Download Lectures on Biostatistics (1971). Corrected and searchable version of Google books edition
Download review of Lectures on Biostatistics (THES, 1973).
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Notice. The huge traffic generated by the posting of Stefan Grimm’s last email brought down the server for an hour or two on December 3rd. Since it went up at 18.30 on 2nd December, it has been getting a hit every second or so. This has been cured by introduction of a caching system, but this had the side effect of breaking links to most of the pictures and documents on this blog. I now have to correct the links manually on 386 posts and 17 pages. This will take a while to complete.
Truly gobsmacked to find this blog got first prize at the Good Thinking Society UK science blog event. It was shared with PhD student, Suzi Gage @soozaphone. We must have been the youngest and the oldest entrants. More in the diary.
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Not sure what I did to get this from the New Statesman. Perhaps it was some comments about David Willetts?.
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Another unsolicited testimonial: this blog appeared in the Sunday Times guide to the 100 best blogs (May 2009)
This blog is archived by the British Library.
22 December 2012. A post in 2006, now removed, criticised the organisation CancerActive, for selling D-mannose and Chlorella with the suggestion that they might help people with cancer. In May 2012, I added to that post a quotation from one of several authors who claimed that there was an a priori case for investigating the relationship between the business and the charitable activities of CancerActive. Mr Woollams then threated to sue me for defamation. As a consequence, the original post has been removed and I am required to publish the following apology. It’s better than destitution.
7 November 2013. My agreement with Chris Woollams’ lawyers was that the apology should be shown for 6 months. It has now been up for almost 11 months. I am, therefore, removing it. It was, of course, bullied out of me by the threat of destitution. Now, thanks in part to people like him, we have a new Defamation Act. This sort of thing should be much less common in the future.
DC’s Improbable Science., at dcscience.net, now comes from a server powered by those wonderful people at The Positive Internet Company. I am enormously grateful to Alex Lomas for his expert help in making the move.
Lime tree in UCL quad, under which I have lunch and talk in summer.
(Older pictures here)
click picture to enlarge
Click picture to watch the Sherlock Holmes video clip (ITV)
“What are you going to do, then?” I [Watson] asked. “To smoke,” he [Holmes] answered. “It is quite a three-pipe problem, and I beg that you won’t speak to me for fifty minutes.” The Red-Headed League. Adventures of Sherlock Holmes, Arthur Conan-Doyle. Posted after seeing Roger Llewellyn in The Death and Life of Sherlock Holmes.
This WordPress blog continues, in a new format, the original DC’s IMPROBABLE SCIENCE Page. Older entries from there are being transferred here as time allows.
This blog now incorporates ‘DC’s goodscience’, which was centred on university politics, in particular, how science should be organised to get the best results, and the invidious rise of management bollocks and corporatisation. It was started as a vehicle for an extended version of an article that I wrote for the Times Higher Education Supplement, HOW TO GET GOOD SCIENCE. This extended version has now been printed in full in the Physiology News, 69, 12 – 14, 2007 [download the pdf version].
News items.
Guardian science podcast is here.
A paper that came out in 2008 was the most fascinating I’ve been involved in for years. On the nature of partial agonism in the nicotinic receptor superfamily. This is the day job, and so not mentioned much here. But this one represents over three years of hard work, especially by Remigijus Lape, and for once it came out well -positively sexy (if you like ion channels). It featured on UCL News. See also the News and Views in Nature and Making the paper in Nature.
UCL Lunch hour lecture. 16 October, 2007.Science in an Age of Delusions: some examples from scientific fraud, quackery, religion and university politics.
See it here. [Seems that this got the biggest audience of the 2007 lectures]
- Wikipedia
- Interview in Molecular Interventions (2002)
- Society for Neuroscience, scholars
Some older sites (really they are all about various consequences of the endarkenment). None of these are now maintained.
- DC’s Improbable Science page
- DC’s politics page
- Education and religion
- Committee for UCL. The pages that helped to thwart the 2002 attempt to merge UCL into Imperial.
- Save UCL. The much wittier and more elegant site written by a Graduate student at the time of the 2002 takeover attempt by Imperial. See especially “ask Jeremy“.
My day job pages
- My original home page (no longer maintained)
- My corporate home page
- OneMol New site: a one stop shop for the single ion channel group at UCL, http://www.onemol.org.uk/
- Our Publications page
- Publications -theoretical papers
- Our computer programs for analysis of single ion channel results (now on the OneMol site: the UCL site is defunct).
- Our summer course on matrix algebra, with applications to analysis of stochastic properties of single ion channels
- UCL photo pages
Here is a movie, made by Faculti, about my day job. You can get reprints of the 2004 and 2008 papers from the OneMol site.
And here is a link to the Faculti site
I just noticed that the ResearcherID button, above, takes you to a site that doesn’t list my most highly cited work. Like other commercial sites it fails to list citations to books or book chapters. Google does that better, and cheaper.
Submit to StumbleUponThis page has been loadedtimes.
[reached the first half-million on July 3rd 2008]
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Hi David, great to see a nice blog format for improbable science, looking forward to more of the same.
Oldfart, I think it’s a need to be logged in to comment. I see a comment box on the ‘BBC makes good on MMR’ page, though that might be a recent fix?
Much better. This wordpress seems ok.
Hello David…and congratulations on your new look.
At least something positive has come out of the recent unpleasantness – Improbable though that may have once seemed!
Hello, I found the link to your website in the Lawrence paper. Its a great essay and I have blogged about it on my site at The Other 95%, plus added my perspective on metrics and taxonomy.
I had a look around and really like what you are doing, will check back often for updates!
Hello David,
Having read your amusing Guardian article about homeopathy its good to see that skepticism is alive and well in the British media – what ashame that you didn’t bother to research your article and find out anything about homeopathy, the principles it is based upon or even the fact that it has been used with great success for over 250 years as opposed to 30 as you suggest. Seems that bigotry is also thriving in the media if your writing is anything to go by. Active debate is always useful but it becomes a great stumbling block to evolution when one makes one’s mind up before actually knowing anything about the topic up for discussion. Arguing from blatant ignorance renders any valid points you make a bit laughable you know…
Just one thing. The Guardian piece was not (primarily) about homeopathy, but about something much more important. I think you missed the point Reginald.
Of course real medicine had hardly begun when homeopathy was invented, and the homeopaths’ solution, to do nothing, could well have been preferable to bloodletting. But homeopaths stayed stuck in 1800 and the rest of us moved on. I wonder if Reginald will opt for a homeopathic general anaesthetic if he needs a hip replacement. Or homeopathic treatment if he is unfortunate enough to get malaria. That would qualify him for a Darwin award. Francis Wheen referred to the Bush-Blair-Khomeini era as a period when mumbo-jumbo came to be mistaken for truth. Homeopathy is just one minor example of that. Being an optimist, it seems to me that the endarkenment is a temporary hiccough which is gradually coming to an end.
David: I see that ‘Reginald’ states that it’s “a shame that you didn’t bother to research your article and find out anything about homeopathy, the principles it is based upon or even the fact that it has been used with great success for over 250 years as opposed to 30 as you suggest.”
Apart from the fact (since Reginald is rightly concerned about them) that your excellent article doesn’t suggest that homeopathy has only been used for 30 years, his own understanding of homeopathy may well have shed new light on the science behind Samuel Hahnemann’s theory, as it would make the good doctor -who was born in 1755 – no more than two years old at the time.
In fact, it wasn’t until 1810 that he compiled the results of his cogitations into a treatise called “Organon of rational therapeutics”.
Splendid – a much more readable blog – but just as good, contentwise, as before….
I’ve only just seen here that the Department of Pharmacology is to be “disestablished”. Sad it’s to go – I have many happy memories of the place, from when I did my PhD there. The building had a ramshackle air, totally belying the furious research effort that went on inside. DC’s pipe, the tiniest and smokiest tea room I’ve ever experienced (presided over by the formidable Joyce,), and practical demonstrations that N2O makes medical students behave weirdly are the three abiding memories….oh, and some pharmacology, too….
