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Archive for Health Fraud

Astrology, Alchemy, ESP and Reiki. One Of These Is Not Like The Other

reiki-hands-pic

I knew that Jann was thinking of writing about reiki and fraud, but did not know the details of her most excellent discussion from yesterday until I had finished my penultimate draft for today. Think of them as a match set, two perspectives on the same elephant.

Fraud: a person or thing intended to deceive others, typically by unjustifiably claiming or being credited with accomplishments or qualities.

There are numerous activities that one human will offer another in exchange for money that are completely divorced from reality.

Astrology. Total bunkum.

There is no force, known or unknown, that could possibly affect us here on Earth the way astrologers claim. Known forces weaken too fast, letting one source utterly dominate (the Moon for gravity, the Sun for electromagnetism). An unknown force would allow asteroids and extrasolar planets to totally overwhelm the nearby planets…
Study after study has shown that claims and predictions made by astrologers have no merit. They are indistinguishable from chance, which means astrologers cannot claim to have some ability to predict your life’s path.

Although 48% of Americans think astrology is a science, as best I can tell astrology is not part of the curriculum at any astronomy division or program. Astronomers know it is bunkum and avoid it . (more…)

Posted in: Energy Medicine, Health Fraud

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Reiki: Fraudulent Misrepresentation

reiki-hands-pic

The Center for Integrative Medicine at the Cleveland Clinic sells reiki treatments (also here) to patients with cancer, fertility issues, Parkinson’s Disease and digestive problems, as well as other diseases and conditions. The Center’s website ad describes reiki as

a form of hands-on, natural healing that uses universal life force energy . . . [a] vital life force energy that flows through all living things. This gentle energy is limitless in abundance and is believed to be a spiritual form of energy. The Reiki practitioner is the conduit between you and the source of the universal life force energy. . . You may experience the energy as sensations such as heat, tingling, or pulsing where the practitioner places her hands on your body, or you may feel these sensations move through your body to other locations. This is the energy flowing into you.

This “universal life force energy” is described as having certain positive effects on one’s own energy, such as “energetically balancing” one physically, replenishing one’s supply of energy, improving distribution of that energy in the body, and dissolving “energy blockages.” It also increases one’s “vibrational frequencies,” although how these frequencies relate to one’s energy, or to anything else for that matter, is not made clear. (more…)

Posted in: Energy Medicine, Health Fraud, Homeopathy, Legal, Medical Ethics

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Of the Trial to Assess Chelation Therapy, Bayes, the NIH, and Human Studies Ethics

An experiment is ethical or not at its inception; it does not become ethical post hoc—ends do not justify means.
~ Henry K. Beecher

tact

A couple of weeks ago, Dr. Josephine Briggs, the Director of the National Center for Complementary and Alternative Medicine (NCCAM), posted a short essay on the NCCAM Research Blog touting the results of the Trial to Assess Chelation Therapy (TACT) (italics added):

The authors found that those receiving the active treatment clearly fared better than those receiving placebo. The accompanying editorial in the AHJ reminds readers about the value of equipoise and the need to “test our beliefs against evidence.”

Most physicians did not expect benefit from chelation treatment for cardiovascular disease. I readily admit, initially, I also did not expect we would find evidence that these treatments reduce heart attack, strokes, or death. So, the evidence of benefit coming from analyses of the TACT trial has been a surprise to many of us. The subgroup analyses are suggesting sizable benefit for diabetic patients—and also, importantly, no benefit for the non-diabetic patient. Clearly subgroup analyses, even if prespecified, do not give us the final answer. But it is also clear that more research is needed to test these important findings.

And TACT findings are indeed a reminder of the importance of retaining equipoise [sic], seeking further research aimed at replicating the findings, and neither accepting nor rejecting findings based on personal biases. The scientific process is designed to weed out our preconceived notions and replace them with evidence.

Dr. Briggs concluded:

So, TACT is a reminder—an open mind is at the center of the scientific method.

