Download Lectures on Biostatistics (1971). Corrected and searchable version of Google books edition
Download review of Lectures on Biostatistics (THES, 1973).
This afternoon I went to the Coliseum to see a revival of Jonathan Miller’s 1986 production of the Mikado. It was beautifully staged. The well-known patter song of Ko-Ko, the Lord High Executioner of Japan, begged for a version that deals with anti-science (original here). The serious post will come later. Meanwhile here’s some late night rhyming.
Ko-Ko
As some day it may happen that a victim must be found,
I’ve got a little list — I’ve got a little list
Of society offenders who might well be underground,
And who never would be missed — who never would be missed!
There’s the pestilential bureaucrats who want to send you on a course —
The HR folks who treat you not as human but as mere resource
Skills specialists who think that education just means training
And all ex-scientists who used to work, but now are only feigning
They’d none of ’em be missed — they’d none of ’em be missed!
Chorus.
He’s got ’em on the list — he’s got ’em on the list;
And they’ll none of ’em be missed — they’ll none of ’em be missed.
Ko-Ko
And that deluded nuisance, whom no one understands
The homeopathist – I’ve got her on the list!
All Reiki folks, pill hucksters and layers on of hands
They’d none of ’em be missed — they’d none of ’em be missed.
And herbalists and Princes who like to talk to trees
Those phony nutritionists who’ll treat you for large fees
And that singular anomaly, the acupuncturist —
I don’t think they’d be missed — I’m sure they’d not be missed!
Chorus.
You may put ’em on the list — you may put ’em on the list;
And they’ll none of ’em be missed — they’ll none of ’em be missed!
Ko-Ko
There’s the vision statement writer, and others of that sort
And the crystal therapist — I’ve got him on the list!
And the people who think long words are a substitute for thought
They never would be missed — they never would be missed!
Then those whose knight starvation makes them crave the honours list
So all below must suffer in case their chance is missed
And those who think that science can be judged by its citations
And so kill creativity by funding only applications
But it really doesn’t matter whom you put upon the list,
For they’d none of ’em be missed — they’d none of ’em be missed!
Chorus
You may put ’em on the list — you may put ’em on the list;
And they’ll none of ’em be missed — they’ll none of ’em be missed!
Postscript
I replaced two lines after my pedantic sister pointed out their imperfect rhyme and scansion. Personally I’m with Charles Babbage.
Here is letter that Babbage is said to have written to Tennyson after reading “The vision of sin”.
In your otherwise beautiful poem there is a verse that reads:
“Every moment dies a man
Every moment one is born”It must be manifest that, were this true, the population of the world would be at a standstill. In truth the rate of birth is slightly in excess of that of death. I would suggest that in the next edition of your poem you have it read:
“Every moment dies a man
Every moment 1 1/16 is born”Strictly speaking this is not correct. The actual figure is a decimal so long that I cannot get it in the line, but I believe that 1 1/16 will be sufficiently accurate for poetry.
I am etc,
(The Mathematical Gazette, 1927, p270)
70 Responses to They’ll none of ’em be missed
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Brilliant, when can we expect the audio?
“Brilliant, when can we expect the audio?”
Surely nothing less than a YouTube performance would suffice (in full Ko-Ko costume and make-up?).
Coincidentally, an apposite book review today in the Telegraph:
http://www.telegraph.co.uk/arts/main.jhtml?xml=/arts/2008/02/24/bosmy124.xml
“…But then as Suart also shows, politicians (though not, of course, Bush) themselves have frequently used the List as a template for speech-making. Newspaper cartoonists have been similarly inspired.
Reflecting a changing political landscape, the Labour Party hardly rates a mention in Suart’s early Little Lists but gradually moves into the limelight. Other figures recur more consistently. Richard Branson’s business deals are an occasional leitmotif, and even his balloon race is recorded: ‘Yes, Branson had to pull out, but his Virgin’s still intacta.'”
Groan!
DC, you seem to have the same musical tastes as my dad. I have very clear childhood memories of listening to the sound track to “Oh what a lovely war!” and various Gilbert and Sullivan – including this very song. Spooky.
Well actually I prefer Verdi to G&S, but who would dare to mess around with the final scene of La Traviata? OK now tell me your dad liked that too.
How ironic Professor Colquhoun’s own home page includes Mahatma Gandhi in his list of timeless quotations; not once but twice.
I’m assuming that’s the same Mahatma Gandhi who said of my faithful servant;
“Homeopathy cures a larger percentage of cases than any other method of treatment and is beyond all doubt safer, more economical, and the most complete medical science. ” …??????
Mindboggling isn’t it. By the way all you London Times readers; Dr Stutterford, homeopathic patient. Whatever will his peers think. True though.
😉
Rather like Rome in it’s vomitorium stage of incredulous insanity, the allopathic profession can’t see the wood for the trees. Maybe now you won’t all be stoned senseless on your useless anti depressants maybe you’ll see how the general public’s trust in ‘conventional science’ is at an all time low.
From Sir Richard Doll’s love in with agent orange (presumebly he didn’t spray it on his cornflakes every morning) to the hilarious non acceptance of gulf war syndrome and onto the next story of psychotic drug crazed American teenagers rampaging through another midwest school common room the game is well and truly up. The end is nigh. You have been found out.
Adios and welcome to the real ‘New World Order’.
Yours faithfully
An increasingly busy Homeopath.
Yes I know about Gandhi’s view of homeopathy. He was a great politician and a good man, but perhaps not so good at clinical trial statistics. Nobody’s perfect.
I wasn’t aware that Stutterford went for homeopathy, but having read some of his columns, nothing would surprise me less.
I suppose the best thing that can be said of the appalling concealment of data about antidepressants is that at least it can be said that science has a self-critical and self-correcting ability. And that is more than can be said for homeopaths who have persisted in believing the impossible for almost 200 years. I suggest you look at Goldacre’s masterly account.
I agree with David. I wouldn’t take lessons in science or medicine from politicians.
