Money well spent?

Tim Hume (Sunday Star Times June 21) has written a good account of traditional Maori Medicine (Rongoa Maori). The Health Ministry provides $1.9 million annually for this nonsense. That money would pay for approximately 1000 hip replacements.

One woman is described as taking her “traveling medicine show” overseas. It has all the elements of quackery – the laying on of hands, mysterious signs, mysticism and spiritualism. Her grandson is described as already showing the healing gifts.

Maori curses (makutu) are no problem. These can be cured, even remotely. We are told that the spiritual healer performed a “remote cleansing” in America but knocked over a chair while leaving the room. Tim Hume comments: “statements like this … tend to invite disbelief, if not ridicule”. And so they should!

One of these practitioners was recently convicted of “sexually assaulting two women with potatoes”. Why potatoes? I thought carrots or a cucumber would have been more useful. He had diagnosed a woman as having both breast cancer and liver disease. She had neither. He claimed to be able to detect abuse by smelling the patient. Unfortunately for him, the patient smelled a rat. Still, smelling the patient makes as much sense as recovered memory.

Rongoa can even cure orthopaedic conditions such as one leg shorter than the other (the leg pull?).

A woman who had failed to achieve pregnancy after one year went for treatment that involved deep massage “dislodging afterbirth remaining from her first pregnancy”. The only way quacks can flourish is when people are ignorant and gullible. The cure is education and an appropriate degree of scepticism starting during early education.

Tim Hume is right on target when he comments: “it sounds like the placebo effect dressed up in cultural justifications.”

At a time when Maori are afflicted with diabetes, obesity, hypertension and renal failure, Rongoa Maori is a colossal waste of money. Anyone daring to criticise it will of course be labeled as a racist.

Deadly allergy treatments

A Dublin man died while receiving treatment for peanut allergy from a kinesiologist. The kinesiologist was using an elimination technique called muscle testing. This is total quackery and I know of at least one NZ doctor who was struck off for harming patients while using this technique. The perpetrator in the Irish case is described as “Dr Brett Stevens”. I was unable to find any such registered doctor of that name on the Irish Medical Register so I can only conclude that this is yet another example of pretentious quacks giving themselves airs.

While I was doing an acupuncture course I saw a demonstration of this nonsense, not realising at the time exactly what was going on. I certainly recognised it as nonsense and I have written before about how astounded I was at the credulity of the other doctors present. Briefly, a patient was presented allegedly suffering from an allergy to tomatoes. While the patient pinched his index finger and thumb together the examiner tried to separate them (the muscle testing, sometimes called bidigital O ring testing) demonstrating a baseline measure of strength. When the patient held a tomato the examiner showed how the pinch grip was weaker. There is absolutely no scientific basis for this absurd test which is totally subjective. There are still quacks using it in New Zealand as well as some doctors but they keep pretty quiet about it for obvious reasons. If I heard of any registered medical practitioner using this test I would not hesitate to report them to the Medical Council.

The unfortunate Irishman collapsed and died on the way to the hospital. The coroner expressed concern but instead of denouncing the quack treatment he “called for re-evaluation of the allergy elimination technique.” This technique doesn’t need re-evaluation, it needs condemnation and the kinesiologist should have been prosecuted for manslaughter.

Allergy Today, Winter 2009

Acupuncture flunks again A trial subjected randomised chronic back pain sufferers to either sham acupuncture, normal care or real acupuncture. Sham acupuncture was administered using toothpicks concealed inside guide tubes. The two acupuncture groups did equally well and significantly better than the normal care group. The improvement gradually waned over a year.

ACC has also examined acupuncture in the context of acute back pain and any effect is short-lived and soon disappears.

It is unclear whether the chronic back pain group showed any functional improvement since the measurements of improvement were all subjective. For example, did large numbers return to work? This is the true test of a treatment, whether it is clinically important rather than just showing some statistical improvement.

What this trial essentially shows is that gimmick + fake gimmick is superior to normal care. What needs to be done next is the same trial using laser acupuncture. The same patients are randomised to normal care, laser acupuncture and (blinded) laser simulated acupuncture. Whilst not given to divination I will modestly predict the results of such an experiment. Both treatment groups will show the same degree of improvement which will be superior to normal care. Just to add a twist, you could add a fourth group being treated by some really motivational and enthusiastic physiotherapists. This of course enhances the placebo effect and could just close the gap between the “normal care” and the two active treatment groups.

Arch Intern Med. 2009; 169(9): 858-866.

And again I was at a conference recently and was alerted to a trial published in the BMJ that allegedly showed that acupuncture led to improved outcomes during IVF therapy for childless couples. In other words, an improved pregnancy rate. This is a load of rubbish and I recommend you look up the article and in particular read the rapid responses. The best one was from Edzard Ernst and after reading it I recalled something I had read in his book Healing, Hype or Harm. Sure enough, it was in a commentary by James Randi who was commenting on scientific misbehaviour around a published article purporting to show improved pregnancy rates for IVF patients who were subjected to prayer from total strangers from around the world. These results were a fraud.

I am not claiming that the BMJ paper is a fraud. It is simply absurd and should be treated in the same way as a paper purporting to show a beneficial effect from homeopathy. As a skeptic you simply think along the following lines: Is it more likely that this is a true effect or more likely to be a mistake or even fraud? A more crude response on this paper would be “bullshit baffles brains”.

Skrabanek has a good take on this as well: Extraordinary claims require extraordinary evidence, and randomised clinical trials, applied to absurd claims, are more likely to mislead than illuminate.

BMJ, doi: 10.1136/bmj. 39471.430451.BE (Published 7 February 2008). Skranabek P. Demarcation of the absurd. Health Watch Newsletter (5) 1990, 7.

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