Download Lectures on Biostatistics (1971). Corrected and searchable version of Google books edition
Download review of Lectures on Biostatistics (THES, 1973).
This post recounts a complicated story that started in January 2009, but has recently come to what looks like a happy ending. The story involves over a year’s writing of letters and meetings, but for those not interested in the details, I’ll start with a synopsis.
Synopsis of the synopsis
In January 2009, a course in "integrated medicine" was announced that, it was said, would be accredited by the University of Buckingham. The course was to be led by Drs Rosy Daniel and Mark Atkinson. So I sent an assessment of Rosy Daniel’s claims to "heal" cancer to Buckingham’s VC (president), Terence Kealey, After meeting Karol Sikora and Rosy Daniel, I sent an analysis of the course tutors to Kealey who promptly demoted Daniel, and put Prof Andrew Miles in charge of the course. The course went ahead in September 2009. Despite Miles’ efforts, the content was found to be altogether too alternative. The University of Buckingham has now terminated its contract with the "Faculty of Integrated Medicine", and the course will close. Well done.Buckingham.
Synopsis
- January 2009. I saw an announcement of a Diploma in Integrated Medicine, to be accredited by the University of Buckingham (UB). The course was to be run by Drs Rosy Daniel and Mark Atkinson of the College of Integrated Medicine, under the nominal directorship of Karol Sikora (UB’s Dean of Medicine). I wrote to Buckingham’s vice-chancellor (president), Terence Kealey, and attached a reprint of Ernst’s paper on carctol, a herbal cancer ‘remedy’ favoured by Daniiel.
- Unlike most vice-chancellors, Kealey replied at once and asked me to meet Sikora and Daniel. I met first Sikora alone, and then, on March 19 2009, both together. Rosy Daniel gave me a complete list of the speakers she’d chosen. Most were well-known alternative people, some, in my view, the worst sort of quack. After discovering who was to teach on the proposed course, I wrote a long document about the proposed speakers and sent it to the vice-chancellor of the University of Buckingham, Terence Kealey on March 23rd 2009.. Unlike most VCs, he took it seriously. At the end of this meeting I asked Sikora, who was in nominal charge of the course, how many of the proposed tutors he’d heard of. The answer was "none of them"
- Shortly before this meeting, I submitted a complaint to Trading Standards about Rosy Daniel’s commercial site, HealthCreation, for what seemed to me to be breaches of the Cancer Act 1939, by claims made for Carctol. Read the complaint.
- On 27th April 2009, I heard from Kealey that he’d demoted Rosy Daniel from being in charge of the Diploma and appointed Andrew Miles, who had recently been appointed as Buckingham’s Professor of Public Health Education and Policy &Associate Dean of Medicine (Public Health). Terence Kealey said "You’ve done us a good turn, and I’m grateful". Much appreciated. Miles said the course “needs in my view a fundamental reform of content. . . “
- Although Rosy Daniel had been demoted, she was still in charge of delivering the course at what had, by this time, changed its name to the Faculty of Integrated Medicine which, despite its name, is not part of the university.
- Throughout the summer I met Miles (of whom more below) several times and exchanged countless emails, but still didn’t get the revised list of speakers. The course went ahead on 30 September 2009. He also talked with Michael Baum and Edzard Ernst.
- By January 2010, Miles came to accept that the course was too high on quackery to be a credit to the university, and simply fired The Faculty of Integrated Medicine. Their contract was not renewed. Inspection of the speakers, even after revision of the course, shows why.
- As a consequence, it is rumoured that Daniel is trying to sell the course to someone else. The University of Middlesex, and unbelievably, the University of Bristol, have been mentioned, as well as Thames Valley University, the University of Westminster, the University of Southampton and the University of East London. Will the VCs of these institutions not learn something from Buckingham’s experience? It is to be hoped that they would at the very least approach Buckingham to ask pertinent questions? But perhaps a more likely contender for an organisation with sufficient gullibility is the Prince of Wales newly announced College of Integrated Medicine. [but see stop press]
The details of the story
The University of Buckingham (UB) is the only private university in the UK. Recently it announced its intention to start a school of medicine (the undergraduate component is due to start in September 2011). The dean of the new school is Karol Sikora.
Karol Sikora shot to fame after he appeared in a commercial in the USA. The TV commercial was sponsored by a far-right Republican campaign group, “Conservatives for Patients’ Rights” It designed to prevent the election of Barack Obama, by pouring scorn on the National Health Serrvice. A very curious performance. Very curious indeed. And then there was a bit of disagreement about the titles that he claimed to have.
As well as being dean of medicine at UB. Karol Sikora is also medical research director of CancerPartnersUK. a private cancer treatment company. He must be a very busy man.
Karol Sikora’s attitude to quackery is a mystery wrapped in an enigma. As well as being a regular oncologist, he is also a Foundation Fellow of that well known source of unreliable information, The Prince of Wales Foundation for Integrated Health. He spoke at their 2009 conference.
In the light of that, perhaps it is not, after all, so surprising thet the first action of UB’s medical school was to accredit a course a Diploma in Integrated Medicine. This course has been through two incarnations. The first prospectus (created 21 January 2009) advertised the course as being run by the British College of Integrated Medicine.But by the time that UB issued a press release in July 2009, the accredited outfit had changed its name to the Faculty of Integrated Medicine That grand title makes it sound like part of a university. It isn’t.
Rosy Daniel runs a company, Health Creation which, among other things, recommended a herbal concoction. Carctol. to "heal" cancer, . I wrote to Buckingham’s vice-chancellor (president), Terence Kealey, and attached a reprint of Ernst’s paper on Carctol. . Unlike most university vice-chancellors, he took it seriously. He asked me to meet Karol Sikora and Rosy Daniel to discuss it. After discovering who was teaching on this course, I wrote a document about their backgrounds and sent it to Terence Kealey. The outcome was that he removed Rosy Daniel as course director and appointed in her place Andrew Miles, with a brief to reorganise the course. A new prospectus, dated 4 September 2009, appeared. The course is not changed as much as I’d have hoped, although Miles assures me that while the lecture titles themselves may not have changed, he had ordered fundamental revisions to the teaching content and the teaching emphases.
