly lonely for all of those people living downwind of a crematorium – they never get any visitors at all!