Skepfeeds-The Best Skeptical blogs of the day

Repeat after me: Acupuncture does not do anything for hot flashes!

Posted in Skepdude by Skepdude on May 19, 2009

Why is it that every few months there has to be yet another worthless, badly designed study to make a ruckus about acupuncture and hot flashes? Or hypnosis and hot flashes? What is it about hot flashes that has people so intrigued? I have had entries in the past about hot flashes and alternative medicine (here, here and here are some examples). A new study has been published, yet again making the claim tha acupuncture works well to reduce hot flashes in menopausal women. Here we go again!

Abstract:
Objective: This study compared the effectiveness of individualized acupuncture plus self-care versus self-care alone on hot flashes and health-related quality of life in postmenopausal women.

Red Flag There was no control group! Giving one groups acupuncture and the other nothing does not constitute a control group. The control groups should have gotten fake acupuncture and self-care in order to be effective. The authors have no way of controlling for the placebo effect. The comparison between the two groups is rendered meaningles.

Methods: This study involved a multicenter, pragmatic, randomized, controlled trial with two parallel arms. Participants were postmenopausal women experiencing, on average, seven or more hot flashes per 24 hours during seven consecutive days. The acupuncture group received 10 acupuncture treatment sessions and advice on self-care, and the control group received advice on self-care only. The frequency and severity (0-10 scale) of hot flashes were registered in a diary. Urine excretion of calcitonin gene-related peptide was assessed at baseline and after 12 weeks. The primary endpoint was change in mean hot flash frequency from baseline to 12 weeks. The secondary endpoint was change in health-related quality of life measured by the Women’s Health Questionnaire.

Results: Hot flash frequency decreased by 5.8 per 24 hours in the acupuncture group (n = 134) and 3.7 per 24 hours in the control group (n = 133), a difference of 2.1 (P < 0.001). Hot flash intensity decreased by 3.2 units in the acupuncture group and 1.8 units in the control group, a difference of 1.4 (P < 0.001). The acupuncture group experienced statistically significant improvements in the vasomotor, sleep, and somatic symptoms dimensions of the Women’s Health Questionnaire compared with the control group. Urine calcitonin gene-related peptide excretion remained unchanged from baseline to week 12.

Conclusions: Acupuncture plus self-care can contribute to a clinically relevant reduction in hot flashes and increased health-related quality of life in postmenopausal women.

StopCareful wording, but insufficient to say the least. At the very least the authors should have mentioned that the way their study was designed, it was impossible for them to separate the placebo effect from any real effects due to accupuncture. It is such a glaring omission that it makes you wonder how it could have been missed? Do you want to bet the the sCAM crowd will jump all over this study, proclaming that yet another study shows acupuncture’s efficacy?  I give the authors a D for effort and an F for their science.

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Quacking Like a Duck

Posted in JREF by Skepdude on May 7, 2009

One of the oft heard complaints about modern medicine is that it’s dominated by “big pharma,” that is greedy, soulless corporations who lie to us and suppress less expensive and more effective treatments for monetary gain. While it’s true that corporations are out for monetary gain, and there have been irregularities as with any big business, let’s take a look at the pot that’s calling the kettle greedy here.

Consider a single product: Oscillococcinum.

Their site never actually says that the “FDA regulated drug” does anything… really, read carefully. It doesn’t. They do claim it is a “Flu Medicine.” And they claim studies have shown its effectiveness in reducing flu symptoms. We’ll save examining the studies for another time, for the purpose of this article, let’s focus on the ingredients.

Pharmaceuticals such as Tamiflu and Zithromax are tested for years before they’re released to the public. Teams of chemists, lawyers, doctors, nurses, clinical researches, and study subjects go over every conceivable side effect or quality control issue before the drug is released to the market. These procedures cost an incredibly large amount of money, and while it may, in fact, be ridiculous to charge $5 for a pill, there is at least some basis for them being expensive. Part of that basis, is that they have active ingredients.

Not so for Oscilloccinum.

Each capsule is 1mg, and it contains a 200X preparation of muscovy duck heart and liver, .15mg of lactose (milk sugar), and .85mg of sucrose (table sugar). For those unwilling to do math, the sugars add up to 1g. Er.. where’s the duck liver? Well, a 200x preparation of anything is past Avogadro’s limit. It’s chemically impossible for there to be even one molecule of duck liver in an Oscilloccinum capsule. That means… there is exactly no duck liver in it. In fact, it’s a capsule of sugar, more suited for sweetening tea than reducing your flu symptoms. The tea might help though.

