Tag Archives: Advertising Standards Authority

WDDTY: the gift that keeps on giving

WDDTY believes the ASA is biased because it is funded at armsa length through a levy on advertising. The solution? A competitor run by practitioners whose livelihood depends on the claims being made.
WDDTY believes the ASA is biased because it is funded at arms length through a levy on advertising. The solution? A competitor run by  the very people whose livelihood depends on the claims being made.

This article was written by Bryan Hubbard, whose style is similar to that of Lynne McTaggart but more outraged and even more credulous of the claims of woo-merchants, as you will see.

I s water good for us? Is there a link between food and cancer? Most of us would say so, but the UK’s arbiter on legal, decent, honest and truthful advertising doesn’t agree.

Actually we have no idea if they would agree, because these are not the claims that are being adjudicated. Hubbard falls for exactly the same fallacy that gets the charlatans into hot water: water is good for you, therefore any health claim you make about water is justified.

That may be true in the woo community, but it’s not true in the real world. And thereby hangs the tale.

For years, the Advertising Standards Authority (ASA) has been making strange decisions about advertisements from the world of alternative medicine, but it’s intensified over the past few years since it also started policing websites.

These are only “strange” if you uncritically accept the claims of charlatans, hucksters, quacks, cranks and crooks.

Which, of course, WDDTY does.

But now alternative practitioners, who have been barred from making self-evident claims about their work on their websites, have created their own ASA, which they believe can fairly and competently evaluate statements on the effectiveness of therapies and products.

They have not set up “their own ASA”. They may have set up their own advertising copy advice team, but this was probably a very bad idea, for reasons that will become obvious shortly.

Despite its name, the ASA is not a government body and it has no legal powers. It is a limited company created by the advertising industry as a self-regulator to ward off a move by the government of the time to set up an independent regulatory body. It’s also funded by the major advertisers, including companies from the food, petrochemical and pharmaceutical industries.

The ASA is a voluntary regulator funded by a levy on advertising. The levy is 0.1% on the cost of paid advertising space and 0.2% on some direct mail, this is not the same thing as being “funded by the major advertisers”, it is much more like being funded by the publications that take in advertising revenue. The ASA’s funding will be identical whether a page in the Daily Telegraph is bought by Esso, Pfizer or Holland & Barrett. It is an arms-length arrangement and it very obviously does not stop the ASA challenging marketing claims made by the industries that advertise.

The ASA exists because the advertising industry persuaded the government of the day that voluntary self-regulation would be effective, and it will continue to be voluntary only so long as that continues to be the case.

There is an official government page on advertising and the law.  Note that the Quackvertising Standards Association is not mentioned there, but the ASA is. Note the bit where it says “If an advert breaks the rules, it may be withdrawn. If the product doesn’t match the description or the advert breaks the law, you could be prosecuted.”

There is no exception listed for quacks who prefer to have their claims heard by True Believers.

This is an area of consumer protection. There are laws in place, most notably the Consumer Protection from Unfair Trading Regulations 2008. That is why, in addition to its powers to remove bulk email discounts and place paid search engine adverts, the ASA has the ability to refer recalcitrant advertisers to the Office of Fair Trading and/or Trading Standards.

However, through its policy-setting sister company CAP (Committee of Advertising Practice), the ASA sets the bar high-and, arguably, impossibly high-for proof and evidence of any claims made by manufacturers and practitioners, even admitting that it often doesn’t have the appropriate experts to assess claims.Not surprisingly, it has never found in favour of any alternative treatment or practitioner website or advertisement.

This, too, is wrong on many levels. The CAP has Industry Panels and (for broadcast) a Consumer Panel. It issues guidance. It draws on expert opinion, as do the ASA.

The requirement for proof is only “impossibly high” if you accept that advertisers should be able to make claims that are not supported by good evidence. Obviously if you are a homeopath or reiki master, the requirement to substantiate any claims to treat or cure disease by reference to robust randomised clinical trials on human subjects is likely to seem impossibly high. This is not the ASA’s problem, it is an indicator that your business model is fraudulent. People selling Ponzi schemes have the same problem.

The ASA has, found in favour of some claims by alternative practitioners (you could start with this search of adjudications and expand out to other CAP code sections to check for yourself).

A search of the adjudications database for the 12 months commencing 4 December 2013 shows 48 Upheld or Partly Upheld out of a total of 56 adjudications under section 12 of the CAP code 2012, dealing with medical claims, and a further 142 informally resolved cases. That’s roughly three-quarters of complaints that are resolved by the advertiser simply withdrawing the advert, and of the remainder, 86% are upheld. It’s high, but it’s not 100%. And some of the adjudications are against Big Pharma.

So the idea that the ASA exists to suppress “alternative” claims and support industry, is simply false. The problem is simply that the alternative industry is in denial: a treatment is only alternative if it either hasn’t been proven to work, or has been proven not to work.

Frightened by the ruling-and having wrongly assumed that the ASA is a government agency with legal powers most practitioners reluctantly removed any health claims from their websites or advertisements, so leaving their potential clients completely in the dark.

I see what you did there. No, removing unsubstantiated  claims does not leave potential clients in the dark, it leaves potential victims in the light. The ASA has no vested interest in either the drugs industry or the alternative medicine industry. It uses exactly the same standard of evidence for both. The problem is not with the ASA, it’s with the fact that quacks, crooks, charlatans and cranks believe their claims to be valid even if they are not supported by robust evidence, usually because they do not understand the concept of evidence itself.

As to why advertisers removed the claims, you might want to talk to the General Chiropractic Council. The British Chiropractic Association also says its members should adhere to the CAP code. So does the Complementary Medical Association.

So, just as it is misleading to imply that the ASA always rule against claims by alternative practitioners, or that they are funded by orthodox medicine, it is equally misleading to imply that alternative therapists cannot abide by the CAP or that there is any problem with trying to do so.

Any that don’t comply appear on the ASA’s ‘noncompliant advertisers’ page on its website.

We like this page. See for yourself who gets listed. You have to publish bollocks, repeatedly, for a long time.

It acts retrospectively and only when it has received a complaint. When the ASA was given its new duties to police the web, Simon Singh, who runs the pharmaceutical-funded ‘charity’ Sense About Science, provided seed capital for a new pressure group, the Nightingale Collaboration, with the sole aim to complain about websites and advertisements from alternative practitioners.

The logical fallacy here is poisoning the wellW.

It doesn’t matter how often you claim that Sense About Science is “pharmaceutical funded”, it remains false. There’s no need to put scare quotes round the word charity, either – this isn’t H:MC21 or the Homeopathy Action Trust, both of whose primary goal appears to be promoting the business interests of the trustees and/or officer, Sense About Science is a genuine charity committed to a tangible public good. It has a close relationship with the Royal Society and there are several Fellows on the board and advisory council.

Yes, Simon did seed-fund Nightingale. The sum was quite small, I understand, and not at all secret. As with all skeptical activism, the Nightingale folks are generally out-of-pocket as a result of what they do, because unlike the quacks, crooks, charlatans and cranks promoted by WDDTY (and indeed many of the contributors), they are not selling a product.

It even created software which it called ‘Shooting Fish in a Barrel’ -that enables its tens of followers to automatically register a complaint about any alternative health website to the ASA.

That’s a lot of Wrong in a short sentence. FishBarrel (not “shooting fish in a barrel”) was written by Simon Perry, and it seems to pre-date Nightingale – Simon did this as a personal thing, not as convenor of Leicester Skeptics in the Pub and certainly not for the Nightingale Collaboration.

It is good, though. Install it from the Chrome store.

Our own magazine was one of the first to be caught in Nightingale’s crosshairs, with around 27 advertisements in one
issue alone reported to the ASA, apparently something of a record.

Yes. You must be very proud of your role as possibly the second most prolific source of misleading health information in print, after the Daily Mail.

But after enduring two years of relentless censorship, alternative practitioners have decided to create their own ASA, one that does have the expertise to evaluate health claims fairly.

That word censorship. You keep using it, but I don’t think it means what you think it means.

For example: removing challenges to misleading information from your Facebook wall, is censorship. Preventing people from making unsubstantiated commercial claims is not. That is, and always has been, a perfectly legitimate act to protect consumers.

It’s been created by one of the regulators of alternative practitioners, The General Regulatory Council for Complementary Therapies (GRCCT), which launched
its advertising certification service last autumn. Its panel of experts from across a wide spectrum of alternative health disciplines has already approved its first websites.

WDDTY claims the ASA can be ignored because it is not a government body.  WDDTY fails to mention that its proposed alternative, GRCCT, is not a stautory regulator, has no legal powers whatsoever, and the trades regulated are not protected so no sanction would be effective anyway.
WDDTY claims the ASA can be ignored because it is not a government body. WDDTY fails to mention that its proposed alternative, GRCCT, is not a stautory regulator, has no legal powers whatsoever, and the trades regulated are not protected so no sanction would be effective anyway.

And who better to guard the hen-coop than the Independent Association of Foxes. They will of course set up a Chinese wall so that the foxes who decide whether a particular fox should be allowed into the coop will not be the same foxes who actually enter the coop, though all will partake of the chickens.