Dr. Briggs’s title was “Bayes’ Rule and Being Ready To Change Our Minds”, a reference to a recent editorial that had accompanied one of the TACT papers. That editorial, by Dr. Sanjay Kaul, a physician and statistician from UCLA, begins with this quotation:

Preconceived notions are the locks on the door to wisdom.
~ Merry Browne

Here is the relevant passage from Dr. Kaul’s editorial (italics added):

Sixth, it has been argued that the trial was unethical because there was no compelling clinical or preclinical evidence that chelation therapy has significant efficacy against atherosclerotic cardiovascular disease, and given that chelation therapy can cause harm, the risk was not minimal. A Bayesian analysis would not look kindly on the results because of the low prior probability of treatment effect (the so-called implausibility argument).6 This is an uncharitable (and unwarranted) interpretation of the data because previous systematic reviews concluded, “insufficient evidence to decide on the effectiveness or ineffectiveness of chelation therapy in improving clinical outcomes among people with atherosclerotic cardiovascular disease.” It is axiomatic that absence of evidence of efficacy is not the same as evidence of the absence of efficacy.

From a Bayesian perspective, the strength of evidence is often summarized using a Bayes factor, which is a measure of how well 2 competing hypotheses (the null and the alternate) predict the data. The Bayes factor and the corresponding strength of evidence for the primary end point result in TACT overall, and diabetic cohorts are shown in Table 1. The p-value of 0.035 for TACT overall cohort translates into a Bayes factor of 0.108, which means the evidence supports the null hypothesis ≈1/9th as strongly as it does the alternative. This reduces the null probability from 50% pretrial (justified by suspension of one’s belief in treatment effect) to 10% post-trial. Although this does not represent strong evidence against the null, it does reduce the level of skepticism surrounding chelation therapy. In the diabetic cohort, the nominal p-value of 0.0002 translates into a Bayes factor of 0.002 (1/500), which reduces the extremely skeptical prior null probability of 95% to 4% post- trial, indicating very strong evidence against the null.

In concluding, Dr. Kaul states:

Finally, TACT highlights the double standard when it comes to accepting inconvenient results not aligned with our preconceived notions on so-called dubious quack cures such as chelation…

Closed minds?

Dr. Kaul’s reference “6” above is to a lengthy article that we published in 2008 titled “Why the NIH Trial to Assess Chelation Therapy Should Be Abandoned”. So, it seems, both Drs. Briggs and Kaul were chastising us for our biased, preconceived beliefs about so-called dubious quack cures. Our minds were, apparently, not open. Let’s examine this contention. (more…)

Posted in: Clinical Trials, Health Fraud, Medical Academia, Medical Ethics, Politics and Regulation

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What Whole Foods Markets Doesn’t Tell You

Whole Foods Market is a relentlessly hip American supermarket chain which prides itself on organic fruits and vegetables, gluten-free just-about-everything, and high-end touches like wine bars and exotic take out items (roasted yucca, anyone?). The health products aisle is stocked with Bach Flower and homeopathic remedies. For example, in-house brand Flu Ease: “an established homeopathic formula that should be taken at the first sign of flu for temporary relief of symptoms including fever chills and body aches.”

Selling Flu Ease and like products certainly exhibits a lack of appreciation for scientific evidence, not to mention basic science. But I recently saw a product in the checkout line that was so filled with over-the-top quackery and so shocking in its disregard for the public’s health that I haven’t been back to Whole Foods since. And I won’t be going back.

The product? A glossy, slickly-produced magazine with the conspiracy-minded title What Doctors Don’t Tell You. The April 2014 issue promises, in banner-headline font size, a “New Light on Cancer.” It features the well-known symbol of fighting breast cancer, a loop of pink ribbon, but with a tear in the middle of the loop. We’ll look into this “new light” in a bit.

