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Fun with homeopaths and meta-analyses of homeopathy trials

ResearchBlogging.orgHomeopathy amuses me.

Well, actually it both amuses me and appalls me. The amusement comes from just how utterly ridiculous the concepts behind homeopathy are. Think about it. It is nothing but pure magical thinking. Indeed, at the very core of homeopathy is a concept that can only be considered to be magic. In homeopathy, the main principles are that “like heals like” and that dilution increases potency. Thus, in homeopathy, to cure an illness, you pick something that causes symptoms similar to those of that illness and then dilute it from 20C to 30C, where each “C” represents a 1:100 dilution. Given that such levels of dilution exceed Avagaddro’s number by many orders of magnitude, even if any sort of active medicine was used, there is no active ingredient left after a series of homeopathic dilutions. Indeed, this was known as far back as the mid-1800′s. Of course, this doesn’t stop homeopaths, who argue that water somehow retains the “essence” of whatever homeopathic remedy it has been in contact with, and that’s how homeopathy “works.” Add to that the mystical need to “succuss” (vigorously shake) the homeopathic remedy at each dilution (I’ve been told by homeopaths, with all seriousness, that if each dilution isn’t properly succussed then the homeopathic remedy will not attain its potency), and it’s magic all the way down, just as creationism has been described as “turtles all the way down.” Even more amusing are the contortions of science and logic that are used by otherwise intelligent people to make arguments for homeopathy. For example, just read some of Lionel Milgrom‘s inappropriate invocations of quantum theory at the macroscopic level for some of the most amazing woo you’ve ever seen, or Rustum Roy‘s claims for the “memory of water.” Indeed, if you want to find out just how scientifically bankrupt everything about homepathy is, my co-blogger Dr. Kimball Atwood started his tenure on Science-Based Medicine with a five part series on homeopathy.

At the same time, homeopathy appalls me. There are many reasons for this, not the least of which is how anyone claiming to have a rational or scientific viewpoint can fall so far as to twist science brutally to justify magic. Worse, homepaths and physicians sucked into belief into the sorcery that his homeopathy are driven by their belief to carry out unethical clinical trials in Third World countries, even on children. Meanwhile, time, resources, and precious cash are wasted chasing after pixie dust by our own government through the National Center for Complementary and Alternative Medicine (NCCAM). So while I laugh at the antics of homeopaths going on and on about the “memory of water” or quantum gyroscopic models” in order to justify homeopathy as anything more than an elaborate placebo, I’m crying a little inside as I watch.

The Lancet, meta-analysis, and homeopathy

If there’s one thing that homepaths hate–I mean really, really, really hate–it’s a meta-analysis of high quality homeopathy trials published by Professor Matthias Egger in the Department of Social and Preventative Medicine at the University of Berne in Switzerland, entitled Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy.
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Posted in: Clinical Trials, Homeopathy

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Announcing two more new bloggers

Last week, we at Science-Based Medicine announced the arrival of a new blogger, Dr. Val Jones. She’s already made her mark here by in the course of her description of how she awakened to the problem of unscientific so-called “alternative” medicine infiltrating its way into medicine coining a new term that may well become more widely used than anyone could suspect.

I’m now happy to announce two more additions to the SBM team. Both are experienced bloggers. Both are excellent bloggers. Both are just as alarmed as the rest of us about how antiscience has insinuated its way into biomedical academia. Moreover, each will bring his own useful new viewpoint here to shake things up.

The first, Dr. Peter Lipson, is an internist in private practice. Consequently, he brings the perspective of how a health care professional “in the trenches,” so to speak, must deal with issues of science-based versus non-science-based medicine. His description follows:
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Posted in: Announcements

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I No Longer Love a Parade

Parade magazine is the most widely read periodical in the US, with a circulation of 32 million and a readership of 71 million (1). They get that readership by placing it, free for readers, in over 400 newspapers.

The column in question is “Ease The Aches Of Arthritis” By Dr. Vijay Vad, published 09/28/2008. Dr. Vad is a physiatrist (a rehabilitation doctor) who has published several books on arthritis for the the public.

In the article, Dr. Vad discusses ways to decrease arthritis pain. Like most popular summaries, it is without references, so I used Pubmed and Google for each of his suggestions to look for the evidence to support the advice he offers. I tried to use both narrow and broad search terms in Pubmed, but I do not doubt I missed key articles. I have confidence that the readers of the blog will show me the error of my ways.
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Posted in: Herbs & Supplements, Nutrition, Science and the Media

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Cholesterol Skeptics Strike Again

I’m really tired of arguing about cholesterol, but I feel obliged to stand up once more to defend science-based medicine from unfair calumny.