The crowning irony here is that WDDTY accuse the ASA of being conflicted because their funding` comes, at arm’s length, from everybody who advertises, but the new body they so credulously promote is actually run by people who have a vested interest in the claims being made!

Such approval comes with a professional guarantee, which includes an uncapped provision for expert witnesses and support in the event of any legal challenge to website claims.

This is where your cunning plan starts to unravel. Homeopathy Plus!W called two expert witnesses in court, but virtually all of the testimony was ruled inadmissible because the fact of an “expert” believing something does not, in law, make that thing so. More on this in a moment.

The GRCCT service is proactive and provides a ‘seal of approval’, which guarantees that claims are legal and not in
breach of any consumer and trading laws. The approval process involves experts from the legal, regulatory, academic and professional sectors, and costs start from £55 (see www.grcct.org for more information).

The GRCCT service – which I guess we should call the Quackvertising Standards Agency or QSA for short – cannot do this. It cannot guarantee that a claim is legal and not in breach of the law, it can only advise that in its opinion the claim is legal. Only the Courts can rule on what actually is legal. 

In fact GRCCT’s claims are more modest, but still ultimately delusional. It is certainly a good idea for quackery trade bodies to give advertising copy advice tot heir members, but if they do this on any basis other than the CAP they are likely to come unstuck. Here’s why:

Homeopathy Plus!W is an Australian outfit run by Fran Sheffield. HP and Sheffield were prosecuted for making false claims about homeopathic pertussis “vaccine”. They fielded as an expert one Isaac Golden, but his testimony was almost all rejected under the rules of evidence because he failed to prove the objective basis on which his beliefs were founded. This follows a legal precedent with parallels that would also rule in the UK (unsurprising: we share Common Law foundations).

An expert may state his belief that X causes Y, but it is not admissible as evidence unless he can provide independent objective evidence that X causes Y. The detail is discussed here and the full text of the judgment is here.

33 At its heart, the difficulty with Dr Golden’s report was that it cast no light upon the reasoning by which the opinions given were reached. Crucially, just as the figure reached in Dasreef as to the likely level of exposure to dust lacked reasons by which the connection between the specialised knowledge and the evidence was demonstrated, equally no such connection between the evidence as to the alleged efficacy of homeoprophylaxis in the prevention of whooping-cough (or other diseases) and the application of specialised knowledge was identified by Dr Golden’s report. As such, the evidence fell well short of meeting the requirements of s 79 of the Evidence Act. In those circumstances, I had no discretion. The passages in question were not admissible.

M’learned friends never use one word where ten will do, and the precedent is incredibly difficult for the layman to read, but as far as we in the reality-based community can tell the precedent, Dasreef, shows that even if you are an expert in something (in that case  the witness’ estimate as to the volume of respirable silica dust to which the plaintiff was exposed over time in the course of his employment lacked reasons, in HCCC v. Homeopathy Plus the issue was that Golden failed to demonstrate any credible scientific evidence that his beliefs were correct.

In other words, courts do not subscribe to the fallacy of appeal to authorityW. The purpose of an authority in law is to act as a shortcut to previous considerations of similar issues.

Here are some examples of ASA adjudications against alternative medicine:

Those “self-evident” claims in full:

These were presumably their bestimonials – the most slam-dunk cases of the ASA willfully suppressing self-evident claims by alternative practitioners. We’ve tracked down most of the cases, referenced the claims, and left you with the facts.

The evidence situation has developed, not necessarily to WDDTY’s advantage.

Evil ASA 7: WDDTY

This is the seventh of a short series on the examples highlighted in January 2015’s issue of WDDTY as “proof” that the ASA is fundamentally flawed, and as justification for replacing it by a body run by practitioners commercially vested in the claims under evaluation.

WDDTY

Yes, we have fallen afoul of the ASA as well. In a leaflet, we stated that doctors were the third major cause of death after heart disease and cancer.

Who could possibly object to that?

deaths

 

There it is, right there, under… er… er… no, it’s not there.

The thing is, the 2000 Starfield JAMA paper did say that, but that was over a decade ago and the debate it sparked brought out a much more nuanced understanding. There are some serious questions about the classifications.

For example, nosocomial infections (hospital-acquired infections) account for 80,000 of the deaths. Preventable? Arguably, though difficult in a context of rising antimicrobial resistance, but the people are only in hospital because they are sick anyway, would they have survived the original disease? Some yes, others definitely no.  There’s a certain pathos in being saved from a myocardial infarction only to die of MRSA for your central line, but did medicine really kill you?

Or what if you are in hospital desperately sick, and suffer a rare interaction of two drugs? Without either, or indeed both, you would almost certainly be dead anyway. Is it really fair to count these deaths as caused by doctors? How about a patient with acute lymphoblastic leukaemia? It’s chemo or death, and the chemo is toxic and might itself weaken you past the point of no return. What killed you, the cancer or the doctors? Only a crank would say: the doctors.

And that was not actually Starfield’s contention either: she was telling her colleagues (she was a US paediatrician) to stop being complacent and look for ways to improve. They rose to the challenge, procedural improvements in catheter and line placement, improved aseptic technique and so on have reduced the genuinely avoidable adverse consequences.

Harriet Hall has deconstructed this “death by medicine” meme and so has David Gorski. Regardless of what you sent the ASA, only the most determined anti-medicine whacknuts place doctors in the top ten causes of death.

When challenged, we produced the evidence-a major study published in the Journal of the American Medical Association in 2000.

Which is, of course, not relevant to the UK as it specifically (and in the title) discusses the US healthcare model.

The ASA reluctantly accepted we were right-but it still found against us, as we were in breach of another CAP code that bars any statement that perturbs the sacred trust between patients and doctors!

So you say. We can’t check because you give no reference number and no link, just as you didn’t with any of the previous ones.  Why don’t you want your readers to check the facts for themselves, I wonder?

Evil ASA 6: H:MC21

This is the sixth of a short series on the examples highlighted in January 2015’s issue of WDDTY as “proof” that the ASA is fundamentally flawed, and as justification for replacing it by a body run by practitioners commercially vested in the claims under evaluation.

H:MC21 conducts a mass protest outside the ASA. Sadly, nobody noticed.

H:MC21

The charity Homeopathy: Medicine for the 21st Century (H:M C2 l) placed an advertisement in a supplement of the New Statesman magazine in 2010. A complaint against it led to a bitter 10-month deliberation,

Whenever WDDTY talk about Sense About Science, they put the word charity in scare quotes. For H:MC21, the scare quotes should be three times the size of the main font, and flashing.

Theopen-quotecharitable purpose close-quote is listed as:

We have been continuing to work with other groups to get the information to the public about the validity of homeopathy and the propagandist nature of the attacks on this therapy. We particularly welcome the initiative by the GRCCT to establish professional accreditation of websites for CAM therapies, and the challenge this offers to bizarre rulings by the ASA.

That’s not a charitable purpose. It’s barely even a political manifesto. The charity raises virtually nothing, spends virtually nothing, and the charitable purpose advances the business interests of the  chief actor, William Alderson.

Ironically, the “propaganda attacks” amount to stating the scientific consensus. The actions of H:MC21 involve cherry-picking, distortion and even outright fabrication. What’s the word? Oh yes: propaganda.

Please do read the adjudication. Note the update comment. H:MC21 did not go quietly, and they still very firmly believe they were right. The ASA showed saintly patience, and received only abuse in return.

The claims adjudicated were:

1. “Homeopathy has a history of success in chronic illness”;

2. “At Bristol Homeopathic Hospital 70.7% of 6,500 patients with chronic conditions benefited from homeopathic treatment and had reduced need for conventional medicine”;

3. “… more randomised controlled trials are positive than negative”; and

4. “In Cuba, an integrated approach to healthcare has led to homeopathy being used to enable 2.3 million, including the elderly, to be cheaply and effectively protected against endemic Leptospirosis”.

The complainants challenged whether the following claims were misleading:

5. “About 6 million people in the UK choose Homeopathy”;

6. “… of the 2,500 most commonly used treatments in the NHS, 51% have unknown effectiveness”;

7. “Even a small increase in spending on homeopathy could produce dramatic benefits, reducing care needs and increasing patient quality of life”;

8. “Sense About Science” is funded by pharmaceutical companies and relies on a strategy of propaganda stunts rather than scientific research”; and

9. “(Trick or Treatment?) has been shown to be scientifically unreliable”.

They also challenged whether the following claims were irresponsible or denigratory:

10. “The NHS spends £2 billion annually on treating adverse side effects of conventional drugs. Homeopathy has no side effects”;

11. “The leading so-called ‘expert’ and critic of homeopathy, Professor Edzard Ernst, has admitted that he has no qualifications in homeopathy”; and

12. “The recent Science and Technology Committee report on homeopathy was voted for by only three MPs”.

The evidence submitted included the “Swiss Report” which is not a Swiss report but is a case study of research misconduct, a customer satisfaction survey masquerading as evidence of efficacy, and sundry other supportive gems mined from the House of Commons Select Committe report whose conclusions (naturally!) they then proceeded to dismiss. Because in their bubble world, only positive outcomes are valid.