READ THE REST OF THIS ENTRY AT “RANDI.ORG”

Quack remedies spread by virtue of being useless

Posted in News by Skepdude on May 6, 2009

Eating a vulture won’t clear a bad case of syphilis nor will a drink made of rotting snakes treat leprosy, but these and other bogus medical treatments spread precisely because they don’t work. That’s the counterintuitive finding of a mathematical model of medical quackery.

Ineffective treatments don’t cure an illness, so sufferers demonstrate them to more people than those who recovery quickly after taking real medicines.

“The assumption is that when people pick up treatments to try, they’re basically observing other people,” says Mark Tanaka, a mathematical biologist at the University of New South Wales in Sydney, who led the study. “People don’t necessarily know that what somebody is trying is going to work.”

The World Health Organization is demanding better proof that folk medicines work before they can be approved. And the Malaysian government has rejected more than a third of the 25,000 applications to register traditional medicines it has received because the treatments are ineffective or dangerous.

Despite these efforts, quack medicine persists around the world. Some Nigerians treat malaria with witchcraft, a South African health minister recently claimed that garlic and beetroot treat HIV, and western health stores brim with unproven treatments for almost any disease imaginable. For instance St John’s wort does nothing for attention deficit hyperactive disorder in children, a recent placebo-controlled trial concluded.

READ THE REST OF THIS ARTICLE AT “NEW SCIENTIST”

Swine flu Woo

Posted in Skepdude by Skepdude on April 30, 2009

It has been predicted that the Swine Flu would bring out the quacks by the millions and the stupid would pour  like the rain in the Flood. And boy has that prediction come true, none more so evident than here. It is too much for any reasonable person to handle. I have writen to the Rogues at the SGU pleading them to handle this on the podcast, as this one is beyon even my mightly skeptical powers. Hopefully they will give her what she deserves.

thestupiditburns1

I moved the over-the-top profanity below the fold

Posted in White Coat Underground by Skepdude on April 29, 2009

Here at ScienceBlogs we have a (very) informal agreement to try to avoid profanity-laden titles. Personally, they don’t bother me at all, but I can see the point—there are lots of folks who probably don’t want their feed reader to pop up with what I’m about to say.

What the FUCK hath swine flu wrought????

I warned you that swine flu would bring out the charlatans. In the course of hours to days, a virtual zombie army of immoral, idiotic, evil fucking quacks has risen to fan your fears and take you cash.

It’s really hard to overstate this, but the people who engage in this fact- and morals-free exploitation are some of the worst people on this planet. Humans invented words for people who exploit and prey on your fears in order to benefit themselves (and, no, the word is not douchemonkey): evil.

Take “Dr” Wegmann at that execrable waste of bytes, the Huffington Post. This guy can’t even write a title without lying: 3 Sure-Fire Strategies to Prevent the Swine Flu.

Hey, fuck face: we don’t know enough about this thing yet to use the hack phrase “sure-fire”. Of course, that doesn’t really matter to you, you lying sack of excrement-filled kishkes. The lies pour out of you like pus from a diabetic foot wound (but less bonum et laudum). You actually go on to recommend fucking glorified massage therapy to prevent the fucking flu! That’s not even wrong! You reason that since chiropractic enhances the immune system (according to some dude–what, did you hear that at the bar?), that it is a “sure-fire” way to prevent the flu.

Now, ignoring (if that is humanly possible) the fact that rubbing someone’s back cannot prevent an infectious disease, and ignoring the vacuously meaningless statement of “boosting immunity”, even if we could “boost immunity”, who’s to say that’s a good thing? One theory for why the Spanish Flu pandemic of 1918 killed so many young people and spared the very young and elderly (unlike the usual flu) is that their relatively more robust immune systems killed them by over-reacting.

Oh, and you just “happen” to sell these “sure-fire” treatments. Yuck. I feel like I have to wash my brain out with bleach.

___________________________

Of course, no one brings the cynical, I’ll-make-up-the-problem-and-sell-you-the-fix paranoidwackaloongoatnuts insanity like Mike Adams. He actually does something clever with this one—he tells just enough truth to make a credible lie. It is true that data on wearing masks to prevent flu transmission is incomplete. Current recommendations are based on best available evidence and experience, skewed to the safer alternative. But let’s let him show off his stoopid skillz. What he is doing is telling people not to be deceived into buying masks to prevent flu. Rather than explaining that is is largely unnecessary at this point, he sets of the mark:

READ THE REST OF THIS ENTRY AT “WHITE COAT UNDERGROUND”

Things More Likely to Save You From Swine Flu Than Homeopathy

Posted in The Rogues Gallery by Skepdude on April 28, 2009

(x-posted on Skepchick!)

