You're Ill! POW! You're Cured!

The 30 Second Skinny DITI is being increasingly offered as a method of early detection of breast cancer, despite little evidence that it is even as effective as traditional mammography. It is also marketed at women in low-risk groups, meaning a greater chance that clients will test positive for abnormalities when none are there. Research suggests it may only be useful in conjunction with mammography.

The Problem Just Goes Underground

A friend the other day accused me of seeking out things that annoy me. This was following me posting a link to the Twitter feed that is promoting the execrable piece of HIV denialism House of Numbers. No, not the idiots at Raindance; someone else. As I explained to said friend, I tend not to hunt these people out. The joy of Twitter is that these people find me, c/o dumb computers and Twitter bots.

It is equally true that, as a result of having to ride the underground, I routinely encounter ads that are just plain wrong. Mainly these are for Vitabiotics (with their tiny tiny "this product probably isn't for you" writing) but tonight's journey offered up the Zhai clinic. They use a holistic, traditional Chinese approach to fertility treatment, boast a 70% success rate, and speak of Dr Xiao-Ping Zhai, who does not appear to be on the GMC register.

Thank heavens for camera phones and the ASA website, what?

The ad stated the clinic, which employs traditional Chinese medicine, enjoyed a 70% success rate. It also made a reference to a Dr Xiao-Ping Zhai.

I would be curious to know whether they can substantiate the 70% claim, and whether or not Mr Zhai is medically qualified.

It transpires that Zhai Clinic is listed under the HFEA, the authority in charge of fertility clinics. They are a "satellite clinic" for the London Fertility Clinic, which means "[the] assessment of patients, drug therapy and monitoring may take place [there] but the egg collection, mixing of sperm and eggs, embryo culturing and embryo replacement are all carried out at the primary clinic". The Zhai ad talks about traditional Chinese medicine - it is "Where Conception Comes Naturally". The implication is that the 70% success rate claimed (the website makes a claim of "about 80%") is attached to this incorporation of TCM; both the ad and the website downplay the role of the rather unnatural IVF program. Either 70% of couples conceive naturally, without IVF, or they conceive unnaturally with, to quote Zhai's site "artificial, invasive fertility treatments", or the 70% figure, which is high even for IVF, has been plucked out of the sky.

The Beacon Writes NICE

Dear sirs/mesdames,

Peter Littlejohns was recently paraphrased by the BBC in an article about the recent and controversial decision to support complementary and alternative medicines such as acupuncture and chiropractic, despite there being no evidence that they work better than treatments mentioned in previous advice. Littlejohns stated that:

the costs to the NHS would be minimal - in the order of £77,000 - because they are offset by the savings in terms of reducing future disability and healthcare needs and moving away from treatments with little supportive evidence.

This seems to suggest that these treatments have some kind of long-term benefit that rest, exercise and painkillers do not. I was wondering what supportive evidence NICE has that these expensive CAM measures are a long-term solution to back pain? Littlejohns quotes a specific figure, so I am assuming that the evidence exists and is robust; I'd be very keen to see it.

--
Kind regards,

Beacon Schuler.

Switzerland Embraces Pretend Medicine

There has been som quite jaw-dropping news from Switzerland where they have incorporated woo such as homeopathy (which doesn't work), acupuncture (which doesn't work), and herbalism (that mostly doesn't work) into their national health insurance scheme. Before, people's premiums were going towards funding evidence based medicine, but now rational human beings must stump up for a range of ineffective treatments. If someone ever says to you "alright, so these treatments are a load of hogwash, but what real harm are they doing?" you need only point to Switzerland to see the threat of real damage that these people pose. It's not even that the wrong pockets are being lined, but EBM is being massively undermined.

“It shows that we are beginning to come out of the two camps – one for orthodox medicine and the other for alternative medicine. In the future, hopefully, it will mean that medical students will study complementary therapies as part of their medical training and be able to integrate some of them into their practice,” says [Alexander] Harbaugh.