What the politicians de nos jours should be doing, but almost universally aren’t, is trying to tackle the problems with society that give us the current mania for consumerism, including “pills for ills”, and also (the other side of the coin) for superstitious “spiritual” mumbo-jumbo, under which heading I include fundamentalist religion and most Alternative Medicine.
The scientific Enlightenment and its values stem from a much older tradition of broadly “scientific” scholarship dating back to the origins of human civilization. This empirical and scientific tradition is the only coherent way man has ever come up with of continuously improving his understanding of the world and his place in it.
If I have to have a “Belief System”, I shall be sticking to one that is verifiable. And that doesn’t believe in Mysterious Deities, “The Force”, Miasms and Magic.
Personally I reckon anyone who goes to a Homoeopath should be required by statute to be presented with a pamphlet of Hahnemann’s and Tyler Kent’s “aphorisms and beliefs”, just so they can see clearly what sort of Loonbaggery they are being sold.
Ahh the arrogance!!…..If you discount improved sanitary conditions and a clean water supply the life extention for Britons has advanced one year for those who reach 70 in 150 years of allopathic ‘advancement.’
The arrogance of a scientific/medical elite who believe pumping a child full of countless vaccines isn’t going to impact on his long term health. There haven’t been any double blind studies proving the safety of this rabidly insane experimentation.
You can see like cures like in the writings of Hippocrates, Goethe, Shakespeare; some of the greatest minds known to man.
Regarding the A level standard of scientific repudiation of homeopathic dilution ie the Avogadro number limit, well Quantum physics and beyond that relativistic physics has already devastated that argument.
Finally it’s the 200 years of clinical practice that proves the efficacy of Homeopathy. The current allopathic hatred runs directly parallel to its resurgence. Ben Goldacre is an interesting character. Doesn’t he claim to be a junior doctor in an NHS hospital??
Not really though is he. The guy is a fraud. Naturally he’s an Oxbridge graduate so he’s an establishment clone. He has been linked to many hard left causes and groups including the marxist demos group including the son of a marxist professor and now Foreign secretary Miliband (the mind boggles).
What qualifications does Goldacre actually have?….He’s reached an MA in philosophy….philosophy?? (funded by the Royal Academy (ditto OSI, DTI!)….and this makes him an expert on anything of note?
Doesn’t he also have links to you Colquhoun and UCL Big Pharma? Hasn’t he won awards funded by Glaxo Welcome and Syngenta? (Do I hear Doll and Monsanto Agent orange)The plot thickens. Wasn’t sense about science set up by a Bilderberger ‘Dicky Taverne’ and supermarketeer par numero uno John Sainsbury; a Bliar adviser. The plot thickens further. Also isn’t the BBC science correspondent Pallab Ghosh a member too. Curiouser and curiouser.
Goldacre is currently studying for a Phd at King’s college at the institute of Psychiatry. He is a junior reseracher for Simon Wessely; advisor to the Science Media Centre and on the Advisory panel of
the US American Council on Science and Health, one of the most
heavily funded pro industry lobby groups in the world. I understand Wessely is one of the chief deniers of environmental illness. The sort who denies the existance of gulf war syndrome; a man after Sir Richard (agent orange) Doll’s heart if you will.
The IOP receives huge amounts in donation from the big pharmaceutical giants thus nailing Goldacre directly to vested interests who are naturally hell bent on destroying public choice in health and well being.
Goldacre is a fraud.
I wonder why…..why are there people so enamoured with power, with prestige and status that they would attempt to deny public choice. Why are there individuals so hell bent on homogenising the planet. Like all elements in our degenerate western society from the war on drugs to the fascist formation of the European union there will be no exemption from the stalinist state that we are entering at our peril. Just remember there are men and women who will NEVER be broken. Mark my words.
Oh dear, I see that the disregard of fact that ‘like-cures-like’ shows in his enthusiasm for homeopathy extends to other areas too.
Everything you say about Goldacre is simply not true. It has just been invented. In fact it is clearly libellous, but it is only homeopaths who use litigation to try to silence their opponents.
And if you care to point out all the Big Pharma funding that went to the late-lamented Pharmacology department, I’d be interested to know about it.
As for my own funding, all I can say is that when Patrick Holford threw a similar allegation my way in the BMJ, he ended up with egg on his face.
I could have deleted ‘the comments by ‘like-cures-like’, but they give a far stronger impression than I ever could of the deluded nature of (one extreme fringe of) the alternative medicine business. So I thought it best to let him have his say. I suspect that some of your colleagues will find your rant very embarrassing to their cause.
Go ahead and sue. Name the department that Goldacre is a junior doctor in??
I repeat he is a clinical researcher. The robot radicals at the guardian I’m sure are fully aware of the grave subterfuge at work. Just as a public relations company a la ‘Wag the dog’ coached the daughter of the kuwaiti ambassador to impersonate a refugee from kuwait (claiming eroneously to witness Iraqi soldiers throwing kuwaiti children out of incubators), Goldacre is nothing but a fraudulent quack placeman as part of a widely funded campaign to hit homeopathy.
It is of couse counter productive because everyone knows bad publicity is better than no publicity. Homeopathy is growing expenetially and that’s why we have the current campaign.
Go ahead and censure.That appears to be your paymasters MO. If it’s not damaging clinical trials you’re trying to stop being published it’s evidence that putting masts on top of schools is detrimental to their health (Goldacre denies it is) but then experiementing on toddlers is your de rigueur afterall.
Over and out.
Just for the record, my own “widely funded campaign” against homeopathy costs £8.99 per year for the domain name, and pay that out of taxed income.
I’m sorry, comments are acceptable but lies are not, so future comments will have to be moderated.
There you go censorious to the last. Care to answer the simple Goldacre question….What department and what NHS hospital is he a junior doctor at??
Surely a simple request can be answered.
😉
That’s funny, a moment ago you seemed to be quite sure, and now you are asking. Did you just make it up the first time?
But you’ll have to ask him yourself. He likes to keep his day job separate from from his journalism, and I respect that.