Lewis Jones’s article “Cholesterol-shmesterol” in Skeptical Briefs (December 2007) included errors and misconceptions about cholesterol. It was a re-hash of the same kind of misinformation that is being spread by The International Network of Cholesterol Skeptics (THINCS) and that I addressed in an earlier post. THINCS would like us to believe that cholesterol has nothing to do with heart disease; that low cholesterol is harmful and high cholesterol is beneficial; and they demonize statins, even falsely claiming that they cause cancer.

I answered Jones with my own article “Cholesterol Clarifications” in the June 2008 issue of Skeptical Briefs. I said I agreed that cholesterol does not “cause” heart disease, that low-fat and low-cholesterol diets have been promoted way beyond the evidence and that statins are being over-prescribed. The public has a lot of misconceptions, but thoughtful science-based doctors agree that the evidence shows: (more…)

Posted in: Nutrition, Pharmaceuticals, Science and Medicine

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Nobel for HIV Discoverers

The Nobel Prize in Medicine was awarded this week to two French virologists, Françoise Barré-Sinoussi and Luc A. Montagnier, for discovering the AIDS causing virus, the Human Immunodeficiency Virus (HIV). They will share half the prize of 1.4 million dollars, the other half going to three Dr. Harald zur Hausen for discovering the human papilloma virus and its relation to cervical cancer.

The prize comes 25 years after Barré-Sinoussi and Montagnier, working at the Pasteur Institute in Paris, published their paper identifying what was later called HIV. The last quarter of a century has proven their discovery to be a triumph of science-based medicine. The Nobel committee is correct, in my opinion, in waiting such long periods of time before granting such recognition. It reflects that fact that, even in a fast-paced arena of science such as medicine, it takes time for the meticulous process of science to work itself out. It takes decades to garner the perspective necessary to tell the difference between a crucial breakthrough and a false lead.

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Posted in: Science and Medicine

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A “Shruggie” Awakening – One Doctor’s Journey Toward Scientific Enlightenment

ED. NOTE: Circumstances have dictated an unexpected change of plans; so you’re in for a treat. Dr. Val Jones is starting two days earlier than previously announced. Beginning next week, her posts will appear regularly on Thursday mornings. Harriet Hall’s post scheduled for today will appear on Thursday this week. Be ready; it’ll be the return of the cholesterol “skeptics.” Now, Dr. Val…

Greetings, everyone. I am a proud new member of the Science Based Medicine blogging team, and have committed to one post each Thursday morning. As part of my “grand entrance” onto the skeptical blogging stage, I was hoping to introduce a new noun into our lexicon. I’ve asked permission from Steve Novella and David Gorski, and they’ve given me a wink and a nod, so here goes:

Shruggie (noun): a person who doesn’t care about the science versus pseudoscience debate. When presented with descriptions of exaggerated or fraudulent health claims or practices, their response is to shrug. Shruggies are fairly inert, they will not argue the merits (or lack thereof) of complementary and alternative medicine (CAM) or pseudoscience in general. They simply aren’t all that interested in the discussion, and are somewhat puzzled by those who are.

I’m sure you’ve encountered shruggies in your daily life. They are quite common – in fact, they may actually be in the majority among healthcare professionals. And I have a confession to make — I used to be one myself.

If you’ll indulge me, I’d like to tell you the story of how I was awakened from my unhealthy indifference toward pseudoscience. (more…)

Posted in: General, Science and Medicine, Science and the Media

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Vitamin C strikes (out) again

I didn’t think I’d be revisiting this topic again so soon. After all, I wrote one of my characteristic magnum opuses (opi?) less than two months ago, when I asked whether a recent animal study had vindicated Linus Pauling’s belief that high dose vitamin C is a highly effective cancer treatment. After that tsunami of verbiage that can only be exceeded by my fellow blogger Dr. Atwood when he’s on a roll doing a multipart deconstruction of some woo or other, I thought it would be best to give it a rest for a while. I guess less than two months will have to be enough.

The reason struck me as I was perusing the very latest issue of Cancer Research, hot off the presses October 1. As I did so, it didn’t take me long to come across an article from the Memorial-Sloan Kettering Cancer Center and the Herbert Irving Comprehensive Cancer Center at Columbia entitled Vitamin C Antagonizes the Cytotoxic Effects of Antineoplastic Drugs, whose first author is Dr. Mark Heaney.

Once more into the fray!
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Posted in: Basic Science, Cancer, Herbs & Supplements, Nutrition

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Voice of Reason Dr. Val Jones joins Science-Based Medicine

We at Science-Based Medicine are very happy to announce that Dr. Val Jones will be joining us this week as a regular blogger. Her first post will appear this Thursday, October 9.

Val Jones, M.D. is the President and CEO of Better Health, PLLC, a health education company devoted to providing scientifically accurate health information to consumers. Most recently she was the Senior Medical Director of Revolution Health, a consumer health portal with over 120 million page views per month in its network. Prior to her work with Revolution Health, Dr. Jones served as the founding editor of Clinical Nutrition & Obesity, a peer-reviewed e-section of the online Medscape medical journal. Dr. Jones is also a consultant for Elsevier Science, ensuring the medical accuracy of First Consult, a decision support tool for physicians.