This is CAM fantasy, to force medical doctors to learn homeopathy, chiropractic and other nonsense despite it being at odds with our understanding of how our bodies work. David Colquhoun has attacked at length and with good cause at the fake respectability that CAM has been creating for itself, the creation of Bachelors of Science [sic] degrees in homeopathy, NICE's recent approval of chiropractic, Switzerland may prove to be a clear example of what may happen if such moves go unchecked.

The only fly in CAM's snake oil is hinted at in the following quote

The current criteria requires that the therapy benefits the patient, that it is cost-effective and appropriate for the patient’s condition.

This hopefully will mean that alternative medicine will have to prove that it is benefitial to the patient. I think most of us could live with evidence-based alternative medicine being included in state-run health schemes.

Co$ and the Chemical Brain

The Church of Scientology, as any fule kno, thinks that all psychiatric drugs are bad. Quite where they draw the line on things like "what is a drug?" and "what is a psychiatric drug" is anyone's guess, but in the broad brushstrokes of their anti-psych rhetoric, they're all bad. As Juliette Lewis said recently, schizophrenics would be much better off forgoing their meds and getting themselves down to a petting zoo.

What amuses me is the reasons given. Invariably two simultaneous but contradictory positions are maintained. Firstly, they claim that psych drugs are based on "brain chemistry" and that this theory is flawed, that there is no evidence for it [sic]. Secondly, and here's the fun part, they claim that psych drugs have a detrimental effect on people. Drugs that operate on a person's brain chemistry can lead them to kill themselves, or shoot up their highschool. So in the first instance, brain chemistry does not exist, but in the second instance it does. Whenever you find yourself in a discussion about this with a Scientologist (flunk! You've let them derail the conversation!) ask them the all important question of how psych drugs effect behaviour.

Now I'm no fan of Big Pharma myself. It is true that mistakes happen, with varying degrees of culpability and intent - trials resulting in negative findings fail to get published, adverse reactions aren't picked up on, and so on. But Big Pharma is slowly getting better. Big Pharma creates self-regulatory bodies with real power to monitor the way that drugs are developed and marketed. There is an increasing momentum behind the ideas that are looking to address flaws in the clinical trial process (such as the trials that are registered but never published). Put simply, it is an evidence-based field, so anything that generates evidence will come out sooner or later, and there is a wealth of patients and practitioners out there who want the straight dope, pun intended, on their lotions and potions.

Big Pharma may not get it right all the time, but they stand a far better chance than the vitamin and dietary quacks who cling to their unmonitored products and wave massively flawed studies and even more flawed reasoning at media whorish enough to lend anyone with the remotest air of scientific authority fifteen minutes in which to flog their snake oil. One weak and yet to be repeated study into the effects of Omega 3 fish oils on kids suffering from ADHD becomes the foundation of sand on which is built an industry safe in the delusion that fish oil turns kids into placid brainiacs. One weak and yet to be repeated study into Narconon suggests that the rehab treatment aint that great, and so is buried away, far from the prying eyes of a public that have a genuine need to know.

But I digress. The cognitive dissonance at the heart of the Church's anti-psych stance stands as a crystalisation at the level of cognitive dissonance that exists throughout the organisation as a whole - the Orwellian double think that allows people to believe they are free, yet unquestioningly follow orders, write cheques, and fill out credit applications. And on the subject of the chemical brain, who says there's no evidence for it? It remains the strongest model we have of the way mood functions, and certainly a stronger model than the suggestion that we are controlled by memories lodged in each and every cell of our body. There is an excellent and balanced blog post on the subject here.

Evolution of CAM

The 30 Second Skinny Alternative Medicine often makes a great deal out of its longevity, but how does alternative medicine get started in the first place? How does it keep going in the absence of evidence? This article puts forward a number of stages that contemporary treatments go through.