Hi David, As a college student in India, I was in an area that had a serious “Cobra Problem” And, of course we had a Homeopath who prescribed his pills for cobra bites. Among my friends were some believers in Homeopathy. So one day in jest I asked if they were bitten by a cobra , would they go to this doctor? Without batting an eylid they said yes !! and then as an after thought, added, they will also see a regular doctor. They were all Science , Engineering and Technology students.
Yes Prem, India is often cited by homeopaths as “a huge population using homeopathy happily”.
Of course, it is not quite the same as in the European situation as my understanding is that in India you have to pay for medical care, Homeopaths presumably charge far less than conventional doctors, so less well off people consult the homeopath because the fees are affordable.
In European countries where medical care does not usually have to be paid for it tends to be more a sense of dissatisfaction with “mainstream” medicine, or with a scientific way of looking at the world generally.
PS Someone bitten by a Cobra taking a homeopathic remedy makes me think “Darwin Award”
http://www.darwinawards.com/
David,
Great site – you are a past master at putting the boot into pseudoscience!
But are you sure you are right about the adverse effects of liberal gun control policy in the US? (I’m referring to your posting on the Virginia Tech murder spree). I think the jury is still out on that issue – indeed there have been quite a few studies whose findings suggest that the widespread availability of guns may reduce rather than increase the crime rate (chiefly because felons fear being shot by their putative victims).
The book to read is John Lott’s ‘More Guns, Less Crime’. You’ll find an interview with Lott here:
http://www.press.uchicago.edu/Misc/Chicago/493636.html
Apart from that, you’re perfect.
Keep up the good work!
It is gratifying to see a young Indian, Prem, who realizes homeopaths as quacks. A colleague of mine from India, whose expertise is in statistics, and I had the following conversation recently:
I: Good to see you. How was your trip?
(He tells me about his trip to China, about which he had told me earlier. His original plan was to leave his toddler in India with grandparents, and go to China only with his wife. He told me that his child went with them as well.)
I: I thought you were going to leave the child in India while you went to China. What happened?
He: Oh, there are all kinds of fevers in the state. So I didn’t want to leave her there.
I: Yes, I heard chikkungunya is really bad there.
He: Yes, but we took some homeopathic medicine, so we were fine.
I: Come on! You are a statistician. You ought to know better! (I am never diplomatic. I am polite, but very direct, which is one reason I am still an honest academic.)
He: But it worked. We didn’t get sick, whereas my mother-in-law did.
There was nothing further I could say. I was flabbergasted! Oh, ours is the top-rated and largest program in the US in our branch of engineering. I won’t say which, but you can probably guess if I tell you that a large component of my branch of engineering is statistics. We are supposed to have the strongest statistics program of its kind. I am from India too. As the only other Indian on the faculty, it is rather depressing to see supposedly expert statisticians believe in such quackery.
Prem, keep it up! India needs more people like you!
Charles Copeland. I’m never sure I’m right about anything, and the experiments on gun control have not been done, nor are they likely to be done.
But you must be as well aware as I am that most guns in the USA are not used on felons, but on family and friends.
It is, I agree, a bit naive to point out that the USA has a vastly higher homicide rate that any other rich country, as well as vastly more guns. For me it is quite sufficient to say that it is uncivilised to have private citizens carrying lethal weapons, just as state executions are uncivilised. One lives in hopes that now the days of the “Texecutioner” are numbered, the USA may perhaps eventually catch up with Europe in such matters.
Sorry…
Can I ask question?
Does the problem of gun availability tie anyway to quackery and homeopathy? 🙂
However, if you are discussing this question…
‘More Guns, Less Crime’ is wrong opinion, certainly. There are many countries where the law prohibits men from carrying arms. Nevertheless, the crime rate in these countries is not more than in USA. Actually, the crime rate and the availability of guns is not tied. A high crime rate is a reflection of an unstable society.
Jack -the reference is to the posting about Virginia Tech on my politics page, at http://www.ucl.ac.uk/Pharmacology/dc-bits/corrie.html#vtech
I think that there is a connection between questions like that and about quackery. They are all about believing things that aren’t true, and about the betrayal of enlightenment values. Originally I had pages on politics and religion as well as about dubious science. Now I agree with Francis Wheen. They are all aspects of the endarkenment.
Yes, David, I’ve understood that the talk is about Virginia Tech case.
You have answered excellently about connection between all these questions. I agree with you that it is different “symptoms” of one and the same “disease” of present civilization – the endarkenment.
Thereby some idea suggested itself to me. Perhaps I have not enough the right to criticize the form of your blogs. And I don’t try to do it, of course. However, maybe would it be interesting solution to tack two your blogs together? In fact the uppermost subject of conversation in both blogs is one and the same. This subject was designated and defined in your profound article “Science in an Age of Endarkenment”.
Certainly, the creation of one great combined blog supposes the additional hard work. But I think that future result of it could be very important – new uncommon website (blog) would arise with clear powerful progressive idea. This blog could be divided into different themes according to all aspects of main problem – the crisis in present world and science.
I could help you in this work, if you would decide to do it. With my pleasure and gladness!
Well… Perhaps, my enthusiasm ran away with me 🙂 Don’t take to heart…
I have linked the Lawrence paper as reading for my scientific english students. They have to prepare two role plays connected to this issue; one with a group leader telling a PhD student and post-doc that they have to add two honorary co-authors to their manuscript, and the other a recruitment committee evaluating candidates’ CVs.
On the theme of CVs and recruitment, I have also linked to the material you obtained on Patrick Holford’s appointment at Teesside. Tomorrow they will be re-enacting the discussion that led to his professorship.
Readers of Improbable Science might be interested in reading Snake Oil Salesmen Hit Jackpot in Nevada, an academic blog about the ongoing campaign in that state to promote medical tourism by legalizing medical devices and treatments that are outlawed in other states: http://faculty.uml.edu/sgallagher/NIRB.htm. Thanks for calling attention to the rising power of irrationality in medicine and other sectors of the knowledge industry.
Re Susan’s link – “…placing the supervision of medical research and treatment in the hands of a unique coalition of homeopaths…”, some of whom have “lost their medical licenses in other states”. Remind me not to get sick in Nevada Susan!
PS – clicking the link brings up a 404 error message. If you copy and paste the link into your browser, the final full stop (or period) needs to be deleted.
The names of the “experts” involved should certainly be published alongside the documents which they have made a contribution to. To make a comparison (in case you need to state a precedent) the Quality Assurance Agency for Higher Education produces subject benchmark statements which set our standards expected for undergraduate degrees. All of the published statements include details of who was on the group which created them – experts drawn from the subject area.
I’ll be interested to see if Skills for Health are covered by the FOI Act – as I can’t see a mention of it on their website. As a similar type of body, QAA are not currently covered.
P.S. If they come back and say they can’t release the names because of data protection…. that really isn’t true….
Hi David, have just stumbled across your site. Very nice indeed… Was impressed to read your robust defence of Martin Walker’s (and Clifford G Miller’s) slanderous accusations about you in the Grauniad’s CiF section (Ben Goldacre – Clinical trials and playing by the rules – http://www.guardian.co.uk/commentisfree/2008/jan/05/1). Keep up the good work.
Comment on In-human resources, science and pizza:
Thanks for that – I LOVED IT. It’s fantastic that the truth of HR (I truly hate that phrase) has been so ruthlessly exposed. Should be part of the School Handbook. Any VC who stripped out all the BS would immediately retain and attract good people and see their productivity soar.
GERD: You don’t have it because it doesn’t exist
10 April 2008
If your doctor tells you that you suffer from GERD (gastro-esophageal reflux disease), he’s lying – because the condition doesn’t exist, and was invented by the drugs industry.
GERD is a serious-sounding name for common-or-garden heartburn, which many of us have from time to time.
http://www.wddty.com/03363800371954492866/gerd-you-don-t-have-it-because-it-doesn-t-exist.html
But you don’t need to take a powerful drug indefinitely in order to deal with heartburn – so that’s why drug giant GlaxoSmithKline invented the condition, GERD, in order to market its drug Zantac.
The same goes for conditions such as ‘overactive bladder’, which was invented by the drug manufacturer Pharmacia in order to market Detrol, and ‘compulsive shopping disorder’, a mental illness devised by Forrest Laboratories and used to promote its antidepressant Celexa.