  1. Private island
  2. Gas mask
  3. Real medicine
  4. Aliens
  5. Mace
  6. Jesus (note: only if you’re in a Stephen King novel)
  7. Superman
  8. Your own immune system

A short recap for those stumbling upon Skepchick for the first time: homeopathy is nothing more than regular water, shaken up and packaged in boxes covered in lies and sold to people who don’t know any better. For a more thorough overview, see this post.

Mark, an official Friend of Skepchick, tweeted us a link to this ridiculous site trying to sell homeopathic remedies by capitalizing on the world’s panicked reaction to outbreaks of swine flu. Here are some highlights (bolding mine):

It is important for those more at risk to seek professional help from their homeopath, GP or health practitioner now. Constitutional treatment is the best way for anyone to strengthen the immune system and Helios would recommend consulting a homoeopath.

Sorry, no. Just . . . no. If you are “more at risk” to have a deadly infectious virus, like you just got back from a pig-licking tour of Mexico* where you were repeatedly sneezed on, then you should see a real medical professional. Homeopaths do not necessarily have medical degrees and all they can do is give you sugar water and then maybe contract swine flu from you and then you can die in one another’s arms, just like Romeo and Juliet only stupider, which is really saying something.

At present we do not have a nosode, i.e.a remedy made from the disease material. However, we do have existing remedies which have been used successfully over many years to treat all stages of flu. These are safe for everyone from babies to the elderly.

Man I am so hoping they manage to get their hot little hands on a vial of swine flu so they can bust that sucker open and dilute the crap out of it until they have their extra special magic water, which they can then drink to cure the swine flu they just gave themselves.

READ THE REST OF THIS ENTRY AT “THE ROGUES GALLERY”

Homeopaths: fallacies, lies, and dangerous advice

Posted in Journey Through a Burning Mind by Skepdude on April 13, 2009

Since this is the World Homeopathy Awareness Week, I might be spending more time on this particular well of credulity. I will also re-post my piece from last year’s WHAW. But today, I’ll be talking about Melanie Grimes, a homeopath who writes for HealthNews as a health “expert”. The irony though is painful -you will soon see that if “expert” was to be used in the same sentence as Melanie, then that would be: “Melanie Grimes is the exact opposite of a health expert“. So let’s start the fun, shall we?

I had a look at 3-4 of her articles*, and I can assure you they are filled with fallacious arguments of the worst kind; a very bad understanding of modern scientific research; misrepresentation or outright ignorance of the relevant scientific literature; and propagation of very dangerous homeopathic beliefs as to what their pet therapy can treat (from cancer to diabetes, it’s all there).

Starting with her piece on this year’s WHAW (starting slowly with some common stuff):

Homeopathy provides an effective and gently way to treat allergies. Using potentized medicines, homeopaths prescribe minute doses to treat both the acute reaction to allergens, as well as the cause.

I hope you have spotted that subtle piece of misinformation: “minute doses”. It’s not minute doses actually. It’s non-existent doses usually. The most common potencies of homeopathic remedies are 12C and above -a dilution so high that no molecule from the original substance remains in the remedy!

But the most interesting claim is that homeopathy is effective for allergies. In fact, this is a very common claim of homeopaths but is there any evidence to back it up? Readers of this blog already know the answer: no.

A quick search in PubMed brings up some relevant reviews [1][2][3], none of them recommending homeopathy (or CAM in general) for diagnosing or treating allergies. Quoting from “Systematic review of complementary and alternative medicine for rhinitis and asthma”[1]:

Some positive results were described with homeopathy in good-quality trials in rhinitis, but a number of negative studies were also found. Therefore it is not possible to provide evidence-based recommendations for homeopathy in the treatment of allergic rhinitis, and further trials are needed. A limited number of studies of herbal remedies showed some efficacy in rhinitis and asthma, but the studies were too few to make recommendations. There are also unresolved safety concerns. Therapeutic efficacy of complementary-alternative treatments for rhinitis and asthma is not supported by currently available evidence. [emphasis mine]

READ THE REST OF THIS ENTRY AT “JOURNEY THROUGH A BURNING MIND”

Top Ten Tips For Creating Your Own New Alternative Medicine

Posted in The Quackometer by Skepdude on March 31, 2009

The economic downturn may mean that you are thinking of retraining as an alternative healer. You might be tempted to invest your redundancy money or savings in training courses and equipment. Think again. It may be far cheaper and much more lucrative to invent your own brand new form of quackery. Most forms of alternative medicine are at most only a few decades old or have only become popular recently. If others can become famous and wealthy by doing this, why can’t you?

