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Behold my power, quacks, and despair! Mike Adams publishes several defamatory articles about yours truly…

Mike Adams seems to view me this way. It started out funny, but isn't so funny any more.

Mike Adams seems to view me this way. It started out funny, but isn’t so funny any more. Of course, Galadriel was offered The One Ring and its great power, but declined it because she was afraid of what she would become. Maybe I am like Galadriel after all.

I decided to write this post for Science-Based Medicine because I’ve taken notice of recent posts Mike Adams has written about me, mainly because they are riddled with misinformation, fabrications, and lies. Even though at least two of his claims about me made me laugh out loud because of their utter ridiculousness, much of the rest of his recent writing about me has been downright defamatory, libelous even.

The stupid stuff

Before I get into the really nasty stuff, let’s look at the stupid stuff. It’s not that the nasty stuff isn’t also stupid, but here I arbitrarily decide to divide the discussion into parts about when Adams amuses me and when he disgusts me. If there’s one lesson I’ve learned from Adams’ attacks on me, it’s that, apparently, I have incredible power—possibly even superhuman! I mean, seriously. Adams really does seem to think that I have massive power over what Wikipedia does and does not publish about vaccines and medicine! Indeed, as I thought last night about what to write and even ended up staying up until 2 AM to do so (mainly because I was so exhausted after a day in the operating room that I crashed on the couch between 8 and 11 PM), I was half-tempted not to disabuse him of his apparent delusions about my overwhelming power. After all, if Adams really does think that I have so much power, why would I want to reveal to him the truth that I do not? On the other hand, far less amusing are Adams’ attempts to link Karmanos Cancer Center and me to the criminal Dr. Farid Fata, a lie by insinuation that is despicable even by his low standards. What should I expect, though, from someone who’s been running scams since Y2K and posting threats against GMO scientists?

Of course, I am not naïve enough to believe that Adams doesn’t actually know damned well that I don’t have that level of influence on Wikipedia. Rather, it’s all a sham, a con man’s patter, to convince his readers that I’m a major player in a conspiracy to manipulate health articles on Wikipedia from behind the scenes. He uses such fabricated stories as tools to fire up his gullible and stupid followers. Does Adams even realize how ridiculous his articles come across with their overwrought language? In fact, I laughed out loud when I read that Arianna Huffington and I “are not directly murdering children, but they are doing everything in their power to kill any truthful discussion about vaccine damage (that might save children)” and then this:
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Posted in: Announcements, Health Fraud

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Acupuncture does not work for menopause: A tale of two acupuncture studies

Women looking for relief from hot flashes will be disappointed if they think acupuncture will help them.

Women looking for relief from hot flashes will be disappointed if they think acupuncture will help them.

Arguably, one of the most popular forms of so-called “complementary and alternative medicine” (CAM) being “integrated” with real medicine by those who label their specialty “integrative medicine” is acupuncture. It’s particularly popular in academic medical centers as a subject of what I like to refer to as “quackademic medicine“; that is, the study of pseudoscience and quackery as though it were real medicine. Consider this. It’s very difficult to find academic medical centers that will proclaim that they offer, for example, The One Quackery To Rule Them All (homeopathy). True, a lot of integrative medicine programs at academic medical centers do offer homeopathy. They just don’t do it directly or mention it on their websites. Instead, they offer naturopathy, and, as I’ve discussed several times, homeopathy is an integral—nay, required—part of naturopathy. (After graduation from naturopathy school, freshly minted naturopaths are even tested on homeopathy when they take the NPLEX, the naturopathic licensing examination.) Personally, I find this unwillingness of academic medical centers that offer naturopathy to admit to offering homeopathy somewhat promising, as it tells me that even at quackademic medical centers there are still CAM modalities too quacky for them to want to be openly associated with. That optimism rapidly fades when I contemplate what a hodge-podge of quackery naturopathy is and how many academic integrative medicine programs offer it.