In the new prospectus the British College of Integrated Medicine has been renamed as the Faculty of Integrated Medicine, but it appears to be otherwise unchanged. That’s a smart bit of PR. The word : “Faculty” makes it sound as though the college is part of a university. It isn’t. The "Faculty" occupies some space in the Apthorp Centre in Bath, which houses, among other things, Chiropract, Craniopathy (!) and a holistic vet,
The prospectus now starts thus.
The Advisory Board consists largely of well-know advocates of alternative medicine (more information about them below).
Most of these advisory board members are the usual promoters of magic medicine. But three of them seem quite surprising,Stafford Lightman, Nigel Sparrow and Nigel Mathers.
Stafford Lightman? Well actually I mentioned to him in April that his name was there and he asked for it to be removed, on the grounds that he’d had nothing to do with the course. It wasn’t removed for quite a while, but the current advisory board has none of these people. Nigel Sparrow and Nigel Mathers, as well as Lightman, sent letters of formal complaint to Miles and Terence Kealey, the VC of Buckingham, to complain that their involvement in Rosy Daniel’s set-up had been fundamentally misrepresented by Daniel. With these good scientists having extricated themselves from Daniel’s organisation, the FIM has only people who are firmly in the alternative camp (or quackery, as i’d prefer to call it). For example, people like Andrew Weil and George Lewith.
Andrew Weil, for example, while giving his address as the University of Arizona, is primarily a supplement salesman. He was recently reprimanded by the US Food and Drugs Administration
“Advertising on the site, the agencies said in the Oct. 15 letter, says “Dr. Weil’s Immune Support Formula can help maintain a strong defense against the flu” and claims it has “demonstrated both antiviral and immune-boosting effects in scientific investigation.”
The claims are not true, the letter said, noting the “product has not been approved, cleared, or otherwise authorized by FDA for use in the diagnosis, mitigation, prevention, treatment, or cure of the H1N1 flu virus.”
This isn’t the first time I’ve come across people’s names being used to support alternative medicine without the consent of the alleged supporter. There was, for example, the strange case of Dr John Marks and Patrick Holford.
Misrepresentation of this nature seems to be the order of the day. Could it be that people like Rosy Daniel are so insecure or, indeed, so unimportant within the Academy in real terms (where is there evidence of her objective scholarly or clinical stature?), that they seek to attach themselves, rather like limpets to fishing boats, to people of real stature and reputation, in order to boost their own or others’ view of themselves by a manner of proxy?
The background
When the course was originally proposed, a brochure appeared. It said accreditation by the University of Buckingham was expected soon.
Not much detail appeared in the brochure, Fine words are easy to write but what matters is who is doing th teaching. So I wrote to the vice-chancellor of Buckingham, Terence Kealey. I attached a reprint of Ernst’s paper on carctol, a herbal cancer ‘remedy’ favoured by Daniel (download the cached version of her claims, now deleted).
Terence Kealey
Kealey is regarded in much of academia as a far-right maverick, because he advocates ideas such as science research should get no public funding,and that universities should charge full whack for student fees. He has, in fact, publicly welcomed the horrific cuts being imposed on the Academy by Lord Mandelson. His piece in The Times started
“Wonderful news. The Government yesterday cut half a billion pounds from the money it gives to universities”
though the first comment on it starts
"Considerable accomplishment: to pack all these logical fallacies and bad metaphors in only 400 words"
He and I are probably at opposite ends of the political spectrum. Yet he is the only VC who has been willing to talk about questions like this. Normally letters to vice-chancellors about junk degrees go unanswered. Not so with Kealey. I may disagree with a lot of his ideas, but he is certainly someone you can do business with.
Kealey responded quickly to my letter, sent in January 2009, pointing out that Rosy Daniel’s claims about Carctol could not be supported and were possibly illegal. He asked me to meet Sikora and Daniel. I met first Sikora alone, and then, on March 19 2009, both together. Rosy Daniel gave me a complete list of the speakers she’d chosen to teach on this new Diploma on IM.
After discovering who was to teach on the proposed course, I wrote a long document about the proposed speakers and sent it to Terence Kealey on March 23rd 2009. It contained many names that will be familiar to anyone who has taken an interest in crackpot medicine, combined with a surprisingly large element of vested financial interests. Unlike most VCs, Kealey took it seriously.
The remarkable thing about this meeting was that I asked Sikora how many names where familiar to him on the list of people who had been chosen by Rosy Daniel to teach on the course. His answer was "none of them". Since his name and picture feature in all the course descriptions, this seemed like dereliction of duty to me.
After seeing my analysis of the speakers, Terence Kealey reacted with admirable speed. He withdrew the original brochure, demoted Rosy Daniel (in principle anyway) and brought in Prof Andrew Miles to take responsibility for the course. This meant that he had to investigate the multiple conflicts of interests of the various speakers and to establish some sort of way forward in the ‘mess’ of what had been agreed before Miles’ appointment to Buckingham
Andrew Miles.
Miles is an interesting character, a postdoctoral neuroendocrinologist, turned public health scientist. I’d come across him before as editor-in-chief of the Journal of Evaluation in Clinical Practice This is a curious journal that is devoted mainly to condemning Evidence Based Medicine. Much of its content seems to be in a style that I can only describe as post-modernist-influenced libertarian.
The argument turns on what you mean by ‘evidence’ and, in my opinion, Miles underestimates greatly the crucial problem of causality, a problem that can be solved only by randomisation, His recent views on the topic can be read here.
An article in Miles’ journal gives its flavour: "Andrew Miles, Michael Loughlin and Andreas Polychronis, Medicine and evidence: knowledge and action in clinical practice". Journal of Evaluation in Clinical Practice 2007, 13, 481–503 [download pdf]. This paper launches an attack on Ben Goldacre, in the following passage.
“Loughlin identifies Goldacre [36] as a particularly luminous example of a commentator who is able not only to combine audacity with outrage, but who in a very real way succeeds in manufacturing a sense of having been personally offended by the article in question. Such moralistic posturing acts as a defence mechanism to protect cherished assumptions from rational scrutiny and indeed to enable adherents to appropriate the ‘moral high ground’, as well as the language of ‘reason’ and ‘science’ as the exclusive property of their own favoured approaches. Loughlin brings out the Orwellian nature of this manoeuvre and identifies a significant implication.”