Here is the Quackometer’s Guide to inventing a new branch of alternative medicine in ten easy to digest and holistic tips:

1. Minimise specific effects

Right. Let’s get one thing out of the way. Your newly designed alternative medicine is very unlikely to actually work. Progress in medicine does not happen with people just making stuff up, but instead relies on remarkable insight, careful analysis, detailed research and long and expensive clinical trials, with lots of false starts and wrong turns before progress is made. You will not have the time, inclination, money or intellect for this.

So, with little chance of being able to offer real benefit to your clients, the best you can do is to ensure you do as little as harm as possible. To this end, make sure your new quackery is inert, neutral and inconsequential in action. Take your inspiration from existing and successful alternative medicine. Homeopathy is just plain sugar pills. Acupuncture is just little pin pricks. Reiki is just hand waving. Bach Flower Remedies is just a few drops of brandy. Reflexology is just a foot massage. Even chiropractic is just a vigorous body rub.

If you make the mistake of delivering real effects, then you may well be found out and your new business will come to sticky end. That is why we do not see old sorts of quackery anymore such as blood letting and trepanning.

2. Maximise placebo effects

Make your treatment theatrical. Make your customer feel as if they have been listened to, been taken seriously, and then had lots of effort made on them to create a cure. This will ensure any available placebo effect is maximised. People will feel better about themselves if you make the effort. We know that the more dramatic the intervention, the greater any placebo effect will be.

So, spend at least an hour with your customer, asking lots of detailed questions, just like a homeopath. Use arcane terms and be thoroughly paternalistic, just like an old-fashioned doctor. Wear a white coat and have a brass plaque outside your spick and span clinic – just like a chiropractor. Get an impressive Harley Street address. Use equipment with dials and flashing lights. Take x-rays. Put certificates on your wall and, if you are doing well, have attractive receptionists. Give the impression you are creating your cure just for this patient. They are special. Make them feel so.

3. Choose what you want to cure carefully

The bread and butter illnesses for alternative medicine are the self-limiting (hayfever, flu, morning sickness) and the chronic but variable and cyclical (bad backs, arthritis, mild depression). The number one reason for people believing in alternative medicine is that it ‘works for them’. What this means is that their particular complaint just happened to improve sometime after rubbing whatever magic beans they had chosen.

Chronic illnesses are ideal – they represent repeat business. Bad backs are a classic. People will come to you when their backs are really playing up. Cast your spells, crack their bones and stick a pin in them and their pain will become less noticable. It will have gone away anyway. But now you have a loyal and evangelical customer. Correlation is causation to your customer. “Regression to the mean” is your friend. Understand it and use it.

Have excuses ready if things are not quite getting better yet – or even if things are getting worse. Homeopaths expect to see ‘aggravations’, that is, things getting worse before they get better. To them, it is more proof that the sugar pills are ‘working’. Have a story ready for every outcome, good or bad. Never admit you have failed.

Avoid illnesses with obvious end points, like death. Getting payment may be the least of your problems. If you want to be heroic and tackle illnesses like AIDS and cancer, best do it offshore. Find a country with fewer regulations, much lower standards of healthcare and more vulnerable people. Homeopaths tend to go to Africa to treat AIDS or prevent malaria. They might be imprisoned here. Find a nice spot in Spain for treating cancer. Or Mexico, if you are from the US.

Invent a ‘wellness’ programme. Tell people you can help them even if they are feeling fine. It’s preventative, you see. Chiropractors are masters at  roping people into prolonged, expensive and unnecessary treatment programmes, all in the name of ‘wellness’. Nutritionists ensure people are popping highly ‘personalised’ lists of vitamin and mineral pills and creating a continuous and easy revenue stream for you.

Perhaps the most lucrative path is to invent illnesses. Create your own problems, diagnostic techniques and cures and you can provide an end-to-end service of imaginary illnesses and cures. The Detox industry has thrived on this. Food intolerances and allergies have made shed loads for vitamin pill sellers. Electrosensitives have been sold millions of pounds worth of useless EMF trinkets and neutralising boxes.  People love their daily aches and pains, tiredness and mood swings to have a name and to have something to blame. You can provide a wonderful service by filling in the gaps for them.