If you believe acupuncturists, acupuncture can be used to treat almost anything. Anyone with a reasonable grasp of critical thinking should recognize that a claim that an intervention, whatever it is, can treat many unrelated disorders is a huge red flag that that intervention is almost certainly not science-based and is probably quackery. So it is with acupuncture; yet, that hasn’t stopped the doyens of integrative medicine at the most respected medical schools from being seduced by the mysticism of acupuncture and studying it. I can’t entirely blame them. I must admit, there was a time when even I thought that there might be something to acupuncture. After all, unlike so many other CAM interventions, acupuncture involved doing something physical, inserting actual needles into the body. However, as I critically examined more and more acupuncture studies, I eventually came to agree with David Colquhoun and Steve Novella that acupuncture is nothing more than a “theatrical placebo.”
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Posted in: Acupuncture, Cancer, Clinical Trials, Traditional Chinese Medicine

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Functional medicine: The ultimate misnomer in the world of integrative medicine

Functional Medicine practitioners like to make patients think that this diagram actually means something.

Functional Medicine practitioners like to make patients think that this diagram actually means something.

We at Science-Based Medicine often describe “integrative medicine” as integrating quackery with medicine (at least, I often do), because that’s what it in essence does. The reason, as I’ve described time and time again, is to put that quackery on equal footing (or at least apparently equal footing) with science- and evidence-based medicine, a goal that is close to being achieved. Originally known as quackery, the modalities now being “integrated” with medicine then became “complementary and alternative medicine” (CAM), a term that is still often used. But that wasn’t enough. The word “complementary” implies a subordinate position, in which the CAM is not the “real” medicine, the necessary medicine, but is just there as “icing on the cake.” The term “integrative medicine” eliminates that problem and facilitates a narrative in which integrative medicine is the “best of both worlds” (from the perspective of CAM practitioners and advocates). Integrative medicine has become a brand, a marketing term, disguised as a bogus specialty.

Of course, it’s fairly easy to identify much of the quackery that CAM practitioners and woo-friendly physicians have “integrated” itself into integrative medicine. A lot of it is based on prescientific ideas of how the human body and disease work (e.g., traditional Chinese medicine, especially acupuncture, for instance, which is based on a belief system that very much resembles the four humors in ancient “Western” or European medicine); on nonexistent body structures or functions (e.g., chiropractic and subluxations, reflexology and a link between areas on the palms of the hands and soles of the feet that “map” to organs; craniosacral therapy and “craniosacral rhythms”); or vitalism (e.g., homeopathy, “energy medicine,” such as reiki, therapeutic touch, and the like). Often there are completely pseudoscientific ideas whose quackiness is easy to explain to an educated layperson, like homeopathy.
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Posted in: Critical Thinking, Diagnostic tests & procedures, Herbs & Supplements

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NCCIH Strategic Plan 2016-2021, or: Let’s try to do some real science for a change

NCCIH
It’s no secret that we at Science-Based Medicine (SBM) are not particularly fond of the National Center for Complementary and Integrative Health (NCCIH). Formerly known as the National Center for Complementary and Alternative Medicine (NCCAM) and before that the Office of Alternative Medicine, NCCIH has been the foremost government agency funding research into quackery for the last 24 years, and, of course, that’s the reason we at SBM have been harshly critical of NCCIH since SBM’s inception. Basically, NCCIH not only funds studies of dubious “alternative” therapies, but it also promotes quackery by funding “fellowships” at various institutions to teach “integrative medicine,” or, as we like to call it, “integrating” quackery with real medicine.

Indeed, back in 2009, when President Barack Obama first took office, Steve Novella and I both suggested that the time was ripe for NCCIH to be defunded and its functions allowed to revert back to the already existing Institutes and Centers of the National Institutes of Health. We were under no illusions that this would happen, given that NCCIH always had a powerful protector in the man who was arguably more responsible for creating NCCIH and guarding it against all attempts at defunding or, even worse, forcing it to do more rigorous science, woo-loving Senator Tom Harkin (D-IA). Harkin is no longer in the Senate, having retired at the end of 2014, but NCCIH is still with us, and the nature of government makes it very much that, unless someone with power is willing to expend serious political capital to eliminate it, NCCIH will be with us always, no matter how much it tries to change its name to eliminate anything implying pseudoscience.