It is telling that H:MC21 chose to buy advertising space in a major national magazine, and use it to make an unwarranted personal attack on Professor Edzard ErnstW. a man upon whose academic credentials they cast aspersions – from the position of having absolutely no academic credentials themselves.

I discussed H:MC21’s fallacious response to the ASA on my blog at the time.  Actually Brian Cox has since put it better:

The problem with today’s world is that everyone believes they have the right to express their opinion AND have others listen to it. The correct statement of individual rights is that everyone has the right to an opinion, but crucially, that opinion can be roundly ignored and even made fun of, particularly if it is demonstrably nonsense! – Prof Brian Cox.

So, what did the ASA find?

On the “Swizz report”:

1. Upheld […] The publication’s main conclusion regarding efficacy was drawn from a reconsideration of a previous meta-analysis of qualifying trials which found no significant difference between placebo and homeopathic treatment and had been published in a reputable peer reviewed journal. It featured a reworking of the analysis of the data by considering only therapeutic studies, and removing the prevention studies. This led to the number of significant versus non-significant trials becoming 28 vs. 23, as opposed to 32 vs. 33 in the original publication. The publication’s editors described this as “a truly remarkable result in favour of homeopathy”. Our expert did not agree with this assertion. However, the authors, in the section that discussed the study, stated, “While the above argument does not allow us to draw the reverse conclusion that homeopathy is effective, it does support the claim that the Shang et al (2005a) study does not prove the ineffectiveness of homeopathy”. Our expert agreed with this second statement only.

This is charitable. The document is in fact shockingly poor: the authors have substantial undeclared conflicts of interest and reversed the normal hierarchy of evidence in order to produce the result they stated, at the outset, they wanted.

So, in summary:

We concluded that H:MC21 had not supplied sufficient evidence to substantiate the claim and noted there was a lack of evidence to support claims for its efficacy. We concluded that the ad was misleading.

This is no more or less than the scientific consensus view. Surely WDDTY don’t want the ASA to treat claims according to the belief systems of claimants? So, for example, allowing people who believe in white supremacism, to publish white supremacist advertisements? Where objective standards exist and are generally considered applicable, then they are the right standards, obviously.

2. Upheld. We considered that most readers would interpret the claim “At a Bristol Homeopathic Hospital 70.7% of 6,500 patients with chronic conditions benefited from homeopathic treatment and had reduced need for conventional medicine” to mean that the study demonstrated that over 70% of the patients tested experienced a reduction in the symptoms of their chronic illness following the introduction of homeopathic treatment.

In other words, customer satisfaction is not evidence of efficacy. The core problem that homeopaths can never actually understand, it seems.

3. Upheld […] We considered that within the context of the claim “… more randomised trials are positive than negative”, the 49% of inconclusive results was a significant piece of information and should have been included in the ad because it indicated that under RCT conditions, inconclusive results had occurred more often than positive results.

Controversial? Hardly.

4. Upheld […] We noted evidence had not been supplied to demonstrate that the homeopathic medicine referred to in the report had been shown to be efficacious against Leptospirosis under clinical conditions and therefore considered that the vast reduction in the incidences of the disease had not been shown to be directly attributed to the homeopathic remedy that had been administered. 

Correct: regression to the mean explains the observation, and the claim that Cuba uses homeopathy for leptospirosis is false, they use Vax-Spiral, a vaccine developed in Cuba. H:MC21 are suffering from “kleptospirosis” here.

5. Not upheld We noted the MHRA had informed the Commons Science and Technology Committee that over 10% of the nation chose homeopathic treatments. We considered that this was sufficient to substantiate the claim that six million people in the UK used homeopathy

The figures are incorrect for other reasons, but ASA correctly agreed that H:MC21 had substantiated this claim. Wait, I thought they were supposed to be anti-SCAM and always vote Upheld? This is soooo confusing!

6. Not upheld  We noted the ad claimed “Homeopathy has a growing evidence base, but according to the British Medical Journal, of the 2,500 most commonly used treatments, 51% have unknown effectiveness”. We also noted H:MC21 provided the pages from the BMJ site upon which this claim was based. We considered that, in the context of this ad, the claim invited readers to consider the view expressed in the BMJ article, but did not go so far as to discourage readers from seeking essential treatment for conditions for which medical treatment should be sought.

I disagree with this, but understand the rationale. The problem is that the study on which it is based essentially says that you can’t interpret the figures as H:MC21 do (for example, how would you conduct a randomised controlled trial for emergency repair of ruptured aortic aneurysm?). That said, the study is not as grossly misrepresented as it usually is by quacks and once again the ASA gives the benefit of the doubt to the advertiser.

7. Upheld We noted H:MC21 had not sent sufficiently robust scientific data, including double blinded clinical trials, to substantiate the claim that homeopathy could effectively treat chronic medical conditions.

We sympathise: it’s hard to do when no such good evidence exists, after all. How it must suck to be a homeopath if you actually care about evidence. Ah, wait…

8. Upheld The ASA noted the ad claimed “The leading organisation opposing Homeopathy, Sense About Science is funded by pharmaceutical companies”.

And no evidence was presented. They should have asked WDDTY. Oh, wait, they never present any evidence when making the identical claim either. It’s almost as if there is none.

9. Upheld We read the publication Trick or Treatment and the paper Halloween Science.

Halloween science is William Alderson’s comically bad “peer reviewed” critique of Trick Or Treatment. The latter is a properly published popular science book. The former is, well, a splenetic rant by someone who is suffering acute pain in the feels. I can’t trace any evidence that it’s really peer reviewed, other than passing round a few like-minded mates, which is not the same thing at all

Alderson also wrote a 62 page “critique” of a seven-year-old A4 flyer from  Sense About Science, which still managed not to make a single valid point. He is really good at this.

10. Not upheld We understood that homeopathy had been shown to have no side effects

Again, I’d have Upheld this as the claim is misleading (homeopathy has no effects) but the ASA again gave H:MC21 the benefit of the doubt. Quacks have no gratitude.

11. Not upheld […] we noted Professor Ernst, as a scientific commentator, did not fall under the definition of those parties that were subject to CAP Code rule 3.42 concerning denigration.

Out of scope. Fair enough, though still a shitty trick.

12. Not upheld We noted the Report made a series of policy recommendations about the future of NHS funding for homeopathy and considered that, without further clarification, the claim implied that MPs had disagreed with the scientific conclusions of the report. However, we noted the report and the Committee did not fall under the definition of those parties that were subject to CAP Code rule 3.42 concerning denigration and therefore concluded that the ad did not breach that Code rule.

In other words, H:MC21 lied but it’s out of scope.

with the ASA finding against both the advert and homeopathy, claiming there was no evidence to suggest it had any effect beyond that of a placebo.

Correct. That is the scientific consensus view. Three separate government level reviews (Switzerland, UK and Australia) have concluded it, the National Center for Complementary and Alternative Medicine says it, the NHS says it. It’s a fact. Not liking it does not make it perverse or any less a fact.

You might as well complain when they rule against free energy devices. Actually, being WDDTY, they probably do.

In addition, the ASA rejected a review of 6,500 patients who had received homeopathic treatment at Bristol’s Homeopathic Hospital, stating that the patients’ own assessments of their health were invalid (although it is common practice in conventional medical trials).

No, they did not reject it, they noted that it did not prove the claim that was made of it. The thing about refuted nonsense is that it only ever works once. Having been refuted, the same refutation works every time.

Patient satisfaction does not prove efficacy. Ever. Subjective self-reported scores are accorded low weight in any trial and generally only really useful to compare two active and proven treatments.

H:MC21 also said its other submitted evidence was either lost or edited.

No, it was just bullshit. Again, William Alderson is a world-leading expert on massive outpourings of tendentious nonsense.  He is pretty much the UK’s version of Dana “Mr Uncredible” Ullman.

So, looking at the actual text complained of, and the outcomes, with their mix of upheld and not upheld, did ASA brutally oppress H:MC21, or did they do a fair and even-handed job of picking apart the claims of a propagandist, allowing those items which are defensible, even if wrong? You decide.

Evil ASA 5: Dr Vernon Coleman

This is the fifth of a short series on the examples highlighted in January 2015’s issue of WDDTY as “proof” that the ASA is fundamentally flawed, and as justification for replacing it by a body run by practitioners commercially vested in the claims under evaluation.

Dr Vernon Coleman.

Advertisements for Dr Coleman’s book, Food for Thought, mentioned a link between certain foods and cancer.

Although countless studies-and government reports-have supported the claim, the ASA found against him. As Dr  Coleman said: “I hate to think how many people might have died unnecessarily if the world had taken notice of the ASA and had decided that there was no link between food and cancer.”

Did you spot the bait-and-switch there? Is there a link between food and cancer? Plausibly. Is there a provable causal link between specific foods and cancer? That would require specific evidence. Evidence of the type that tends to become very elusive, slippery even, when cranks start talking about it. An innuendo here, a tangential finding there, and voila! A case built on smoke and mirrors.

