Tag Archives: Alternative medicine

It’s official: WDDTY have lost

farcebookWe have arrived at a turning point. Tesco have dropped WDDTY, and the editors know that this is the beginning of the end of their attempt to appear to be a legitimate magazine.

As proof, I offer the Facebook post captured at right, from WDDTY’s wall, where all dissenting views are ruthlessly excised because free speech.

Notice two things:

First, McTaggart leads with a ridiculous personal attack on Laura and Mike Thomason, two people whose identities they seem to think are a sinister secret, presumably because they have never heard of Google or are truly incompetent at following the projects of their self-declared nemesis Simon Singh.

Laura, as all UK skeptical activists know, is painstakingly scrupulous in being fair to those she critiques.  I can find no evidence at all that she has called for the banning of WDDTY- but of course as far as McTaggart is concerned any campaign designed to force WDDTY to be honest in its self-promotion and content, is precisely that: a call for it to be banned. Presumably they know, deep down, that they cannot ever be factual and honest.

I cannot think of anybody who it would be more insane to describe as a troll, though of course cranks have always used such labels for anyone who does not accept their belief on their own say-so – it’s a way of managing the cognitive dissonanceW.

Nothing says “credible health resource” quite like vitriolic personal attacks against private individuals who have a reputation for being fair, polite and reserved.

Second, as if this repugnant personalisation of the issue were not enough as an admission of defeat, there’s a cartoon aping the many spoof WDDTY covers created by skeptics, targeting Simon Singh.

According to WDDTY, Singh says that “every drug works and is perfectly safe”. This will come as news to the followers of All TrialsW, championed by Sense About ScienceW and Simon, who have been critiquing “big pharma” for covering up the fact that all drugs do not work and are not perfectly safe. In fact, I have never heard anybody, even the most hardened shill for big pharma, claim that all drugs are effective or that any drug is perfectly safe. Most, however, are both effective and acceptably safe.

As to the idea that “alternatives don’t work at all”, I cite Minchin’s Law: “By definition”, alternative medicine” has either not been proved to work, or been proved not to work. You know what they call “alternative medicine” that’s been proved to work? Medicine.””

Simon Singh is not in denial about this. Alternative treatments can be tested, objectively. A few have been found to be effective. They are no longer alternative. By definition.

The John Diamond Challenge

excellent-frogWe’ve already discussed the “apology deficit” at WDDTY, but we have been well and truly outdone by the following exceptional article by David Hills (@WanderinTeacake). The absolute best bit is that skeptic legend John DiamondW has, in a very real sense, reached out from beyond the grave and poked Lynne McTaggart with the pointy stick of reason.  We will absolutely rename our “Corrections and Clarifications” page in his honour.

Enjoy this post, reblogged from WanderingTeacake, because it’s eleven different kinds of awesome. Continue reading The John Diamond Challenge

When science is a dirty word

An anti-science commentary by Lynne McTaggart makes some bold and controversial claims about science. Do they stand up to scrutiny?

One of the most misused terms being hurled at us as a rebuttal to What Doctors Don’t Tell You is the term ‘science’.

One of the terms most misused by WDDTY is science.

The main contribution of science to medicine has been objectivity: the ability to minimise the well-known cognitive biases that affect all human observations, to turn the practice of medicine from an essentially religious field to an essentially scientific one.

WDDTY prefer to view mainstream science as a sinister activity pursued by a technocrat minority, an elite that is simultaneously brilliantly manipulative and ideologically hide-bound, lacking in vision, intelligence and the ability to grasp the unfamiliar.

Like proponents of every religion whose precepts are at odds with objective science, they seek ways to portray science as lacking objectivity.

In reality most people now have at least the rudiments of a scientific education and scientific methods of inquiry are a part of everyday life. The room is dark: how do you work out if it is the fuse, the switch or the lamp? The tests are essentially scientific. You do not use intuition, you isolate the components one by one, look for common points of failure (one lamp on,another not, probably the lamp) and thus arrive at the correct answer.

WDDTY’s approach to the darkened room is to basically to advocate a return to candles. And oil lamps. And remote viewingW. Anything other than electricity, because what do scientists know about visual perception?

We have been accused of being unscientific, of pedaling (sic) unproven and harmful alternatives, as opposed to the real thing, true ‘scientific’ medicine.

The evidence supports the accusation that you peddle unproven and harmful alternatives, also that you distort and misrepresent the science you do quote.