"If Goldacre and others really are engaged in posturing then their primary offence, at least according to the Sartrean perspective adopted by Murray et al. is not primarily intellectual, but rather it is moral. Far from there being a moral requirement to ‘bend a knee’ at the EBM altar, to do so is to violate one’s primary duty as an autonomous being.”
This attack on one of my heroes was occasioned because he featured one of the most absurd pieces of post-modernist bollocks ever, in his Guardian column in 2006. I had a go at the same paper on this blog, as well as an earlier one by Christine Barry, along the same lines. There was some hilarious follow-up on badscience.net. After this, it is understandable that I had not conceived a high opinion of Andrew Miles. I feared that Kealey might have been jumping out of the frying pan into the fire.
After closer acquaintance I have changed my mind, In the present saga Andrew Miles has done an excellent job. He started of sending me links to heaven knows how many papers on medical epistemology, to Papal Encyclicals on the proposed relationship between Faith and Reason and on more than one occasion articles from the Catholic Herald (yes, I did read it). This is not entirely surprising, as Miles is a Catholic priest as well as a public health academic, so has two axes to grind. But after six months of talking, he now sends me links to junk science sites of the sort that I might get from, ahem, Ben Goldacre.
Teachers on the course
Despite Andrew Miles best efforts, he came in too late to prevent much of the teaching being done in the parallel universe of alternative medicine, The University of Buckingham had a pre-Miles, legally-binding contract (now terminated) with the Faculty of Integrated Medicine, and the latter is run by Dr Rosy Daniel and Dr Mark Atkinson. Let’s take a look at their record.
Rosy Daniel BSc, MBBCh
Dr Rosy Daniel first came to my attention through her commercial web site, Health Creation. This site, among other things, promoted an untested herbal concoction, Carctol, for "healing" cancer.
Carctol: Profit before Patients? is a review by Edzard Ernst of the literature, such as it is, and concludes
Carctol and the media hype surrounding it must have given many cancer patients hope. The question is whether this is a good or a bad thing. On the one hand, all good clinicians should inspire their patients with hope [6]. On the other hand, giving hope on false pretences is cruel and unethical. Rosy Daniel rightly points out that all science begins with observations [5]. But all science then swiftly moves on and tests hypotheses. In the case of Carctol, over 20 years of experience in India and almost one decade of experience in the UK should be ample time to do this. Yet, we still have no data. Even the small number of apparently spectacular cases observed by Dr. Daniel have not been published in the medical literature.
On this basis I referred Health Creation to Trading Standards officer for a prima facie breach of the Cancer Act 1939. ]Download the complaint document]. Although no prosecution was brought by Trading Standards, they did request changes in the claims that were being made. Here is an example.
A Google search of the Health Creation site for “Carctol” gives a link
Dr Daniel has prescribed Carctol for years and now feels she is seeing a breakthrough. Dr Daniel now wants scientists to research the new herbal medicine
But going to the link produces
Access denied.
You are not authorized to access this page.
You can download the cached version of this page, which shows the sort of claims that were being made before Trading Standards Officers stepped in. There are now only a few oblique references to Carctol on the Health Creation site, e.g. here..
Both Rosy Daniel and Karol Sikora were speakers at the 2009 Princes’s Foundation Conference, in some odd company.
Mark Atkinson MBBS BSc (Hons) FRIPH
Dr Mark Atkinson is co-leader of the FiM course. He is also a supplement salesman, and he has promoted the Q-link pendant. The Q-link pendant is a simple and obvious fraud designed to exploit paranoia about WiFi killing you. When Ben Goldacre bought one and opened it. He found
“No microchip. A coil connected to nothing. And a zero-ohm resistor, which costs half a penny, and is connected to nothing.”
Nevertheless, Mark Atkinson has waxed lyrical about this component-free device.
“As someone who used to get tired sitting in front of computers and used to worry about the detrimental effects of external EMF’s, particularly as an avid user of mobile phones, I decided to research the various devices and technologies on the market that claim to strengthen the body’s subtle energy fields. It was Q Link that came out top. As a Q link wearer, I no longer get tired whilst at my computer, plus I’m enjoying noticeably higher energy levels and improved mental performance as a result of wearing my Q Link. I highly recommend it.” Dr Mark Atkinson, Holistic Medical Physician
Mark Atkinson is also a fan of Emo-trance. He wrote, In Now Magazine,
"I wanted you to know that of all the therapies I’ve trained in and approaches that I have used (and there’s been a lot) none have excited me and touched me so deeply than Emotrance."
"Silvia Hartmann’s technique is based on focusing your thoughts on parts of your body and guiding energy. It can be used for everything from insomnia to stress. The good news is that EmoTrance shows you how to free yourself from these stuck emotions and release the considerable amounts of energy that are lost to them."
Aha so this particular form of psychobabble is the invention of Silvia Hartmann. Silvia Hartmann came to my attention because her works feature heavily in on of the University of Westminster’s barmier “BSc” degrees, in ‘naturopaths’, described here. She is fanous, apart from Emo-trance, for her book Magic, Spells and Potions
“Dr Hartmann has created techniques that will finally make magic work for you in ways you never believed to be possible.”
Times Higher Education printed a piece with the title ‘Energy therapy’ project in school denounced as ‘psychobabble’. They’d phoned me a couple of days earlier to see whether I had an opinion about “Emotrance”. As it happens, I knew a bit about it because it had cropped up in a course given at, guess where, the University of Westminster . It seems that a secondary school had bought this extreme form of psychobabble. The comments on the Times Higher piece were unusually long and interesting.
It turned out that the inventor of “Emotrance”, Dr Silvia Hartmann PhD., not only wrote books about magic spells and potions, but also that her much vaunted doctorate had been bought from the Universal Life Church, current cost $29.99.
The rest of the teachers
The rest of the teachers on the course, despite valiant attempts at vetting by Andrew Miles, includes many names only too well-known to anybody who has taken and interest in pseudo-scientific medicine. Here are some of them.
Damien Downing:, even the Daily Mail sees through him. Enough said.