The hubris of claiming that lives have been saved by ignoring the CAP is quite remarkable. The vast majority of information about cancer is not provided by Coleman, or indeed by the alternative community in general.

But hubris is what Coleman does.

His claim was not the measured statement that there may be a link between food and cancer. Nope. He says things like:

As your knife cuts into the meat you could well be cutting into a lump of cancer. The piece of meat you raise to your mouth, on the end of your fork, could well contain a tumour.

This adjudication was harder to track down than the others because it is old, but you can still read it via the wayback machine.

The ad is splendidly deranged (and trust me, it is not an outlier):

A national press ad, for a book by Dr Vernon Coleman, was headlined “How Many Times A Week Do You Eat Cancer? Dr Vernon Coleman”. Text continued “Cows, sheep, pigs and other animals all get cancer. So, how do you know, when you cut into a steak, a lamb chop or a piece of ham, that there isn’t a lump of cancer inside your steak, chop or ham? How do you know that your burger or sausage doesn’t contain ground up bits of cancer? You don’t. As your knife cuts into the meat you could well by [sic] cutting into a lump of cancer. The piece of meat you raise to your mouth, on the end of your fork, could well contain a tumour. Now that animals are increasingly likely to have been ‘fed’ or ‘treated’ with carcinogenic chemicals, this risk gets greater every year. Farmers and butchers claim that animals are checked before they’re slaughtered. But they can’t possibly see what is happening inside an animal’s tissues. You won’t be able to see the lump of cancer. But you’ll be eating it. So will everyone else who eats meat. And I thought you’d like to know. You will never forget this warning. Every time you eat a piece of meat (or see someone else cut into a piece of meat) you will wonder … how much cancer am I eating today? For more information about food, cancer and health read Food for Thought and Coleman’s Laws by Vernon Coleman. Available from all good bookshops and libraries

This is Linda McCartney on crack.

The complainants, long before Nightingale started, complained as follows:

The complainants challenged whether:

1.  the ad misleadingly exaggerated the likelihood of cancerous tissue being present in meat products and

2.  Vernon Coleman could substantiate the implication that eating cancerous tissue was damaging to human health.

3.  Two of the complainants challenged whether the ad used an undue appeal to fear to promote the views of Vernon Coleman.

One of the complainants questioned:

4.  whether the claim “Now that animals are increasingly likely to have been ‘fed’ or ‘treated’ with carcinogenic chemicals, this risk gets greater every year” could be substantiated and

5.  whether the ad unfairly denigrated farmers and butchers by suggesting that they allowed sick or diseased animals to enter the food chain.

Coleman did not respond. Guess what? the adjudication went against him.

So, was the ASA suppressing the vital fact that there is a link between food and cancer, or were they responding to frankly bonkers claims that every sausage is a skin full of cancer just waiting to get you, and unable to view it other than on its face because the crackpot author refused to even respond? You decide.

Evil ASA 4: Zoë Harcombe

This is the fourth of a short series on the examples highlighted in January 2015’s issue of WDDTY as “proof” that the ASA is fundamentally flawed, and as justification for replacing it by a body run by practitioners commercially vested in the claims under evaluation.

You can see why this is more appealing than the NHS version eat well plate
Harcombe version. Mmmmm, steak. NHS version. WHERE’S MY STEAK?

Zoë Harcombe

This is a best-selling author

Really? According to whom? The Obesity Epidemic is currently ranked 1,231,560 in Books by amazon. That’s not really Dan Brown territory. Speaking of which: Dan Brown is  a best-selling author. He still writes unmitigated tripe. And so, it seems, does Zoe Harcombe…

who holds ‘alternative’ views about weight gain and diets.

You can say that again. Or you can say this:

Looking at her overall message, Zoe basically disagrees with the advice you would get from mainstream health organisations. The result of this is that people are likely to become confused. […]

And the fact is that Zoe’s conclusions that relate to cancer, at least as presented in the Mail, just aren’t supported by the overall body of scientific evidence.

This is why it is best to ignore the advice and stick to credible sources of health information from charities like World Cancer Research Fund (WCRF), or from NHS Choices.

She believes, for example, that the calorie theory and conventional weight-loss advice are wrong-and she said so in a recent video that’s on her website. However, as she
had recently published a new book, The Obesity Epidemic: What Caused It? How Can We Stop It?, the ASA considered
the video an advertisement for the book and so subject to its rulings.

This is similar to the issue Fran Sheffield had in ACCC v. Homeopathy Plus: a claim made “in trade or commerce” is taken to be any claim generally supporting the sale of a product, or from which the person making the statement might expect to profit.

There’s little doubt that the promotional video was selling the whole concept of her miracle diet plan: it’s “Zoe Harcombe: The Brand”.

The term “calorie theory” is used almost exclusively by quacks trying to sell miracle diets where you can eat as much as you like and still lose weight. The easiest way to spot if a miracle diet is fraudulent is this: it’s a miracle diet.

Another litmus test is when it’s credulously promoted by the Daily Mail.

WDDTY’s view that Harcombe’s claims are valid appears to rest on her status as a “bestselling author”. The ASA takes a different view:

Not surprisingly, it found against the video,

Please read the adjudication for yourself.

1. the claims in ads (a), (b) and (c) relating to Candida, hypoglycaemia and food intolerance misleadingly implied that they caused food cravings and could be treated by the Harcombe diet;

2. the claim “In no way is the body as simplistic as energy in = energy out – and, therefore, we do not need to put less energy in and/or try to get more energy out. We need to eat better, not to eat less” in ad (e) and comparison in ad (g) misleadingly implied that conventional weight loss advice was wrong;

3. the implication in the testimonials in ad (d) that the Harcombe diet led to weight loss could be substantiated;

4. the claim “it is recommended to stay on Phase 1 for longer if you have more than 20lb to lose” in ad (b) marketed treatment for obesity which would not take place under suitably qualified supervision;

5. the claim “Imagine yourself in just 30 days time feeling healthier than you can ever remember being. Imagine that you’ve successfully and easily lost up to 20 pounds in weight” and testimonials in ad (f) made reference to a rate of weight loss that was not compatible with good medical and nutritional practice; and

6. the testimonials in ad (f) implied the diet could treat medical conditions, including conditions that required medical supervision.

Harcombe’s response was another of the standard SCAM responses: a list of peer-reviewed studies which appeared to cast doubt on some elements of the current consensus understanding of the role of calorie intake on obesity.

The problem with this is that the scientific consensus, by definition, already incorporates all valid views according to their validity and the quality of evidence. That is the definition of a scientific consensus. And when you blow away the smoke:

We had not been provided with any evidence that Candida, hypoglycaemia or food intolerance were associated with being overweight or food cravings, nor that the conditions could be treated by the Harcombe diet. We therefore concluded that the claims breached the Code.

And:

The claim “In no way is the body as simplistic as energy in = energy out – and, therefore, we do not need to put less energy in and/or try to get more energy out. We need to eat better, not to eat less” appeared in ad (e) on the home page for the Harcombe Diet Club website. We considered that the claim was presented as factual and that it implied it was not necessary to consume fewer calories to lose weight by dietary change and that conventional weight loss advice was therefore wrong. Ad (g), a page on a website which promoted a book by Zoë Harcombe, included a comparison between a “Mother Nature” diet and the NHS recommended “‘Eatwell’ Plate”, which included the description “Fat & Sick”. We considered that, because the claim appeared in the context of a website focused on promoting a book and was connected with the content of that book, that it fell within the ASA’s remit. We considered that although it was clear that it related to the content of a book the comparison was presented as factual, and that it implied that conventional weight loss advice was wrong and contributed to obesity.

The thing is, if you are going to stand up and say that essentially the entire medical community is wrong about diet, you need to have solid credentials and robust research.

Harcombe claimed in 2011 to be “studying for a PhD in nutrition”, but told Ben Goldacre that she was not actually enrolled anywhere. She claims to have graduated from Cambridge in Mathematics, and actually her entire research base looks like an n=1 study.

Se claims to be “a qualified nutritionist with a Diploma in Diet & Nutrition and a Diploma in Clinical Weight Management”. The title nutritionist is not protected, qualifications such as these are often worth nothing. She says she is “first and foremost an obesity researcher”. A PubMed search turns up exactly one paper, a somewhat underwhelming piece in the Mayo Clinic’s house journal, with a respectable impact factor of roughly 6. The finding covers a small part of Harcombe’s claims, and definitely not the part about the “calorie theory” being wrong.

So, the ASA ruling is founded on the fact that (a) Zoe Harcombe provided no credible evidence to back her own claim, (b) the views she asserts to be wrong are backed by a mass of evidence, and have the weight of endorsement by governments, obesity specialists and diet researchers, and (c) Harcombe’s own authority falls well short of the level necessary to establish her dissenting opinion as being valid.

Not, as WDDTY imply:

as the CAP code holds to the calorie theory

No the CAP does not “hold to the calorie theory”. The CAP merely says that diet claims have to be well founded. The guidance is quite straightforward and entirely in line with sane guidelines for weight loss. Because, you know, people do stupid things. Fortunately Zoe Harcombe would never stoop to exploiting such a tragedy. Oh. She did.