Dr. Jones was born in Greenwich, Conn., and raised in Nova Scotia, Canada. She completed her bachelor’s degree at Dalhousie University in Halifax, Nova Scotia, and a master’s degree at Dallas Theological Seminary in Texas. She also participated in several research projects in biomedical imaging and vaccine research at the Mayo Clinic in Rochester, Minn.

She graduated from medical school at Columbia University College of Physicians and Surgeons in New York City and was a regular contributor to the medical student section of the Journal of the American Medical Association. She received a scholarship to conduct research in the department of plastic surgery at New York-Presbyterian Hospital, as well as did a summer research fellowship in pediatric surgery at the University of Southern California, which was funded by the National Institutes of Health. She also completed research at Memorial Sloan-Kettering Cancer Center in New York City in its Department of Physical Medicine and Rehabilitation.

Dr. Jones was the principal investigator of several clinical trials relating to sleep, diabetes and metabolism, and she won first place in the Peter Cyrus Rizzo III research competition.

Dr. Jones is the author of the popular blog, “Dr. Val and the Voice of Reason,” which won The Best New Medical Blog award in 2007. Her cartoons have been featured at Medscape, the P&S Journal, and the Placebo Journal. She was inducted as a member of the National Press Club in Washington, DC in July, 2008.

Dr. Jones has been quoted by various major media outlets, including USA Today, The Wall Street Journal, and the LA Times. She has been a guest on over 20 different radio shows, and was featured on CBS News.

As you will see beginning Thursday, Dr. Jones provides a viewpoint we have not yet had here at SBM in that she was initially indifferent to the infiltration of non-science-based medicine into respected institutions but was forced to confront the problem when it unexpectedly reared its ugly head in her life. We will let her tell her story herself, however, and are confident that you will soon see why we asked her to join SBM. Suffice it to say that she now understands more than most how unscientific medical modalities gain traction in the media.

Finally, this is not the end. Now that SBM has become established, we have concluded that it is time to bring on new bloggers who can increase the quantity and quality of our content, as well as fill in holes in our expertise that may exist. Consequently, over the last few weeks, we have been seeking new medical bloggers who are of a similar mind to ours when it comes to the importance of science as the basis for medicine, and Dr. Jones will be the first of what we hope will be a new wave. Two more excellent bloggers will be joining us the week of October 13. In the tradition of “leaving ‘em wanting more,” however, we will hold off on an official announcement until later this week.

Posted in: Announcements

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Pitfalls in Regulating Physicians. Part 2: The Games Scoundrels Play

A Few Things that No Doctor Should Do

When a physician is accused of DUI, “substance abuse,” being too loose with narcotic prescriptions, throwing scalpels in the OR, or diddling patients, the response of a state medical board† tends to be swift and definitive. Shoot first, ask questions later. After all, the first responsibility of the board is to the public’s safety, not to preserving the physician’s livelihood. One might therefore expect that a physician accused of using dangerous, substandard treatments would face a similar predicament. As you’ve undoubtedly guessed, such is not the case.

Here on Science-Based Medicine I’ve discussed at least 4 risky and implausible treatments: Laetrile, the “Gonzalez Regimen,” Na2EDTA “chelation therapy,” and intravenous hydrogen peroxide. Any medical board worth its salt ought to recognize each of those as dangerous and sub-standard, and therefore ought quickly to impose serious disciplinary measures upon any licensed physician found using them. Sometimes that is the case, but all too often it isn’t.

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Posted in: Health Fraud, Medical Ethics, Politics and Regulation, Science and Medicine

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Is medical academia just following academia?

Is Medical Academia repeating Academia’s history? In a recent essay in a small-circulation, specialized periodical, Academic Questions, Prof. John M. Ellis, emeritus Professor of Literature at the University of California, Santa Cruz, recounts the past 4-5 decades of changes in liberal arts departments in US colleges. (How Preferences Have Corrupted Higher Education, Acad Quest, 2008; 21(2):265-274)  One modern academic controversy not needing recounting is the takeover of liberal arts departments by post-modernist theology and the partial takeover of universities themselves by radical politics dating from the 1960s.  But as recounted by Prof. Ellis, the fifty-year metamorphosis has not only changed universities, but has produced a branching network of intended and unintended consequences.

We have noted before that medicine is both a science and a practice that reflects current social attitudes and mores. (I minimize the aliquot of art, persisting from prior centuries; cultural influences being a more accurate term.) But the changes in universities now reflect in the normative thinking and mores of the modern medical school – at least a nucleus of them.  Thus Dr. Ellis’s observations may be a metaphor or template for a medicine of the next several decades.

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Posted in: General, Medical Academia

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