Kim Jobst, homoepath and endorser of the obviously fraudulent Q-link
pendant. His Plaxo profile says
About Kim A. Jobst
Consultant, Wholystic Care Physician [sic!] , Medical Homoeopath, Specialist in Neurodegeneration and Dementia, using food state nutrition, diet and lifestyle to facilitate Healing and Growth;
Catherine Zollman, Well known ally of HRH and purveyer of woo.
Harald Walach, another homeopath, fond of talking nonsense about "quantum effects".
Nicola Hembry, a make-believe nutritionist and advocate of vitamin C and laetrile for cancer
Simon Mills, a herbalist who is inclined to diagnoses like “hot damp”, ro be treated with herbs that tend to “cool and dry.”
David Peters, of the University of Westminster. Enough said.
Nicola Robinson of Thames Valley University. Advocate of unevidenced treatmsnts.
Michael Dixon, of whom more here.
And last but not least,
Karol Sikora.
The University of Buckingham removes accreditation of the Faculty of Integrated Medicine
The correspondence has been long and, at times, quite blunt. Here are a few quotations from it, The University of Buckingham, being private, is exempt from the Freedom of Information Act (2000) but nevertheless they have allowed me to reproduce the whole of the correspondence. The University, through its VC, Terence Keeley, has been far more open than places that are in principle subject to FOIA, but which, in practice, always try to conceal material. I may post the lot, as time permits, but meanwhile here are some extracts. They make uncomfortable reading for advocates of magic medicine.
Miles to Daniel, 8 Dec 2009
” . . . now that the University has taken his [Sikora’s] initial advice in trialing the DipSIM and has found it cost-ineffective, the way forward is therefore to alter that equation through more realistic financial contribution from IHT/FIM at Bath or to view the DipSIM as an experiment that has failed and which must give way to other more viable initiatives."
"The University is also able to confirm that we hold no interest in jointly developing any higher degrees on the study of IM with IHT/FIM at Bath. This is primarily because we are developing our own Master’s degree in Medicine of the Person in collaboration with various leading international societies and scholars including the WHO and which is based on a different school of thought. "
Miles to Daniel 15 Dec 2009
"Dear Rosy
It appears that you have not fully assimilated the content of my earlier e-mails and so I will reiterate the points I have already made to you and add to them.
The DipSIM is an external activity – in fact, it is an external collaboration and nothing more. It is not an internal activity and neither is it in any way part of the medical school and neither will it become so and so the ‘normal rules’ of academic engagement and scholarly interchange do not apply. Your status is one of external collaborator and not one of internal or even visiting academic colleague. There is no “joint pursuit” of an academically rigorous study of IM by UB and IHT/FIM beyond the DipSIM and there are no plans, and never have been, for the “joint definition of research priorities” in IM. The DipSIM has been instituted on a trial basis and this has so far shown the DipSIM to be profoundly cost-ineffective for the University. You appear to misunderstand this – deliberately or otherwise."
Daniel to Miles 13 Jan 2010
"However, I am aware that weather permitting you and Karol will be off to the Fellows meeting for the newly forming National College (for which role I nominated you to Dr Michael Dixon and Prof David Peters.)
I have been in dialogue with Michael and Boo Armstrong from FIH and they are strongly in favour of forming a partnership with FIM so that we effectively become one of many new faculties within the College (which is why we change our name to FIM some months ago).
I have told Michael about the difficulties we are having and he sincerely hopes that we can resolve them so that we can all move forward as one. "
Miles to Daniel 20 Jan 2010
"Congratulations on the likely integration of your organisation into the new College of Integrative Health which will develop out of the Prince’s Foundation for Integrated Health. This
will make an entirely appropriate home for you for the longer term.Your image of David Colquhoun "alive and kicking" as the Inquisitor General, radiating old persecutory energy and believing "priestess healers" (such as you describe youself) to be best "tortured, drowned and even burnt alive", will remain with me, I suspect, for many years to come (!). But then, as the Inquisitor General did say, ‘better to burn in this life than in the next’ (!). Overall, then, I reject your conclusion on the nature of the basis of my decision making and playfully suggest that it might form part of the next edition of Frankfurt’s recent volume ["On Bullshit] http://press.princeton.edu/titles/7929.html I hope you will forgive my injection of a little academic humour in an otherwise formal and entirely serious communication.
The nature of IM, with its foundational philosophy so vigorously opposed by mainstream medicine and the conitnuing national and international controversies which engulf homeopaths, acupuncturists, herbalists, naturopaths, transcendental meditators, therapeutic touchers, massagers, reflexologists, chiropractors, hypnotists, crystal users, yoga practitioners, aromatherapists, energy channelers, chinese medicine practitioners et al, can only bring the University difficulties as we seek to establish a formal and internationally recognised School of Medicine and School of Nursing.
I do not believe my comments in relation to governance at Bath are "offensive". They are, on the contrary, entirely accurate and of concern to the University. There have been resignations at senior level from your Board due to misrepresentation of your position and there has been a Trading Standards Authority investigation into further instances of misrepresentation. I am advised that an audit is underway of your compliance with the Authority’s instructions. You have therefore not dealt with my concerns, you have merely described them as "offensive".
I note from your e-mail that you are now in discussions with other universities and given the specific concerns of the University of Buckingham which I have dealt with exhaustively in this and other correspondences and the incompatibility of the developments at UB with the DipSIM and your own personal ambitions, etc., I believe you to have taken a very wise course and I wish you well in your negotiations. In these circumstances I feel it appropriate to enhance those negotiations by confirming that the University of Buckingham will not authorise the intake of a second cohort of students and that the relationship between IHT and the University will cease following the graduation of those members of the current course that are successful in their studies – the end of February 2011."
From Miles 2 Feb 2010
"Here is the list of teachers – you can subtract me (I withdrew from teaching when the antics ay Bath started) and also Professor John Cox (Former President of The Royal College of Psychiatrists and Former Secretary General of the World Psychiatric Association) who withdrew when he learned of some of the stuff going on…. Karol Sikora continues to teach. Michael Loughlin and Carmel Martin are both good colleagues of mine and, I can assure you – taught the students solid stuff! Michael taught medical epistemology and Carmel the emerging field of systems complexity in health services (Both of them have now withdrawn from teaching commitments).
