The 10:23 campaign

January 5, 2010

You may have noticed a lot of bloggers putting 10:23 at the end of their posts about homeopathy. It’s something called the 10:23 campaign, and so far it’s very secretive. Don’t ask me any details, I know nothing more than any of you can find out on the website (although I can tell those of you who don’t know that 10:23 refers to Avogadro’s Number).  If you clicked on that you’ll notice that the website’s changed in the last few days, I only just noticed myself. Now it has an nuclear bomb style counter on it counting down until (I presume) the campaign launches properly.

So what can you do? You can sign up to help the campaign in you do want to be involved, or you can sign the letter to Boots which the Merseyside Skeptics came up with, or if you don’t know that much about homeopathy, you can get some information.


Daily Fail tackles winter ails

December 27, 2009

My parents used to read the Daily Express. That was bad enough, you used to be able to guarantee there’d be a picture of Princess Diana, another royal, or Madeleine McCann on the front together with a fear-mongering headline about some made-up health emergency or miracle cure, or some bullshit story about nig-nogs. Ok, that sounds very much like the Mail, and they’re almost indistinguishable, except the Mail sells a lot more for some reason. Anyway, whilst I’ve been away my parents have switched to the Mail, and I’ve been having a quick flick through the pages. I suppose I needed to throw up, especially after the Mail is yet again cashing in on the recently-deceased. Here’s one taken from the health section of the Mail website.

Yes, the Mail is revealing to the world 5 of the best cures for your winter cough. So how have they figured out what the best cure is? Well, let’s see… let’s see… oh right! Here we are, at the top it says:

A study from the American College of Chest Physicians says there is no evidence that over-the-counter cough syrups work. But herbal alternatives have been used for generations. Here are five options to soothe nasty coughs.

Nothing else, no studies, not even a testimonial from a patient, nothing. Just ‘these have been used for generations’ and therefore they’re “5 of the best”. I wonder how they define “the best”. Are all cough remedies counted underneath the banner of “the best”? Because that’s the only way I can think of that means they can justify counting these as “5 of the best”. It’s rather telling that they lead with a little jibe at the usual cough remedies which may or may not work anyway, it’s the only possible justification they could come up with for a story which is less like journalism and more like false advertising. I did a search for “American College of Chest Physicians over the counter cough” and found various articles about the same study, published in January 2006. That’s just under 4 years ago. And this is from a news service. Last night.

And it’s without a touch of irony that they start the article with ‘there’s no evidence that these usual treatments work, but here’s a list of alternative remedies with no evidence behind them’. That’s impressively stupid. That’s pretty much the whole article, all the rest of it is a little description of the products which could have been taken right off the website selling them, with no critical thought put into it whatsoever. So seeing as the Mail haven’t done any work into this, I’m not going to do any more on it either.


Secret Shopping in Spain

December 22, 2009

So a few weeks ago, the Merseyside Skeptics Society set a piece of homework for their listeners which involved going to a pharmacy to ask about homeopathic remedies for a friend’s cough, to see whether they’ll sell you them or not. Homeopathy is widely advertised at pharmacies in Spain, so I decided to go and see how a pharmacist would react to such a request.

Homeopathy advertised in one of many pharmacies in Malaga

So I went in with a spiel that I sort of learnt. It didn’t matter if it sounded like it was learnt because they’d know I wasn’t a native speaker, but I basically said that my friend has a very bad dry cough and that his normal medicine isn’t working. He doesn’t speak Spanish so he asked me to go to the pharmacy for him. We don’t know anything about homeopathy but we were thinking that maybe it might help.

Now I didn’t want to actually buy any remedies, because I was planning on going to several different pharmacies (and besides, if I wanted sugar pills I’d go to the sweet shop), so at the last minute I’d say I’d return with my friend so that he can describe his symptoms more accurately than I can.

So I went to 5 different pharmacies in the city centre of Malaga. 2 of them had advertisements for homeopathic medicine on the outside of the pharmacy, and the other 3 did not. The first one had it advertised, so I went in, gave my spiel, and she picked a bottle of pills off the shelf behind her and scanned them before I could say anything. So I said “don’t you want to know anything more about the symptoms?” and she said something about a cough being a cough basically. Now I don’t know if the hour-long consultation normally associated with homeopathy really does make it work more, but the lightning-fast ‘consultation’ that I got in the pharmacy (I’m tempted to say it was a homeopathic quantity of consultation but I think it’s been overdone a bit, that one) definitely had the opposite effect and I was quite taken aback, so I said I’d be back the next day and left. Big cross for her, she was gagging to sell it.