In response, Zoe said: “CAP admit they have no evidence [to support their views].

No, they do not. They state, rather, that you provided no evidence to support yours. If you rely on reversing the burden of proof – “go on, prove me wrong” – then you have already lost.

The ASA admit they have no choice but to administer the opinions of CAP. If someone complains to the Alternative-view Silencing Agency about you, don’t waste a second of your time
submitting evidence.”

Gosh, the ASA can’t ignore the code by which it is committed to regulating advertisements, just because you demand special treatment and your own special code. How evil is that?

In reality, of course, people who have genuinely defensible claims can and do submit evidence. 14% of health-related claims that went to adjudication last year, were Not Upheld.

So, were the ASA unjustly suppressing alternatives to the “calorie theory” dogma, or were they just upholding their own published standards against special pleading by somebody whose credentials and evidence fall well short of where her ego believes them to be? You decide.

Evil ASA 3: Quinton Water

This is the third of a short series on the examples highlighted in January 2015’s issue of WDDTY as “proof” that the ASA is fundamentally flawed, and as justification for replacing it by a body run by practitioners commercially vested in the claims under evaluation.

quinton
The relationship between elements in the body. Allegedly. Warning: may contain traces of nuts.

Quinton Water

Under the CAP code, a health claim is “any claim that states, suggests or implies that a relationship exists between a food category, a food or one of its constituents and health”.

That seems reasonable.

As Quinton Water offers a range of products based on a sea-water solution, they are considered foods, and any health claims for them are regulated by the EU. Even a self-evident statement such as ‘Water is good for you’ with no supporting evidence is inadmissible.

I doubt if it is, but somebody would have to complain first, and then the advertiser would have to fail to provide substantial evidence to support the claim. Water is good for you would be rather easy to substantiate. Perhaps that’s why, despite WDDTY’s harping on about this, there is no evidence anybody ever has actually complained about the claim that water is good for you.

What did they complain about? Read the adjudication here.

Claims for the product “Quinton Isotonic” included a range of health claims, including the product name, and that it: had anti-inflammatory and calming properties; could boost the immune system; maintained a healthy digestive tract, so encouraging “friendly” bacteria and helping repair the gut lining; improved the health of developing eggs and sperm, so increasing the chances of conception and the strength and health of babies; caused better sleep patterns and sleep quality; could detoxify and boost the body; and could help the body “regain optimum mineral balance to maintain health”. Further claims, that the product could reduce the risk factors of disease, included “Red Blood Cells become less sticky and stop forming into stacks called rouleaux. RBC rouleaux is one of the high risk factors for retinal degeneration in diabetics”. The website also included claims that the product could prevent, treat or cure disease, including that it could: reduce allergic reactions; reduce anxiety; support the respiratory system in people with conditions such as asthma and hayfever; alleviate the symptoms of stomach and bowel diseases such as IBS and ulcers; cause insomnia and chronic fatigue to disappear; eradicate blood-borne infections; and cause significant improvements in children with autism.

Claims for the product “Quinton Hypertonic” included a range of health claims, including the product name, and that it could: enhance mental focus and alertness; boost the immune system; counteract the dehydration and “mineral excretion” caused by alcohol consumption; help the body maintain maximum hydration and performance during exercise; and replace minerals lost from the body “during stress”. The website also included claims that the product could prevent, treat or cure disease, including that it could help people with depression and infections.

Claims relating to the use of both the Isotonic and Hypertonic products included: health claims that they helped regulate metabolism and stabilised and regulated blood sugar; and claims to prevent, treat or cure disease, including that they were beneficial for gingivitis, tonsillitis, mouth ulcers, dental caries, hypothyroidism and hyperthyroidism.

Claims for the efficacy of the product “Quinton Ocular Spray” included “Disturbances in mineral balance and loss of anti-oxidants allow degenerative changes and reduce resistance to ocular infections. Quinton Ocular replaces and balances minerals and anti-oxidants within the eye”, and that the product was beneficial for treating allergies, conjunctivitis, blepharitis, chalazion, scleritis, keratoconjunctivitis and sties.

Claims for the efficacy of ”Quinton Nasal Sprays” included that the products supported the local immune system, had anti-inflammatory properties, treated bacterial, fungal and viral infections within the nose and sinuses, prevented infection and allergies, reduced a risk factor in Asthma, and could help the conditions rhinopharyngitis, allergic rhinitis, obstructive sinusitis, ozena, colds and influenza.

Claims for the efficacy of ”Quinton Dermo Spray” included that the product helped treat sunburn, nappy rash, premature ageing, cuts, grazes, psoriasis, eczema, acne and seborrheic dermatitis.

That goes far, far beyond “water is good for you” and includes a number of very specific therapeutic claims. Specific enough that, well, you’d expect a vendor not to make them without good evidence. Especially when they could just say “water is good for you”.

Although Quinton says its products have helped millions of people, it has conducted many large clinical trials, and it has testimonials from doctors and patients, the ASA ruled that it was not permitted to make any health claims for its products.

Or, to put it in the ASA’s words:

The ASA understood that Quinton Isotonic and Quinton Hypertonic were foods. Ads for foods were subject to specific rules in the CAP Code, which reflected the requirements of EC Regulation 1924/2006 on Nutrition and Health Claims made on Foods (the Regulation).

That EU regulation? It’s a law. Regardless of what the ASA say you are not allowed to make that claim. It will be interesting to see if the QSA permits such claims (I am betting it won’t, given that there would be a highly costly test case to fight if they were ever challenged on it, and they claim to have legal advisors).

As the adjudication makes abundantly clear, this is a technical breach, in that the claims made are regulated claims under EC Regulation 1924/2006 on Nutrition and Health Claims – the CAP code says that claims covered by this regulation must be duly approved under the regulation, Quinton’s were not, end of.

Incidentally, the food labelling regulations are incredibly lax, much more so than those on medicines. So if you can’t even meet the low hurdle of food labelling regs, you might have a bigger problem than the ASA.

Was this a capricious act by the ASA taken to suppress natural “cures” for the profit of its corporate paymasters, or just an everyday case of unapproved food labelling claims? You decide.

Evil ASA 2: Islington Homeopathy Clinic

This is the second of a short series on the examples highlighted in January 2015’s issue of WDDTY as “proof” that the ASA is fundamentally flawed, and as justification for replacing it by a body run by practitioners commercially vested in the claims under evaluation.

Islington Homeopathy Clinic

I-Spy: Woo. How many mutually contradictory alternatives to medicine can you spot in this picture?
I-Spy: Woo. How many mutually contradictory alternatives to medicine can you spot in this picture?

Its website stated that homeopathy”is sanctioned by the UK government and has been an integral part of the National Health Service (NHS) since it was founded in 1948”. The Nightingale Collaboration challenged the statement as it suggested that homeopathy is an effective treatment. In response, the clinic pointed out that Aneurin Bevan, the architect of the NHS, stated that “homeopathic institutions will be enabled to provide their own form of treatment, and the continuity of the characteristics of those institutions will be maintained”.

Please read the adjudication.

The website home page on or about the date complained of said:

Homeopathy is the second most popular system of healing in the world, used by over 30 million people in Europe alone. In 2005, the World Health Organization estimated that homeopathy is the fastest growing healthcare modality in the world with more than half a billion users. It is over 200 years old, was introduced to the U.K. by Dr Quin in 1828, is sanctioned by the UK government and has been an integral part of the National Health Service (NHS) since it was founded in 1948. In November 2000, a House of Lords report on complementary and alternative therapies judged homeopathy to be one of five ‘group one’ therapies (out of thirty examined), with convincing research evidence of effectiveness, suggesting that it should be more widely available on the NHS.

(Archives from before and after the complaint do not differ materially).

In context, then, the claim of Government endorsement is very clearly being used in lieu of evidence of efficacy. In fact, they go one better, citing the House of Lords report in 2000 which found homeopathy to be a “group one” therapy. By which they mean:

The first group embraces what may be called the principal disciplines, two of which, osteopathy and chiropractic, are already regulated in their professional activity and education by Acts of Parliament. The others are acupuncture, herbal medicine and homeopathy. Each of these therapies claims to have an individual diagnostic approach and are seen as the ‘Big 5’ by most of the CAM world.

Oddly, Islington Homeopathic Clinic didn’t identify where in the Lord report they found the suggestion that homeopathy should be more widely available on the NHS. I say oddly, actually it’s because as far as I can tell it isn’t in there. The report deals with regulation. Feel free to point out if this is wrong.

Oddly, too, Islington Homeopathy Clinic didn’t mention the 2010 report by the House of Commons Science and Technology Committee which recommends the precise opposite, and which, unlike the Lords report, actually looks at the validity, not the regulation, of SCAM. Specifically:

23.  The Government should stop allowing the funding of homeopathy on the NHS. (Paragraph 110)

Homeopath in selective-and-misleading-presentation-of-evidence shock.