Aha… It’s Global Conspiracy Deja Vu…. all over again.
Other more rational folk, looking at the small bunch of volunteer “Bad Science Busters”, might see a people with a shared agenda to promote reasoned thinking and evidence.
Since this is what scientists all believe in, and think of as the Central Tenet of science, it is hardly a great surprise that some of them will defend it publically.
LikeCuresLike and co (Martin J Walker, John Stone, JABS, sundry Homoeopaths at the madder end of the AltMed spectrum) prefer instead to see All-Embracing Dark Establishment Conspiracy and Wizards Behind The Curtain.
As David says, read the rants above and then ask yourself where this “Conspiracy-verse” worldview really comes from.
If this ranting person ‘like cures like’ is so sure that Ben Goldacre is part of some major conspiracy by the pharmaceutical industry, scientists, the Guardian and anyone else, why does he or she not ask a simple question: Why did Goldacre write a severe criticism of drug companies for today’s Guardian?
It seems that that people who put belief systems before reason are not capable of rational thinking and will continue to believe whatever they want to believe regardless of evidence and truth.
“Maybe now you won’t all be stoned senseless on your useless anti depressants”
The medical profession has, with some justification, been criticised for the unthinking way in which they prescribes anti-depressants.
My question to “like cures like” and other supporters of so-called alternative medicine is, when will nutrition therapists stop prescribing expensive and useless vitamin pills?
The scientific establishment, for all its faults, is regulated. Who will protect us from alternative medicine?
Bless, LeeT needs protection from AltMed – send in the lawyers!
The regulation of the ‘scientific establishment’, as you call it, is no guarantee of public protection. Shipman operated within a regulated system and the regulation of orthodox medicines still produces questionable drugs like anti-depressants. Instead of certainty, orthodox medical science creates perpetual uncertainty – which class of drugs will have to be withdrawn next? My guess would be statins, but really, it could be any of them.
LeeT, if you want to live in a world of zero risk, then you’ve come to the wrong planet…
Re Anti-D’s statin comment, not a ghost of a chance. Statins are incredibly well-studied and are well tolerated, and the benefits are very clear to all except a band of nutri-fantasists.
Whether statins are over-prescribed in terms of COST-benefit (not, note, the same as RISK-benefit), or whether they are sometimes given at too high doses because of an inappropriate focus on lipid lowering “target figures”, is a different Q, and one being actively debated in the medical literature.
But anyone who doubts that statin and antihypertensive therapy has saved tens, or even hundreds, of thousands of lives in the UK over the last couple of decades is living in cloud cuckoo land.
“Bless, LeeT needs protection from AltMed – send in the lawyers!”
Strange how “alternative” people are always quack … I mean quick to call in the lawyers. See Dr (sic) Mckeith and professor (sic) Holford for examples. How about send in the researchers?
Who said regulation was a guarantee of protection? It is more a question of public confidence.
It would be interesting to know your opinions on proposals to regulate your line of work.
Dr A – Yes, yes, we’ve all heard these kinds of pronouncements about the safety of particular drugs only for them to be withdrawn from the market at a later date. Orthodox medical scientists are repeat offenders when it comes to this type of behaviour. Do you ever get a sense of deja vu?
If the experimental method is supposed to stop one from being deceived about the effectiveness of orthodox medicines, then how come so many of them turn out to be dangerous to health and well-being? Far from providing us with any certainty about drugs, the methods of orthodox medical scientists seem to be nothing more than an elaborate way of fooling us.
LeeT – Does this regulated game of smoke and mirrors fill you with confidence? Or are you left in a state of perpetual uncertainty?
(1) The only people who are certain are the quacks
(2) Rare side effects take time to become apparent, for obvious statistical reasons
(3) Why do quacks resist regulation that requires demonatration of efficacy?
None of the above justifies of course, the dishonesty of big pharma, nutritional therapists, homeopaths or anyone else. But that dishonesty is usually exposed by regular scientists (as in the antidepressant case) because we do the work, not just shout.
“Homeopathy is growing expenetially and that’s why we have the current campaign.”
That’s an interesting quote. Is homeopathy really growing exponentially? I’ve seen that claim made several times by homeopaths and their supporters, but never seen any figures that back up the assertion. If true, it really is a sad indictment of the critical thinking skills currently being deployed by clients of homeopaths.
“Bless, LeeT needs protection from AltMed – send in the lawyers!” – this statement seems to ridicule the idea that anyone would need protection from AltMed. Unfortunately, it is indeed the case that protection from AltMed is necessary. As long as homeopaths etc offer dubious remedies for serious (and sometimes even fatal) diseases there will always be cases where harm is caused: http://whatstheharm.net/index.html and http://quackfiles.blogspot.com/2006/12/must-see-dangers-of-chiropractic.html have details of the potential consequences of AltMed.
DC, you can’t fool me, “like cures like” isn’t a real person at all. I’m sure you’ve just written all his posts yourself as a cruel parody of the ranting, raving lunatics you consider homeopaths to be. It was the descent into “Europe union…. stalinist state” gibberish at the end that gave it away. I think you must have got a bit overenthusiastic with the overall “madder than mad Jack McMad” tone of the piece.
But seriously though, are there many of them llike that?
Sadly much of “Like Cures Like”s raving. e.g. about Ben Goldacre, is common currency at the madder end of the Alt.Conspiracy-verse.
If you want to see what true paranoia looks like, visit the JABS website, or some of the ME forums, or check out the writing of Martin J Walker about Andrew Wakefield vaccines (or about anything, really).
Some of this stuff has reached a wider audience via George Monbiot, who sees pro-GM conspiracies everywhere
LCL’s rant also exemplifies how people who buy one bit of the Alt.Conspiracy-View tend to buy all the rest: Homoepathy is being trashed because it works but the Pharmas don’t like it, Vaccines cause autism, Richard Doll was a Pharma-Shill, The Illuminati control Ben Goldacre as their own personal BadScience Manchurian Candidate etc etc.