The next one didn’t have it advertised so I went in and asked and the guy pointed me over to a shelf at the back with a book next to it, with no comment whatsoever. Presumably I was supposed to self-diagnose and then look up my own symptoms to find the appropriate remedy. I had a look through the book but it was really big and I’m lazy (plus making head or tail of most pseudoscience is difficult enough in English), so I put a big cross next to Pharmacy No. 2 (mainly for poor customer service, humph) in my book and made my way to the third one.

The third one didn’t have advertising either, and when I went in and gave my spiel, the man behind the counter said that they didn’t have any homeopathic remedies. So I decided to add another question for this eventuality, and asked why they didn’t have it. He said he wasn’t a qualified homeopath. I suppose that’s fair enough, that’s the responsible thing to do if you don’t know anything about it. I can only assume the last pharmacist didn’t know anything about it but still sold it, since he literally didn’t give me a single word of advice. Quite impressively, this pharmacist said I should take my friend to the doctor because it could be a symptom of an underlying condition. He got a big tick, just as soon as I’d wiggled my way out of buying the bottle of real medicine he then tried to sell me.

The fourth pharmacy did advertise homeopathic products. After I’d said my piece, the pharmacist walked me over to the shelf where they had lots of bottles of white pills and asked me a few more questions about the symptoms of my friend’s cough. Now I didn’t have too big of a problem with that. Yes, they were selling sugar pills for money, but at least they wanted to know about the symptoms, presumably to check they weren’t too serious. So, a mini cross for them.

The last one was my favourite. It had no advertising, so I went in, gave my spiel, and the pharmacist said they didn’t have any. Following previously established procedure, I asked why, and he said “well, it doesn’t work”. I shook his hand, told him what I was up to and gave him a big tick. So quite a varied response really.

10:23


Developments in Homeopathy

December 15, 2009

No, not as in actually good evidence that it works, we’re still waiting for that and I daresay we will be until someone throws an alabaster model of a water molecule at the statue of Hahnemann in Berlin and makes him bleed. No, instead there’s been interesting things happening in the evidence-based medicine movement with regards to homeopathy in the last few weeks and I thought I should write something on it for those readers who are perhaps more involved in atheism and humanism than skepticism.

So I was prompted to write this by a video I just caught wind of over Facebook. It’s a very basic introduction to homeopathy by Ben Goldacre (but more importantly his incredible eyebrow waggling) for the Bristol Science Festival in October (I think). I’ve found a few of these basic introductions, and I urge you all to go and watch Here Be Dragons if you haven’t already, and spread it around to people who perhaps aren’t all that involved in skepticism. Anyway here’s the video:

Now it’s a good introduction, but he makes a point right at the very end that I’m not all that keen on. He says, “is it alright to deceive patients in order to help them get better? And that’s something that only you can decide on.” I wholeheartedly disagree with that last part. The whole medical establishment has been moving towards greater openness between doctor and patient for many years now, and it would be a travesty to go back on that in order to preserve patient choice. After all, what’s the point in choice if it’s not an informed one? It sounds all democratic but this isn’t like a preference in a political candidate. There is a very good way to determine which treatment is the best, and that’s the very simple question: does it work? The evidence doesn’t show homeopathy to be any better than placebo, so we shouldn’t be helping people get better through it purely by ignorance. We would have a problem if a doctor allowed a patient to choose meatballs as a cure for cancer purely because they didn’t know any better, and the same should be true with other treatments.

Now I’m sure Ben Goldacre doesn’t really disagree with me here (although maybe not, more on that later), and that he was probably trying to keep it short and didn’t want to go into the more boring arguments, hoping that anyone who thought about it would come to the conclusion that dishonesty in healthcare is a bad thing. But if anyone is thinking about this in a bit more depth, I have a post on this blog about why we shouldn’t allow homeopathy to claim efficacy, even if we know it’s a placebo (and I’d also like to add the point that it’s a bit arrogant to say “we know it’s a placebo, but we’ll let these ignorant people take it anyway because it’ll do them good to keep them in the dark.”). You may remember that I originally didn’t have a problem with homeopathy but changed my mind completely in the space of a few days after reading around the subject. You can read all about that by following this link and starting at the bottom.