This practice is known in the industry as condition branding, a new book, Our Daily Meds, reveals. Doctors usually fall for it because most of their ongoing education after leaving medical school is from the drug company salesmen or company-sponsored conferences.
(Source: Our Daily Meds, by Melody Petersen, published by Farrar Straus Giroux, 2008).
MMR: Major mumps outbreak proves the vaccine doesn’t work
10 April 2008
At a time when health officials are quietly admitting that there could be a link between the MMR (measles-mumps-rubella) vaccine and autism, a new study has also discovered that it doesn’t work.
Researchers investigating a large outbreak of mumps in 2006, when 6,584 cases were reported among college students, have discovered that virtually every sufferer had been vaccinated twice against the disease.
The Centers for Disease Control (CDC) reveals that at least 84 per cent of young adults aged between 18 and 24 years had received two-dose vaccines against mumps. And in 2006 – when the outbreak occurred – the national two-dose coverage among adolescents reached 87 per cent, the highest in US history, and just one point below that needed for ‘herd immunity’.
CDC researchers speculate that the outbreak – primarily among 18- to 24-year-olds – was the result of the ‘wrong type of mumps’. The vaccine is supposed to protect against A-virus mumps, whereas the outbreak in 2006 was caused by the G-virus strain.
Despite its limitations, the CDC team reckons that all children need a third dose of MMR – even though the two-dose vaccine was introduced following a 1980 mumps outbreak among children who had received a single vaccine dose.
It may be a measure that will be hard to introduce at a time when health officials are accepting that the MMR vaccine can cause autism among children with a ‘mitochondrial disorder’.
(Source: New England Journal of Medicine, 2008; 358: 1580-9).
Cancer Drugs: Why ‘wonder’ treatments almost never are
10 April 2008
New ‘wonder’ cancer drugs may be nothing of the sort – and could be given miracle status by zealous drug companies anxious to get their new drug on the market before all the proper studies have been carried out.
In the past 10 years, 25 studies on cancer drugs have been stopped early by the sponsoring drug company because, they have said, results looked ‘promising’.
Researchers who investigated the pattern discovered that the trials were stopped, on average, after just 30 months, and had been tested on a fraction of patients that were originally enlisted.
Lead researcher Dr Giovanni Aplone commented: “Data on effectiveness and potential side effects can be missed by stopping a trial early.”
He said that the true effectiveness and safety of any drug could be established only after years – and not months – of study, and usually among much larger groups than those used for the trials. Most of the studies that were ended prematurely had tested the drug on just 40 per cent of those who had been initially recruited.
(Source: Annals of Oncology, 2008; March 28: doi: 10.1093/annonc/mdn069).
Just posted 3 sample items which I hope you will not “moderate” David.
Just wanted to show that Improbable Science might want to consider some of the lies sold to us by big money interests in pharma.
Makes a change from constantly having a pop at alternative medicine which doesnt result in long term conditions due to over / wrong prescribing, and which results in thousands of deaths every year even when prescribed “correctly”.
Perhaps you can turn your energies onto the hand that appears to be feeding you?
…let me start you off with over prescription of Ritalin and the great fluoride deception
You really should check before accusing me of taking money from phams. Perhaps you should look at the interchange on that topic with Patrick Holford. Which of us has the vested interest?
I’d also recommend that you read my blog more carefully. If you did you would see that I criticise pharma almost as much as I criticise the alternative industry (they are both industries – the main difference is that the alternative industry lies all the time to shift the product, whereas pharma lies only some of the time).
I can’t answer your question about the halting of cancer trials because I don’t know what stopping rule they uses -there are perfectly good statistical ways to deal with that dilemma. I’m willing to bet that you haven’t read the originals either, but are merely repeating the headlines.
Hear hear, DC.
One of the hallmarks of the AltMed / Nutri-Balls / Natural Therapy lot is that:
(i) they never met a “natural” therapy they didn’t like;
(ii) they never met an “allopathic” remedy they did.
In contrast, conventional science and medicine generally, and the BadSci lobby, will call time on bullshit, or bad science to be less Anglo-Saxon, wherever it can be found… for instance, see Ben Goldacre’s discussion of fluoride. And you can find extensive discussion of Pharma’s disease-mongering over GERD, or ritalin, or SSRIs, in the mainstream medical literature as well as on the BadSci forums.
And now a question:
When did you EVER see a complementary therapist, or natural therapy advocate, discussing the possibility that compelmentary theraies are ineffective or over-sold?
Anyone?
Thought not.
When the Complementary Therapy crew stop pushing bullshit, and develop any meaningful level of self-critique, they might get less of a flaying. Until then, as John Wayne would say, ” not hardly”.
Well Dr Aust (I guess you feel the need to include the magic letters DR in your username to add to your credibility), you seem to think that the “AltMed / Nutri-Balls / Natural Therapy lot” are something different to your superior “allopathic crew”.
You may want to find out how many of your Dr, physiotherapist, Nurse, Midwife, Oncologist, etc etc colleagues are ALSO part of the “Altmed Lot”. Why is it that mainstream health practitioners are increasingly incorporating CAM into their practice, maybe its because they have found that many of them WORK!
Example is Nutritional therapy. It is easy for “educated ” professionals like yourself to scoff at treating many conditions with nutrition, however I would ask how many hours of nutritional input do doctors have in their training?
As is often said, the medical establishment serves as the retail arm of the pharma industry and the core of medic training is to dispense patented medicines.
As Im sure you will know, the OTHER part of the Hippocratic oath is “Let your food be your medicine and your medicine be your food”.
How many times do doctors apply this strategy rather than writing a prescription?
It is, sadly, true,that there are a few corrupt clinicians who act as mouthpieces for big pharma (but not many pharmacologists). My guess that is nothing like the number of alternative people who act as salespeople for the truly enormous alternative industry. That is specially true in the peddling of unnecessary “supplements” by nutritional gurus who often qute blatantly have strong financial interests in the recommendations that they make.
*sigh*
bigpharma-bigbucks, if you check on my blog you will see I am a PhD type working in a medical school. I use the alias “Dr Aust” because I picked it after about 20 seconds thought two years ago and I can’t be arsed changing it.
I am not a clinician and have no direct vested interest in selling you pills. I do not work for a PharmaCo, and have never had a single penny of money off them either.
One thing I do know a bit about is what medical students are taught, since I do the teaching. They are taught about nutrition throughout their courses. And from my wife – who is a doctor – and my GP friends I know that doctors DO dispense basic nutritional advice – the simple stuff that is actually known to be soundly based, like “eat more complex carbohydrates” “eat less saturated fat”, “eat more fruit and veg”, and “oily fish is good for you”. They also do “lifestyle advice”, like taking exercise, and do various kinds of “counselling”-type talk.
The line about “doctors exist to push pills for PharmaCos” is a tired piece of nonsense. Apart from anything else, it is cheaper for the NHS if doctors DON’T put people on expensive drugs. Most doctors are far more interested in NOT medicating patients unnecessarily than in dosing them full of pharmaceuticals. The demand for “pills for ills” increasingly comes from the patients, fuelled by a societal trend towards demanding quick-fix solutions. The complex supplement regimes peddled by tossers like Patrick Holford are just another example of this rather unhelpful Zeitgeist.
also interesting to compare the attitude of the GMC towards a GP involved in recommending nutritional supplements (in which they have a direct financial interest) to a patient with that of the BANT (whose code of ethics seemingly permits people to take payment from pill companies for pills they give to customers)
I’m not sure this is the right question: “how many hours of nutritional input do doctors have in their training?”
Presumably, MDs receive sufficient training to give basic advice and are able to refer patients to Registered Dietitians if necessary.
RDs must have a BSc in Nutrition / Dietetics. There are no requirements whatsoever for Nutritionists to receive any training.
Just to say I thought your article was great on HR gobbledegook and I now work in HR! Actually, I have a perfect view of both science and HR as I am a senior research scientist whose funding ran out and now manage a new University programme for training (yes, training!) principal investigators! It actually makes sense to give PIs all the information they need to manage groups rather than trying to get competitors to help them out, so I have been designing an appropriate Programme for them see http://www.admin.cam.ac.uk/offices/personnel/staffdev/pi/. It is early days yet but people seem to find it helpful.