As to the Bevan quote. That is discussed in Hansard (see commenter Mojo at the Quackometer):

The Secretary of the Faculty also said: The Faculty of Homoeopathy is under an obligation by Act of Parliament to do everything in its power to advance the principles and extend the practice of homoeopathy and the Minister of Health has given assurances that under the National Health Service Act homoeopathic institutions will be enabled to provide their own form of treatment and that the continuity of the characteristics of those institutions will be maintained. For the sake of brevity, I shall not quote a great deal of what Aneurin Bevan said in 1946, when he was engaged on establishing the National Health Service, but he gave various categorical assurances. On 23rd November 1946 he said: If they”— homoeopathic hospitals— are to be brought in it must be the obligation of the Regional Boards in establishing their Management Committee to see that these Management Committees are of a character which maintains the continuity of the characteristics of those institutions. I think that I can give that absolute guarantee, because otherwise it would be an emotional mutilation which nobody could possibly defend. I am afraid that that guarantee has become less than absolute over the years, and I indict the Department of Health and Social Security for that.

Note that the speaker is Tom Ellis (Lab, Wrexham) apparently a homeopathy supporter.

The statement by Bevan does not itself appear in Hansard, nor, int seems, in any of the relevant Bills or Acts. It is taken from a speech, in which Bevan makes only one commitment: that the Management Committees of such homeopathic institutions as are brought in, should maintain their doctrinal purity. No guarantee of continuity is implied int his statement, nor would it be binding or even relevant given the subsequent scientific inquiry demonstrating homeopathy to be clinically ineffective.

In point of fact, the Management Committees have, since they were effectively devolved from NHS control as Trusts, have for the most part abandoned any form of doctrinal purity and adopted instead the omniwoo known as “integrative medicine”. This is hardly the fault of the NHS, as institutions were severed from NHS control by statutory instruments.

It is unequivocally the case that the present statutory framework holds no guarantees in respect of homeopathy. The speeches of Bevan are of no more relevance today than those of Churchill in support of the gold standardW. The road of politics is positively littered with broken promises, even if this was a promise as represented, which is debatable at best.

Were the ASA right to say that this claim of legitimacy was misleading? I think so. Actually I think they were more than fair. They could have expanded it to include the selective presentation of a tangential comment from a Lords report, editorialised without justification to give a conclusion which is firmly contradicted by a directly relevant subsequent Commons report.

The ASA found for the complainant, but it ended up being the best thing that could have happened to the clinic (see box, right), which is seeking to have its site sanctioned by the GRCCT initiative.

It will be interesting how the Quackvertising Standards Association (QSA) handles this. In particular it will be interesting to see what therapeutic claims they endorse.

This will be doubly interesting since the Society of Homeopaths apparently accept the validity of the ASA and have been working with them to provide clear guidance on copy. In fact, they specifically say:

Advertising and Media
38) Members should ensure that they do not allow misleading advertising and information about their practice. Advertising should be honest, decent, legal and truthful (as defined by the Advertising Standards Authority and conforming to the UK Code of Non-Broadcasting Advertising Practice (CAP)). [emphasis added]

That’s the problem with fields like homeopathy where everything is based on opinion instead of empirically testable fact: who’s to say whether the SoH is right, or the defiant homeopath who apparently also believes in (mutually exclusive) chiropractic?

Evil ASA 1: Medical Thermal Imaging

This is one of a short series on the examples highlighted in January 2015’s issue of WDDTY as “proof” that the ASA is fundamentally flawed, and as justification for replacing it by a body run by practitioners commercially vested in the claims under evaluation.

Medical Thermal Imaging

An advertisement in WDDTY from Thermal Imaging claiming “100% safe breast screening … thermography can detect active breast abnormality before it’s possible with nammography” was challenged by the Nightingale Collaboration (NC).

But as thermography was used as a complementary screening method alongside mammography until the late 1980s-and is still routinely used by a major London hospital-the company
was able to produce 1,24 7 scientific papers, including studies authored by some of the world’s leading experts in the field. The ASA lost some of the papers and deliberately excised relevant sections from others before deciding the evidence was not’robust’.

First, please read the adjudication. It is not very much like what Bryan describes, is it?

Now, about breast thermography. I don’t know all the history of its development and testing in the medical world, but the critical fact to focus on here is that this is a relatively cheap instrument that could, if it actually worked, be used by any medical facility. Radiographers could use it without significant additional training.

Bear in mind also that there are significant ongoing concerns about false-positives and radiation exposure in mammography.

If breast thermography were as good as mammography, it would be universally used. If it were better, as proponents claim, then there would probably be massive scientific prizes for the inventor.

No rationale is advanced for why this test is “alternative”. You can probably guess the rest.

From the American Cancer Society:

Thermography has been around for many years, but studies have shown that it’s not an effective screening tool for finding breast cancer early. Although it has been promoted as helping detect breast cancer early, a 2012 research review found that thermography was able to detect only a quarter of the breast cancers found by mammography. In other words, it failed to detect 3 out of 4 cancers that were known to be present in the breast. Digital infrared thermal imaging (DITI), which some people believe is a newer and better type of thermography, has the same failure rate. This is why thermography should not be used as a substitute for mammograms.

From the US Federal Food and Drug Administration:

Certain facilities, websites, and mobile units are promoting the use of thermography as a stand-alone evaluation tool for screening and diagnosing breast cancer, claiming that is a substitute for or superior to mammography. They also claim that thermography can detect pre-cancerous abnormalities and diagnose breast cancer long before mammography and that compressing the breast during mammography will cause or spread cancer by pushing cancer cells into additional locations in the body. The FDA is concerned that women will believe these misleading claims about thermography and not receive needed mammograms. [emphasis in source]

From a news report by the Canadian broadcaster CBC:

Two provinces have issued cease and desist orders against medical clinics that promote the benefits of thermography, a diagnostic test for breast cancer that medical experts say is useless.

From the Australian Government Department of Health:

Studies have shown that a tumour has to be large (several centimetres in diameter) before it can be detected by thermography (Homer 1985). Screening mammograms have the ability to detect breast cancer at a much smaller size, and therefore to reduce deaths from breast cancer. Less than 50% of breast cancers detected by mammography screening have an abnormal thermogram (Martin 1983).

There is no current scientific evidence to support the use of thermography in the early detection of breast cancer and in the reduction of mortality.

Cancer Research UK:

In 2012, researchers pulled together all the research that has been done on heat scans. This is called a systematic review. They found that there is not enough evidence to show that thermography is reliable enough as a screening test for breast cancer. There is not enough evidence that it can help to diagnose breast cancer when used with mammograms in screening. And there is not enough evidence that it can help to diagnose breast cancer when there are signs that a breast cancer might be there.

Until we have research evidence to show it is reliable, thermography is not recommended as a screening test or to try and diagnose breast cancer.

A PubMed search shows what’s actually going on. Thermography may be useful as an adjunctive diagnostic tool in breast cancer (the jury is still out), but it is definitively not useful as a primary screening tool.

Women frightened by the prospect of X-rays may well fall for the seductive claim of non-contact, radiation-free screening, but it simply is not reliable for this use,. and there’s already a problem even with the dramatically more reliable mammograms currently in use.

And in saying that there may be some value as an adjunctive approach, we are giving the vendors the benefit of the doubt.

Let’s remind ourselves of the actual text complained about:

100% Safe BREAST SCREENING …Thermography can detect active breast abnormality before its [sic] possible with mammography …  Medically recognised

 

Two claims:

  1. It can detect abnormality before mammography;
  2. It is medically recognised.

The 2012 review to which the ACS alludes says this:

CONCLUSIONS: Currently there is not sufficient evidence to support the use of thermography in breast cancer screening, nor is there sufficient evidence to show that thermography provides benefit to patients as an adjunctive tool to mammography or to suspicious clinical findings in diagnosing breast cancer.

So the two claims on which the ASA adjudicated are categorically false. The evidence shows that breast thermography is dramatically less sensitive than mammography as a screening tool, which is exactly as expected given how they both work, and the medical community, charities, regulators and governments all seem to be unanimous in saying that it is not accepted.

It leaked its decision to the Daily Mail, which ran a misleading story under the headline ‘Clinic found guilty of misleading women by claiming it could detect breast lumps through thermal imaging’.

Not true. ASA Adjudications are sent out under embargo. They are released on a Wednesday, and by a curious coincidence I happen to have the ASA press release in my mail archive still.

Subject: ASA weekly rulings published
Date: Wed, 9 Jan 2013 08:49:16 +0000
Reply-To: ASA press office <[email protected]>
Message-ID: <[email protected]>
To: [my email address]
From: Press <[email protected]>

[...]

Advertising Standards Authority

Adjudications alert

Weekly adjudications published

This week's adjudications have now been added to the ASA website. The following advertisers have been subject to ASA rulings:

[...]
Medical Thermal Imaging Ltd
[...]
Regards

ASA Press Office

The Daily Mail’s online story went up at 10:57 GMT on 9 January 2013, two hours after the press release. ASA embargos allow release on  the same day so if it was in the same day’s print edition it also did not violate the embargo. No leak, it seems, just a press release (ironic, given that recycled press releases form a substantial part of WDDTY’s content).

Yet another schoolboy error, by the looks of it.