The main thing that’s been happening in the last few weeks is the Evidence Check on Homeopathy that is being carried out in the Parliamentary Committee for Science and Technology. There were two sessions, the first one is on YouTube starting here (I’m linking to YouTube because I understand they take videos off the Commons website after a while), and the second one can be found here. I can’t find it on YouTube so that’s on the Commons site, it works best in Internet Explorer because Firefox plugins are a faff.

Ben Goldacre was a witness at the first evidence check as well as Edzard Ernst of Trick or Treatment, Tracey Brown from Sense About Science, Jayne Lawrence, James Thallon, and on the side of the homeopaths Robert Wilson, Peter Fisher, Robert Mathie, as well as Paul Bennett from Boots.

Now skeptics have been all over this like a rash. A glorious, skeptical rash. Paul Bennett’s admission that Boots doesn’t really know whether or not homeopathy works, but they’ll sell it anyway as long as they can make money, was picked up in the mainstream media too, and prompted this open letter from the Merseyside Skeptics Society, which I reproduced a couple of weeks ago. There were some absolutely startling claims made during the proceedings, such as (paraphrasing) ‘a trial with less than 500 participants cannot be statistically significant’, followed by citing a study which only had 25 participants. The other studies cited by Robert Wilson have been most elegantly ripped limb from limb, also by the MSS, so go and read that if you like, it’s well worth reading.

On the whole I thought the committee did fairly well. As usual, Britain’s best MP, Dr Evan Harris, was an absolute star and if you live in the Oxford area, make sure you vote for him, but there was another member who asked ‘is there any evidence that homeopathy does not work?’, evidently not realising what a daft and irrelevant question that was, and IIRC none other than the chair of the committee kept asking repeatedly ‘Can you show one specific example of a peer-reviewed trial which proves the effectiveness of homeopathy?’, even though throughout the hearings there had repeatedly been testimonies saying that even if there was one that showed the effectiveness, it wouldn’t prove it because every now and again you will get an anomalous result. Picking one that showed it worked would be cherrypicking.

In the second hearing there were representatives from the Department of Health and the MHRA. It all fell down on Mike O’Brien, one of the ministers for health, who basically said there were two justifications for homeopathy, the fact that it had the placebo effect (like… any treatment you could possible conceive of), and the fact that there is a significant lobby of people who believe that homeopathy works. He also said that he didn’t need evidence to justify the NHS spending and institutional support for homeopathy, he needed justification to change the policy from its current situation. I really don’t understand that, surely you need to justify spending, not justify stopping it. I was really waiting for someone to ask him what would be sufficient justification for changing the policy. Would he need the whole homeopathy lobby to disappear? Would he like another few meta-analyses showing it doesn’t work? The second part was best ripped apart by Martin over at the Lay Scientist, who I’m sure will have more to say about the head of the MHRA as soon as he recovers from his broken hand.

So I mentioned that I wasn’t sure about where Ben Goldacre stands on some things about homeopathy. The MSS had as their question of the week a few weeks ago:

Should alternative medicine be viewed as a tax on scientific illiteracy?  Do those who know have a responsibility to educate those who don’t?  Should educators make special efforts for people who wear scientific illiteracy as a badge of honour?  Or should medical interventions, legitimate and pseudoscientific, be subject to state regulation and required to back up claims of efficacy with robust scientific data?

It was in response to something written in Bad Science by Goldacre, which I still haven’t read. Now I am certainly not of the opinion, as Goldacre seems to be, that we should let people spend their money on rubbish just because they haven’t read up on what exactly homeopathy is and the latest meta-analyses on whether it works or not. Sorry but it would be like letting people go on a dodgy aeroplane because they weren’t smart enough to get an engineering degree and know that it wasn’t up to scratch. But it’s not that simple, of course, just like any other moral question, so I went with a thought experiment. If I went to a shop and bought bleach and decided to drink it, then that’s my own fault, I suppose that’s a tax on the fatally stupid. But the bottle of bleach would have ‘harmful’ and ‘toxic’ written on the side of the bottle in big letters, and probably tell you not to drink it. The same should be true of homeopathic remedies. Whilst I wouldn’t ban their sale, they shouldn’t be able to claim effectiveness for something that they can’t prove, just like any other product. It’s false advertising if nothing else. As Evan Harris said in the evidence hearing to illustrate a slightly different point, you couldn’t say that paracetamol is effective for heart conditions.

