How to differentiate good from bad research

One of the questions I hear frequently is ‘HOW CAN I BE SURE THIS STUDY IS SOUND’? Even though I have spent much of my professional life on this issue, I am invariably struggling to provide an answer. Firstly, because a comprehensive reply must inevitably have the size of a book, perhaps even several books. And secondly, to most lay people, the reply would be intensely boring, I am afraid.

Yet many readers of this blog evidently search for some guidance – so, let me try to provide a few indicators – indicators, not more!!! – as to what might signify a good and a poor clinical trial (other types of research would need different criteria)...

Read more: How to differentiate good from bad research

---

We advise bookmarking this incredibly useful post

The role of criticism in the realm of alternative medicine

Nobody really likes to be criticised; it can be painful. Painful but often necessary! Criticism produces progress. Criticism is therefore important. So, let’s think about criticism for a moment.

Obviously I am not talking of criticism such as ‘YOU ARE AN IDIOT’. In fact, that’s not criticism at all; it’s an insult. I am also not thinking about criticism like ‘YOUR ARGUMENT IS IDIOTIC’. I prefer to focus on criticism that is constructive, well-argued and based on evidence.

In healthcare, there is plenty of that type of criticism...

Read on: The role of criticism in the realm of alternative medicine

A new RCT tests homeopathy in cats … and the results are unsurprisingly negative

Hyperthyroidism is, so I am told, a frequent veterinary problem, particularly in elderly cats. Homeopathic treatment is sometimes used to treat this condition. One article even provided encouraging details based on 4 case-reports. All 4 cats showed resolution of clinical signs; three attained normal thyroid hormone levels.  The authors concluded that homeopathic and complementary therapies avoid the potential side effects of methimazole and surgical thyroidectomy, they are less costly than radioactive iodine treatment, and they provide an option for clients who decline conventional therapies...

Read on: A new RCT tests homeopathy in cats … and the results are unsurprisingly negative

FDA: homeopathic teething remedies were toxic

I am sure this  FDA press-release will interest many readers (we reported about this case before):

The U.S. Food and Drug Administration announced today that its laboratory analysis found inconsistent amounts of belladonna, a toxic substance, in certain homeopathic teething tablets, sometimes far exceeding the amount claimed on the label. The agency is warning consumers that homeopathic teething tablets containing belladonna pose an unnecessary risk to infants and children and urges consumers not to use these products...

Read more: FDA: homeopathic teething remedies were toxic

Cerebral Haemorrhage Following Chiropractic ‘Activator’ Treatment

We have repeatedly discussed the risks of chiropractic spinal manipulation (see, for instance here, here and here). Some chiropractors seem to believe that using a hand-held manipulator, called ‘activator’, better controls the forces used on the spine and therefore is safer. This recent paper raises doubts on this hypothesis.

A neurosurgeon from Florida published the case-report of a 75-year-old active woman who presented to a local hospital emergency room with a 3-day history of the acute onset of severe left temporal headache, initially self-treated with non-steroidals, to which they were resistant. Additional complaints included some vague right eye blurring of vision and a mild speech disturbance. Her primary-care physician had ordered an outpatient MRI, which was interpreted as showing a small sub-acute left posterior temporal lobe haemorrhage. He then referred her to the emergency room where she was categorized as a “stroke alert” and evaluated according to the hospital “stroke-alert” protocol...

Read on: Cerebral Haemorrhage Following Chiropractic ‘Activator’ Treatment

Acupuncture and the disgraceful Dr Cummings

Mike Cummings recently stated on this blog “I’m not into blog banter.” Is he perhaps referring to some ‘alternative facts’? The truth seems to be that he blogs happily, regularly and – I am sad to say – disgracefully. This is a quote from his new post about the discussions regarding an acupuncture trial which was in the press a few days ago, (and also has been discussed on this blog):

START OF QUOTE

So there has been a big response to this paper press released by BMJ on behalf of the journal Acupuncture in Medicine. The response has been influenced by the usual characters – retired professors who are professional bloggers and vocal critics of anything in the realm of complementary medicine. They thrive on oiling up and flexing their EBM muscles for a baying mob of fellow sceptics (see my ‘stereotypical mental image’ here)...

Read on: Acupuncture and the disgraceful Dr Cummings

Acupuncture is not an effective treatment of pain: results from a new RCT

Acupuncture is often recommended as a treatment for shoulder pain, but its effectiveness is far from proven. A new study has just been published; but does it change this uncertainty?