So those of us who recognize that NCCIH was created to promote the “integration” of “outside of the mainstream” or “unconventional” treatments (the vast majority of which are quackery) into real medicine have to learn to live with NCCIH and, as much as it might gall us, to try make lemonade out of the lemon by prodding it to doing some actual rigorous science on “complementary and alternative medicine” that have at least a modicum of biological plausibility and avoid wasting taxpayer money on fairy dust treatments whose precepts either violate the laws of physics (e.g., reiki, homeopathy, and other “energy” medicine) or depend on nonexistent anatomy or physiology (e.g., reflexology, craniosacral, traditional Chinese medicine tongue diagnosis).

This brings me to something I saw on the NCCIH Director’s Blog late last week, a post by the director Josephine Briggs, Requesting Comments on NCCIH’s Draft Strategic Plan. Patriotic US citizen and advocate of SBM that I am, how could I turn down such a request? Kimball Atwood didn’t shirk from such a request back when Dr. Briggs was asking for comments on the NCCAM 2011-2015 strategic plan, nor did I.

In fact, you, too, can comment as well. The deadline is April 15.
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Posted in: Basic Science, Clinical Trials, Politics and Regulation

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Vaxxed and the Tribeca Film Festival: How Robert De Niro learned the hard way about Andrew Wakefield and the antivaccine movement

Robert De Niro made a massive mistake last week.

Robert De Niro made a massive mistake last week. Fortunately, he started to make up for it.

One of the disadvantages of only doing one blog post a week here at Science-Based Medicine is that sometimes stuff happens at too fast a pace for me. If something happens on Tuesday, by the time Sunday rolls around and it’s time for me to do my weekly post, it’s often old news, too old to bother with. That’s why it’s a good thing that I have my not-so-super-secret other blog, where I can keep up with such events. On the other hand, the advantage of a once-a-week posting schedule is that there are times I can look back at a story that evolved over the last week and, instead of blogging about it in daily chunks, I can put together a post that tells the whole story and puts it in context. Something like that happened last week. The beauty of it is that I played a major role in bringing the story to public consciousness, followed the story as it evolved, and now can provide a fairly complete recounting. Or so I hope.

First, however, let’s take advantage of another good thing about waiting to blog about a story, namely getting to see the reactions of quacks to what happened. No one can do it better than everybody’s favorite all around quack, crank, and all-purpose conspiracy theorist Mike Adams, who greeted me yesterday morning with this headline: VAXXED film pulled from Robert De Niro’s Tribeca Film Festival following totalitarian censorship demands from pharma-linked vaccine pushers and media science trolls. What on earth is Adams talking about, you might wonder? In case you haven’t been following the news, here’s a link to the New York Times story on the same incident: “Robert De Niro Pulls Anti-Vaccine Documentary From Tribeca Film Festival.” Basically, the 2016 Tribeca Film Festival selected an antivaccine documentary directed by Andrew Wakefield for screening and then thought better of it after a major uproar and a whole boatload of bad press.

I’ll deal with Adams’ post a bit later because it’s so hilariously nutty but also because it is basically the propaganda line that antivaccinationists are putting on this PR debacle brought about by Andrew Wakefield and Robert De Niro. (I never thought I’d use those two names in the same sentence.) Let’s go back a week and see what I mean. (more…)

Posted in: Book & movie reviews, Science and the Media, Vaccines

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The hijacking of evidence-based medicine

One of our heroes at SBM: John Ioannidis.

One of our heroes at SBM: John Ioannidis.