The company’s proprietor Phil Hughes became ill as a result and suffered catastrophic organ failure, and had to be treated in intensive care where he also suffered cardiac arrest.

Very sad. He should have done the smart thing and removed the advertisements when ASA first contacted him. Perhaps he should have read his own hype: he seems to think thermography can detect heart disease as well.

To be fair, I think he might have his thermal imaging cameras confused with the X-ray specs they used to sell in comics.

The 7-Step Plan

WDDTY have published a 7-step plan for any practitioner who has attracted the attention of the ASA. The whole page is comedy gold.

If you were a magazine under constant criticism for publishing misleading information, would you take the time to promote the ASA’s adjudications against your contributors and advertisers?

Well, you might if you were in denial and didn’t care about reality I suppose.

7-step

“After enduring two years of relentless censorship, alternative practitioners have decided to create their own ASA, one that has the expertise to evaluate health claims fairly”

Since the ASA is the voluntary regulator charged with monitoring the advertising industry, and has powers of sanction that include the ability to place Google ads warning of fraudulent practice, removing postal discounts and so on, setting up an “alternative” is a futile and ridiculous exercise. It will have precisely no effect on the ASA or its backstop, Trading Standards.

The 7-Step Plan is written by Jenny Hautman of the Islington Homeopathy Clinic. This is like taking tips on avoiding arrest from Ronnie Biggs!

Step1 Register all your social media (Facebook, Twitter, Google plus etc) on Klout.com, which registers your online influence, and watch your impact grow as you follow the next six steps.

Ah yes, that will certainly help with the accuracy of your advertising. Oh, wait, no it won’t.

Step 2: When you get the complaint from the ASA, thank them, but also tell them you don’t intend to take any advice from a limited company with no legal powers and which has a conflict of interest. Send them an invoice for your time. You can use a template letter from the Freedom4Health website created specifically to help
practitioners deal with the ASA.

This is essentially simply refusing to co-operate. It will not stop ASA from adjudicating against you, it will not stop them from publishing your details as a misleading advertiser, it will not stop them listing you as a non-compliant advertiser if you continue to refuse to comply, and it will not stop them taking out a paid Google ad to tell the world about your misleading advertisements.

The ASA has no “conflict of interest”, that is conspiracist nonsense. It is funded by a levy on advertising. It constantly finds against advertisers. If, in fact, the source of funding was a conflict of interest, the ASA could not function and would never have been set up.  The claim of conflict is self-evidently wrong.

You may be member of a voluntary register such as OfQuack. They do listen to the ASA. A defiant approach to ASA adjudications is very likely to lead to formal complaints. Think how that’s going to look. Of course, you can leave the voluntary register (they have no teeth either), but that’s one more tool gone from your marketing armoury.

And, most importantly, if your misleading advertisement ends up in front of the courts, your defiant stance is not going to look too good in court. It really isn’t. Oh, did WDDTY forget to tell you that there is an actual law in play here, not just a voluntary regulator? That was mind-bogglingly stupid of them, wasn’t it?

Maybe, you know, it is not so smart to take advice with potential legal ramifications from people with absolutely no legal training and a vested interest in denying that their fraudulent claims are misleading.

Step 3: Post a summary of your correspondence with the ASA on your website. Better yet, record a video of interviews with you and your clients presenting the situation as you all see it

Oh yes, please do. It will be hilarious! There is nothing more calculated to give a skeptic a good belly laugh than a quack bleating about criticism from the reality-based community.

Step 4: Tell all your clients that, when It comes to complementary therapies, the ASA is neither legal, decent, honest nor truthful. Present examples of your experience and give them the link to your site to find out more, and ask them to write to their local newspaper. Post all or this on your website.

Again, a goldmine for mockery. Just think to yourself: how’s it going to look when you go tot he newspaper and for balance they contact the ASA? ASA will put them in touch with someone like Prof. Ernst or Sense About Science. And if they present only the self-serving claims of quacks, the Press Complaints Commission beckons, because newspapers (unlike quack websites) are duty bound to be accurate and are themselves subject to regulation.

Step 5: Post a link to your website on your Facebook and Twitter pages, as well as to any relevant Facebook groups.

How does this address the issue of misleading claims? Oh, it doesn’t.

Step 6: Sit back and watch your Klout score rise as the ‘skeptics’ feed on your audacity (their natural hunting ground is Twitter, so make sure you post there too). Don’t worry about nasty comments from the trolls – they’re only boosting your Google rank and Klout Score.

Ah, the “no such thing as bad publicity” gambit. That worked so well for Stephen Ferguson and Errol Denton, didn’t it?

The mistake here is assuming we care. And indeed that we are unaware – skeptics are pretty good at social media because we’re nerds. And one thing we can guarantee: the more often you promote your bogus claims, the more often they will be challenged, and the more prominent the rebuttals will become. Bring it on!

Step 7: Get ready for all the new clients you’ll get (and quietly give thanks lo the ASA and Sense About Science for helping you).

Ah, bless.

So, in the spirit of sharing, here’s our competing guide which, we venture to suggest, will work rather better.

  1. Check the CAP code, which is freely available online.
  2. Make sure you have robust evidence to support your claims, in the form of large, properly conducted clinical trials on people.
  3. If in doubt, consult the Copy Advice Team, also free.
  4. If the ASA do contact you, remove the claim and tell them you have done so. Informally resolved cases are not put before Council and have limited impact on your reputation.
  5. Encourage your fellow practitioners to do the same. ASA is more likely to act if there are a large number of misleading advertisers.
  6. Familiarise yourself with the relevant law. If you do end up in trouble, consult competent legal advisers.
  7. Do not be tempted to go it alone and whatever you do, don’t go to the echo chamber of other quacks, because that will only result in your errant behaviour being reinforced.

In summary: WDDTY thinks that if your misleading claims are challenged, the best response is to defy criticism try to boost your social media presence.

This is probably the single most stupid thing you can possibly do, because in deciding whether to pursue criminal charges for unfair trading, the likelihood of an effective civil remedy is a deciding factor.

Follow WDDTY’s advice and you may end up on criminal charges. And you can bet they won’t be there to serve time for you.

Meet the people who would dictate your health care

It’s time for the double-barrelled WDDTY-McTaggart spam shoot again. Seriously, what idiot imagined that sending subscribers to one list exactly the same emails from a second list they never signed up for was a smart marketing move? Oh, right, McTaggart. Who else?

McTaggart’s clearly getting jittery, and it’s everybody’s fault but hers that her precious monthly bundle of lies is under  attack. This is just in:

Meet the people who would dictate your health care

Dictate health care? Isn’t that a bit over the top? I haven’t seen anybody in Parliament sponsoring a Bill to prevent people refusing treatment, even for serious conditions, and opting for dumbfuckery.

As you know, we have been the target of a concerted campaign to get the store chains to stop stocking us. The architects of this campaign are the same people who spend a good deal of time attacking and harassing alternative practitioners of every variety.

Nope, they’re not being targeted qua fringe therapists. They’re being targeted qua blatant liars in their marketing blurb. And being asked for evidence. I know Sandra Hermann-Courtney thinks being asked for evidence is hate speech (no, gentle reader, this is not exaggeration on my part). Am I to conclude that you have the same paranoid mentality, Lynne?

And now, from the Dept. of Hasn’t A Fucking Clue:

Their numbers aren’t large (there’re only about 80 of them in total), and they aren’t well followed (Alan Henness of the Nightingale Collaboration, for instance, has just 462 followers on Twitter; Simon Singh, just 44 actively following him), but they are well organized and fuelled by a good deal of self-righteous passion about their mission, which is to stamp out what they view as quackery (ie, natural medicine of every variety, particularly the likes of homeopathy).

Learn to read, woman. Alan Henness follows 462 accounts; quite a lot more follow him. Simon Singh follows 44 people, with all of 54k following him. That’s a lot more than are following our Lynne, who clocks in at around 17K followers. I see we’ve also gone from the previous rant’s “handful” to “about 80”. Ye gods, those skeptics must breed like rabbits!

By the way, quackery is only “natural medicine” if you consider that doing nothing (at best), and charging large amounts of money for it, is natural medicine.

So we thought we should shine a light on the qualifications of the most vocal proponents of a group who believe they have the right to determine what you can or can’t read about your health or indeed the kinds of medical treatments you should be allowed to have access to.

What What Doctors Don’t Tell You Doctors Don’t Tell You

Of those who can be found on the GMC List of Registered Medical Practitioners, one has been issued with a warning, one has relinquished his registration, and all of them advocate dubious interventions, some of which have been shown to do more harm than good.

By all means. First though, let’s shine a light on WDDTY’s qualifications. To start with, we have McTaggart and Hubbard, who have no medical expertise or qualifications whatsoever. Remember this; it’s important.  They also don’t even hack it as journalists, given the quality of their copy. I keep running out of breath trying to read the sentences, so bereft of punctuation are they. Each has their own-brand whackjobbery: McTaggart’s “Intention” is just Reiki in an expensive wrapping; while Hubbard has a “Time-Light” plan that he claims cures chronic depression.