(more…)

Posted in: Cancer, Critical Thinking, Faith Healing & Spirituality, Health Fraud, Herbs & Supplements, Homeopathy, Nutrition, Science and the Media

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Amber Waves of Woo

As a pediatrician I have an opportunity to observe a wide variety of unusual and sometimes alarming parental efforts meant to help children through illness or keep them well. I have recently noticed one particular intervention that seems to be becoming more prevalent, at least in my practice. I’ve begun to see more and more infants sporting Baltic amber teething necklaces. These consist of multiple small beads of amber on a string that is worn around a baby’s neck, and are supposed to relieve the discomfort of teething. Before I had any idea what these necklaces were for or how they were supposed to work, my first reaction was to inform these parents of the dangers of necklaces or anything placed around an infant’s or young child’s neck. Strangulation is a known cause of accidental injury and death in children, and pediatricians are trained to discuss this as part of the routine anticipatory guidance we give to parents. In addition, we strongly advise against giving infants or young children any small items that could be accidentally aspirated, such as the beads found in a necklace of this sort. But I was equally surprised to learn that these necklaces are not intended for babies to chew or gum. Instead, they are supposed to ease a baby’s teething discomfort simply by lying against the skin.

I will not discuss teething here, or the many myths that surround it; that was well covered in a previous post. I will reiterate that there is little-to-no evidence that the majority of concerns parents have about teething are actually due to teething, including fever and diarrhea. The irritability associated with teething also tends to wax and wane for only several days before and after the emergence of a tooth. But let’s assume for the moment that these necklaces actually work to ease the discomfort of teething, and whatever other problems parents tend to associate with the long period of time during which infants and young children develop their teeth. Assuming these necklaces work as recounted in the glowing testimonials on countless websites and parent blogs, how do they produce their dramatic results?
(more…)

Posted in: Critical Thinking, Energy Medicine, Health Fraud, Herbs & Supplements, Pharmaceuticals

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The Detox Scam: How to spot it, and how to avoid it

The Detox and Cleanse Scam

Note to SBM’s regular readers: Today’s post revisits some older material you may have seen before. Happy New Year!

New Year, New You, right? 2014 is the year you’re finally going to get serious about your health. You’re winding down from a week (or more) of celebrations and parties. You’re pretty much recovered from New Year’s Eve by now. It’s time to make some resolutions. Conveniently, there is no shortage of solutions being advertised to absolve you of your sins while overhauling your body and soul for 2014: What you need to do is “detox”. You’ll see the detox kits at your local Whole Foods (or even your local pharmacy). Books, boxes or bottles, with some combination of “detox”, “cleanse” or “flush” in the product name. Supplements, tea, homeopathy, coffee enemas, ear candles, and footbaths all promise detoxification. The advertising suggests you’ll gain a renewed body and better health – it’s only seven days and $49.95 away. Or try to cleanse yourself with food alone: Dr. Oz is hyping his Holiday Detox plan. Bon Appetit is featuring their 2014 Food Lover’s Cleanse. Or what about that old standby, the “Master Cleanse”? It’s the New Year – wouldn’t a purification from your sins of 2013 be a good idea to start the year? After all, the local naturopath offers complete detoxification protocols, including vitamin drips and chelation. There must be something to it, right? (more…)

Posted in: Health Fraud, Herbs & Supplements, Homeopathy, Naturopathy

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The Exciting Conclusion

On the slim chance that you’ve been perched on the edge of your seat wondering how the New Mexico appellate court ruled on chiropractic prescription privileges, whether the Council on Chiropractic Education got approved for another three years as an accrediting agency, if NCCAM ever came clean about spinal manipulation, and the fate of Brandon Babcock, DC, at the hands of the judicial system, here are your updates.

Prescription privileges for New Mexico chiropractors

A surprisingly titillating tidbit about New Mexico “advanced practice” chiropractors.

As discussed in previous posts, New Mexico “advanced practice” chiropractors succeeded in getting limited prescription rights. The statute specifically says they can:

prescribe, administer and dispense herbal medicines, homeopathic medicines, over-the-counter drugs, vitamins, minerals, enzymes, glandular products, protomorphogens, live cell products, gerovital, amino acids, dietary supplements, foods for special dietary use, bioidentical hormones, sterile water, sterile saline, sarapin or its generic, caffeine, procaine, oxygen, epinephrine and vapocoolants.