In the HR world where verbosity currently rules and management-speak dominates, it may be possible to change this balance in HE and create an efficient, leaner and less grotesque HR function if you actually encourage more academics and scientists in! HR is a very wide remit and presents a short circuit into HE management. In my view, only by encouraging academics to leap across the divide and join in – can that divide begin to close.
Dr Denise V. Dear,
Academic Development Consultant – PI programme,
University Teaching Associate,
Staff Development,
University of Cambridge,
25, Trumpington Street,
Cambridge.
CB2 1QA
01223 765786
dvd20@admin.cam.ac.uk
More big pharma fuelled rubbish:
‘Killer’ Vitamins: It’s bad science, but everyone believes it
17 April 2008
So are you about to die if you take an antioxidant vitamin supplement, such as A, C and E? A study that has been pounced on by the world’s media suggests you may. It says that not only do the vitamins not make you healthier or help you live longer, they may even shorten your life.
The study looked at 67 medical trials, involving 232,550 people, most of whom were taking a high-dose antioxidant because they had a health problem, such as heart disease, gastrointestinal ailments or neurological complaints.
Overall, 13.1 per cent of participants who were taking an antioxidant died, compared with 10.5 per cent of deaths among those who were either taking a placebo or no nutritional.
As a result, say the researchers, vitamins must be more carefully controlled, and their use restricted.
This is just the news that opponents of the booming nutritionals industry wanted to hear, and at a time when worldwide bans and restrictions are being considered by the EU and others.
Better yet, the study is from the prestigious Cochrane Collaboration, which styles itself as the independent and scientific evaluator of medicine and therapies.
But there’s a story behind the headlines, and it’s one that nobody is getting to read. Dr Robert Verkerk, scientific director of the Alliance for Natural Health, which is fighting to keep high-dose vitamins on the healthshop shelves, has found a range of faults with the Cochrane review.
* The ‘new’ study isn’t new at all. It was first published in the Journal of the American Medical Association (JAMA) in February last year. The only difference is that the ‘new’ Cochrane review includes one less study. So the anti-nutritional lobby has had strong press coverage twice from the same data.
* Despite its claims to be an independent review, the Cochrane study excluded 405 studies into vitamins because there were no deaths, and another 69 because they weren’t ‘randomised’ trials. As it is, the review looked only at studies that involved sick people, taking very high-dose synthetic vitamins, and which had participants dying. This does not replicate average use, and does not give the researchers the authority to claim that supplements shouldn’t be taken by healthy people.
* The studies look only at synthetic vitamins, and did not include those that are sourced from plants, such as flavonoids, anthocyanins, and sulforaphanes, which are included in leading-edge supplements, usually produced by small independent companies.
* The review flies in the face of many other studies that have established that high-dose vitamins are effective in reducing the risk of lethal diseases, such as cancer and heart disease.
(Source: Cochrane Database of Systematic Reviews, 2008, 2: No. CD007176; Alliance for Natural Health)
I see that bigpharma-bigbucks is again on the side of the enormous nutritional supplement industry, much if which is, of course, owned by the industry that he loves to deride. What a gift for them! By recommending their pills for diseases, but describing them as “supplements”, not drugs, they are able to get away from all that tedious stuff about producing evidence for the truth of their claims. That is how Boots get away (so far) with their ludicrous claims that CoQ10 peps you up.
bp-bb, your conspiracy mania is playing up again.
For those that haven’t actually looked up the Cochrane review, the authors are Danish academics (not “Pharma shills”) and have precisely no “big Pharma” funding, or connections.
Celebrity vitamin peddler-in-chief Patrick Holford was even forced to admit on R4 that his viewpoint on supplements was “less independent” that that of Professor Gluud, one of the study authors.
Quite contrary to our resident conspiracist’s ravings, the Cochrane study was in fact funded by this Danish Foundation for (objective) Research into Complementary Therapies. Strange but true.
PS Sarah Boseley over at the Guardian has just penned one of her best ever pieces detailing just exactly why Bp-bb and Co. are frantically trying to rubbish and smear the Cochrane review. Solid gold stuff.
bigpharma-bigbucks has sent two more comments, one immensely long, but simply repeating points that have already been made at length. The most striking thing to be is the alarming similarity of the tricks used by both the regular pharmaceutical industry and the alternative industry. The difference is that at least some of the products of the former do some good. I wonder if you will opt for a herbal general anaesthetic if you need a hip replacement. Or homeopathic treatment if you are unfortunate enough to get malaria.
Ah I see you are now acting as spokesman for me now David. Not necessary, as I am quite able to put forward my own view without your censorship. oh sorry, its “moderation” isnt it….
You and I both know that my posts were most definitely not repeating things, and even if they were, this is allegedly a forum for discussion isnt it? Or just a shop window for your own belief system and biased rantings?
Strange how those who are allegedly seeking truth have to suppress the views of others who may be as eloquent as themselves in expressing a different view.
I guess looking at other views is not part of your agenda and easy targets are the best you can do, so my challenge will remain unanswered for now.
What is funny is that you felt the need to comment on my 2 posts anyway, as if that in some way justified your censorship, and avoided me directly accusing you of ignoring them, and thus compromising your own self image as a “truth seeker”.
And bravo for the tired cheap shot at the end, knowing full well that you wouldnt print my response anyway. For the record, you should understand the difference between surgery and practice of medicine for non urgent disease. I also would not want my NHS GP to perform surgery on me. (incidentally hypnosis was used extensively AND successfully for anesthetic purposes as far back as the 19th century), and I would certainly not be getting ANY vaccinations for malaria having seen what is in them, though its unlikely I would need this in this part of England.
Perhaps I will just forward my comments to others on this forum direct as you have not afforded me the courtesy to do so.
You are safe, BP-bb. There are NO vaccines available for malaria. If there were, perhaps we could save some of the millions round the world, notably in Africa, who suffer and die from the disease.
If you go on a trekking holiday to a malarial part of Thailand, we Pharma-Shills would recommend prophylactic antimalarial DRUGS (see threads passim). That’s what I take for trips to malarial regions, anyway.
If you want to take a useless homeopathic remedy instead, I hope you are lucky and do not get bitten by a malarial mosquito. I also hope you don’t come home to clog up our local tropical diseases unit with an eminently preventable disease brought on by stupidity.
New malaria vaccine raises high hopes
Prospects for a malaria vaccine have been boosted by “tantalising” results from a trial in 2000 children in Mozambique. Although the vaccine reduced the risk of infection by only 30% compared with a control vaccine – this is far better than any previous result.
“With 300 million people in Africa with malaria, a 30% reduction in infection is pretty substantial,” says Ripley Ballou, vice president of clinical development at GlaxoSmithKline (GSK), the company co-developing and testing the vaccine.
Even more impressive, say the investigators, is that the vaccine reduced the risk that the children – aged one to four – would develop the most severe and lethal form of malaria by 57%.
Better still, the risk of severe disease in recipients aged less than two saw a 77% reduction. The investigators are delighted by this because, ultimately, they want to give the vaccine to infants in their first year of life to maximise early protection.
Orders of magnitude
“We’ve found these results to be quite tantalising,” says Pedro Alonso of the Hospital Clinic of the University of Barcelona, and head of the team. “This is clearly the best result we’ve seen with a candidate malaria vaccine,” he said in a press briefing, organised by the international Malaria Vaccine Initiative, GSK and the Bill & Melinda Gates Foundation.
The vaccine attacks Plasmodium falciparum – the parasite which causes malaria – at the early infection stage, when it has just been injected into human blood by the bite of a carrier mosquito.
The vaccine, named RTS,S/AS02A carries two short proteins, called RTS and S, mimicking a key surface component of the sporozoite usually recognised by the immune system.
Incorporated into the empty shell of a hepatitis B vaccine, the new vaccine is thought to trigger production of antibodies and white blood cells that recognise and neutralise the sporozoites.
Manifestation decreased
“It works by preventing the parasite from emerging from the liver, or at least diminishing the load of parasites emerging,” says Joe Cohen, inventor of the vaccine at GSK.
“The next parasitic stages are controlled and manifestation of the disease is greatly decreased,” he adds.
The development partners hope to begin larger, phase III trials as soon as possible, working steadily towards the goal of a vaccine for infants. “One million children under five die each year from malaria,” says Melinda Moree of the Malaria Vaccine Initiative.
