Download Lectures on Biostatistics (1971). Corrected and searchable version of Google books edition
Download review of Lectures on Biostatistics (THES, 1973).
Sometimes I wonder why one bothers with print. You don’t have active links, you don’t get discussion in comments, and editors alter what you want to say.
This post is about events that followed the removal by the University of Buckingham of its accreditation of the Diploma in Integrated Medicine, as described here.. This diploma was run by the "Faculty of Integrated Medicine" (FIM) which consists largely of Dr Rosy Daniel and Dr Mark Atkinson. The FIM is, in turn, the product of a charity, the Integrated Health Trust (IHT). Oddly enough, the IHT’s web site still says "The two-year, part-time Membership Programme in Integrated Medicine has been accredited as a post-graduate diploma by the University of Buckingham" (as of 13 May 2010). The FIM web site makes similar claims. "Used to be" accredited would be more appropriate.
The advisory board of IHT consists almost entirely of supporters of various forms of alternative medicine, some of whom have been mentioned already on this blog. The respectable supporters who appeared when FIM’s diploma was first announced have vanished, and now they rely entirely on a couple of celebrity endorsements, and a few anecdotes about miracle cures. This is behaviour that is characteristic of all quacks.
After the post here, the story was printed on 13th April in Times Higher Education, under the headline It’s terminal for integrated medicine diploma. On 25th April a reply from Dr Daniel on the THE web site, ‘Terminal’? We’ve only just begun. This attracted a lot of comments. I rather liked the first one,
“The question is: who will stand up and support the formalisation of IM education for doctors and nurses in the UK?”. Not anyone with more than one working neuron, that’s who.
My own comment was rather more restrained than some of the semi-literate abuse from alternative medicine enthusiasts.
On 29th April, Daniel got another go in on the Times Higher Education web site, with the title ‘Bad’ Scientist. This time she got rather personal. Realising that not everyone reads the web version, I thought a print response was called for. I sent them a full response. At their request it was
cut down to the length of a letter, and even then they cut out the reference to Andrew Weil. The abbreviated letter was published on 13th May as Don’t shoot the messenger.
For the record, here is the complete response that I sent.
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In response to your report [It’s terminal for integrated medicine diploma] and my blog Dr Daniel, in her two recent contributions to THE [‘Terminal’? We’ve only just begun, and ‘Bad’ Scientist], Dr Daniel describes me as misguided, intimidatory, undemocratic, antisocial and prejudiced. Ouch. I can understand that she may well be a bit upset, having recently been rejected by both the University of Buckingham and even by that bastion of all things barmy, the Prince’s Foundation for Integrated Health (now deceased). I’d like to remind her that it was not I who closed the Buckingham course. That decision was made by Terence Kealey (Buckingham’s VC) and Prof Andrew Miles. And it was the Office of Trading Standards, not I, who made her change the claims on her company’s web page about the alleged “healing” powers of a herbal concoction, Carctol, for cancer. All that I did was help to find out about some of the things that were being taught on her course. I find it quite surprising how often vice-chancellors have no idea what’s going on, but Kealey, unlike most, was interested to find out. Dr Daniel is right about one thing. I’m not a clinician. On the other hand, I do perhaps know a little bit about evidence. She claims that diet can save you from breast cancer but in the comments section it has already been pointed out that the 2007 study invoked by Dr Daniel does not come to the conclusion that she said it does. Furthermore she ignores entirely the 2010 EPIC study, published in the Journal of the National Cancer Institute (102:529-537). This study, of almost 500,000 people in ten European countries, found barely any relationship between intake of fruit and vegetables and cancer risk. This may be disappointing, but it can only harm patients to ignore the evidence when, as in this case, it exists. There are plenty of reasons to eat well, but apparently avoiding cancer is not one of them. It seems to be a bit more complicated than that. Dr Daniel says "IM in