It’s no secret that I’m a fan of John Ioannidis. So, I daresay, are pretty much all of the editors and regular contributors to this blog. (If you don’t believe me, just type Ioannidis’ name into the blog search box and see how many posts you find.) Over the last couple of decades, Ioannidis has arguably done more to reveal the shortcomings of the medical research enterprise that undergirds our treatments, revealing the weaknesses in the evidence base and how easily clinical trials can mislead, than any other researcher. Indeed, after reading what is Ioannidis’ most famous article, “Why Most Published Research Findings Are False“, back in 2005, I was hooked. I even used it for our surgical oncology journal club at the cancer center where I was faculty back then. This was long before I appreciated the difference between science-based medicine (SBM) and evidence-based medicine (EBM). So it was with much interest that I read an article by him published last week and framed as an open letter to David Sackett, the father of evidence-based medicine, entitled “Evidence-based medicine has been hijacked: a report to David Sackett.” Ioannidis is also quoted in a follow-up interview with Retraction Watch.

Before I get to Ioannidis’ latest, I can’t help but point out that, not surprisingly, quacks and proponents of pseudoscientific and unscientific medicine often latch on to Ioannidis’ work to support their quackery and pseudoscience. They’ve been doing it for years. Certainly, they’re already latching on to this article as vindication of their beliefs. After all, their reasoning—if you can call it that—seems to boil down to: If “conventional” medicine is built on such shaky science, then their pseudoscience isn’t wrong after all, given that the same scientific enterprise upon which conventional medicine is based produces the findings that reject their dubious claims and treatments. Of course, whenever I hear this line of argument, I’m reminded of Ben Goldacre’s famous adage, seen in one form on Twitter here:

The adage can be generalized to all EBM and SBM as well. Just because big pharma misbehaves, EBM has flaws, and conventional medicine practitioners don’t always use the most rigorous evidence does not mean that, for example, homeopathy, acupuncture, or energy medicine works.

Still, when Ioannidis publishes an article with a title provocatively declaring that EBM has been “hijacked,” we at SBM take notice. (more…)

Posted in: Basic Science, Clinical Trials, Medical Academia, Pharmaceuticals, Politics and Regulation

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Confusing overdiagnosis for an “epidemic” of thyroid cancer in Japan after Fukushima

A Japanese girl being screen for thyroid cancer.

A Japanese girl being screen for thyroid cancer.

One of my favorite topics to blog about for SBM is the topic of overdiagnosis and overtreatment. These are two interrelated phenomena that most people are blissfully unaware of. Unfortunately, I’d also say that the majority of physicians are only marginally more aware than the public about these confounders of screening programs, if even that.

Overdiagnosis has long been appreciated to be a major impediment to translating programs to screen for disease into better outcomes in a number of diseases but has only recently really seeped into the public consciousness, beginning in particular in 2009 when the United States Preventative Services Task Force (USPSTF) issued mammography recommendations that pushed back the recommended age to start screening to 50. Certainly, the concept of overdiagnosis is counterintuitive. After all, why do we screen for disease in asymptomatic people? The reason is simple—and maddeningly intuitive. We screen for disease based on the belief that catching potentially deadly diseases like cancer early, before they produce clinical symptoms, will allow earlier intervention and save lives. It seems blindingly obvious that this should be the case, doesn’t it? Unfortunately, real life biology and pathophysiology aren’t quite so neat and tidy, and the relationship between early detection and improved survival is muddied by phenomena such as lead time bias and the Will Rogers effect, in addition to overdiagnosis.

What is overdiagnosis? In brief, it is the detection of pathology or disease that, if left untreated, would never endanger the life of a patient or even harm him. Note that overdiagnosis is not the same thing as a false positive. A false positive occurs when a test detects disease that isn’t really there; in contrast with overdiagnosis there is definite pathology. The disease being screened for is there, at least in an early form. It’s just that, at the very early stage detected, it’s either not progressive or so indolent that the patient will grow old and die of something else before it would ever cause a problem. Indeed, it’s been estimated that as many as one in three breast cancers detected by mammography in asymptomatic women might be overdiagnosed and that one in five might spontaneously regress. However, because we don’t know which ones are unlikely to cause harm and haven’t worked out a safe method of observing them and intervening if they look as though they are progressing, we are obligated to treat them all when discovered. The problem of overdiagnosis has led to multiple alterations in what once were considered definitive recommendations for screening mammography, first by the USPSTF and most recently by the American Cancer Society.
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Posted in: Cancer, Epidemiology

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The claim that Gardasil causes premature ovarian failure: Ideology, not science

It's amazing how, to antivaccine activists, it just so happens that a vaccine that targets a sexually transmitted virus must also destroy a girl's ovaries.