Journal reference: The Lancet (vol 364, p 1411)
So with the greatest of respect “DA” …fuck you!
Very erudite sign-off, Bp-bb.
And I’m surprised and delighted to see you approving of the efforts of BigPharma, in the form of the GSK vaccine development operation.
Yes, there is an experimental vaccine in development. (“Experimental” is the key word missing from the headline of the story you cut and pasted – lazy journalism.) That is not what I call a vaccine, in its normal sense of “something non-experimental, widely available, and which offers a reasonably high degree of protection against the disease”.
When (if?) the experimental vaccine is actually finished trials, and licenced for mass production, it will be “a vaccine”.
There have been many attempts over the years to develop a malaria vaccine, sadly all unsuccessful. This is the latest try.
If it actually does make it through Phase III trials (not a certainty) it will be a big improvement on “no vaccine” for people in malaria-endemic areas, though only a stage on the road given the very partial protection it appears to provide.
The wider point is that I actually understand the difference between “an experimental treatment in the research stage” and “a fully tested and validated treatment ready to be rolled out”. Your statements on this and other threads make it very clear that you do not.
Incidentally, for people from malaria-free countries like the UK travelling to malaria-endemic areas, a vaccine like this is quite clearly NOT going to replace malaria prophylaxis with drugs even if it is gets to the market.
I guess I should have referred to homeopathic, or acupuncture general anaesthesia, not herbal. Nevertheless, I expect that Bp-bb would opt for something like halothane rather than opium and henbane.
I don’t think anyone disputes that herbal things can be effective, and there is evidence that a few actually are effective. But not many. Herbal medicine is, in my view, just pharmacology circa 1900, from the time before it was realised how to do proper clinical trials, and the time before it was realised how important it was for the patient to standardise potency.
Nice post
Typical response I would expect. unfortunately your poor attempts at mind reading of myself are most unscientific. If you had read one of my (uncensored by yourself) posts you would see I wrote
QUOTE: I also would not want my NHS GP to perform surgery on me. (incidentally hypnosis was used extensively AND successfully for anesthetic purposes as far back as the 19th century), END QUOTE.
Rather than sarcasm about herbal remedies many of which are very effective, how about looking at killers like aspartame, which only got FDA approval because Donald Rumsfeld was Searle Chairman.
And Im guessing these clinical trials are the same ones that allow around 40,000 Britons each year to die from reactions to prescription drugs? And the 150,000 which are disabled or need hospital treatment after taking a drug?
And lets not get into thalidomide, or pemoline (took 23 years to realise liver toxicity), ketoconazole (took 15 years to realise it caused heart complications). The list goes on…
And how many clinical trials take into account combinations of drugs?
For a site which claims to look at bad science, all Ive seen is smugness and unflinching belief that science has all the answers.
Which it doesnt…
The one thing that is blindingly obvious is that science has not got all the answers,
The difference is that scientists, unlike bigpharma-bigbucks, don’t feel free to invent the answer when there is none.
The irony is that BB resembles rather closely the marketing people in the pharmaceutical industry that he loathes so much. They too feel free to invent evidence if there isn’t any, and to misrepresent what evidence there is.
{Another long post cut down, because it is getting so repetitive DC]
And you still havent provided any evidence that alternative treatments dont work as requested in my censored post.
I just had to post the final sentence of BB’s last long submission, because nothing shows more clearly his/her lack of comprehension about how one goes about separating truth from fiction,
Have we (UCL) been infiltrated? UCLU now has a new complementary medicine society (although the UCLU website seems unsure whether their medicine is complimentary or complementary…). Their events include regular case discussions with students/staff from Westminster. See
http://www.freewebs.com/uclucomplementarymedicine/index.htm
I’m appalled. Why has UCLU accepted their affiliation?
drsquared2b. Yes I had a horrified mail from an undergraduate a while back when she discovered this society, but nothing can be done about it. It makes one worry about the selection process a bit though. I just hope their medicine is better than their spelling. I called in on their stand at the Freshers’ Fayre [sic] and may get invited to speak there. If so please come and bring your friends. I may need allies.
Funny seeing a ‘colleague’ being so angry on this thread. I’m not sure what that is about. We are all here to be in dialogue with each other. Herbalists are a funny bunch, and many of them make me question my profession. However, be assured that not all of us are as angry as bp-bb. I’m not angry at all. Just curious as to how we can bring plant medicines into the 21st century.
I would like to say this: Medicine should be first and foremost about compassion. I don’t care about anything but human beings getting first-class health-care. The NHS does not have the resources to care for everyone. I worked in the busiest surgical ward in my local hospital for 3 years and saw the short-comings of the system: Old people not being fed or given something to drink, medicines being badly prescribed by junior doctors, pharmaceutical toxicity, problems with surgery, psychological problems not being dealt with…. etc etc, ad infinitum.
I came home from my job on many days and cried at the sheer frustration of not being able to help the people I wanted to help. For the ‘anti-woo’ set: there are SO many shortcomings in modern orthodox medicine. These need to be addressed properly.
I have a dream that one day people will be given the care they deserve, in private rooms, with proper consultations by specialists who have time to talk to them and doctors and nurses who can support this work. For all of the skeptics: in the meantime, some of us do really care what happens to people when they are ill and we are investigating every way we can make their suffering a little less. If I can help one of my patients feel better, I consider what I do a success.
Perhaps academic discussions about evidence are moot when you consider the scope of human suffering? I find this a very difficult subject. Dr. Colquhoun?
Any progress in getting invited to talk to the complementary medicine society? Maria and I would love to come to support you!
I suppose George L is the sort of acceptable academic face of homeopathic apologism. Personally I lost any respect for him when he started making noises about how double-blinded placebo trials were not an adequate way to assess CAM interventions.
Perhaps he combined the talk with one of his visits to his Harley Street alternative clinic?
Hi DC,
Thought your readers might chortlee at the following The Daily Mash (http://www.thedailymash.co.uk/news/health/complementary-therapists-to-be-regulated-by-witch-doctor-200901201522/):
COMPLEMENTARY THERAPISTS TO BE REGULATED BY WITCH DOCTOR
STRICT standards must be applied to alternative medicine, according to the voodoo priest who will run the UK’s complimentary therapy watchdog.
Haitian born Papa Limba said his first task as chairman of the Complementary and Natural Healthcare Council would be to identify which therapists were righteous shamans and which had the bad juju.
But the witch doctor stressed the therapists would be judged not on the effectiveness of their treatments but on the strength of their mogambo.
Limba said: “There are many frauds and not everyone has as strong a connection to the serpent god Demballa as they like to make out.
“I place my hands on their head and if their spirit vibrates to the rhythm of the ocean I give them a sticker to put in the window. If not I rub them with the mashed root of the banyan tree and we never hear of them again.”
He added: “Once a year I shall visit them and cast my chicken bones on their consulting room floor. If they are still there a week later I report them to health and safety.”
A CNHC official said all applicants would be judged on the four key elements: earth, fire, water and the age of the magazines in their waiting room.
Homeopaths will be able to apply for accreditiation by visualising the application form and then beaming their thoughts down the nearest ley line.
How very sad to hear of the trials and tribulations of poor UC Pharmacology. I was so sad to hear of the departure of the mechanical genius from the basement, whose father had also worked with previous generations of UC physiology “greats”. Another irreplaceable resource lost.
David I stand corrected: irascible is much preferable to jaudiced. I look forward to Bonnie Prince Charlie’s revelations.
HeadtoHead (BMJ)
[DC comment. This refers to the HeadtoHead blog]
Eager to support EPSRC’s new “Three strikes and you’re out” policy (http://www.epsrc.ac.uk/ResearchFunding/HowToApply/Exclusions.htm), I have the following suggestion:
“Blueprint of events for an EPSRC bootcamp”
1. Crossing the critical path: an example from aeronautics
This pod will comprise two minutes of dart throwing at an image of a well-known scientific leader to be chosen following “cess-pit” discussions within the group. Three bulls and you’re out will apply only to the boot-camp delegate, the scientific leader being immune to all challenges.