the UK is still clouded by complementary and alternative medicine (CAM) detractors owing to an important misunderstanding: IM is not CAM.". I beg to differ. The content of the course is about alternative as you can get. It included teachers who have advocated the Q-link pendant to "protect" you from evil radio waves. It is not long since Ben Goldacre opened one of these pendants and found it contained "No microchip. A coil connected to nothing. And a zero-ohm resistor, which costs half a penny, and is connected to nothing". You can’t get more alternative than that. We are told that a new programme is to be launched in May by "advisory board member, Andrew Weil. If you want to learn more about Weil, I suggest the article by ex-editor of the New England Journal of Medicine, Arnold Relman [A Trip to Stonesville: Some Notes on Andrew Weil (1998)]. That is the Dr Weil who has claimed he has insights into medical truth while under the influence of drugs. It is also the Dr Weil who, last year, was threatened with criminal prosecution in a warning letter sent jointly from the Food and Drugs Administration and the Federal Trade Commission because of “Unapproved/Uncleared/Unauthorized Products Related to the H1N1 Flu Virus” In fact every good doctor takes into account the " interaction of emotional, social and physical needs". There is no need to call this "integrative". it is just good medicine. I suggest looking at Michael Baum’s superb Samuel Gee lecture, "Concepts of holism in orthodox and alternative medicine". We are told that "The IHT is now looking for a strong collaborating university partner that will not be intimidated by the likes of Colquhoun". I’m sorry that Dr Daniel sees my approach as "intimidation" and “scare tactics”. The fact of the matter is that the content of the course is truly scary. Once what is taught on courses on alternative medicine is made public, the courses usually seem to close. The contents are just too embarrassing for even the most mercenary vice-chancellor to tolerate. Dr Daniel tells us she is “now looking for a strong collaborating university partner”. If any universities are tempted, I’d suggest that they should first write to the vice-chancellor of Buckingham, Terence Kealey, to seek his advice. |
Follow-up
Still no takers for FIM: June 2010. I made some enquiries about rumours that the Faculty of Integrated Medicine (FIM), having been fired by Buckingham, and rejected by the Prince’s Foundation (deceased), would seek validation from another institution. The University of Bristol says it has not been contacted by FIM. The University of Middlesex, which still runs several courses in magic medicine, was a more likely taker. However, after a long correspondence they responded as follows on June 15, 2010.
“Following an approach by Dr Rosy Daniel to the University, an informal meeting took place between Dr Daniel and our Associate Dean, Academic Development. As a result of that meeting and conversations with other colleagues in the University it was decided that proposals for the University to become a validating partner for the Faculty of Integrated Medicine would not be taken forward. The decision was relayed to Dr Daniel orally.”
3 March 2011. Unsurprisingly, Dr Daniel is up and running again, under the name of the British College of Integrated Medicine. The only change seems to be that Mark Atkinson has jumped ship altogether, and, of course, she is now unable to claim endorsement by Buckingham, or any other university. Sadly, though, Karol Sikora seems to have learned nothing from the saga at the University of Buckingham. He is still there as chair of the Medical Advisory Board, along with the usual suspects mentioned above.
15 Responses to Rosy Daniel and the Integrated Health Trust are not happy
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I see from the Press Release for this year’s International Integrative Medicine Day: cited on the IHT website and supported by the usual suspects, such as Andrew Weill’s Arizona Center for IM, the day’s activities asked them to [cringe]:
“# Share a nutritious meal with friends
# Be in the moment for a moment
# Practice Integrative Medicine
# Organize a political rally
# Host experiential workshops”
I can think of more useful things UK medical students could be doing.
Elsewhere it states:
“Research shows that cardiac issues, diabetes and obesity can be alleviated and even prevented through the use of integrative modalities such as a nutritious diet, physical activity, stress management and healthy lifestyle choices.”