That is not to say that evidence-based medicine is perfect, only that the solution to its imperfection is not to jettison all attempts at objectivity in favour of a credulous acceptance of any claim based primarily on its ideological appeal.

Science is pursued by humans, humans are fallible. The scientific method is, fallible humans or not, the most reliable means ever devised to tell truth from fiction. Without it, you would be printing WDDTY with wooden blocks on coarse paper and distributing it at street corners. The process that delivered the knowledge that makes computers and the internet work is fundamentally indistinguishable from the process of medical science delivering knowledge to be used (or abused) by medicine.

There are three points to be made here, adding up to one indisputable truth: there is nothing remotely scientific about conventional medicine.

That statement is neither true nor indisputable.

1.Most of the science behind standard treatments is fiction. As leading members of the medical establishment have made clear in recent books, the so-called ‘proof’ of most so-called ‘proven remedies’ is data that has been invented or manipulated by drug company marketing teams.

Some of it is, some of it isn’t. Cochrane reviews are usually pretty objective, and they are the highest tier of evidence. There’s good reason to suspect systematic manipulation of scientific results by any party with a vested interest in the outcome of the trial – this is a big problem for medicine and a huge problem for alternative medicine, where virtually nobody other than True Believers does any research at all.

But the issue of manipulation of studies is not the us-and-them situation that Lynne presents here. In the case of homeopathy, for example, proponents routinely bring up known issues with individual treatments but miss the point that the entire field of homeopathy is based on refuted doctrines, lacks a coherent framework, is inconsistent with robustly established scientific principles and so on. All clinical trials are prone to bias, therefore they are necessarily less compelling when the treatment is completely implausible.

There is no informed dissent from the view that measurable quantities of pharmacologically active compounds can have an objective effect on the body; there is no credible evidence that giving unmeasurable amounts of substances whose connection to disease is arbitrary and based on a refuted doctrine, can cause any effect other than placebo.

The therapeutic systems of Hoxsey, Gerson and their ilk are not “whole medical systems” existing in a parallel bubble universe apart from science, like homeopathy, acupuncture, chiropractic and the like, but they are still entire classes of unproven therapy, rather than unproven members of a proven class.

This is an important distinction, because the issues with individual medicines are often exposed by diligent scientific comparison of effect between treatments.

2.Most treatments haven’t been proven to work. The British Medical Journal has concluded that only about 12 per cent of all medical treatments have adequate evidence demonstrating that they work.

This is a zombie statistic. The BMJ article did not say that at all, and indeed specifically counsels against interpreting the figures as Lynne interprets them.

What the source says is that of the treatments currently on the books, 11% are well established to be beneficial, 24% are likely to be beneficial, 7% have a trade-off between benefit and harm, 5% are unlikely to be beneficial, 3% are likely to be ineffective or harmful, and 50% have unknown effectiveness, established from RCTs. These will include older treatments, those for which an RCT would be unethical.

This is not a reflection of the evidence base for individual prescribing decisions. Further:

‘Unknown effectiveness’ is perhaps a hard categorisation to explain. Included within it are many treatments that come under the description of complementary medicine (e.g., acupuncture for low back pain and echinacea for the common cold), but also many psychological, surgical, and medical interventions, such as CBT for depression in children, thermal balloon ablation for fibroids, and corticosteroids for wheezing in infants.

‘Unknown effectiveness’ may also simply reflect difficulties in conducting RCTs of an intervention, or be applied to treatments for which the evidence base is still evolving. As such, these data reflect how treatments stand up in the light of evidence-based medicine, and are not an audit of the extent to which treatments are used in practice.

We make use of what is ‘unknown’ in Clinical Evidence by feeding back to the UK NHS Health Technology Assessment Programme (HTA) with a view to helping inform the commissioning of primary research. Every 6 months we assess CE interventions categorised as Unknown effectiveness and submit those fitting the appropriate criteria to the HTA via their website: http://www.nets.nihr.ac.uk/programmes/hta.

So it turns out that the large number of “unproven” interventions include most SCAM interventions (the balance are unlikely to be beneficial or are known to be harmful; this is Minchin’s Law in action).

How would you conduct an RCT for emergency surgery for ruptured aortic aneurysm?

3.Most treatments cause harm. Modern medicine is the third leading cause of death in the western world. Fact. Prescribed drugs and medical error kills 204,000 people every year in America alone, with only cancer and heart disease claiming more

This claim has already been debunked. It is based on taking an invented figure, taking a second invented figure which would be part of the same figure, adding the two together and arising at a figure that is wronger than wrongW.