A total of 227 patients with subacromial pain syndrome were recruited to this RCT. The patients were allocated to three groups who received either A) group exercise, B) group exercise plus acupuncture or C) group exercise plus electro-acupuncture. The primary outcome measure was the Oxford Shoulder Score. Follow-up was post treatment, and at 6 and 12 months. Data were analysed on intention-to-treat principles with imputation of missing values.

Read more here: Acupuncture is not an effective treatment of pain: results from a new RCT

Rest in peace, Dan Olmsted

Dan Olmsted, one of the editors of Age of Autism (the blog full of lies and misrepresentations, and a near-psychotic obsession with trying to link vaccines and conspiracies to anything that happens in the world) has passed away. There must always be honor in the battlefield of ideas, especially from those of us who fight […]

Read more at: Rest in peace, Dan Olmsted by Reuben

What is it with Gwyneth Paltrow and the vagina?

First she promoted vaginal steam baths and now Gwyneth Paltrow claims that putting a ball of jade (which you can order from her online-business, if you happen to have the cash) in their vaginas is good for women.

Yes, I kid you not; this is what she states on her website:

The strictly guarded secret of Chinese royalty in antiquity—queens and concubines used them to stay in shape for emperors—jade eggs harness the power of energy work, crystal healing, and a Kegel-like physical practice. Fans say regular use increases chi, orgasms, vaginal muscle tone, hormonal balance, and feminine energy in general. Shiva Rose has been practicing with them for about seven years, and raves about the results; we tried them, too, and were so convinced we put them into the goop shop. Jade eggs’ power to cleanse and clear make them ideal for detox…

Steel yourself and read on: What is it with Gwyneth Paltrow and the vagina?

Goodbye, Goop: 7 of Gwyneth Paltrow's most ridiculous recommendations

How do you like your eggs in the morning? Up your cooch, if you're Gwyneth Paltrow. Its mother hen allegedly parted ways from her online lifestyle site, Goop, last year, but its recent suggestion that women insert jade eggs (which are golf-ball sized. Gulp) into their vaginas to aid "hormonal balance, and feminine energy in general" seems decidedly Paltrow-esque.

Some women might have better uses for $66, but not Goop's users who, presumably fuelled by kimchi shakes and the fumes of organic hand-sanitiser...

Read on: Goodbye, Goop: 7 of Gwyneth Paltrow's most ridiculous recommendations

Homeopathy: disclosing the ‘alternative truths’*** of ‘Ullman and Co’

Why has homeopathy such a bad name?

Why have the most ardent defenders of homeopathy become the laughing stock of the science community?

Why is there, after >200 years, still no proof of homeopathy’s efficacy?

Why is there not more research into homeopathy?

Why is there not more money in homeopathy?

Why is there so much opposition to homeopathy?

Nothing to do, of course, with the fact that highly diluted homeopathic remedies are pure placebos. No, no, no! It is because BIG PHARMA is doing everything they can to suppress homeopathy!!! They have no choice: if the good news about homeopathy would go any further, they would go bankrupt...

Read on: Homeopathy: disclosing the ‘alternative truths’*** of ‘Ullman and Co’

Alternative medicine: a thing for the elderly!?!?

We all know that alternative medicine is currently popular, and much of the evidence suggested that this is mostly because mostly people in the midst of their lives are using it. This may be so, but it is about to change; it stands to reason that these ‘baby boomers’ are getting older, and therefore the typical user of alternative medicine is or will soon be an elderly person. In addition, the ‘oldies’ (I am one of them) are likely to be multi-morbid and therefore have more reason to try everything that is on offer.

Not convinced? But that is roughly is what this website seems to suggest...

Read on: Alternative medicine: a thing for the elderly!?!?

Beware of the alkaline diet and the claims made for it! A plea for journalistic accuracy

Currently, we witness an unprecedented hype about the ALKALINE DIET. It seems to be everywhere: on TV, radio, in the dailies, magazines, books and the Internet. The diet is being promoted for an amazing array of conditions by a dazzling list of VIPs. To me this merely indicates that very important people have paid very little attention when it was explained to them how the body controls its pH. It seems that VIPs tend listen to stuff that is not only factually incorrect but potentially dangerous. (Perhaps ‘VIP’ stands for ‘very ignorant person’?) This website (one of millions on the subject) is as good an example as any for the level of misinformation that is currently out there..