The tutors shown are described by Rosy as the finest minds in IM teaching in the country. I interviewed tham all personally on (a) the basis of an updated CV & (b) via a 30 min telephone interview with me personally. Some were excluded from teaching because they were not qualified to do so academically (e.g. Boo Armstrong, Richard Falmer, not even a first degree, etc, etc., but gave a short presentation in a session presided over by an approved teacher) and others were approved because of their academic qualifications, PhD, MD, FRCP etc etc etc) and activity within the IM field. Each approved teacher was issued with highly specific teaching guidance form me (no bias, reference to opposing schools of thought, etc etc) and each teacher was required to complete and sign a Conflicts of Interest form. All of these documentations are with me here. Short of all this governance it’s impossible to bar them from teaching because who else would then do it?! Anyway, the end is in sight – Hallelujah! "
From Miles 19 Feb 2010
"Dear David
Just got back to the office after an excellent planning meeting for the new Master’s Degree in Person-centred Medicine and a hearty (+ alcoholic) lunch at the Ath! Since I shall never be a FRS, the Ath seems to me the next best ‘club’ (!). Michael Baum is part of the steering committee and you might like to take his thoughts on the direction of the programme. Our plans may even find their way into your Blog as an example of how to do things (vs how not to do things, i.e. CAM, IM, etc!). This new degree will sit well alongside the new degrees in Public Health – i.e. the population/utilitarian outlook of PH versus the individual person-centred approach., etc. "
And an email from a senior UB spokesperson
"Rumour has it that now that Buckingham has dismissed the ‘priestess healer of Bath’, RD [Rosy Daniel] , explorations are taking place with other universities, most of which are subject to FoI request from DC at the time of writing. Will these institutions have to make the same mistakes Buckingham did before taking the same action? Rumour also has it that RD changed the name of her institution to FIM in order to fit neatly into the Prince’s FIH, a way, no doubt, of achieving ‘protection’ and ‘accreditation’ in parallel with particularly lucrative IM ‘education’ (At £9,000 a student and with RD’s initial course attracting 20 mainly GPs, that’s £180,00 – not bad business…. And Buckingham’s ‘share of this? £12,000!”
The final bombshell; even the Prince of Wales’ FIH rejects Daniel and Atkinson?
Only today (31 March) I was sent, from a source that I can’t reveal, an email which comes from someone who "represent the College and FIH . . . ".. This makes it clear that the letter comes from the Prince of Wales’ Foundation for Integrated Health
|
Dr Rosy Daniel BSc MBBCh Director of the Faculty of Integrated Medicine Medical Director Health Creation 30th March 2010 RE: Your discussion paper and recent correspondence Thank you for meeting with [XXXXXX] and myself this evening to discuss your proposals concerning a future relationship between your Faculty of Integrated Medicine and the new College. As you know, he and I have been asked to represent the College and FIH in this matter. We are aware of difficulties facing your organisations and the FIM DipSIM course. As a consequence of these, it is not possible for the College to enter into an association with you, any of your organisations nor the DipSIM course at the present time. It would, therefore, be wrong to represent to others that any such association has been agreed. You will appreciate that, in these circumstances, you will not receive an invitation to the meeting of 15th April 2010 nor to other planned events. I am sorry to disappoint you in this matter. Yours sincerely |
Conclusions
I’ll confess to feeling almost a little guilty for having appeared to persecute the particular individuals involved in thie episode. But patients are involved and so is the law, and both of these are more important than individuals, The only unfair aspect is that, while it seems that even the Prince of Wales’ Foundation for Integrated Health has rejected Daniel and Atkinson, that Foundation embraces plenty of people who are just as deluded, and potentially dangerous, as those two. The answer to that problem is for the Prince to stop endorsing treatments that don’t work.
As for the University of Buckingham. Well, despite the ‘right wing maverick’ Kealey and the ‘anti-evidence’ Miles, I really think they’ve done the right thing. They’ve listened, they’ve maintained academic rigour and they’ve released all information for which I asked and a lot more. Good for them, I say.
Follow-up
15 April 2010. This story was reported by Times Higher Education, under the title “It’s terminal for integrated medicine diploma“. That report didn’t attract comments. But on 25th April Dr Rosy Daniel replied with “‘Terminal’? We’ve only just begun“. This time there were some feisty responses. Dr Daniel really should check her facts before getting into print.
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 related above. He is still there as chair of the Medical Advisory Board, along with the usual suspects mentioned above.
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Bravo DC.
I had to re-read much of that to convince myself that it’s not all part of some very elaborate April Fools joke.
“Well done.Buckingham”
Well done DC !
Well done, DC. It is telling that even with repeat iterations of
-from Buckingham, Rosy D’s crew couldn’t muster up enough to run a course, and simply proffered the same old Usual Suspects.
And well done to Terence Kealey, too. He certainly is a right wing maverick, and I don’t agree with any of his ideas about science funding – but he was also a scientist. So it seems some of the old scepticism has stuck.
That is very good news and I hope other VCs will have the courage of what should be their convictions and follow UB in rejecting any approaches from RD and her mates.
I must say I couldn’t read some of the things on the links above as they are too dreadful in their lack of reality and post-modern nonsense.
I had another look on the Health Creaton site and find that on this page
http://www.healthcreation.co.uk/node/100
there is advertised a booklet called ‘Alternative Cancer Treatment Guide’. I would have thought that even the title could breach the cancer act since it implies that cancer can be treated by alt med. Perhaps they would argue that it is the cancer that is alternative rather than the treatment…………
Maybe my info is incorrect here but I wonder how Ms Daniel can call herself ‘Dr’. Her qualifications do not look to me like a full medical qualification nor has she a PhD.
@Lindy
Thanks. Actually both Daniel and Atkinson have got regular medical qualifications, hard though that may be to believe.
Excellent work DC. A tour de force.
Interesting to see that the unevidenced healthcare researched by TVU’s Nicola Robinson includes putting knives under the bed for nightmares, dressing in red to prevent measles and using herbs as a remedy for Down’s Syndrome. With research interests such as these, she is no doubt eminently qualified for her role as the long-standing Chair of the British Acupuncture Council’s Research Committee.
Re people with real medical degrees “going to the Dark Side”, I think it comes down to a combination of blind spots, fixed ideas, and vanity.