In fact, medical misadventure does not figure anywhere close to the top ten causes of death in the USA, and the real figure is nearly two orders of magnitude smaller according tot he very source McTaggart claims to have used for this figure.

Your greatest risks

According to data assembled by the Alliance for Natural Health, which examined the statistics of all the most and least likely things that could kill you, the greatest risk of death any of us face is going to the hospital. If you add the risk of reactions to correctly prescribed drugs, any interaction with modern medicine has to be the greatest risk to your life and limb.

Amazing. A SCAM trade body comes up with a figure that shows you should use SCAM instead of going to the hospital. Who predicted that? Presumably they remembered to exclude people rushed to hospital with acute surgical emergencies, as Gary Null… didn’t?

Feel free to come back with a reliable source.

Let’s look at so-called ‘unscientific’ natural health care, which supposedly causes so much harm. The risk of dying from taking any herbal remedy or food supplement is around 0.01 per one million people. In other words, 100 million people would have to take a supplement or herb before there is a risk of one person dying because of it.

Presumably according to the same source? Not that they have a dog in the fight or anything?

A repeatable feature of WDDTY is accepting the most optimistic claims of the SCAM industry and the SCAM industries worst (and often entirely false) claims about medicine, entirely uncritically.

Why would a manufacturer of supplements be any less likely to misrepresent the science than a manufacturer of a drug?

Why would a university biochemist working on disease biochemistry be any more likely to misrepresent a claim than a SCAM believer looking for proof of his pet theory?

This is never explained.

Compare that to the risk of pharmaceutical drugs, which kill 1000 people for every million people taking them.

According to?….

Leaving aside the tautology, yes, drugs can have adverse effects. So can supplements. There’s a list of recalls. Ayurvedic herbs with heavy metal contaminants, aristolchic acid, OxyElite Pro. And what about the harms due to untreated or incorrectly diagnosed disease?

The biggest difference between medicine and SCAM in this regard is that medicine acknowledges the potential for harm and has proactive and reactive monitoring in place. The reaction of SCAM to problems is best characterised as denial.

So that risk is: 0.01/1 million for natural substances vs 1000/1 million for drugs. In other words, the risk of lethal harm from modern medicine is 100,000 higher than that of herbal or nutritional medicine.

Source? Risk v benefit figures? The risk in a homeopathic remedy is close to zero (it will almost certainly be inert). The benefit is also zero. There is an attendant risk due to failure to treat disease. A homeopath weighs this equation, adds belief in the unverifiable on the positive side of the scale, and asserts that homeopathy is superior to medicine. That is not a rational, consistent or appropriate view.

This beggars the basic question: which form of medicine is the least scientific?

Lynne appears not to understand the language of formal logic, understandable since the entirety of SCAM is founded on logical fallacies. It does not even beg the question. It invites it, but the answer will not be found by listening to a biased argument based on several provably incorrect numbers.

Biochemical individuals

There’s a good reason why medicine is not a science. Drugs constitute a one-size-fits-all model, whereas every human being is unique. Drugs that work on me may not work on you and vice versa; most drugs can’t be made smart enough to, say, slot only tab A into slot B without affecting slot C, D and E, because humans are holistic.

This is complete nonsense. Most diseases have more than one treatment, different treatments are used depending on patient history and other factors. Some drugs are incredibly individual: they are based on genetic profiling.

The idea that SCAM is “holistic” because the practitioner listens to you for an hour before giving you the ideologically driven “prescription” for magic sugar pills, acupuncture, alkaline diet, dairy and wheat exclusion or whatever, is simply fatuous.

Medicine is holistic. It embraces everything from physiotherapy and diet to the latest cutting edge microsurgery or genetic therapies. You don’t become more holistic by abandoning the majority of medicine and substituting evidentially questionable practices.

Biochemical individuality creates mayhem with drug trials, which are designed to look for common results in everyone—one reason their results are so often manipulated, massaged or even made up. As the new medical explorers are discovering, the systems of the body interact as a complex, dynamic and highly individualistic whole.

The decline effect is well-known, it is an inevitable result of moving from idealised trial populations to non-idealised real populations. However, the differences between individuals are as nothing compared with the similarities.

Any two randomly selected humans will share between 99.6% and 99.9% of their genome. We share the majority of biochemical pathways (absent genetic defects), a doctor trained in surgery on Africans will have no difficulty with Europeans and vice versa.