Anyway so this has turned into another mammoth post (sorry), and mainly about things that have been covered elsewhere (sorry again), but well worth putting together for anyone who hasn’t heard about these things. Till next time.

10:23


An Open Letter to Boots

November 27, 2009

You may have heard recently that the Parliamentary Subcommittee on Science and Technology heard a panel of oral evidence about homeopathy. It’s a very good watch and I recommend it, even if just to see how subcommittees work (they ask some very good questions). You can watch it here on the House of Commons website, although it’s a bit fiddly with plugins and things, I had to try several times before it worked, and do bear in mind that the player takes a few seconds to load.

Anyway as a result of this, I understand that the Subcommittee will be recommending to the government that they stop funding homeopathy and that they do not make an exception for homeopathic products in terms of licencing.

One of the members of the panel was Paul Bennett from Boots, who stated basically that as long as people want the homeopathic remedies, Boots has no problem selling it. The Merseyside Skeptics Society has written an open letter to Boots which has already been picked up by Skepchicks and Richard Dawkins. I’m posting it here because I agree with it.

There is also more information about this case on the new blog A Glasgow Skeptic, which I’ll also be adding to my blogroll.

An Open Letter to Alliance Boots

//

The Boots brand is synonymous with health care in the United Kingdom. Your website speaks proudly about your role as a health care provider and your commitment to deliver exceptional patient care. For many people, you are their first resource for medical advice; and their chosen dispensary for prescription and non-prescription medicines. The British public trusts Boots.

However, in evidence given recently to the Commons Science and Technology Committee, you admitted that you do not believe homeopathy to be efficacious. Despite this, homeopathic products are offered for sale in Boots pharmacies – many of them bearing the trusted Boots brand.

Not only is this two-hundred-year-old pseudo-therapy implausible, it is scientifically absurd. The purported mechanisms of action fly in the face of our understanding of chemistry, physics, pharmacology and physiology. As you are aware, the best and most rigorous scientific research concludes that homeopathy offers no therapeutic effect beyond placebo, but you continue to sell these products regardless because “customers believe they work”. Is this the standard you set for yourselves?

The majority of people do not have the time or inclination to check whether the scientific literature supports the claims of efficacy made by products such as homeopathy. We trust brands such as Boots to check the facts for us, to provide sound medical advice that is in our interest and supply only those products with a demonstrable medical benefit.

We don’t expect to find products on the shelf at our local pharmacy which do not work.

Not only are these products ineffective, they can also be dangerous. Patients may delay seeking proper medical assistance because they believe homeopathy can treat their condition. Until recently, the Boots website even went so far as to tell patients that “after taking a homeopathic medicine your symptoms may become slightly worse,” and that this is “a sign that the body’s natural energies have started to counteract the illness”. Advice such as this directly encourages patients to wait before seeking real medical attention, even when their condition deteriorates.

We call upon Boots to withdraw all homeopathic products from your shelves. You should not be involved in the sale of ineffective products, because your customers trust you to do what is right for their health. Surely you agree that your commitment to excellent patient care is better served by supplying only those products whose claims can be substantiated by rigorous scientific research? Or do you really believe that Boots should be in the business of selling placebos to the sick and the injured?

The support lent by Boots to this quack therapy contributes directly to its acceptance as a valid medical treatment by the British public, acceptance it does not warrant and support it does not deserve. Please do the right thing, and remove this bogus therapy from your shelves.

Yours sincerely,
Merseyside Skeptics Society


Royal Fail

April 26, 2009

The perfect blogpost opportunity! It’s antimonarchy, antialtmed and involves climate change too. I did post this yesterday but somehow half of it got deleted and I couldn’t be bothered typing it again at the time.

So hopefully most of you will be familiar with Prince Charles and his often unorthodox behaviour. He talks to plants (not an entirely stupid thing to do but it doesn’t have to be a conversation, they respond to any noise, like a radio), he’s very much into his alternative medicine, and indeed he has his own complementary medicine charity. He also has a company called Duchy Originals which sells herbal tinctures. Recently there was coverage of a funny typo which is still there. And then of course he has pledged to declare himself the Defender of Faith should be become monarch, to reflect the multicultural British society. Brilliant.