2. Interdisciplinary chanting
Going forward from the aeronautics challenge, this pod will build on the team-working skills developed in Pod 1 by enabling delegates to bark collectively into the wind until either (a) they, as a unit, see the error of their non-pan-industrial ways or (b) there is a change of government, whichever is the longer.
3. The lab. diary room
When the previous two pods have been successfully passed, each delegate will have the opportunity for personal reflection and immersion in the lab. diary room. There will be ample opportunity for one-way discussions with a leading policy maker, who, drawing on CIA seige strategy, will sing “you’re not laughing over there” for a period not less than fifteen minutes.
4. The signature
In a final act of contrition, each delegate will sign the creed of re-alignment with best industrial practice and be immediately re-deployed as a Business Development Executive.
Hi Just registered, wow what can I say, I have a place to post my blogs now. I love the fact there are still people who believe the fact that because you cannot understand the science behind it, it cannot work.
You must all be anti-depressant swallowing junkies, and thank god we now have evidence based science behind homeopathy. I am a student of Homeopathy and a qualified Nutritional Therapist who is currently doing a MSc in Nutritional Therapy. Accept the fact that not everything should be medicalised, if a baby has colic give the mother a tea to help, instead of the sugar laden chemical cocktail found in the chemist.
Remember our bodies are not designed to metabolize the ongoing ingestion of chemicals and suppressants the medical profession churn out willy nilly.
Look forward to your comments, oh yeah Ben goldacre if you read this please respond, Im in the mood for a good arguement.
Hi Arsenicum. You say “thank god we now have evidence based science behind homeopathy.” Could you let us know the details of the evidence please ? Thank you.
OK Arsenicum, here are a few things for you to think about.
(1) If you knew anything at all about pharmacology, you would realise it is quite common for the mechanism of action of drugs not to be known. What matters is that they are tested properly. Most of the things that you sell are either not tested or have failed tests.
(2) If you had read anything that I (or Goldacre) writes, you’d have known that we absolutely oppose the tendency to medicalise everyday life.
(3) The tendency to medicalise everyday life has been encouraged by some big pharmaceutical companies. But the worst offenders by far is the alternative medicine industry, and in particular, nutritional therapists. They specialise in giving people tests, often fraudulent, on the basis of which they sell you a lot of expensive supplements that you don’t need and won’t help you,
(4) The extreme wing of the nutritional therapy business kills people. It is estimated that AIDS denialism, encouraged by Matthias Rath’s efforts in treating AIDS patients with vitamins, has cost 300 000 lives. You can read all about it here. That isn’t medicine, It is homicide.
I wonder how many of these things you learned on your course? Not much, I’ll bet, If hope your course wasn’t anything like this one at Westminster University, or this one at Thames Valley University, because they have become a bit of a laughing stock since it was revealed what they actually teach (watch this space for more).
Perhaps you should consider suing your college for misleading you about the what’s true and what isn’t.
At least Arsenicum got the first four letters of his/her alias correct and rather neatly summarised his/her contribution.
If a baby has colic what is the point of giving the mother a cup of tea ?
And if our “””bodies are not designed to metabolize the ongoing ingestion of chemicals””” what are we supposed to do for food ? These quacks seem to constantly ignore the fact that food is made out of chemicals.
“If a baby has colic what is the point of giving the mother a cup of tea?”
It’s probably something to do with “quantum entanglement”, or something. To quote Lionel Milgrom:
“If that is the case, then perhaps you have to consider the owner and the animal as an entangled entity. Ergo if you gave the remedy to the owner, would it have the same effect? I was giving a talk down in the South West recently and apparently there is a vet down there who works in that way, which I find absolutely fascinating.”
congratulations on succesful move to new server!
Hello all,
I have just read all the comments, and this is all nonsense…
Science is a library of all the things there are to known…
Its all a question of what books have you be reading in that library.
Homeopathy is not a question or discussion between believers and non-believers, Its a question and discussion between knower’s and non-knower`s.
Start reading the Scientific literature, first, and then come and discuss Homeopathy.
Homeopathy, was already proven (Scientifically) more than once.
In 2003 the Physica A (for who who don`t know- is the best Scientific journal, where all the new scientific discovers are published) published an article that finally proves the Scientific evidence of Homeopathy, and how homeopathy works above the Avogrado`s number.
The Memory of water by Louis Rey (he also didn´t believed in Homeopathy, and was a major critic of Homeopathy)
This article is on internet, you can all look for it and read something Scientific.
As a MD it is sad to see so much ignorance and personal persecution for Homeopathy…
Maybe there are many interests to defend, or afraid of something to happen in a near future…
Dr Rey’s work did not in any way prove homeopathy. Indeed, it didn’t claim to. It simply purported to show, using one particular thermoluminscence technique, that there appeared to be a difference between water and a homeopathic remedy. This has been widely and inaccurately touted by homeopaths as demonstrating that the memory of water is a fact, and that therefore (they infer) the rest of their mumbo-jumbo must be true too.
Rey’s work was not (technically speaking) a particularly well-controlled experiment, and the method he used (which essentially depends on freezing the sample, then irradiating it, and finally rewarming it and examining thermoluminescent emissions) offers many possible sources of artifacts and/or explanations. One of the most notable is that the method relies on thermolumininescent emissions generated at “irregularities” in the crystal structure of the frozen sample. If lots and lots of shaking causes gas micro-bubbles, which is quite plausible, then a “more shaken” sample might be expected to produce different results in a thermomluminescence experiment. This would not, note, show that the sample had a “memory of dissolved solutes”. Just that it had been shaken harder.
As ever, homeopaths will believe what they want to believe. That is how faith-based positions work.
The link between mother and baby is not so mysterious, especially if the baby is being breast-fed! Not sure about the tea, but when my baby had colic I was told to eliminate dairy products from my diet, by the conventional medical establishment. Hard cheese, as they say!! Funny thing about cause and effect, though, the day I was going to cut out my beloved cheese, the colic suddenly vanished on its own. One day earlier and I would been convinced it was dairy, and suffered without for months! Oh, and I do drink lots of tea……
Ah Mr Colhoun
I see that you have finally seen the light and decided to join the alternative medicine crowd by becoming a committee member of the Complementary and Natural Healthcare Council http://www.cnhc.org.uk/pages/index.cfm?page_id=98
Well done for seeing sense at last!
Or as CNHC is so closely associated with FIH, are we just after a knighthood perhaps?
I wonder if your colleagues are aware and if this comment will be censored like many others?
Oh yes, everyone knows. I announced it on the blog. I gather that I was appointed to the Conduct and Competence committee because I have some experience in assessing evidence. It is proving to be a quite fascinating job.
“EU inquiry pours doubt on benefit of health foods – EFSA has done good job on nutriquacks”.
To see a list of the reports (in a couple of cases they did find that the evidence submitted supported the claim), go to the EFSA website at http://www.efsa.europa.eu/EFSA/efsa_locale-1178620753812_ScientificDocuments.htm
and in the box labelled “search for term” type:
1924
(This is the number of the European Regulation under which the reports are made).
I find the piece in the Independent ( miniblog) about the resignation of City’s VC, Malcolm Gillies, is quite shocking and I feel it has wider implications for universities everywhere in the UK. Says it all: money first, education and truth afterwards.
The university’s website already has the name of the new acting VC, but I shall be sending an e-mail to vicechancellorsoffice@city.ac.uk
but I will address the comments therein to Malcolm Gillies expressing support for him and his approach etc.. If several people do this it will at least be a bit embarassing.
just an update. If that ex chiro student from NZCC is Jonathan mann, perhaps you should check out the NZ Sunday Times website for fake physio clip. he as a student of NZCC but was booted out for false academic records. He then enrolled at Osteopathy school at Unitec and kicked out of there as well. Finally set up as a unqualified and unregistered physio at a auck clinic. Thats one pathological liar, and I’m sure David slowly worked out that one out and hence why you cant find the article. It kind of sums up the depth and integrity of Davids Dr Who article is the NZMJ. keep up the good work
@epigenetics
Very interesting, but it wasn’t Jonathan Mann
hey blogs, google the following case. It came about when the AMA tried to push the quackery committee. A bit like the tone of Singh, but no, its all about Singh’s freedom of speech of course bla bla..the Singhs to David Colquhoun’s of this planet just need a perspective change, its not the title Dr,lack of evidence and all that rubbish. Chiropractic is everywhere, you prove it wrong with your evidence based shoes, and whilst you trip and stumble around, individual results will tell a different story, like the Wilk trial
Wilk v. American Medical Association, 895 F.2d 352 (7th Cir. 1990), was a federal antitrust suit brought against the American Medical Association (AMA) and 10 co-defendants by chiropractor Chester A. Wilk, DC, and four co-plaintiffs. It resulted in a ruling against the AMA.