It’s amazing how, to antivaccine activists, it just so happens that a vaccine that targets a sexually transmitted virus must also destroy a girl’s ovaries. It must be a coincidence, right?

When you’ve been blogging for over 11 years on your own blog and 8 years on a blog like Science-Based Medicine, particularly when what you blog about is skepticism and science-based medicine, with a special emphasis on rationally and scientifically discussing quackery, inevitably you see the same misinformation and lies pop up again and again. Indeed, those of us in the biz not infrequently refer to such stories as “zombie lies,” because no matter how often you think they’ve been killed they always come back. Personally, I like to refer to them as Jason, Michael Myers, or Freddy Krueger lies (or just slasher or monster lies), for basically the same reason. You kill them with facts, evidence, science, and reason, but sooner or later they always come back. Always. That’s why trying to refute them is like playing Whac-A-Mole. This time around, a group called the American College of Pediatrics (ACP) is claiming that Gardasil is causing infertility in girls, a claim that showed up last week on that repository of quackery, NaturalNews.com. Oddly enough, despite the article’s hysterical tone, it wasn’t written by NN’s big macher himself, Mike Adams.

The reason that slasher lies keep coming back is because they never really go away completely. They only look that way because they recede for a while until someone new discovers them or their originators decide the coast is clear and they can repeat them again. There’s one particular slasher lie that keeps coming up about the HPV vaccine, usually Gardasil (mainly because that’s the brand of HPV vaccine most commonly used in the US) but not restricted to Gardasil. Sometimes Cervarix falls prey to the same lies, mainly overseas where it is the predominant version of HPV vaccine used. Given that I was in Boston at the annual meeting of the Society of Surgical Oncology over the weekend and was also busy hanging out with Kimball Atwood and Clay Jones one night, surgical colleagues another night, and the Boston Skeptics on Saturday, it seemed to me to be a good time to revisit this topic, particularly given that it hasn’t been covered on SBM before. If this post looks familiar, it’s because it has appeared before, but it was in a different form. Consider this a beefed up version of the prior post, because even when I recycle material I can’t just recycle it unchanged. I have to tinker, add, and, of course, customize for the blog. It’s what I do.
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Posted in: Public Health, Religion, Vaccines

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Are the recommended childhood vaccine schedules evidence-based?

The vaccine schedule: Safe and efficacious.

The vaccine schedule: Safe and efficacious.

We write about vaccines a lot here at SBM, and for a very good reason. Of all the medical interventions devised by the brains of humans, arguably vaccines have saved more lives and prevented more disability than any other medical treatment. When it comes to infectious disease, vaccination is the ultimate in preventive medicine, at least for diseases for which vaccines can be developed. We also know that when vaccination rates fall, it opens the door for diseases once controlled to come roaring back. We saw this phenomenon with the measles a year ago in the Disneyland measles outbreak. We’ve seen it around the country, with measles outbreaks occurring in areas where a lot of antivaccine and vaccine-averse parents live. Perhaps the most spectacular example occurred in the UK, where prior to Andrew Wakefield’s fraudulent case series in The Lancet that was used to link the MMR vaccine to autism, measles was under control; it came roaring back as MMR uptake plummeted in the wake of the publicity his research engendered. By 2008, ten years after Wakefield’s case series was published, measles was again endemic in the UK. Measles outbreaks flourished. Although MMR uptake is improving again in the UK, there remains a reservoir of unvaccinated children aged 10-16 who can transmit the virus.

Thanks, Andy.