There are differences, but not in the way that “holistic” practitioners pretend when listening to the worried well for an extended period before selling them the same witches’ brew of supplements or herbs that they sold the last person.

No humans are known to have yin and yang. The flow of qi is not evidentially established as different between individuals.. Tests for these things give the same result for everyone – namely that they don’t exist.

Basing your diagnosis and prescribing practice on provably false premises such as homeopathic similimum, subluxation complex, damp kidney or whatever, merely makes it unlikely that you will be right, other than by accident.

It’s important here to make a distinction between science—the open-minded pursuit of truth without fear or favour—and scientism, a solidified set of beliefs around which academics, industries and professions are framed.

It is indeed. Science is the process that has skepticism at its heart, scientism is a term primarily used by believers in creationism and other empirically unverifiable ideas, to attack those who accept the scientific consensus, and try to pretend that ideology is equivalent to following the evidence wherever it leads.

Science is the process that found helicobacter pylori to be the cause of ulcers, rather than stress as had been previously supposed.

Scientism would be the insistence that only the empirically proven causes of disease should be accepted, and that no credence should be given to the possibility that they are caused by miasms, qi, subluxations or whatever. This is perfectly reasonable in the absence of credible evidence that these concepts exist.

Pseudoscience, pathological science and cargo cult science are various flavours of activities giving the outward appearance of science but pursued in a way that excludes any conclusion that conflicts with the ideology of the inquirer. Homeopathic experiments are a perfect example. This is in contrast with the open-minded testing of alternative ideas by medical science, even though those tests rarely produce anything other than an equivocal or negative result. The US National Center for Complementary and Alternative Medicine (NCCAM) and its predecessor have spent well over a billion dollars testing alternative therapies. They have yet to validate a single one, but it’s not for want of trying.

The resistance we’ve experienced has more to do with the latter. This seems clear from the way the scientism of medicine greets any discovery, breakthrough or possibility that questions or threatens the current medical paradigm—by dismissing such ideas out of hand as ‘quackery’, even when they are the work of eminent scientists at prestigious institutions such as Oxford, Harvard and Cambridge.

It is certainly more appealing to believe that opposition is due to an ideological bias against you, rather than the fact that you are wrong, but the facts are against you.

The advice WDDTY gives is either wrong, misleading or (conversely) perfectly normal advice that your doctor would give you. The problem is that you seem unable to distinguish the three.

True science is heresy

We tend to regard science as presenting some sort of static truth, but science is an ever evolving story, told in instalments. New chapters refine—and usually supplant—chapters that have come before.

Someone has been reading Kuhn, the crank’s favourite author.

This view is superficially true but actually wrong. For example, relativity technically supersedes Newtonian mechanics, but Newtonian mechanics is till used for the vast majority of calculations because it the results of the two systems approximate extremely closely other than under extreme conditions.

Schroedinger wave equations technically supplant the classical Bohr electron model, but the Bohr model is still close enough for many calculations and the difference only becomes significant at extremely small scales.

Every last advancement in science and healthcare begins as heresy, each important new discovery negating the prevailing views of the day.

This is simplistic to the point of being wrong. Improvements in medical treatments may be incremental or revolutionary.

What s being asserted is essentially the Galileo gambit. In truth, Galileo was following the scientific method and his opponents were the dogmatists, and the thing that SCAM proponents always forget about Galileo is that he was also right. Now, SCAM proponents always think that they are right, but there are so many “lone geniuses”, “brave maverick doctors” and so on, with so many often mutually exclusive ideas, that it is inconceivable that more than a tiny handful are right – whereas SCAM proponents tend to believe most of them, the process known as”crank magnetism”.

This idea that SCAM has the best, the brightest, the visionaries, and medical science the ideologically blinded plodders, requires that not only the process of medical science, but also the entire system of education is wrong, since the process that supposedly delivers those with the highest academic achievement is, according to this view, instead delivering venal dullards.

A Sagan quote reveals the more likely explanation:

But the fact that some geniuses were laughed at does not imply that all who are laughed at are geniuses. They laughed at Columbus, they laughed at Fulton, they laughed at the Wright Brothers. But they also laughed at Bozo the Clown.

The most telling thing is that science is full of examples of self-correction, wrong ideas being discarded. We have yet tot race a single example of a SCAM treatment that has been discarded after being found to be false by scientific inquiry.

What if stones fall from the sky? What if there is no end of the earth to sail off? True science always begins by asking outrageous questions or pursuing unpopular notions, even if the answer threatens to overturn every last one of our cherished beliefs.