However,

Dangerous drugs or controlled substances, drugs for administration by injection and substances not listed [above] shall be submitted to the board of pharmacy and the New Mexico medical board for approval.

Apparently, the Chiropractic board couldn’t read the plain language of the statute and blew off this requirement, even though their own lawyer told them they couldn’t. This got them hauled into court by the medical and pharmacy boards. The International Chiropractors Association joined the fight. (more…)

Posted in: Chiropractic, Health Fraud, Legal, Politics and Regulation

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Full of Energy

Want to know what a craniosacral treatment is actually like? How about reiki? What about Eden energy medicine – do you even know what that is? Read on, because this past Sunday afternoon I experienced all three.

But first, the why and where. The local Healing Arts Alliance of the Big Bend (which is what they call the area of Florida I live in) held an information session for the public at our local library’s meeting room. Practitioners of about 10 different “healing arts” sat at a circle of folding tables chatting with visitors and handing out information. One even brought her diagnostic machine, which measures a person’s aura. (More on this later.) Some offered free samples of their treatments. It was a great opportunity for science-based medicine field work and I aimed to take full advantage.

The Alliance handed out a free booklet at the door listing local health care practitioners who:

. . . share a commitment to the whole person, patient-centered approach to health and wellness.

But, as the booklet explains,

[w]e do not endorse any specific method or system. Our member/practitioners are committed to a nonjudgmental collaboration and cooperative relationship . . .

This philosophy is indeed fortunate. If any of these practitioners endorsed a specific method, such as, say, the scientific method, it could lead to the judgment that what some of the others are saying is gobbledygook.

The booklet contains a helpful “Glossary of Holistic Health Terms,” which further serves to make the point that nonjudgmental collaboration is absolutely necessary to the cause. A few examples:

BioMat: This device delivers the highest vibrational resonance deep into all the tissues of the body using negative ions, amethyst, and Far-Infrared light to open the channels for intelligent cellular communication leading to DNA repair and total body wellness. Negative ions, found in abundance in nature, heighten alertness and mental energy, and decrease drowsiness. Amethyst enhances strength, stability and vigor. Far-Infrared light assists blood flow, helps release toxins and enlivens metabolism. Elevating temperature eliminates bacteria, heals and relaxes muscles, boosts immune system [sic], and promotes cardio fitness and healthy arteries.

Total body wellness is hard to beat. The one true cure, indeed! (more…)

Posted in: Cancer, Chiropractic, Energy Medicine, Health Fraud, Herbs & Supplements, Homeopathy

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CAM Docket: Functional Endocrinology Update

Sometimes the media gets it right.

From time to time, SBM has reported on the disheartening credulity of reporters when they cover so-called “alternative” medicine. Denver’s Channel 7, an ABC affiliate, is a happy exception to the rule. Reporter Theresa Marchetta first broke the story of Brandon and Heather Credeur, chiropractors practicing “Functional Endocrinology.” And for three years Marchetta, with the assistance of reporter Phil Tenser, followed up, interviewing hundreds of patients who lost thousands of dollars paid to the Functional Endocrinology Center of Colorado for treatment of their diabetes and other endocrine disorders. They’ve reported regularly as the Credeurs legal travails progressed through various judicial and administrative forums. Channel 7 and its reporters deserve substantial credit for pursing this story. The Credeurs might have escaped further censure without their persistence.

Another recurring frustration at SBM is medicine’s embrace of alternative medicine, expressed repeatedly at SBM in posts on quackademic medicine and the branding device known as integrative medicine. We’ve also lamented the seeming complicity of the state medical societies in allowing quackery to be legalized in the form of complementary and alternative medicine provider practice acts.

But sometimes medicine gets it right.