On a more scientific note, my favourite bit of LCL’s rant is that assertion about how how “Quantum physics and… relativistic physics has already devastated” Avogadro’s Number and the inconvenient (to put it mildly) “nothing whatsoever in homoeopathic remedies” problem, famously evident even to early 19th century thinkers like Oliver Wendell Holmes.
Ah, the wonders of Magic Shaking. Personally I think it’s all in the wrist.
Staggering isn’t it how a therapy aiming to trigger the innate healing mechanism within us all is deemed insane ,whilst the indiscriminate multiple and deliberate polution (through vaccine) of a child whose immune system is in its infancy, with NO long term efficacy to prove its safety, is deemed the height of science.
Is this where we are today. What would Hipocrates say? 😉
Anti-D you might like to read this excellent article by Professor Ernst in the BMJ for a reply to your question to me: http://www.bmj.com/cgi/content/full/321/7269/1133 (I previously mentioned it on Holford Watch, but I suspect you are not an avid reader of that blog.)
In particular he writes, “Double standards in medicine existed for many years; undoubtedly they still exist today, but hopefully their days are numbered.” If we are trying to stamp bad practice amongst Big Pharma why should we tolerate it amongst so-called alternative medicine.
Professor Ernst sometimes comments on this blog. It would be interesting to know how much he thinks things have changed since he wrote the artice back in 2000.
LCL, I have two questions for you.
When was the last case of smallpox in the world?
Why haven’t there been any since then?
I am sure you can find the answers on wikipedia.
Total eradication of a fatal childhood disease is a pretty good example of long-term efficacy in my book.
Dear Mr Colquhoun,
You recently came to my attention because of the bad press about you regarding complimentary therapy. I didn’t have a very good impression of you so I googled you to see if I could get a less one sided view. I enjoyed journeying around your website and my opinion changed. I had the sense that you are a passionate and sensitive man with integrity.
I then started to wonder whether, perhaps, the anger that you justifiably feel about the withdrawal of funding for the pharmacological work that you are so passionate about, is misdirected towards the complimentary therapy industry. If I follow my assumption further, I dont see that the money spent in the complimentary field is money that has been taken from the pharmacological field. I think the government cuts and regulations are affecting both fields, as well as numerous other social needs.
I am looking forward to the day when conventional doctors and alternative healers can stand along side each other, strong and supportive pillars either side of the healing profession, as do both the snakes of the caduceus. What was it Einstein said? Something like: “Science is blind without religion and religion is lame without science”. Religion, like philosophy, is unproven science, which does not mean it is invalid. Perhaps we should consider that the scientific pharmaceutical method of healing is blind without the holistic philosophy that underpins complimentary therapy and complimentary therapy is lame without scientific pharmaceutical methods to step in when the need is life threatening.
Kezzie. Thank you very much. That is quite the nicest letter that I’ve ever had from a homeopath.
I must point out though, that I haven’t had any funding withdrawn. Funding for research doesn’t come from UCL but from the MRC and the Wellcome Trust, and that is quite unaffected by internal rearrangements at UCL.
It’s true that I have some reservations about the rearrangements, because it squanders well-known ‘brand names’, and because, in the words of John Grant (in his book Corrupted Science), “. . .whenever science is controlled by nonscientists, the result is corruption of science”. It is not to do with funding.
I appreciate the sincerity of your wish for integration, but I can’t really see it happening until alternative people begin to take seriously the assessment of the claims they make. Do you really think it is right to treat malaria and AIDS with homeopathic pills?
Despite all the letters that I’ve had suggesting that ‘like cures like’ is actually me, trying to discredit the alternative business, it is not so. We’ve had some off-list correspondence, and it seems that ‘like cures like’ is a real person.
LeeT – I may be wrong, but I believe that Prof Ernst is against the regulation of AltMed therapies. He believes that regulation is like an official seal of approval and implies evidence of efficacy in the public mind.
DC – You will find that no one in AltMed is resisting regulation that ‘requires demonstration of efficacy’. This is because evidence of efficacy is not the criterion that the government is using to push the regulation issue (public protection is its excuse). Perhaps you’d like to take this up with the DoH and not AltMed practitioners…
Like I’ve said before, the regulation of AlloMed guarantees neither public protection nor efficacious medicines. Is it any wonder that there is resistance to following this shining regulatory example?
Anti-D – I think Professor Ernst is actually on record as saying that he does not believe in the concept of alternative medicine. He points out that, in the rest of Europe, a lot of what we understand as alternative medicine is carried out by trained medical doctors.
His aim, and I suppose that of other serious scientists, is to find out whether a given treatment is effective or not. Obviously, it is pointless regulating nonsense. That rather begs the question as to just what exactly alternative medicine is. Perhaps you could define the concept in a short paragraph?
LeeT – Perhaps the good Prof E could explain how it is that he is Chair of Complementary Medicine at Exeter then?
As I’ve pointed out above, the pronouncements and methods of orthodox medical scientists can hardly be taken seriously when so many of their ‘approved’ drugs have to be withdrawn from the market because they’re either harmful to health or useless…
Yes I do think that malaria and AIDS should be treated with homeopathy. I know a very nice gentleman who came here to study engineering in the 80’s. His debilitating periodic attacks of malaria took him to try homeopathy and when he found he was cured, he switched to learning homeopathy and then took his medicine back to successfully serve his people in his homeland. His name is Sigsbert Rwegasira. (See: http://www.tiamproject.com)
I met a wonderful Filipino healer called William Nonog at a phsychiatry convention in Basle, Switzerland. I travelled to Bagio City in the Philippines to observe him in his clinic for two weeks. A business man from Manila came for treatment for a brain tumour which was energetically removed (sometimes called bare hands surgery). I followed up on the patient a week later and the feeling had returned to his right arm and his memory function was improved.
Why should I rely on scientific research to prove what I saw? Can science prove to me that my heart will take its next beat or that the sun will rise again tomorrow? No, of course not, and I would not wish to put such a burden on science which has such a valuable place within its own limitations.