Mr Colquhoun… I can’t see your response to ‘Notawitchdoctor’. Would you be so kind as to post your response…many thanks
@patientscomefirst
One reason for not having replied to NAWD is because I have been a patient myself, and I’m still recovering: http://www.dcscience.net/?page_id=1621#neph1 That experience has been quite helpful in formulating an answer.
NAWD says “I would like to say this: Medicine should be first and foremost about compassion.”. I simply disagree. Medicine is first and foremost is about getting people better who would otherwise be ill. It turned out that I had an early stage renal cancer. In all probability I owe my life to the smart people who first spotted it during imaging, and the smart surgeons who got it out before it had time to do much harm.
As it happens, both physicians and surgeons were compassionate too, As I have said, the attitude of everyone at the Royal Marsden was wonderful. They know how to make you feel better when you are a bit down. That is wonderful, and greatly appreciated, but it is no substitute for knowing your stuff.
If I had gone to the most compassionate herbalist in the world, I’d probably have died quite soon of metastatic renal cancer. If that had happened it would be a result of people saying things like “Medicine should be first and foremost about compassion.”
Great. Sounds like education standards are higher in the UK than here in the US, where alt.med. universities can sell completely nonscientific belief systems as “science” degrees with complete impunity and complete accreditation. With help from State and Federal Dept.s of Education, I might add.
Medicine should be first and foremost about compassion?
No. Compassion may or may not be an effective “medicine” for what is essentially or primarily emotional pain, but for strictly physical medical conditions, first and foremost what is required is a physical solution. Compassion in these cases is a sad second best.
People die everyday because of charlatans and their magic potions. People must be aware of that.
Dear Pr. Colquhoun.
As a homeopath physician, I’d like to say here how much I agree with you. We share certainly the same love for science and strictness. I’m very interested to read the comments left on your blog.
For example, when you write « Medicine should be first and foremost about compassion. I simply disagree. Medicine is first and foremost is about getting people better who would otherwise be ill », you’re almost quoting Hahnemann himself. He writes in §1 of the Organon :
« The physician’s high and only mission is to restore the sick to health, to cure, as it is termed». I hope nobody here disagrees?
Talking of compassion is sweet, but in no way medical. Of course compassion should be there within the physician, otherwise we become nothing else but technicians, but first we have to learn to have a neutral attitude.
I’m fighting everyday against the intrusion in the field of medicine of “doux rêveurs” as we say in French. Certainly some of them are loaded with good intentions but I’m afraid that consulting people longing for compassion in a comfortable study, is somewhat different from the reality of suffering people, the hospitals, the emergencies.
Ready to believe anything, most of these people lack of discernment, not unlike people taking cannabis. Prone to syncretism, they mix up many theories: the “astral influences”, “graphology”, so-called interpretation of the brain scanners, magic thinking, and so on.
Here I can’t resist quoting Hahnemann again, in his note to §1 about the physician’s duty:
“His mission is not, however, to construct so-called systems, by interweaving empty speculations and hypotheses concerning the internal essential nature of the vital processes and the mode in which diseases originate in the interior of the organism, (whereon so many physicians have hitherto ambitiously wasted their talents and their time); nor is it to attempt to give countless explanations regarding the phenomena in diseases and their proximate cause (which must ever remain concealed), wrapped in unintelligible words and an inflated abstract mode of expression, which should sound very learned in order to astonish the ignorant – whilst sick humanity sighs in vain for aid. Of such learned reveries (to which the name of theoretic medicine is given, and for which special professorships are instituted) we have had quite enough, and it is now high time that all who call themselves physicians should at length cease to deceive suffering mankind with mere talk, and begin now, instead, for once to act, that is, really to help and to cure”
If junkies start dealing with mechanics, can they do anything but junk-mechanics? Do we have then to attack and destroy mechanics? I suggest to be careful not to throw the baby out with the bath water.
If time allows, it’ll be a pleasure to write here again, if my clumsy English is not too repulsive 🙂
I wish you a speedy recovery.
It seems unlikely that given the logevity of acupuncture and its widespread and regular use that it can be explained away by pure science
Normally I would delete an obvious advertisement like that from Chester Acupuncture Clinic. But the comment is so garbled that I can’t resist leaving it.
I presume though, that it is intended to mean that it has been around a long time, so it must be true. Well, christianity and islam have been around for a long time too, and they aren’t both true.
In addition to that, acupuncture in its present from has not been around for a long time. It is essentially a post-war invention used by Mao Tse-Tung as a means of promoting Chinese nationalism (though he is reported to have preferred more effective medicine himself).
Reading the miniblog ‘Ghastly report from WHO’, I am wondering whether I’ve been in a time warp and that it is April 1st already!
It reads like a total micky-take, with stuff about gratitude to Lombardy for hosting the meeting and then all the serious sounding nonsense. What a con! How can we have faith in WHO’s workings when they produce this stuff?
Re 84/85
The preface to the appalling WHO document “Safety issues in the preparation of homeopathic medicines ” contains the following:
‘The resolution on traditional medicine adopted by the World Health Assembly
(WHA) in May 2009 (WHA62.13),1 urges Member States to “formulate national policies, regulations and standards, as part of comprehensive national health systems, to promote appropriate, safe and effective use of traditional medicine.”‘
The appalling author of the said document is Dr Xiaorui Zhang, anointed and appointed by the WHO, so it would seem, to extend the posthumous writ of Chairman Mao around the globe by seeking to integrate anti-scientific traditional gobbledegook with scientific medicine.
This is the person responsible for producing a WHO report on acupuncture which even the Medical Director of the British Medical Acupuncture Society condemned as being “highly biased” saying “this unsystematic review cannot be used to support the contention that acupuncture is efficacious”.
http://beta.medicinescomplete.com/journals/fact/current/fact0803a02t02.htm
I should clarify that Zhang was author of the preface to the WHO homeopathic document.
The World Health Assembly resolution WHA62.13 follows on from the Beijing Declaration 2008
http://www.un.org.cn/cms/p/news/27/868/content.html
A relevant European regional WHO document here is EUR/RC59/6:
“Several EU countries are supporting WHO’s traditional medicines programme, and there are a number of WHO collaborating centres in the European Region.
Research and development programmes in Europe also address the effectiveness and safety of TM, and this could be further expanded within the global strategy on public health, innovation and intellectual property.”
Click to access rc59_edoc06.pdf
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I have just joined this site and, I must say I have really enjoyed reading such a range and variety of entries. I have an MSc in Social Science Research and am a qualified paediatric nurse and Health Visitor. I am also a qualified acupuncturist. So, I am reading about many things that not only interest me but also relate to my work. Until I have read more though, I shall reserve comment, except to say that whatever the background or discipline the truth of medical practice is, surely, first do the patient no harm? I have seen immense (and I mean dreadful) harm done in 32 years of NHS practice: I have seen the most spectacular results, too, from brave practitioners who defied science and did all they could to save a life. Amazing stuff. I have also worked with CAM therapists that I would not let look after a rice pudding, let alone an illness, as well as therapists who are smart, on the ball and getting good results. I have nursed very sick children who did not survive the most robust treatment, and children who should have died and didn’t. I have, as an acupuncturist, seen patients recover from stuff that has had me scratching my head and patients not respond to the most rudimentary intervention. I don’t know what the answer is. Hiding from the clinical gaze is not good but, neither is taking the moral/intellectual high ground. On either ‘side’, even though I don’t consider myself to be on any ‘side’. However, I am looking forward to some engaging and informative times on this site. Thanks.
@isobelmet
I’m delighted that an acupuncturist finds something of interest here. I’m not against acupuncture or any other sort of alternative medicine, just against treatments that don’t work. That includes some conventional treatments too.