No-one disputes that a certain amount of acting and presentation, and how things are presented to the patients, is part of the therapist-patient relationship and thus part of delivering care. But some people (including medically-qualified ones) find this so “empowering” (and ego-stroking) that they begin to think that this is the main point of what they are doing. They then lose track of the fact that you have to base what you do on:
(i) stuff that you have a good idea (i.e. based on real evidence) works; and:
(ii) not actively deceiving people, even the ones who seem to want to be deceived
David;
“But perhaps a more likely contender for an organisation with sufficient gullibility is the Prince of Wales newly announced College of Integrated Medicine. ”
I followed the link (http://www.fih.org.uk/404.rm?url=/media_centre%2520new_integrated.html) behind that sentence and it leads to;
“404 – Page missing
Sorry, the page you requested is not at this location.
If you followed a link from within the site, we will have been notified of this in order to correct it.”
Have you been even more successful and scuppered the FIH’s pet College? Ot is it just a fault at their site.
How very pleasing to learn of this! Well done to all concerned, and especially to you, DC, for your invaluable consciousness-raising. Your actions serve as great encouragement to pursue the woo that passes for health service here in Australia. Just today I saw an ad for a health insurer offering rebates for Chiro. The mountain of woo just seems to keep growing…
@BadlyShavedMonkey
Thanks -the link has now been updated, to
http://www.fih.org.uk/media_centre/new_integrated.html
Long may the Inquisitor/Witchfinder General, radiate his old persecutory energy!
Is that just a long winded and old fashioned method of referring to a healthy degree of scepticism?
Keep up the good work!
Congratulations to David Colquhoun in helping remove the mote from the eye of the University of Buckingham; but surely a far greater achievement would be to remove the beam from the eye of UCL. I refer to a posting I made here last year in the Salford University thread in which I pointed out the bizarre situation of UCL awarding a science degree (MSc) in theoretical psycho-analysis. (As far as one can tell most respectable psychologists reach for the bargepole whenever SS Freud hoves into view.) Emeritus Prof Jenkinson subsequently told of his singular experience at UCL Medical Faculty’s Postgraduate Degrees Committee when he suggested that a proper academic approach to the subject of analysis be adopted …. “Though I argued on and on for the inclusion of other strands of thought on analysis and psychotherapy, I found myself in a minority of one and the course was duly approved. It still runs. “
I followed DC’s advice and wrote to UCL Provost Malcolm Grant pointing out that if UCL believe psycho-analysis to be a science on par with, for example, physiology, biochemistry or pharmacology, then that has to be justified. He replied with a covering letter and 3 sheets of A4, written I suspect by Prof Fonagy.
There were interesting concessions, here are two extracts
a) “The Theoretical MSc focuses mainly on modern qualitative research methods – there may be an argument that these are non-scientific but this is broader issue within the entire field of social science and nothing whatever to do with psychoanalysis.”
b) “….and there is an extensive module tackling the debates about whether psychoanalysis is a science, including the very critiques you cite. In other ways, though, this theory course is more linked to philosophy and the humanities and is a science degree because of the Faculty in which the Psychology Division is sited.)”
What other department in the science faculty at UCL has an extensive module enquiring whether the subject is a science …Genetics? Physiology? Furthermore, when describing the nature of the M.Sc. in theoretical psycho-analysis it is conceded that it falls within the purview of social science/philosophy and is a science degree not because of its content but because of the division administering the degree. This is most remarkable state of affairs. But the real story here is that probably nothing can or will be done because these courses “(often with high fees and therefore lucrative to their instigators)” as Prof Jenkinson points out, provide a valuable source of income.
Malcolm Grant signs off by implicitly but inadvertently separating psychoanalysis from science. There is he says “ a remarkable degree of integration at UCL between science and psychoanalysis and I do not share your implicit comparison between this activity and the purveyors of complementary or alternative medicine.”
I maintain that UCL awards a science degree in a non-science subject and, if were I to be uncharitable, might state that the difference between UCL and the University of Buckingham is one of degree not kind. (No pun intended).
Hilarious if you follow the new link to Quacktitioner Royal’s exciting new college of disintegrated healthcare.
Lord High Promoter and hon-seeking (oops, how did that hyphen get in there) Dixon says on the page,
‘Many universities are already doing extremely good work on integrated health. But there is an obvious need to provide a focus for information, develop more opportunities for continuing professional education and provide a much needed resource for patients’. ………..
Er, some Universities seem to me to be starting to an extremely good job, yes. They are seeing sense and are sacking the courses in such stuff…………….
Great stuff. Just tried to follow the link for “Stafford Lightman? Well actually I mentioned to him in April that his name was there and he asked for it to be removed, on the grounds that he’d had nothing to do with the course.” but it leads to http://www.dcscience.net/?page_id=733
which doesn’t seem to be the right page?
“Professor Ruth Chambers, Dr Michael Dixon, Simon Fielding, Professor Stephen Holgate, Professor George Lewith, Michael MacIntyre, Professor David Peters, Professor Jane Plant and Dr Catherine Zollman. ”
Anyone care to give a users’ guide to this bunch of tools sitting in the FIH box? Are the ones not overtly waving red woo flags trustworthy or have they all drunk the Kool-Aid?
[…] This post was mentioned on Twitter by ben goldacre, le canard noir, David Colquhoun, David Colquhoun, David Colquhoun and others. David Colquhoun said: RT @Simon_Perry: World's longest blogpost from @david_colquhoun: hehe true but it has got synopsis http://bit.ly/cCqrWX […]
Crews Control – Bravo – I wondered when the euro was going to drop all round with this stuff
“theoretical psycho-analysis. (As far as one can tell most respectable psychologists reach for the bargepole whenever SS Freud hoves into view.)” – indeed, indeed.
@isitmedicine
damn -an improperly closed hyperlink. Stafford Lightman link fixed now.
The bit about Daniel characterizing herself as a “priestess healer” and DC as the “Inquisitor General” had me helpless with laughter. What planet, sorry, “Astral Plane”, do these people think they are on?
Anyway, all in all a good April 1st for rationality. Perhaps the joke is on the magic medicine fraternity.