May I be bold and suggest that, perhaps, you should get out and about a bit more?
I’m sorry to say this, because Kezzie is clearly a well-meaning person, but to pretend that you can cure malaria, AIDS and brain tumours with homeopathic pills is plain wicked. It is nothing short of murder. It is only a matter of time before a homeopath gets taken to court for manslaughter for this sort of thing.
Your view also illustrates well the conflict within homeopathy. It contradicts directly the views of the Faculty of Homeopathy. Bacall that Peter Fisher, the Queen’s homeopathic physician and clinical director of the Royal London Homeopathic Hospital, said
I’ll try and find the source. However, I think the point he was trying to make is that in the rest of Europe what we called CAM therapies are carried out by proper medical practioners whose main aim in using the techniques are to help their patients get better. Here we seem to have an army of specialist homeopaths, herbal doctors etc. Anyway, I don’t think professors or any other staff member at a university have much control over their job titles.
Though going back to my original question, what is complementary/alternative medicine? Surely there is just medicine isn’t there?
Kezzie said “Why should I rely on scientific research to prove what I saw? ”
Because extraordinary claims require extraordinary evidence.
In both examples you give the mechanisms proposed – homeopathic dilutions that only contain the water/alcohol diluent, and putative “energy” fields – are incompatible with chemistry and physics, that we know work in all sorts of other applications. Do you really imagine that the computer you use to post your comments would actually function if the theories used to build it were incorrect?
So there really does have to be incredibly strong evidence in favor of homeopathy and other alt med therapies before we chuck out everything we’ve learned about chemistry and physics over the last three hundred years or so. To begin with, it might be a good idea to consider the cases you have witnessed with a bit more circumspection. The questions that immediately spring to my mind concerning the philipino businessman are,
How do you know he had a brain tumor in the first place (as opposed to some other pathology)?
How could you tell that this tumor was removed by the therapy? The practitioner saying “His energy field has changed, I can feel that the tumor has gone” in a serious sounding voice would not be enough to convince me that anything in fact had happened.
Did the patient actually survive any longer than one week? How about the 6-month, 1 year and 5 year time points?
Look, I understand that you saw what you saw, but I honestly think that more mundane explanations that do not require us to re-invent the laws of physics are more likely to be correct. For example
a) patient did not in fact have brain tumor in the first place, or
b) patient did have brain tumor, but after further follow-up was not in fact cured.
Standard clinical trials attempt to look at possible explanations a) and b) very carefully, so as to reach a valid conclusion on the efficacy of the treatment that’s being tested. On the other hand, I don’t see anything apart from credulous over-interpretation in the anecdotes recounted in favor of homeopathy and the rest.
LeeT – We have a tradition of doing things differently from the rest of Europe.
Surely using the term AltMed is necessary so that sites like this can lump a whole lot of diverse therapies together and bash them without having to fully understand how they work individually…
Now, perhaps you’d like to answer a couple of questions I posed earlier: If the experimental method is supposed to stop one from being deceived about the effectiveness of orthodox medicines, then how come so many of them turn out to be dangerous to health and well-being? How can Joe Public know with any certainty that the AlloMed treatment he is taking isn’t about to have the plug pulled on it because it’s being reclassified from ‘life-saver’ to ‘killer’?
My answer is that far from providing us with any certainty about drugs, the methods of orthodox medical scientists seem to be nothing more than an elaborate way of fooling us and themselves…
“LeeT – We have a tradition of doing things differently from the rest of Europe” Errr … I wound certainly disagree with that statement. Euroskeptics and the right-wing press would probably have us believe different. Strange how the so-called AltMed lobby claim to be radical progressives, but are actually quite conservative when you scratch under the surface. Sorry I am digressing from bad science to politics. Now where was I …
There is no certainly no need for the terms AltMed, Comp Med, Western Medicine, Chinese Medicine, Indian Medicine, Homeopathic medicine, herbal medicine, allopathic medicine or CAM. Any treatment that does not work whether it be promoted by homeopaths or Big Pharma should be abandoned.
In answer to your question about clinical trials let me refer you back to the quotation from Professor Ernst in comment 26: “Double standards in medicine existed for many years; undoubtedly they still exist today, but hopefully their days are numbered.” We should be making the regulation of drugs and clinical trials more rigorous. We don’t really want to lower standards to accommodate the so-called AltMed lobby. See this very interesting post about so-called AltMed journals from Dr Aust: http://draust.wordpress.com/2007/11/
It is often a long and difficult process to establish scientific truth. People disagree with the methodology of a particular clinical trial or they disagree with the conclusions. So more research is done.
What you appear to be saying is it is difficult to establish with certainty the effectiveness of drugs so why bother. Have you any suggestions on what regulated clinical trials should be replaced with? Perhaps you have a better idea that you want to share with us?
Mcilroy. You’re connection is non existant. The vaccination cures disease is a lie proven by statistics. All you have to do is look at the graphs and see the incidence of all infectious diseases a mere fraction of what they were long before vaccination. You could also look at scarlet fever; an infectious disease that has never been vaccinated against. Scarlet fever mirrors measles, small pox, rubella etc etc. It’s a perfect match in terms of its irradication and there I repeat is NO VACCINE FOR SCARLET FEVER. Open and shut case.
Small pox deaths in the u.k were endemic after the vaccine was introduced. The vaccine was made compulsory in 1853. Between ’53 and ’71 there were three small pox epidemics that killed 80,000 Britons. Those deaths were a direct result of vaccination. 80,000 britons slaughtered at the behest of a despicable murdeous policy.
Small pox has been eradicated through sanitation laws. The medical establishment was for centuries violently opposed to improved sanitation. Small pox cases were locked in sick rooms with no ventilation or natural light. the perfect environment for proliferation of disease.
Regarding small pox in those vaccinated it was the established rule not to list cause of death as small pox. With regard to its demise the book is very much open. What is clear however is vaccination in no sense has ever cured small pox. That is a baseless lie.