Anywho now Charlie is turning his hand to climate change. He’s going to write a book and make a film, Al Gore style, under the title Harmony, which will attack big businesses and their effect on the environment. Here’s what he had to say:

“I believe that true ‘sustainability’ depends fundamentally upon us shifting our perception and widening our focus, so that we understand, again, that we have a sacred duty of stewardship of the natural order of things,” said the prince in a statement yesterday. “In some of our actions we now behave as if we were ‘masters of nature’ and, in others, as mere bystanders. If we could rediscover that sense of harmony; that sense of being a part of, rather than apart from nature, we would perhaps be less likely to see the world as some sort of gigantic production system, capable of ever-increasing outputs for our benefit – at no cost.”

Fair play to the guy, I say. I’m sure rationalists and holistics can can be bedfellows on this issue at least for now, although phrases like “sacred duty of stewardship” and “natural order of things” should be ringing alarm bells for some people. To me it seems that holistics care less about actually solving the problem of climate change and more about getting back to nature, which is often at odds with modern science. But as I say, he’s on the right side here.

That was a while ago now. 2 days ago, I came across this blog post from Republic, a campaign group for an elected Head of State (HT Lay Scientist). They point out that The Prince’s Foundation for Integrated Health, the complementary medicine charity mentioned above, has investments as follows (pg 21 of that pdf):

  • £112,000 in Artemis UK Special Situations, which includes investments in BP, Shell, GlaxoSmithKline and BAE systems
  • £92,000 in Investec Global Energy, 26% of which is invested in ‘Oil and Gas Exploration’
  • £65,000 in Jupiter Emerging European Opportunities Fund, whose top ten holdings include LUKOIL (Russia’s largest oil company) and Gazprom (the world’s largest gas company)

Take a look at that first point. The man who bangs on about climate change, whose new book and film are going to attack big businesses that affect the environment, his charity has large investments in oil and gas companies and funds oil and gas exploration! The babe of the altmed community has investments in GlaxoSmithKline! Astounding. Even if Charles doesn’t have anything to do with this, why does a complementary health charity have investments with GSK? It doesn’t make sense.

Anyway I don’t have Photoshop so I made my own ridiculously crap fail picture on MSPaint. Enjoy.charles22

And whilst we’re on the topic of alternative health, here’s a story from the Irish Independent where a man died from anaphylactic shock an hour after being treated for his peanut allergy by his chiropractor. Yeah, these kinds of people are going to be able to prescribe drugs in British Columbia, but I’m sure it’ll be ok, don’t you worry.


Pseudoscience merits media pseudocoverage

April 17, 2009

Just a short one today because I need to do some more revision. Two stories found their way onto my screen which are quite lame and need highlighting.

First of all very briefly, British Columbia, a province of that usual bastion of common sense, Canada, which according to Wiki has a high proportion of atheists, agnostics and humanists, has given naturopaths the right to prescribe drugs. Now I don’t want to just lump the word ‘naturopath’ in with homeopaths and other snake oil vendors, so I should be clear about what naturopathy involves. In its strictest sense naturopathy is using natural medicine in preference to drugs and surgery. I don’t have a big problem with that in itself, some herbs and things can be shown to be effective. The only problem I have with this strict sense of the word is that it involves that old chestnut ‘helping the body’s natural healing powers’. In maths this is called regression to the mean, once the illness is over you’re going to get better as your immune system repairs itself. Your own body has done the work, it has nothing to do with the remedy, you may as well have administered a placebo.

However, in practice naturopathy involves getting qualifications like homeopaths here get, and advocating things like acupuncture, nutrition (which may differ from conventional nutrition, as shown by Patrick Holford), reflexology, applied kinesiology and homeopathy. Anyway they’re going to have to take some kind of test and then they’ll be able to do prescriptions, brilliant. You’ll notice that nowhere in that report is there any kind of scientific objection.

The second story is from the BBC, covering a new report by the Cochrane Collaboration which says that homeopathic remedies don’t cause side effects in cancer patients. Yes, I can hear you, “No shit Sherlock”. Now what’s interesting is the coverage from the Beeb. They can’t be held at fault for what the report says, it is a distinctly dodgy report which claims undiluted remedies as homeopathic, and according to Quackometer’s post on the same topic, the paper on the cream doesn’t even have the word homeopathy in it! But it’s very typical BBC science and medicine reporting. Here’s how it goes…

1. Outrageously misrepresentative headline and first paragraph.

2. Explanation of possible implications, who said what etc

3. Comments from people who might be affected by it, particularly people welcoming the news

4. The science, or what I like to call ‘Oh by the way, all of the above is bullshit’.

Good one, BBC.


Follow

Get every new post delivered to your Inbox.