Your observations are interesting, but sadly simple observations are not sufficient to tell whether or not a treatment works, because so many conditions get better without any treatment at all.
As you say, it is important to do no harm, but that is a very minimal criterion. The aim must be to do positive good, whenevr that is possible (sadly not always).
I am interested in your challenge to universities issuing degrees in various therapies. When I did my acupuncture training I did not want a degree – I already had two – but that was what was available. As a former senior lecturer I had concerns about the academic process and standards, which is not to say that the underlying Chinese philosophy did not have rigour. Rather, trying to make very different paradigms ‘fit’ each other is not necessarily a good thing. As a social scientist I am used to the conflicts around this issue (sociology is not scientific, say the chemists, for example) and to a certain extent I have come to agree to differ. However, you are right to bring questions to the table. Maybe with not quite as much hostility, perhaps, but I note an equal amount of hostility from CAM people, too. Doing positive good is a worthy ideal but, as a practitioner of some years standing, I realise what I believe is good for the patient is not always shared by the patient. Nobody can dispute the advantages of breastfeeding, or of not smoking, but somehow or other neither of these messages have got home to patients (including health professionals as patients), or policy makers. The human condition is not easily encapsulated, but seemingly easily manipulated. As I said before, I don’t know. And I often tell my patients that, too. Accusations that CAM practitioners are all liars is a little inflammatory! Yes, often things will get better on their own, many conditions are self limiting. Both camps, if you like, are guilty of generating business. As an acupuncturist I work a lot with people having IVF and am dismayed at the level of intervention ordered for people who are being made to feel inadequate and lacking. As a HV I spent far too many hours with parents who cared nothing for their children yet my ‘performance’ was judged on the amount of time I wasted on them. The point I am trying to make is that scientific evidence is all well and good but, translating it into meaningful, effective practice is hard, wherever you come from. Allopathic medicine needs to accept there IS a placebo effect, there IS some kind of therapeutic interaction between the practitioner(s) and patient, and that patients individual experiences are part of the healthcare continuum. I am not saying it’s easy, though!
@isobelmat
I have never accused all CAM practitioners of being liars. Many I have met are obviously quite sincere in their beliefs. Oddly enough, I get the imprssion that the dafter the belief the more sincere the believer. Homeopaths and crysral enthusiasts seem quite sincere. At the other extreme, nutritional supplement salesman seem often to be in the business just for the money. There is an interesting chapter in Robert Park’s Voodoo Science on this topic: the road from delusion to fraud.
I see that you use acupuncture with IVF. Does it not worry you that the latest analysis shows it to be ineffective?
http://www3.interscience.wiley.com/journal/120847906/abstract
Thanks for the reference. There are conflicting reports about the efficacy of improving conception with acupuncture and IVF. Southampton Uni’s meta analysis felt is was a worthwhile intervention (cf. BMJ Aug 2008). However, acupuncture, as in sticking needles in, is only a part of the cannon of Chinese medicine. I will freely admit that I give the same advice re: lifestyle changes, treatment co-operation, sex activity, as I did as an HV. No contest there. But, many women find their periods become regular or sleep improves or stress responses drop when I combine it with sticking pins in, and that didn’t happen to the same extent when I didn’t stick pins in. I’m not claiming anything special. I frequently treat for free, as I am aware of the very high expense people go to with IVF. Does it not worry you that the NHS spends millions a year on an intervention that is, at best, only 35% effective and shows only minimal improvement year on year? I can’t think of any other service offered at public expense with such poor results. Cardiac units with better rates have been shut on the grounds that they are not worth the cost, and my specialist area as a nurse (neonatal intensive care) has frequently been responsible for increasing the degree and incidence of chronic neurological/developmental problems without closer scrutiny of the interventions used. Health care the world over is complex and becoming increasingly sophisticated in the messages given to practitioners and users alike. As a researcher, I spent many hours on literature searches and was astonished at the amount of unmitigated b****cks published in learned journals, all in the game of research. I also saw work that was ‘edited’ to suit the prof or funders or to get someones membership passed. I was not popular. If any acupuncturist claimed they could cure it all, or that it was the best, I would give them a wide berth, and advise others to do the same. There is room for intelligent debate (not rude defence) but, where widely different paradigms exist, there is also room for misunderstanding and arrogance – a claim to know the absolute truth. Nobody has the right to do that on behalf of anyone, let alone vulnerable, confused or frightened patients. BTW, there are far weirder things than homeopathy or crystal healing out there. Trust me. I’m an acupuncturist. Namaste.
Just had an idea for a website based upon your excellent work:
“So you want to be a Quack?”
Which could list all the educational institutions in the UK teaching altmed bollocks.
If a wiki format was used then the workload could be crowd sourced.
And the site could be a ‘Wikileaks’ for educational material from these courses.
What do you think?
VinylTiger
@isobelmat:
I have a bridge for sale.
No, honestly!
I am a Nutritionist, would I lie to you?
In fact, this bridge is rather special, as it generates ~AU$32,500 per day in tolls.
I have to go to Nigeria to cure AIDS patients with acupuncture, and due to strict tax rules, I need to ‘park’ it in someone else’s ownership for 3 years or more. You can keep the revenue. All I ask is that you deposit AU$500,000 into my bank account as a refundable deposit. You seem like the kind of intellect that can spot a great opportunity such as this.
What do you say?
Thank you, Michael. I came to this site so I could access some of the sharp thinking associated with great minds of science. I wanted to add to my knowledge as well as engage in honest, open debate. I had been led to believe this is what clever people do, so I sought out clever people (given that I am, clearly, not one of Them). And so I remain Not One of Them, as your comments might indicate that I was mistaken in my beliefs. Who knows what else we can be mistaken about? Isn’t life exciting….
isobelmat,
When deciding whether acupuncture is worthwhile for IVF, which is more important: your recall of your own experiences, or a ctritical look at the quality of all trials and the validity of their conclusions?
Perhaps you could keep detailed records for all your patients, with objective outcome measures and avoiding the liability of patients telling you what you want to hear and the bias of only recording notable examples.
That might help you with your decision-making. But you must accept that your judgement alone is fallible and has its place.
Yes, I agree clinical audit is a vital part of generating evidence. However, the clinic I previously worked in felt it was a waste of my salary to give me time to design and run proper audit tools (a common complaint from those who do not know what they are talking about). I intend to do it in my own practice, which is just getting going in a different location. Naturally, if I can enlist the support of a range of IVF clinics, this will be a much better exercise than just my caseload. Any suggestions on how I can convince them it might be worthwhile joining forces? It’s because I know (not merely ‘accept’) that my judgement alone is not a basis for disseminating good practice that I feel this must be done.
Michael. I note your blog spot and have tried to access it so we could maybe discuss one or two things off this site (as an non-theistic person who recognises god). However, it seems to be impossible to access your blog. I have tried many times, and have been sent lotsa passwords and codes and things and STILL and I can’t get to speak to you. Spooky, eh? Or is it a way of keeping us heretics out? Anyway, how can I contact you to engage in, hopefully, meanigful dialogue.
Sorry. Meaningful. Bit too much communion wine.
@Teige
You are quite right to question subjective impressions of the efficacy of some unproven intervention, and look to proper research and systematic reviews as a way of eliminating bias or even self-delusion.
However, taking notes of outcomes in a single-handed private practice is not going to help much. Audit is about modifying existing clinical protocols to refine and improve practice. It applies in areas where there is already a broadly agreed approach which produces positive results, but identifies changes in the protocol that are likely to improve outcome.
Clinical audit of IVF and acupuncture won’t tell you if acupuncture works for IVF or not. In fact until you know that there is a proven method of using acupuncture to improve IVF outcome, then it doesn’t make sense to engage in the audit cycle. It’s like trying to redecorate a house that hasn’t been built yet.
Isobelmat’s phrase of “disseminating good practice” is a nonsense. The premise of that phrase is that the technique is already reasonably efficacious. That is completely unproven. So you end up with trying to say what is a “better” way to produce the same null result.
It would seem that despite all her self-proclaimed qualifications, this nurse doesn’t seem to understand the difference between research and clinical audit: demonstrating a lack of intellectual rigour that so often accompanies a lack of discernment in matters of clinical evidence.