A few facts about smallpox.
Alas it is untrue that smallpox was eliminated by sanitation. Smallpox is like flu, it spreads by the respiratory route- basically you get infected if you breathe near a sick person (who shed virus as they cough and from their skin sores). You can be as clean as you like and live in the most wonderful airy and healthy environment – that does not change your likelihood of coming down with the disease if you are exposed.
Equally, being malnourished or unfit certainly doesn’t help anyone faced with a serious disease, infectious or otherwise, but being healthy and well-fed does not save you from dying of smallpox if you catch it. It is not a disease that spares the prince and kills the pauper, as demonstrated by the numbers the disease killed in the royal families of early modern Europe (see
Princes and Peasants: Smallpox in History by Donald R. Hopkins, University of Chicago Press 1985)
If sanitation worked, you would expect smallpox to spread less and/or to be less lethal in very recent times (say 1960’s Europe) than in the Victorian era, or in the poorer countries. This is not true: in twentieth-century Europe, each case of smallpox infected on average between 3.5 and 5 people (Gani & Leach, Nature 414, 748). You may be interested to know that in 1970 in a German hospital (pretty sanitary places, believe me), a smallpox patient with a cough, although isolated in a single room, infected persons on 3 floors see refs in http://jama.ama-assn.org/cgi/content/full/281/22/2127. This sort of infectiousness is enough to produce nasty epidemics.
So what about the smallpox eradication project? Are you suggesting that it worked by improving sanitation in the Third World rather than by vaccination? That beggars belief.
Take India: in 1974 there were 188,003 cases. In January 1975 there were 1010 and in March, 84. The last case there was in May 1975 (numbers from Hugh Pennington’s Smallpox Scares, London Review of Books, available free at http://www.lrb.co.uk/v24/n17/penn01_.html
Was that the sudden onset of sanitation? Were the poor of India suddenly well fed and properly housed? If only!
Of course, smallpox vaccine is probably the least safe of all vaccines- but average mortality is 30% for variola major, and no antiviral substances have yet proved effective for the treatment of smallpox (see JAMA http://jama.ama-assn.org/cgi/content/full/281/22/2127) so if we were again faced with this disease, we’d be back to vaccines, believe me.
“…there I repeat is NO VACCINE FOR SCARLET FEVER…” [Like cures Like]
http://www.cdc.gov/ncidod/dbmd/diseaseinfo/scarletfever_g.htm – it’s a bacterial disease, treatable by anti-biotics.
“Small pox deaths in the u.k were endemic after the vaccine was introduced. The vaccine was made compulsory in 1853. Between ‘53 and ‘71 there were three small pox epidemics that killed 80,000 Britons. Those deaths were a direct result of vaccination. 80,000 britons slaughtered at the behest of a despicable murdeous policy.”
I think you will find that vaccine production in the 21st century is a lot different – and orders of magnitude safer – than what went on in the 19th century, thanks to the efforts of doctors, scientists and engineers.
“…If we were again faced with this disease, we’d be back to vaccines, believe me.”[Lucia Sivilotti]
Even given the risks associated with this vaccine, it has to be better than the alternative strategy for a highly infectious, high mortality disease for which there is no other treatment, i.e. forcible containment/isolation of infected communities who are left to survive as best they can – or not.
“The vaccination cures disease is a lie proven by statistics.” [Like cures Like]
“…Hib vaccine is another good example, because Hib disease was prevalent until just a few years ago, when conjugate vaccines that can be used for infants were finally developed. (The polysaccharide vaccine previously available could not be used for infants, in whom most cases of the disease were occurring.) Since sanitation is not better now than it was in 1990, it is hard to attribute the virtual disappearance of Haemophilus influenzae disease in children in recent years (from an estimated 20,000 cases a year to 1,419 cases in 1993, and dropping) to anything other than the vaccine…]
http://www.cdc.gov/vaccines/vac-gen/6mishome.htm#Diseaseshadalready
kezzie
“Can science prove to me that my heart will take its next beat or that the sun will rise again tomorrow? ”
in the truest sense one cannot say for certain the sun will rise tomorrow, because science is all about margins of error and degrees of confidence in statements.
But, if the sun were to rise again in, say, London, tomorrow we know precisely what time it will rise, what time it will set, and we’ve a fairly rigorous model for the reasons why it does what it does. We know why it shines, why spots appear on its surface, how far it is from Earth, what it is made of, it’s expected life span, and plenty, plenty more.
As for your heart taking another beat, well, if wired up to an ECG machine a skilled professional can, by detecting the QRS waves of your heart, tell you an awful lot about your heart, and coupled with ultrasound you’ll be able to say with almost complete certainty that you’re heart is due to take another beat.
Can you be equally certain that a homeopathic sugar pill can cure malaria?
Perhaps it’s you who should get out and about a bit more!
Come on DC, get moderating! You’re holding up the debate…
Anti-D. If you will produce some data, rather than jsut hurling abuse, it would become a debate. Try writing a post like Sivilotti’s, I suggest.
as an aside, it’s always interesting that the more bizarre end of the CAM spectrum claim that improvements in longevity are mainly due to improvements in sanitation, hygiene etc not modern drugs. True or not, two people who did the most to recognise bacteria as causes of diseases and sterile conditions as important in avoiding infection were Pasteur and Lister, both of whom made their discoveries through a thorough grounding in science and the scientific method.
LeeT – Precisely, it’s a ‘long and difficult process to establish scientific truth’ and often ‘more research is done’. There is a double standard at work here: it’s OK for AlloMed to require more time to do research or develop new methodologies, but not AltMed. This suggests that you believe, a priori, that AltMed is useless.
Be sure to let me know when Prof Ernst finally writes the paper declaring the end of double standards in medicine.
I’m not suggesting that clinical trials should be abandoned. I am saying that orthodox medical scientists should stop putting themselves forward as paragons of research and regulatory virtue. There is uncertainty inherent in the scientific method and we all need to aware of this.