The Colorado Medical Board has somewhat redeemed itself in ordering Brandon and Health Credeur to cease and desist the unlicensed practice of medicine. That’s right. A medical board has finally put its collective foot down and pushed back against chiropractic’s increasingly aggressive push to practice medicine.

And sometimes SBM appears to be making inroads into the hostile incursion of alternative medicine.

I recently discovered that if you google “functional endocrinology”, first up on the list is CAM Docket: Functional Endocrinology, the very post updated today. Admittedly, it appears at the head of a depressingly long list of chiropractic websites advertising the practice, but at least we get a first crack at anyone who might be considering paying thousands of dollars and wasting time, and perhaps their health, on this useless nonsense.

A trifecta in the war on quackery! Revel in this victory, supporters of science-based medicine, for it is small and the victory may be fleeting. Let’s see how the battle is going. (more…)

Posted in: Chiropractic, Health Fraud, Herbs & Supplements

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When doctors betray their patients and science-based medicine for money

We spend a lot of time on this blog discussing failures of the medical system. Usually, we such discussions occur in the context of how unscientific practices and even outright quackery have managed to infiltrate what should be science-based medicine (SBM) in the form of so-called “complementary and alternative medicine” (CAM) or “integrative medicine,” in which the quackery of alternative medicine is “integrated” with SBM. Our attitude towards this practice is, of course, completely in tune with that of fellow SBM blogger Mark Crislip when he so famously wrote, “If you integrate fantasy with reality, you do not instantiate reality. If you mix cow pie with apple pie, it does not make the cow pie taste better; it makes the apple pie worse.” However, as grave a threat to SBM as CAM and integrative medicine are, there is a threat at least as grave here in the U.S. (and, I presume, in many places in the world). It has little or nothing to do directly with CAM, but often CAM practitioners benefit from it. What I am referring to is the utter ineffectiveness of most state medical boards in reining in quackery and bad physician behavior that endangers patients. A recent story about a prominent Detroit area oncologist named Farid Fata, MD, who has been arrested and charged with administering unnecessary chemotherapy and of diagnosing patients with cancer who turned out not to have cancer in order to defraud Medicare, has led me to think that now might be a good time to revisit this issue. Then I heard about an Ohio spine surgeon indicted for performing unnecessary surgeries to defraud insurance companies, and I knew that now is a good time to revisit the issue.

I’ve discussed this issue before with respect to various practitioners over the years. One that comes to mind immediately is Dr. Rolando Arafiles at the Winkler County Memorial Hospital in Kermit, TX. Basically, a CAM-friendly physician was practicing substandard medicine, and two nurses reported him anonymously to the Texas Medical Board. Dr. Arafiles was a business partner with Winkler County Sheriff Robert Roberts, who left no stone unturned to discover who had complained about his good buddy, leading to the prosecution of the two whistleblowing nurses for violation of patient privacy, even though Texas law explicitly said that using patient information to report substandard care is not a violation of patient privacy. The entire medical establishment seemed to be trying to come down on the two brave nurses like the proverbial ton of bricks. Ultimately, the Texas Medical Board did the right thing, but it took a long time, and two responsible nurses who couldn’t bear seeing Dr. Arafiles continue to betray patient trust. There are many other examples, such as that of Dr. Rashid Buttar, a North Carolina doctor known for using “alternative” treatments for autism and cancer who got off with a slap on the wrist for some truly horrendous violations of the standard of care.

And don’t even get me started on the utter failure of the Texas Medical Board to put a stop to Dr. Stanislaw Burzynski’s unethical abuse of clinical trials and use of an unproven cancer drug for over 36 years or on how it took decades to finally put a stop to Dr. Mark Geier’s autism quackery in the United States. So what about these recent cases have in common? It’s that they were both busted by the feds. The relevant state medical boards in Michigan and Ohio (both states in which I hold a medical license) did not detect the medical misadventures and did, as far as I can tell, basically nothing to stop it.
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Posted in: Health Fraud, Politics and Regulation

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