Read on: Beware of the alkaline diet and the claims made for it! A plea for journalistic accuracy

If your baby is crying. what do you do? Stick pins in it

This piece is almost identical with today’s Spectator Health article. 

This week there has been enormously wide coverage in the press for one of the worst papers on acupuncture that I’ve come across. As so often, the paper showed the opposite of what its title and press release, claimed. For another stunning example of this sleight [...]

Read the rest at: If your baby is crying. what do you do? Stick pins in it

DC's Improbable Science: Truth, falsehood and evidence: investigations of dubious and dishonest science

Advertising naturopathy

The Committees of Advertising Practice (CAP) write and maintain the UK Advertising Codes, which are administered by the Advertising Standards Authority. On their website, the CAP recently published an updated advertising code for naturopathy. As we have regularly discussed the fact that the public is being frequently misled in this area, I consider the code important in the context of this blog. I therefore take the liberty of repeating it here – not least in the hope that this helps preventing misinformation in the future [the numbers in square brackets refer to me footnotes below]...

Read the rest here: Advertising naturopathy

Dear Gwyneth Paltrow, I’m a GYN and your vaginal jade eggs are a bad idea | Dr. Jen Gunter

Dear Ms. Paltrow,

I’ve been reading all about the jade eggs you are selling on GOOP for $55-66 a pop and the corresponding interview with a jade egg enthusiast. I have tried not to respond to this hot mess, after all a man who leers at naked 15 year-olds and brags about sexual assault is about to assume the highest office in the land. Quite frankly women have more compelling health interests right now, however, I have been asked by so many people about your vaginal rocks that I felt it necessary to drop you a line.

I read the post on GOOP and all I can tell you is: it is the biggest load of garbage I have read on your site since vaginal steaming...

Read the rest: Dear Gwyneth Paltrow, I’m a GYN and your vaginal jade eggs are a bad idea | Dr. Jen Gunter

Two hallmarks of alternative medicine

Whenever a level-headed person discloses that a specific alternative therapy is not based on good evidence, you can bet your last shirt that a proponent of the said treatment responds by claiming that conventional medicine is not much better.

There are several variations to this theme. Today I want to focus on just one of them, namely the counter-claim that, only a short while ago, conventional medicine was not much better than the said alternative therapy (the implication is that it must be unfair to demand evidence from alternative medicine, while accepting a similar state of affairs in conventional medicine). The argument has recently been formulated by one commentator on this blog as follows...

Read on: Two hallmarks of alternative medicine

Acupuncture study on colicky kids shows the opposite of what the authors conclude

This new RCT was embargoed until today; so, I had to wait until I was able to publish my comments. Here are the essentials of the study:

The Swedish investigators compared the effect of two types of acupuncture versus no acupuncture in infants with colic in public child health centres (CHCs). The study was designed as a multicentre, randomised controlled, single-blind, three-armed trial (ACU-COL) comparing two styles of acupuncture with no acupuncture, as an adjunct to standard care. Among 426 infants whose parents sought help for colic and registered their child’s fussing/crying in a diary, 157 fulfilled the criteria for colic and 147 started the intervention...

Read on: Acupuncture study on colicky kids shows the opposite of what the authors conclude

Crystal healing “empowers us to lead a more meaningful life”

Originally, I had meant this blog to discuss all types of alternative therapies – well, perhaps not all (there are simply too many of them), but at least the most popular ones. And so far, I have omitted one that seems certainly quite wide-spread: CRYSTAL HEALING.

What the Dickens is crystal healing, you ask? It is the attempt to bring about healing with the power of crystals, of course. And how is it supposed to work? This is where things get quite nebulous; this website, for instance tells us that...

Read on: Crystal healing “empowers us to lead a more meaningful life”

Chiros fighting chiros

The ‘CHRONICLE OF CHIROPRACTIC’ recently reported on the relentless battle within the chiropractic profession about the issue of ‘subluxation’. Here is (slightly abbreviated) what this publication had to say:

START OF QUOTE

Calling subluxation based chiropractors “unacceptable creatures” chiropractic researcher Keith H Charlton DC, MPhil, MPainMed, PhD, FICC, recently stated “. . . that it is no longer scientifically acceptable for any responsible chiropractic clinician to ever use the word subluxation except as theory . . .” Charlton made the comment to members of the Chiropractic Research Alliance a group of subluxation deniers who routinely disparage the concept of subluxation...