As fascinating as this “research” is, it is interesting to see the use of the term “integrative modalities”. In what sense is diet and exercise an “integrative” approach to health? This is nothing to do with so-called integrated medicine – it is just common-sense advice you get from your GP: a balanced diet, regular moderate exercise, not drinking too much, and not smoking at all, and taking time out for leisure and a rest – this is bog-standard stuff that has been bolted on to the “holistic” tag. You don’t need World Medicine and agit-prop workshops to state the bleedin obvious.
Yet more thinly veiled cancer-curing claims on IHT’s website.. Carctol!?
How do they get away with it? Perhaps the Cancer Act needs stronger enforcement, or some ammendments that cover weasel-wording.
@Teige
Trading Standards did enforce some changes on the HealthCreation site, but in general you are right. They simply fail to enforce existing law: see Most alternative medicine is illegal
One problem is that Trading Standards are organised in an archaic way. Almost everything is done through local offices. That worked fine when their main job was to check weights and measures, but it is totally unsuited to the internet age. You are lucky if you can find even one person in a local office with enough knowledge of medical evidence to judge properly cases of this sort.
You are right, too, that the wording of the law is inadequate. It is illegal to claim that you can ‘cure’ cancer, but is it OK to say you can ‘heal’ cancer? I’d guess that the average person would interpret ‘cure’ and ‘heal’ to mean much the same thing, but if the law mentions only ‘cure’, it is easy for quacks to get away with murder.
Homoeopathy is “witchcraft”
http://www.telegraph.co.uk/health/alternativemedicine/7728281/Homeopathy-is-witchcraft-say-doctors.html
Interesting that two high court judges have asked for the inquest of a 23 year old man, who was prescribed fentanyl patches, to be reviewed. It turns out that there are 79 such deaths in the UK (MHRA). Considering only 1 in 10 ADRs are reported thats 800 potential deaths. The NHS spent over £60 million last year on fentanyl patches. Somewhat puts the campaign against homoeopathy into perspective, doesn’t it David. Now which should we review first David. Fentanyl? A yes or no answer will do.
@Dangerous
Clearly both (and everything else) should be reviewed. In fact homeopathy has been reviewed again and again. It has failed and it is dead.
Fentanyl has actions quite like those of morphine, and like morphine it is dangerous in overdose (morphine, of course, is one of your ‘safe’ natural medicines).
Are you proposing that patients with severe cancer pain should be given sugar pills rather than morphine of fentanyl? That would be ludicrous.
In the Paton lecture that I gave last year at the Pharmacological Society meeting, I singled out analgesia as one area in which pharmacology had failed (so far) to find really satisfactory drugs. Things like morphine and fentanyl are far from perfect, but they are the best we can do at the moment. At least we are trying, whereas you seem to just stand on the sidelines, shouting.
As I have mentioned on previous threads, homoeopathy is of little if any benefit. The point I’m trying to hammer home, with little success, is the fact that that there are far bigger fish to fry. The gentleman who died was prescribed fentanyl for pain due to Crohn’s disease by our glorious NHS out of hours service (a cock up even by New Labour standards).The fentanyl I tend to see prescribed is initiated by pain clinics, not palliative care.
Back to my original question. Which should we review first? Fentanyl, PPIs, SSRIs, NSAIDs or homoeopathy.
@Dangerous Conventional
This blog is about improbable science and quackery. Your complaints that Prof Colquhoun isn’t dealing with mis-prescribing of drugs is a bit like going into a haberdashers and complaining they don’t sell meat. If you want to enlighten the public with warnings of drug dangers, then why don’t you set up your own website and do it yourself?
One might ask why you are going on about fentanyl, when there are “bigger fish to fry” like the social acceptance of machines called motor vehicles which cause 3000 deaths every year in Britain, 1.2 million worldwide, and is leading cause of death in children. The answer is obvious. This thread is about the IHT and its attempts to promulgate unevidenced alternative medicine within the umbrella of “integrated medicine”. Having to read off-topic posts is annoying for anyone trying to follow a thread. Netiquette please!