@CrewsControl
I agree entirely, as when we last discussed this in the comments at http://www.dcscience.net/?p=885
I can offer only two excuses for having done nothing about it. One is that I don’t know much about psycho-analysis. The other, perhaps more important, reason is that the Faculty of Life Sciences has bigger problems than that to deal with at the moment (see, for example, http://ucllifesciences.wordpress.com/ ). For example, we have an HR department that advertises for people who are trained in “neuro-linguistic training”, at near-professorial salaries. HR seem to be incapable of distinguishing between psychobabble and sense, and that effects a lot more people than the MSc in theoretical psycho-analysis.
Very scary that there’s even a rumour that the University of Bristol, my institution, might consider taking this on. Does this really seem to be a serious prospect?
David Colquhoun wrote;
One is that I don’t know much about psycho-analysis.
I think that it is fair that you shouldn’t be critical about a subject you have little knowledge of.
Just wondering what training you’ve had in complementary medicine? The occasional trip round PubMed looking for references doesn’t count.
Astoundingly complete piece of investigative journalism and written record DC!
Another thing that impresses me is how on earth Dangerous Conventional hasn’t got bored of commenting here by now. I’ve got bored of reading that rhetoric. CAM is so hard to understand yaawwwn lack of paradigm overlap zzzzzz
P.S. DC, your hyperlink to nhsblogdoc’s blog , embedded in the text “disagreement about the titles” leads to a “blog cannot be found” page. Which is unfortunate because it seemed an intersting and relevant piece of periphery.
Ho hum, DangerCon
Back to your usual line, I see.
DC, in common with someone like Edzard Ernst, knows rather a lot about complementary medicine. More specifically, he knows a lot about approaching CAM with a trained, critical, eye.
In contrast, those who learn to practice CAM therapies are well schooled in the moves, but completely lack the ability, training and (most importantly, in my personal view) the basic inclination and insight to engage in any kind of meaningful self-critique.
This is clearly apparent (yet again) if you read between the lines of the correspondence between Rosy Daniel and Prof Miles.
So it is back, yet again, to the difference between Cargo Cult Science (looks superficially like it but lacks the core habit of inbuilt scepticism and rigorous questioning) and the real thing. Alt Med practitioner training likes to call itself scientific, but is 100% Pure Cargo Cult.
And when people like Edzard Ernst, Prof Miles, DC and Ben Goldacre try to make the CAM crew take this issue seriously, the CAM gang just cry “Persecution!” and flounce off to have tea with the Prince of Wales.
Prof Colquhoun, there really is no need for you to apologise at all, I recognise there are many demands on your time. It seems to me that you have adopted as your motto “All that is necessary for nonsense to triumph is for rational men to do nothing” and you have correctly identified those areas of mumbo jumbo where you can make a significant difference. There is no credit in attempting the impossible and failing and I suspect that psycho-analysis is so tightly interwoven into the financial, academic and political fabric of UCL that change/separation is now impossible. You direct me to http://ucllifesciences.wordpress.com/ where the talk is about redundancies of academic staff in faculty of Life Sciences. I can’t help feeling that a real tragedy for UCL would be if staff in the real sciences were dispensed with before any teachers of psycho-analysis.
I can assure you that if you have the time to give it even a cursory inspection you will find psycho-analysis is in no sense a scientific subject.
Teige – “Dr Crippen” of nhsblogdoc has retired (from medical practice) and taken his blog down. Only happened within the last few weeks.
@Teige
Ouch, another broken link The link you refer to was to http://nhsblogdoc.blogspot.com/2009/05/imperial-college-disowns-karol-sikora.html
This post was written over quite a long time, and already some of the links are dead. Sadly “Dr Crippen” has given up writing NHSBlogdoctor. I replaced the link in the text with one from the Guardian. I’ll recover from the Google cache the three pages from NHSBlogdoctor that refer to the Sikora story.
Actually most of NHSBlogdoctor seems to be archived at Truste.md, and the posts that refer to Sikora can be found with the following Google search
http://www.google.co.uk/search?hl=en&client=firefox-a&hs=9L8&rls=org.mozilla%3Aen-GB%3Aofficial&q=Sikora+Imperial+site%3Ahttp%3A%2F%2Ftrusted.md%2F&meta=&aq=f&aqi=&aql=&oq=&gs_rfai=
Thanks for fixing the link and the extra “Dr Crippen” (not his real name?) goodies.
Incidentally DC, your blog is a useful resource for those deciding where to start higher education. I doubt it was ever intended for that purpose but your blog offers a very useful insight into university politics and oversights of priorities, which all tend to have tell-tale signs beyond the PR bit.
Dr Aust,
Interesting to read Cochrane comments about Ernst’s systematic review on mistletoe (which is used by about half of German cancer patients).
http://www.cochrane.org/reviews/en/ab003297.html
Available evidence from systematic reviews
Ernst 2003 addressed the question of the safety and effectiveness of mistletoe extracts in cancer treatment. We found inconsistencies in this review between the numbers of trials that were included and from which the authors presented results. Though the au- thors claimed a comprehensive search strategy, they missed three published studies (Borrelli 1999; Luemmen 2001; Salzer 1983) and two unpublished studies (Lange 1993; Schwiersch 1999). The authors were using the criteria suggested by Jadad for as- sessment, however for their review they fail to define the cut-off points between good and mediocre methodological quality. When discussing the safety of mistletoe extracts, the authors presented prevalence rates of low grade adverse effects linked with a list of severe ones. Through this, the review suggested a bad tolerability of mistletoe extracts, which did not comply with the data from the included RCTs.
Hum
Also interesting to read
“Proponents claim that mistletoe extracts stimulate the immune system, improve survival, enhance quality of life and reduce adverse effects of chemo- and radiotherapy in cancer patients.”
If that is true, the benefits should be easily demonstrable. Surely this is exactly the kind of low-hanging fruit that ought to be targetted to make the field of alternative treatments respectable.
What kind of anachronism allows extravagant claims to pre-date the discovery of supporting evidence?
At last, a Vice Chancellor actually doing what they are paid for!
But how on earth does this transparent bollocks manage to get past even the secretary who opens the mail, let alone multiple approval committees over the years?
It truly staggers the mind as to the competence of those involved in the vetting process, (or their actual goals).