Read on: Chiros fighting chiros

Homeopathy for infectious diseases: it is time for homeopaths to stop lying

Homeopaths have, since about 200 years, insisted that their remedies are efficacious treatments for infectious diseases. As evidence for this notion, they often produce epidemiological data showing that a group of infected patients treated homeopathically had better results than another group treated conventionally. While potentially interesting, such findings never constitute proof, because the two groups might not have been comparable and many other factors could have determined the observed outcome. In fact, these stories are prime examples for the need of rigorously controlled trials when testing the efficacy of medical treatments...

Read on: Homeopathy for infectious diseases: it is time for homeopaths to stop lying

Post-truths? No, they are simply lies!

Trump says he never mocked a disabled journalist.

YET THE WHOLE WORLD SAW HIM DO IT!

UK Brexit politicians such as Boris Johnson claim they never promised £ 350 million per week of EU funds for the NHS.

BUT WE ALL SAW THE PICTURES OF THE CAMPAIGN BUS!

These are just two of the numerous, obvious and highly significant lies that we have been told in recent months. In fact, we have heard so many lies recently that some of us seem to be getting used to them. We even have a new term for the phenomenon: the ‘post-truth society’.

Personally I don’t like the word at all: it seems to reflect a tacit acceptance of lies and their legitimisation.

I find it dangerous to put up with falsehoods in that way. And I think the truth is far too valuable to abandon it without a fight. I will therefore continue to call a lie a lie!

And, by Jove, in alternative medicine, we have no shortage of them...

Read on: Post-truths? No, they are simply lies!

Educating chiros

At a recent conference in Montréal (October 2016), the WFC (World Federation of Chiropractic) and the ACC (Association of Chiropractic Colleges) reached a consensus on education. Consequently, recommendations were produced that offer 12 key ‘take away messages’. I take the liberty of reproducing these statements entitled ‘Training Tomorrow’s Spine Care Experts’ (the square brackets were inserted by me and refer to brief comments I made below)...

Read on: Educating chiros

Did you miss me?

It would be a world-class understatement to tell you that I’ve been busy lately. I’ve traveled from one side of the planet to the other and back. I’ve been chasing viruses and bacteria wherever that three-lettered health organization has needed me, and I’m exhausted. So I’m back home to recoup before heading out into the […]

Read more at: Did you miss me? by Reuben

Does auricular acupuncture reduce anxiety? A new study says YES, but I say NO

If you want to scientifically investigate this question, it might be a good idea NOT to start with the following sentence: “Auricular acupuncture (AA) is effective in the treatment of preoperative anxiety”. Yet, this is exactly what the authors did in their recent publication.

The aim of this new study was to investigate whether AA can reduce exam anxiety as compared to placebo and no intervention. Forty-four medical students were randomized to receive AA, placebo, or no intervention in a crossover manner. Subsequently they completed three comparable oral anatomy exams with an interval of one month between the exams/interventions...

Read on: Does auricular acupuncture reduce anxiety? A new study says YES, but I say NO

The most important myth about acupuncture

The ACUPUNCTURE NOW FOUNDATION (ANF) has featured on this blog before. Today I want to re-introduce them because I just came across one of their articles which I found remarkable. In it, they define what many of us have often wondered about: the most important myth about acupuncture.

Is it acupuncture’s current popularity, its long history, its mode of action, its efficacy, its safety?

No, here is the answer directly from the ANF:

The most important myth that needs to be put to rest is the idea promoted by a small group of vocal critics that acupuncture is nothing more than a placebo...

Read on: The most important myth about acupuncture

Prayer as a medical therapy? Time to stop this nonsense!

Can intercessory prayer improve the symptoms of sick people?

Why should it? It’s utterly implausible!

Because the clinical evidence says so?

No, the current Cochrane review concluded that...

Prayer as a medical therapy? Time to stop this nonsense!

Is acupuncture pseudoscience?

Is acupuncture a pseudoscience? An interesting question! It was used as the title of a recent article. Knowing who authored it, the question unfortunately promised to be rhetorical. Dr Mike Cummings is (or was?) the ‘Medical Director at British Medical Acupuncture Society’ – hardly a source of critical or sceptical thinking about acupuncture, I’d say. The vast majority of his recent publications are in ‘ACUPUNCTURE IN MEDICINE’ and his blog post too is for that journal. Nevertheless, his thoughts might be worth considering, and therefore I present the essence of his post below [the footnotes refer to my comments following Cummings’ article]...

Read on: Is acupuncture pseudoscience?