The idea that stones fall has never been controversial. Empirical scientist Robert Hooke suggested that it worked by an inverse square law. Newton quantified it. This may appear revolutionary, but it was evolutionary, with moments of very rapid progress.

The idea that earth is flat was based on the existence of the horizon. It doesn’t take much sailing before you work out it’s wrong.

I struggle to think of any scientific discovery in the last couple of centuries that renders the entirety of the previous theory and practice redundant. As soon as people started measuring and recording, results converged on what was true and theories had to fit observed facts (the Baconian school). The Cartesian school allowed for theory to run ahead of evidence, but the theory had to be discarded if the predictions it made did not hold up.

Even geocentric cosmology, which persisted for longer than it should, did so primarily due to religious belief.

True science seeks to drive a stake into science, particularly scientism.

No it doesn’t. True science seeks to explain the observed facts as accurately and completely as possible, The best example is probably evolutionary theory, a complex set of interlocking ideas founded on the fossil record, observations, DNA analysis and even planetary geology.

Consilience is the term used for multiple lines of inquiry leading to the same conclusions. Most medical science is consilient. Physiology, biochemistry, anatomy, chemistry – all offer different views of the same facts.

And then the Brave Maverick Doctor asserts some other set of facts that is inconsistent, and lacks a complete or consistent framework. Occasionally the brave maverick is right: Marshall and Warren took several attempts to persuade, but they admit this was because they had left important questions unanswered (notably: how bacteria could live in the acid environment of the stomach).

SCAM proponents brush these inconvenient details under the carpet and accuse those who ask about them of “scientism”.

Nevertheless, mainstream science, particularly mainstream medicine, has grown ever more fundamentalist, dominated by a few highly vocal people who believe that our scientific story has largely been written and that the job of science is simply to confirm it.

That is one opinion, just not supported by facts. Feel free to cite prominent authorities in medical science who think our understanding is anywhere near complete.

Thankfully, an enormous body of resistance carries on in defiance of this restricted—highly unscientific—view. May they and all the true scientists like them continue to light our way.

Whatever helps you manage the cognitive dissonanceW, I suppose. Doesn’t make it any more correct, though. I close with three quotes that illustrate how real science actually works:

The most exciting phrase to hear in science, the one that heralds new discoveries, is not “Eureka” but “That’s funny…” – Isaac Asimov

In science it often happens that scientists say, ‘You know that’s a really good argument; my position is mistaken,’ and then they would actually change their minds and you never hear that old view from them again. They really do it. It doesn’t happen as often as it should, because scientists are human and change is sometimes painful. But it happens every day. I cannot recall the last time something like that happened in politics or religion. – Carl Sagan

The whole problem with the world is that fools and fanatics are always so certain of themselves, but wiser people so full of doubts – Bertrand Russell

As to which party in this dispute shows the attributes of religion, of fools and charlatans, of the “Eureka!” moment versus the patient inquiry of “that’s funny….”, we leave that  as an exercise for the reader.

The SCAM cash machine

One of the biggest criticisms of WDDTY is that it acts as a marketing machine for the deeply cynical supplement industry, and for the entire subculture of supplements, complementary and alternative medicine (SCAM) generally.

In short, it makes claims for SCAM products and treatments that would be illegal if the SCAM vendor made them directly.

Here’s a checklist you can use to spot whether a story is promoting something which it should, if it were remotely ethical, be exposing as abuse.

  1. A vulnerable population, such as those with a chronic condition, anxious parents or cancer patients.
  2. Use of early and misleadingly vivid research results which were credulously reported as a “miracle breakthrough” in the press (the “Daily Mail factor”).
  3. Minimising or ignoring subsequent findings contradicting the early reports, the usual reason why an “alternative” treatment is not part of the standard of care (Minchin’s Law).
  4. A standard of care that involves drugs with side-effects, such as chemotherapy or NSAIDs.
  5. Uncritical acceptance of the claims of people who are selling the treatment over those who could use it, but aren’t.
  6. Use of anecdotes in place of evidence (anecdote-based medicine, or eccevide-based medicine).
  7. A conspiracist narrative of suppression especially use of sources violating Scopie’s Law and references to brave maverick doctors censured for providing the treatment.

These are the classic elements in a WDDTY story.

Why don’t doctors tell you these things?

Because the evidence doesn’t support them, they don’t have a vested interest in selling them, and they have a robust ethical framework.