4. Embrace the language of quackery

READ THE REST OF THIS ENTRY AT “THE QUACKOMETER”

Dr. Emoto’s water woo metastasizes

Posted in Respectful Insolence by Skepdude on March 30, 2009

Indiana Jones had a saying: “Snakes. Why’d it have to be snakes?” This line was most famously delivered in Raiders of the Lost Ark after he and his friend Sallah had opened the Well of Souls and were staring down into it. Sallah noticed that the ground appeared to be moving within; so Indy shined a light down the entrance, only to see thousands of snakes waiting for him at the bottom.

Sallah then drily observed, “Asps. Very dangerous. You go first.”

As we knew from earlier in the movie, Indiana Jones hated snakes and was afraid of them; so it was only natural that later in the movie he would encounter a floor literally writhing with thousands of them. So it was when I innocently picked up the latest issue of TIME Magazine and started perusing it yesterday. What to my fearfully wondering eyes should appear but an article entitled Mind over Chocolate. Because I like chocolate, I was curious and began reading:

Move over, organic, fair trade and free range–the latest in enlightened edibles is here: food with “embedded” positive intentions. While the idea isn’t new–cultures like the Navajo have been doing it for centuries–for-profit companies in the U.S. and Canada are catching on, infusing products with good vibes through meditation, prayer and even music.

My reaction was much like Indy’s: “Intent. Why’d it have to be intent?”

To which my imaginary companion replied, “Emoto. Very woo-ey. You go first.”

So I will, because as much as the whole concept of “intent” in various “alternative medicine” and other woo irritates the crap out of me, it also holds a bizarre fascination as well.

Before I go on to deal with these products, let’s take a trip back down memory lane to nearly two and a half years ago. That’s when I first encountered the infamous Dr. Emoto and his amazing water woo. Naturally, being the…pioneer that he is, a lot of this business of “imbuing” water and food with happy “intent” can trace back to him, at least as a business plan, given his H20m water. The long story is in the link immediately preceding this; the short story is that Dr. Emoto believes that water can somehow be altered by “vibrations” sent from someone focusing his or her intent upon it and that those vibrations leave behind residue of that intent that can then be imparted to the people who consume H20m. As “evidence” for this, Dr. Emoto cites “studies” (I’m using the term very loosely here, as you might imagine) in which he claims to be able to differentiate different ice crystals on the basis of whether “good” or “bad” intent had been directed at them. Being of an entrepreneurial bent, Dr. Emoto decided to scale up his focusing of intent on water into an industrial process, infusing the water with happy thoughts thusly:

READ THE REST OF THIS ENTRY AT “RESPECTFUL INSOLENCE”

Acupuncture – Disconnected from Reality

Posted in Science Based Medicine by Skepdude on March 18, 2009

The primary goal of science-based medicine (SBM) is to connect the practice of medicine to the best currently available science. This is similar to evidence-based medicine (EBM), although we quibble about the relative roles of evidence vs prior plausibility. In a recent survey 86% of Americans said they thought that science education was “absolutely essential” or “very important” to the healthcare system. So there seems to be general agreement that science is a good way to determine which treatments are safe and work and which ones are not safe or don’t work.

The need for SBM also stems from an understanding of human frailty – there are a host of psychological effects and intellectual pitfalls that tend to lead us to wrong conclusions.  Even the smartest and best-meaning among us can be lead astray by the failure to recognize a subtle error in logic or perception. In fact, coming to a reliable conclusion is hard work, and is always a work in progress.

There are also huge pressures at work that value things other than just the most effective healthcare. Industry, for example, is often motivated by profit. Institutions and health care providers may be motivated by the desire for prestige in addition to profits. Insurance companies are motivated by cost savings. Everyone is motivated by a desire to have the best health possible – we all want treatments that work safely, often more so than the desire to be logical or consistent. And often personal or institutional ideology comes into play – we want health care to validate our belief systems.

These conflicting motives create a disconnect in the minds and behaviors of many people. They pay lip service to science-based medicine, but are good at making juicy rationalizations to justify what they want to be true rather than what the science supports. We all do this to some degree – but, in my opinion, complementary and alternative medicine (CAM) is a cultural institution that is built upon these rationalizations.  It is formalized illogic and anti-science conceals as science under a mountain of rationalizations.

Some recent news items and reports dealing with acupuncture demonstrate this disconnect quite well.

READ THE REST OF THIS ENTRY AT “SCIENCE BASED MEDICINE”