Very good point, Superburger. Although it was not the germ theory of disease that gave rise to the appreciation that adequate sanitation prevented much ill-health – that came from public health and epidemiological work in the mid 19th century – it was the coming together of things like public health recording and reporting, John Snow’s tracing of the 1854 London cholera epidemic, and the work of Pasteur and then Koch on the germ theory of disease that caused a “paradigm shift” to germ theory and thereby made the case for universal clean water supplies absolutely inarguable.
By 1880-90 rational people could see clearly exactly how and why unclean water caused epidemic disease. But…. Note that the old “Miasm” theories that were displaced by the epidemiology and then by the germ theory ONLY died out in “Allopathic” medicine. The homeopaths, of course, refused to admit that germ theory was a better explanation than “disturbances of the vital force” and have stuck with miasms ever since. Funny that.
Anti-D. Double standards are indeed the problem.
Every normal treatment has to be tested for safety AND efficacy before you can sell it. Alternative medicine has loopholes in the law that allow claims to be made for efficacy without evidence to back them up,
That is a double standard for which I can see no excuse at all.
“it’s OK for AlloMed to require more time to do research or develop new methodologies, but not AltMed”
You can have as much time as you want. Who or what is stopping you? Homeopathy has been around for more than 200 years. How long do you think it will be before it is proven?
Glad to hear you are not suggesting clinical trials should be abandoned. My experience of so-called alternative medicine is that its practitioners often claim there is no need to prove that it works since they have seen how it helps their clients.
“This suggests that you believe, a priori, that AltMed is useless.” Not really because I don’t believe there is any such thing as alternative medicine. Can you define it for me?
I have a question for Like Cures Like. What percentage of prescription drugs were withdrawn from the market last year? Or in the last 5 years?
Here’s another one. For the celebrated bête noir Vioxx, what is the absolute risk of cardiovascular disease? Not the relative, risk, or the odds ratio, but the absolute risk.
And while were are at it, please provide the reference for at least one peer reviewed experimental paper providing evidence of quantum effects in ultra-dilute solutions.
http://www.newswise.com/articles/view/538255/?sc=rsmn
Aromatherapy seems to be a candidate for the little list – smells nice, but that’s about all:
“…One of the most comprehensive investigations done to date on aromatherapy failed to show any improvement in either immune status, wound healing or pain control among people exposed to two often-touted scents.
While one of two popular aromas touted by alternative medicine practitioners – lemon – did appear to enhance moods positively among study subjects, the other – lavender – had no effect on reported mood, based on three psychological tests.
Neither lemon nor lavender showed any enhancement of the subjects’ immune status, nor did the compounds mitigate either pain or stress, based on a host of biochemical markers.
In some cases, even distilled water showed a more positive effect than lavender…”
LeeT doesn’t seem to be having much luck getting a definition of alternative medicine from Anti-D. I quite like the definition Richard Dawkins gave in his introduction to John Diamond’s Snake Oil:
LeeT – Just because you don’t believe something exists or it can’t be defined,
doesn’t make the fact of its existence disappear. You’re avoiding grappling with the AltMed hydra by burying your head in the sand.
Sbartfast – It’s not a question of percentages, it’s about the fact that drugs are withdrawn at all. If the experimental method is supposed to stop one from being deceived about the effectiveness and safety of orthodox medicines, then how come ANY of them turn out to be dangerous to health and well-being?
I’m sure the victims of Vioxx will care deeply about the distinction between its relative and absolute risk of causing heart failure or stroke.
DC – Yes, there is a loophole. But what about the elephant in the room? Is there not a problem with the system (both legal and scientific) that approves medicines on grounds of safety and effectiveness, only for some of those medicines to be withdrawn from the market at a later date because they’re either harmful to health or useless?
Far from providing us with any certainty about drugs, the system and its methods seem to be nothing more than an elaborate confidence trick. Why do you want AltMed to join AlloMed in this shambles?
Anti-D. All I can do is recommend that you get a textbook on statistics (sadly my own Lectures on Biostatistics is out ot print or I’d plug it here). You can’t detect rare effects with time and large numbers of people. It really isn’t that hard. The problem of establishing causality is not trivial. Sorry if this is all a bit technical for you, but it’s important.
Of course there is no excuse for the handful (as far as we know) of cases where Big Pharma have withheld data. Nor for the cases where TCM has kept quiet about side effects. Sadly, money corrupts and it does so every bit as much in the alternative world as in the world of real medicine.
Take another example? Does glucosamine cause liver failure?
“AlloMed” – now that’s catchy!
I wonder, if I asked nicely, if the folks at the Lancet would consider renaming it Allo! Magazine?
DC – You use the word ‘rare’, but every orthodox drug has side effects. Withheld data and statistical blips certainly skew knowledge on particular drugs, but it is only through long term studies that we can really know whether a drug’s side effects are tolerable or deadly. Orthodox drugs are brought to market far too soon when one considers that they are novel compounds whose negative effects can take decades to manifest. Does your book have a chapter on this particular issue?
“You’re avoiding grappling with the AltMed hydra by burying your head in the sand”
No, I am definitely not burying my head in the sand about so-called alternative medicine. I have spent much more time than is healthy or necessary trying to find out what it is. No one seems to be able to help me out which is rather a shame.
The charge you are making in an echo of George Orwell is Big Pharma bag, AltMed good. As far as I am concerned Big Pharma and Big CARMA seem to have a lot in common.
“Why do you want AltMed to join AlloMed in this shambles?” I am really not that bothered to be perfectly honest unless you want public money to promote what you are doing.
You speak of “orthodox medicines.” “Orthodox”, of course, comes from the Greek words “othos” and “doxa” meaning right way. I would hope that all drugs being used on patients are following the right way. If not they are decidedly unorthodox.
Now the sum of my scientific knowledge is only a “B” grade in GCSE chemistry. From what I recall from the practicals we had to do to get a chemical reaction between two different substances you need an adequate amount of each substance. Does the fact that there are rarely any side effects from alternative medicines not say something about the chemical reactions going on? Or rather the lack of reaction?