@Dangerous Conventional
Why does it have to be a zero sum game? why can’t we do all of it? Also as David often points out, CAM manufacturers spend almost nothing on R&D. BigPharma spends big on it and is being held nose the grindstone to be honest about it like never before. So it is a little disingenuous to complain that scientists and medics are looking at CAM evidence, because nobody inside CAM is. Not properly anyway as a casual look at the meta studies will show you. A short course in the design of appropriate controls would help for eg.
This blog is about improbable science and quackery
In that case it must be about conventional medicines such as the ones I’ve mentioned.
CAM manufacturers spend little on R&D because they haven’t got the huge profit margins and turnover of Big Pharma. Hardly, a level playing field is it? When they do spend money on R&D such as Schwab with hawthorn there is no chance of it being prescribed in the UK anyway, so why bother unless it’s for a German audience.
@Dangerous Conventional:
Benefit/Risk ratio.
Need I say more?
(I expect that I must, but you are going to have to actually think, rather than react, for once)
@dangerous
Your comments are now being moderated to check for relevance. But I can’t let the last one go. You said
As ususal, you haven’t checked your facts. Just one homeopathic company, Boiron, has sales of over half a billion euro in 2008 and paid its chief executive €423.1K. Its profits in 2009 were over €50 million.. Even in their own words they spend very little on “research”
And of course such “research” as they do is designed to disguise the fact that they are making a large fortune by selling pills that contain nothing.
As David has said, and as Reuters has reported, CAM is big business.
I’m sure that many people here will have seen their report that in the US, people spent nearly $34 billion – yes, billion – on CAM treatments in 2007:
http://www.reuters.com/article/idUSTRE56T6MN20090730
But it is worth re-posting to illustrate how this is not some battle of overly-demanding skeptics vs. an impoverished group of CAM proponents who would fund research but do not have the money to do so.
To quote Ben Goldacre: “With alternative therapists, when you point out a problem with the evidence, people don’t engage with you about it, or read and reference your work. They get into a huff. …They accuse you of being a paid plant from some big pharma conspiracy. …
They shout, “What about thalidomide, science boy?”
(http://www.guardian.co.uk/science/2007/nov/16/sciencenews.g2)
No-one on this page has called David “science boy” but calling for an enquiry into fentanyl isn’t engaging with the issues raised about Rosy Daniel in this article and the various THES pieces.
Competing interests: I made several comments, and asked several questions of Dr Daniel, on the recent THES articles/letters (see links above) under the pseudonyms “The study called for additional investigation… ” and “‘Bad science argument’ appears *not* to be flawed”. She didn’t really answer my questions. That doesn’t make me a shill for Big Pharma though.
Oh come on Dangerous Conventional. If you want your message to be coherent you have first to get your facts straight, secondly figure out just what it is you’re campaigning for in the first place and seperate your concerns about medicine from any CAM advocacy, and thirdly set out a place and format for it, because it’s totally off-topic here and just makes you seem like a heckler.
To contribute to the refutation of the poor-CAM-no-money-for-all-the-research-we-wish-we-could-do fallacy…
USA, just look at the comparative spending for NIH departments: http://nccam.nih.gov/about/budget/institute-center.htm
Equal to Cancer Institute funding and approaching 10 000% the funding for departments for drug abuse; arthritis, musculoskeletal & skin conditions; neurological disorders & stroke…
Click to access nejm_998.pdf
M Angell found that of 30 research grants issued by a section of NCCAM (now merged I think), only 9 resulted in an end paper, only 4 made it into a journal used by libraries and archives, and none of those provided any useful or reliable information as to whether the treatments work.
So there dosn’t seem to be a very great desire to produce good research.
Not to mention the PFIH (RIP) here in the UK. A lot of money running through that group (some of which perhaps ended up lining the pockets of George and Gillian Gray.)
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