“What kind of anachronism allows extravagant claims to pre-date the discovery of supporting evidence?”
The anachronism of superstitious voodoo dangerous alternative ‘medicine’. That’s what.
There’s a lot of voodoo going on in Germany, Switzerland and Austria then.
I note the comments about Ernst’s review made by Cochrane were ignored. Now why didn’t that surprise me.Sound of one hand clapping?
What’s wrong with voodoo?
Are it’s proponents too differently cultured for CAM?
As you are doubtless aware, DangerCon, in those places it is mostly conventional doctors who also use manipulation, acupuncture, herbal remedies etc.
Which is still not all that reassuring, given the feeble evidence base for most of the stuff, but does at least give one some hope the practitioners should be able to appreciate the difference between fantasy and reality. As opposed to the bonkers cabal of subluxationists, “white witches”, homeopaths and other mystic crackpots practising as lay CAM “therapists” in the UK.
Equally, some of the doctors in the German-speaking countries may be humouring the patients with placebos and collecting the insurance reimbursement. Not very ethical, in my view, but it does happen – especially when the use of some patent nostrum (like spa therapy, for instance) is deeply embedded in the health system and in the popular consciousness, and is covered on the insurance plan.
Oh dear, DangerCon, are you in a huff because no one thought you important enough to pen an instantaneous response? I apologise profusely for letting a full two days of Easter holiday weekend pass by. Obviously I had nothing more important to do.
Anyway, I would be interested to hear Edzard’s take on it – perhaps if he happens by we will hear what it is. At a first glance, missing “unpublished studies” is no doubt pretty easy if one doesn’t know about them, given that they are not in the literature anywhere. And of the three “omitted published studies”, one is an old study in a not terribly prominent German-language journal, another is in a special supplement of another obscure journal, and the third seems to be reported only in conference abstract; so again, perhaps not that hard to miss in a search. Are you hoping to imply that something sinister had gone on? Seems rather small beer, if you are.
Incidentally, I note that the conclusion of the Cochrane review is:
On that basis, if half of German cancer patients are using mistletoe/Iscador then they and the health insurers are likely wasting their money. Though it is perhaps a testament to the lasting influence of Rudolf Steiner’s mystic wibble in the German-speaking world.
Dangerous Conventional, I ignored your comments on Prof. Ernst’s systematic review on mistletoe because it was off topic, and approaching trolling.
The idea of universtiies giving “accreditation” to courses produced by small sectional interest organisations seems to be selling out the credibility (“brand” for the management) of the universities for tiny amounts of money. Are there other targets, marketing goals, or indicators the administrators want? Perhaps they just not see the difference between a real academic course and a fake one (their recent policies do suggest they can’t see the difference between a real academic and a fake one).
At least the private University of Buckingham realised the dangerous farce they were getting into when Professon Colquhoun pointed it out to them, and were willing to invest staff effort in minimising the harm. They did far better than Westminster, University of Central Lancashire, or University of Wales.
[…] to the tenacious David Colquhoun, the recent attempts by an FIH backed organisation to set up an Integrated Medicine course with the University of Buckingham has failed. In particular Ms Armstrong was rejected as a teacher because she was “not qualified to do so […]
@cranium
“Interesting to see that the unevidenced healthcare researched by TVU’s Nicola Robinson includes putting knives under the bed for nightmares, dressing in red to prevent measles and using herbs as a remedy for Down’s Syndrome.”
Good grief! Such utter twaddle, and not even original.
Putting a knife under the bed was the maid’s proposal for analgesia (“To cut the pain in half”) when Melanie Wilkes was giving birth in besieged Atlanta in Gone With the Wind. No wonder Scarlet gave her a slap in the next scene.
Draping patients in red was standard treatment for smallpox for centuries. It was used to treat Elizabeth 1st (who recovered) and many of the Austrian Habsburgs – who were not so fortunate.
DMc
[…] at the University of Salford, the University of Central Lancashire, Robert Gordon University, the University of Buckingham, and even at the University of Westminster (the worst offender), one course has closed (with […]
I notice that Dr Daniel’s response to this story, in Times Higher Education, has attracted some comments.
[…] 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 […]
[…] at the instituition. He was also Dean of the Faculty of Integrated Medicine until it has its contract terminated by the University of Buckingham, where Sikora is also Dean of the Medical School. Sikora was also involved with the […]
[…] to financial fraud has thrown the spotlight on the failed attempts of its bastard offspring, the Faculty of Integrated Medicine. While this blighted institution has no formal links with the RLHIM, it is sustained from the […]
[…] Dr Michael Loughlin A post-modernist theorist who hates Ben Goldacre. Read about him here. […]
[…] The only VC who has ever thanked me for opening his eyes is Terence Kealey, of the University of Buckingham. All the rest have stayed silent. I can interpret this silence only as guilt. They know it’s […]
[…] Dr Rosy Daniel of Health Creation is an old friend. After I complained about her promotion of some herbal concoction called Carctol to “heal cancer”, she was reprimanded by Trading Standards for breaching the Cancer Act 1939, and forced to change the claims (in my view she should have neen prosecuted but, luckily of her, Trading Standards people are notoriously ineffective). There is, of course not the slightest reason to to think that Carctol works (download Carctol: Profits before Patients?). Read also what Cancer Research UK say about carctol. Dr Daniel is also well known because ran a course that was, for one year, accredited by the University of Buckingham. But once the university became aware of the nonsense that was being taught on the course, they first removed her as the course director, and then removed accreditation from the course altogether. She then tried to run the course under the aegis of the Prince’s Foundation for Integrated Health, but even they turned her down. Now it is running as a private venture, and is being advertised by YesToLife. […]
[…] In fact, when faced with real-life examples of what happens when you ignore evidence, those who write theoretical papers that are critical about evidence-based medicine may behave perfectly sensibly. Although Andrew Miles edits a journal, (Journal of Evaluation in Clinical Practice), that has been critical of EBM for years. Yet when faced with a course in alternative medicine run by people who can only be described as quacks, he rapidly shut down the course (A full account has appeared on this blog). […]
[…] featured several times on this blog. I met her, with Karol Sikora,here. Her course in quackery was ditched by the University of Buckingham after a […]