Now the so-called doctors on the editorial panel. I invite you to peruse this useful and well-researched post by Josephine Jones, whose only fault is that it classes Harald Gaier as a doctor. McTaggart doesn’t like Josephine Jones. We will come to this later.

Simon Singh. Singh is not a medical doctor; he has a Ph.D in particle physics.

Yes, this is common knowledge. He doesn’t hide it.

As he often signs his letters ‘Dr Singh’ when writing to Tesco or our distributors, most stores and media naturally assume that he has medical qualifications.

Please produce these letters where he does this, and explain how you obtained them. Of course, since Simon Singh is quite famous (u jelly, Lynne?), especially in the UK, I think it unlikely that his use of the title “Dr.” – which he has every right to – would mislead anybody. No more than, say, Dr. Brian May or Dr. Rowan Williams. I’ll leave the next paragraph as-is, since the venomous stupidity of someone who has no history of studying or writing about conventional medicine, other than as an exercise in writing fiction, is most entertaining.

He does not, nor does he have a history of studying or writing about conventional medicine. He’s written books about mathematical problems and patterns, codes and code-breaking and even cosmology, but nothing to date about conventional medicine – only one co-authored book (Trick or Treatment?- the clue to the slant is in the title) largely trashing alternative medicine. Singh is the public face of Sense About Science, a charity set up by a holding company in India, whose trustees include Simon Singh and his older brother, Tom, who founded the high street chain New Look. Sense about Science reports that it is supported by donations from a variety of sources, including the Royal Pharmaceutical Society and many pharmaceutically backed charities, such as Cancer UK.

Yes, yes, the “charity set up by a holding company in India” is pure spiteful misrepresentation. Either she hasn’t a clue about how charities work, or she couldn’t care less as long as it sounds bad. Tom Singh is not on the Board of Trustees, so I’m going for the second option. Now we come to the implied call for harassment, which already went out on Facebook this weekend. I’m removing the employers’ names, because we know what fanatics like to do, don’t we?

‘Josephine Jones’. ‘She’ is the pseudonym for two people: Michael and Laura Thomason, who live in Warrington. Mike works as a database developer at [redacted] Pharma Solutions; there is a Laura Thomason on Linkedin who works as a supervisor at a [redacted] Coffee Shop, but we can’t verify if they are one and the same. If so, there can’t be many people popping in and ordering cappuccinos because she and her husband seem to have the time to catalogue WDDTY‘s every move, which they circulate on Josephine Jones’ blog as a constantly updated ‘Master List’. Presently, they are carrying out a survey of stores we’re in, presumably in hopes they might be able to pick us off, one store at a time. Neither professes to any medical qualifications.

I don’t know who Mike Thomason is, but he has nothing to do with Josephine Jones. One of the reasons Laura hesitated to come out from behind the pseudonym was precisely due to bullies like McTaggart trying to sic their followers on her and her family. Female bloggers always get rougher treatment than male bloggers, because sexist brutality. Well done, Lynne, for proving her right. That is what I call balls-out übercuntery.

Guy Chapman, who created a website called ‘What What Doctors Don’t Tell You Doesn’t Tell You’, and writes a good deal of bile-filled statements about alternative practitioners, is a software developer for Dell Computers. He’s also a member of a choir.

Like me, you may be wondering what all this has to do with the price of fish. Is she jealous of people who seem to lead fuller lives than she does? I do hope she’s not mistaking my prose for Guy’s, although we are by no means the only contributors to this blog. And talking of bile-filled, Lynne, can we have some evidence for that claim? There’s plenty of bile in the missives you’ve been spitting out over the past year, if by “bile” you mean defamatory statements and hate speech.

Jo Brody works two days a week as a public engagement coordinator for a research project which runs across four sites, including UCL, Queen Mary, City University and Swansea University), studying how to make medical devices safer. Jo’s job is to update the website and expand the project’s online presence. For the rest of the week she works as an information officer at Diabetes UK. Previously she worked as a secretary for Professor Stephen Wharton. As she freely admits: ‘I am not medically trained.’

Nor are you, Lynne. In fact, your qualifications are far worse than Jo’s. Incidentally, are you sure you’ve got the right person?  Next name on the list is Alan Henness. Usual distortion of facts and petty-minded sniping applies.

Alan Henness. He and his wife Maria MacLachlan, who live in Harrow, are effectively the Nightingale Collaboration, a tiny organization that was given seed money by Sense About Science, but that spends a prodigious amount of time reporting advertisers and practitioners of alternative medicine to The Advertising Standards Authority. Despite the name, the ASA is not a government body; it’s an advertising-industry-sponsored organization with no teeth. The best it can do is place advertisers it deems out of line on the naughty step, listing them on as a ‘non-compliant advertiser’ on its own website. Evaluations of the advertisements of alternative medicine or practitioners through the ASA are a stacked deck; they are evaluated, as our ads were, by known skeptics like Dr. Edzard Ernst, Simon Singh’s co-author of Trick or Treatment?

Now, if the ASA is toothless, why is reporting illicit advertising claims to them bullying and harassment? Make your mind up, doughball. As for the stacked deck, well, that’s just the usual quack special pleading. All the ASA asks for is evidence. If you can’t back up your claims, tough shit. I’m going to snip a bit, because McTaggart has delusions of being a great investigative journalist and, frankly, all she’s doing is demonstrating that the people she hates are more rational and thoughtful than she is. Here’s a wee cracker, though:

 Maria (Maclachlan ) wrote, in a short précis of what it means to be a humanist: ‘Humanists embrace the moral principle known as the Golden Rule. This means we believe that people should aim to treat each other as they would like to be treated themselves – with tolerance, consideration and compassion.’

I wonder if this ‘Golden Rule’ also includes harassing groups, practitioners or organizations who advocate or advertise alternative medicine?

No, sweetie popkins, it does not mean standing by while the naïve and vulnerable get conned out of their health and wealth by unscrupulous hucksters and charismatic fruitcakes. Lastly, she gets very upset over Andy Lewis, aka @lecanardnoir, because he’s made it difficult for her to use ad hominem.

Andy Lewis. Set up the ‘Quackometer’ site, which he claims to be an experiment in ‘critical thinking’. Doesn’t reveal what his credentials, education or employment history are – says they ‘don’t matter’ nor does an honest debate of the issues because the wording on websites will, through his own use of critical thinking, offer prima facie evidence of ‘quackery’.

It must be really frustrating to be unable to create a diversion by attacking the writer instead of the words. I can only conclude that McTaggart and her cronies are livid that they can’t answer criticism on the Quackometer. Not, I hasten to add, because they’re not allowed to post. It isn’t the WDDTY Facebook page. It’s because they have no evidence for their often totally unrealistic and long-debunked claims.

That’s who they are. WDDTY, on the other hand, has seven medical doctors on its editorial panel, plus several PhDs and highly qualified practitioners of a number of alternative disciplines.

I refer you again to the Josephine Jones post exposing this august assembly as a bunch of quacks, frauds and profiteering dingbats, irrespective of the letters they have after their names.

Thousands of doctors and health practitioners of every persuasion regularly read WDDTY and comment enthusiastically.

The Facebook page doesn’t seem that busy. Or are the enthusiastic comments mostly negative, and therefore deleted? I think you need a large FPI™ order to wash that assertion down.

The two editors of our magazine have been medical science writers for 25 years, and every word in our pages is checked by a science editor with an extensive history of writing and editing medical studies for the pharmaceutical industry.

Bad news, McTaggart and Hubbard: WDDTY, Intention and Time-Light do not qualify as writing about medical science. I see you fail to name your science editor. It seems uncharacteristic  that you should use someone in the pharmaceutical industry. After all, you constantly spit on Big Pharma and once issued the challenge to find a drug, other than antibiotics, that had ever cured anything.

Do you want these eight people to be the ones to determine what you can read about your own health care?

I thought there were 80 of us?

If not, write to Tesco today and ask them to re-stock What Doctors Don’t Tell You….

Etc. etc. whine, whine. It ends with the now habitual plea to ask Tesco to stock WDDTY again. Being chucked out of Tesco has really hurt, it would seem. Could it be that WDDTY doesn’t attract enough subscribers, in spite of the hard sell (every month I see a SPECIAL SUBSCRIPTION OFFER email befouling my inbox), and they desperately need to prey on the innocent who might see it presented in their local supermarket as a genuine health magazine? I suspect so.

All the more reason to encourage all supermarkets and newsagents to drop WDDTY like a mouldy, worm-infested potato. If people are stupid enough to subscribe, fine. But they shouldn’t be gulled into buying this crap because it’s on the same shelf as publications that don’t tell you as if it were solid fact that cancer can be treated with intravenous vitamin C, that HIV doesn’t cause AIDS, that vaccines are pure poison, that homeopathy reverses cancer, that electric power lines cause Alzheimer’s, that pollution causes diabetes…. and so on.

Responses from those personnally targeted:

Jo Brody’s Stuff that occurs to me: It seems the magazine ‘What Doctors Don’t Tell You’ doesn’t like me

Guy Chapman’s Blahg: WDDTY goes “the full Errol”

Maria Maclachlan: Comment on Think Humanism forum