Fortunately, Wakefield has been relegated to sharing the stage with crop circle chasers, New World Order conspiracy theorists, sovereign citizen cranks, and other antivaccine cranks like Sherry Tenpenny. Unfortunately, the damage that he has done lives on and has metastasized all over the developed world. Given the persistence of the antivaccine movement, which fuels concerns about vaccines in parents who are not themselves antivaccine but are predisposed to the antivaccine message because they distrust government and/or big pharma or have a world view that overvalues “naturalness,” I was quite interested in an article that appeared in The BMJ last week. Basically, it asked the question “Is the timing of recommended childhood vaccines evidence based?
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Posted in: Clinical Trials, Epidemiology, Public Health, Vaccines

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What naturopaths say to each other when they think no one’s listening, part 2

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When last I visited this topic, I started out by making a simple observation, namely by quoting John Wooden’s famous adage, “The true test of a man’s character is what he does when no one is watching.” What I was referring to was a private discussion forum for naturopaths known as Naturopathic Chat, or NatChat for short, and how a leak from the group had revealed the sort of pure quackery that naturopaths talk about when they are among themselves and think that no one else is listening. Basically, NatChat revealed just how quacky naturopaths are, based on the advice they gave each other about patients and their general discussions of what passes for “naturopathic medicine.” I found examples of naturopaths recommending intravenous peroxide, homeopathic drainage therapy, black salve (for a huge protruding breast cancer), and even ozone to treat a postsurgical J-pouch abscess that clearly required the attention of a colorectal surgeon. After naturopaths on NatChat became widely aware that someone on the list had revealed discussions on the list, apparently the moderators, instead of moving to another platform, stayed on Yahoo! Groups.

None of what I’ve described in this brief recap of my first post about NatChat should be surprising to regular readers of this blog, who would also know that we are not particularly fond of naturopaths, even the nice ones, who might be perfectly fine as people. Of course, it is naturopathy we don’t like, mainly because it is, as I like to describe it, a cornucopia of quackery based on prescientific vitalism mixed with a Chinese restaurant menu “one from column A, two from column B” approach to picking quackery and pseudoscience to apply to patients. Indeed, whenever the topic of naturopathy comes up, I like to refer readers to Scott Gavura’s excellent recurring series “Naturopathy vs. Science,” which has included editions such as the Facts Edition, Prenatal Vitamins, Vaccination Edition, Allergy Edition, Diabetes Edition, Autism Edition, Fake Diseases, and, of course, the Infertility Edition. We’ve also described just what happens when a naturopath tries to treat a real disease like whooping cough. The results are, to put it very mildly, not pretty.

Of course, as I’ve pointed out, any “discipline” that counts homeopathy as an integral part of it, as naturopathy does to the point of requiring many hours of homeopathy instruction in naturopathy school and including it as part of its licensing examination, cannot ever be considered to be science-based, and this blog is, after all, Science-based Medicine. Not surprisingly, we oppose any licensing or expansion of the scope of practice of naturopaths, because, as we’ve explained time and time again, naturopathy is pseudoscience and quackery.

Interestingly, what led the Reddit user and naturopathy critic NaturoWhat (who inspired my earlier post regarding NatChat) to give me the heads up as to what’s going on in NatChat again is an incident on the discussion board involving a naturopath who featured in the previous edition of my coverage of NatChat, Eric Yarnell. He’s a naturopath who tried to point out to his fellow naturopaths how black salve is a really nasty treatment because of the way it fries normal tissue just as badly as it fries abnormal tissue. He also appears to be one of those rarest of beasts, a seemingly pro-vaccine naturopath. I say “seemingly,” because whenever I encounter a naturopath billing herself as pro-vaccine (e.g., Erika Krumbeck), a closer examination of his or her views almost always reveals he or she believes in at least some antivaccine misinformation. Surprisingly, Yarnell is the naturopath who comes closest to actually being pro-vaccine that I’ve seen.
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Posted in: Naturopathy, Vaccines

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