It is self-evident, really, that one cannot test drugs before they hit the market with a study of the same “size” as the group of people who will ultimately take the drug. If there are millions of people with A.N.Other treatable condition (e.g. more than 100 million worldwide w Type 2 diabetes), it is clearly not feasible to run a trial for a new anti-diabetic drug on even a million people. One has to basically set the “acceptable” detection limit for side effects and then design the trial accordingly. As DC says, basic statistics. But CAM-mers don’t understand stats because CAM doesn’t need them; why bother with evidence when you can just have Belief (in CAM) and Paranoid Delusions (about “Allomed”, aka “medicine”)
Given the trial size factor, post-marketing surveillance for drugs will inevitably turn up rare unwanted effects, and sometimes unexpected things based on long-term use, that were not detected in the “advance” drug trials. That, after all, is why there is post-marketing surveillance.
As DC has pointed out here and elsewhere, one of the things that most clearly distinguishes conventional medicine from CAM is that conventional medicine routinely re-examines things once they become accepted wisdom, e.g. drugs post-marketing (like Vioxx, or SSRIs for depression). Find me a CAM-mer who is REALLY trying to test rigorously if CAM therapies work…. and you won’t be able to. Or will you end up with Edzard Ernst, who precisely because he tries to do the tests properly is routinely denounced by CAM people as “an enemy”.
CAM utterly lacks the ability for critical self-examination, because it is NOT based on skepticism, as science is. Instead, it is based squarely on credulity and blind Belief. Jdc’s Dawkins’s quote says it all.
anti-D, your post 59 sounds like an argument in favour of improved drug trial design long-range analysis of potential drug problems, which is an interesting topic, and firmly withing the realms of orthodox/”allopathic” science.
It’s not, however, an argument in favour of throwing the baby out with the bathwater and assuming that because some drugs are flawed then all CAM is better.
Airborne, Makers of a herbal/vitamin preparation initially advertised as ‘preventing’ colds has agreed to refund money to consumers as part of a $23.3 million settlement of a class-action lawsuit for false advertising (action brought by Center for Science in the Public Interest):
http://www.webmd.com/cold-and-flu/news/20080304/cold-remedy-airborne-settles-lawsuit?src=RSS_PUBLIC
Press release from MHRA, yesterday, warning of poor practice in unlicensed herbal medicine sector:
http://www.mhra.gov.uk/NewsCentre/Pressreleases/CON014134
“…The issues found were:
* Reports of suspected adverse drug reactions, which were linked to an illegal unlicensed product being marketed for diabetes, which gave extremely dangerous advice to patients to stop taking prescribed medication. The MHRA took action to remove the product DBCare from the UK market (See notes to editors)
* A case of liver toxicity where two multi ingredient Traditional Chinese Medicine (TCM) products were being taken. This case highlighted the illegal practice of sticking a different label with a different list of ingredients on top of the original product label, so it’s anyone’s guess as to what the actual ingredient are!
* Poor sourcing practices i.e. buying from companies with bogus addresses and taking samples of unknown provenance from a ‘travelling salesman’ e.g. the case of Tian Li (See notes to editors)
* Evidence of the adulteration of products with potent pharmaceuticals or toxic ingredients. This is a serious problem that is indicative of low grade manufacturing standards and in some cases a deliberate intention to deceive the public, e.g. Li Da Dai Hua a herbal slimming product which was found to contain Des methyl sibutramine (a POM)
Many unlicensed herbal medicines are not made to such low standards. The problem is that consumers have to guess whether these unlicensed products contain the ingredients that are declared, and have reliable information about their use…”
Dr A – Trial size factor, post-marketing surveillance etc. add up to members of the public being treated like guinea pigs in trials they’ve not consented to. I really don’t understand how AlloMed gets away with it…
option 1. No drug can ever be guaranteed 100% safe, therefore it is too risky to sell any pharmaceutical (herbal included) as there is a finite chance of an unexpected reaction. If people get sick, well, they can try their luck with the homeopaths and the crystal healers.
option 2. We accept the risk, do a large number of studies to eliminate the immediate, obviously dangerous drugs then release the drug to the market, to be prescribed and dispensed by (public funded) professionals with a framework in place to monitor for the chance (certainty?) of adverse effects in the future. We accept that bad things might happen, but can also be grateful for effective treatments for serious illness.
Anti-D, you’re seem now to just be making arguments for better drug trials and testing. Which is fairly mainstream science. Perhaps you’ve got some ideas on how to improve the current route from laboratory to pharmacy?
As for ‘AlloMed’ getting way with it, well the regulatory framework is set, essentially, by government.
Since we live in a democracy it is perfectly feasible to campaign for a change in the law.
Oh grow up , Anti-D. It is because otherwise there would be NO modern medicines for anything – so e.g. people with hereditary hypercholesterolaemia would be dead by 40 from ischemic disease instead of (as now) surviving reasonably happily on statins and other lipid-lowering therapies. And there would be no insulin for type 1 diabetics, who would all be dead by 20, and so on, and so on.
Most people actually get this idea of “risk-benefit” when it is explained to them, as it is for instance with people having surgery. For reasons I am at a loss to explain, AltMedders refuse to engage the brain and grasp this rather basic concept.
DC – I’ve obviously hit a raw nerve. So all your noble sentiments about ‘engaging’ go out the window. If you can’t acknowledge the dark heart of orthodox medicine – that it advances on the corpses of previous generations – then we are truly living in an age of endarkenment…
Perhaps it is time to draw this thread to a conclusion. I can only thank ‘like cures like’ and anti-D for showing so clearly the level of argument that we can expect from one extreme wing of the alternative medicine business.
If you think LCL and Anti-D were the Endpoint of irrationality, David, have a look at the arguments and conspiracy theories here.
“Perhaps it is time to draw this thread to a conclusion”
Shame, it would have been great if one of them had been able to explain what they mean by the terms alternative and allopathic medicine. Never mind. Another time perhaps.