Anti-vax chiropractor is okay ’cause it’s just his opinion
A quick update on Nimrod Weiner from Newtown Community Chiropractic.
I get emails. And recently I was reminded of one I got back in June which somehow slipped from my consciousness. With all the negative attention Nimrod has been receiving of late the response from some authorities has been, “we can’t respond unless someone reports him.” Indeed, last month, chair of the Chiropractic Board of Australia urged people to make a formal complaint against Mr Weiner after Australian Doctor posted audio of his two-hour public lecture on the dangers of vaccination.
So I went back through my emails and found a complaint from Dr John Cunningham, forwarded to me and submitted to AHPRA (then passed onto the Chiropractic Council of NSW) on April 4th, 2011. Dr Cunningham received the following response on May 31st, 2011 (my emphasis).
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Really? So it’s okay for a registered health professional to disseminate false, misleading and dangerous information under the guises of “it’s my opinion”? But what if the evidence says the opposite, which in this case it most certainly does.
If you take a look at the references Weiner uses in the 4 pages of anti-vax rhetoric posted on his website (which was the subject of Cunningham’s complaint), and his 2-hr long lecture on “18 reasons to not vaccinate” (pdf of references here) you’ll find a grab-bag of some of the most prominent anti-vaxers. He cites all my favourite loons including the AVN and their previous publication “Informed Choice”, Not-a-doctor Andrew Wakefield, Viera “parsnip box” Scheibner, Joseph Mercola, Whale.to and Vaccine Information Service Australia or VISA (amongst others).
There’s a glass and a half of crazy right there.
Weiner also drags out the some of the old favourite canards of the antivaxers. See the following paragraph as an example of vaccines cause everything;
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“Other conditions linked to vaccination include pervasive developmental disorder (PDD), Asperger’s syndrome, eczema, encephalitis, Guillain-Barre syndrome, convulsions, seizures, anaphylaxis, thrombocytopenia, optic neuritis, ocular palsies, retinitis, deafness, otitis media, ulcerative colitis, bowel disease, Crohn’s disease, headaches, dizziness, hearing and vision problems, arthritis, arthralgia, learning disorders, chronic fatigue, diabetes, multiple sclerosis and more.”
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He doesn’t provide a reference for these claims.
And as usual, Weiner beats the dead horse of vaccines = autism
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“After years of denying a link between vaccination and autism, on November 9, 2007 the US government in Court of Federal Claims admitted that vaccines can cause autism.”
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The reference Weiner cites for this claim is David Kirby writing for the Huffington Post in 2008. Kirby is also the author of “Evidence of Harm” a book detailing the personal stories of parents of children who have autism who went onto establish the advocacy group SafeMinds. So there may be a conflict of interest in what Kirby has to say.
There also *may* have been some advances on our understanding of the evidence against a link between vaccines and autism – which have occurred since 2008, both in the courts and in the lab.
But despite the fact that Weiner claims to base his information on the latest science, he uses outdated references, claims Wakefield’s work is “sound” and uses scary language that has no basis in science.
There’s more…
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Robert Mendelsohn, MD writes: “My suspicion, which is shared by others in my profession, is that the nearly 10,000 SIDS deaths that occur in the U.S. each year are related to one or more of the vaccines that are routinely given to children.”
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My suspicion? So you don’t have any evidence for that then? The reference for this statement is simply Mendelsohn. Ibid:250 which makes no sense to me. In any case, Mendelsohn is well known for his “unusual ideas”.
For example, he has opposed water fluoridation, immunization, coronary bypass surgery, licensing of nutritionists, and screening examinations to detect breast cancer. He has a listing on Quackwatch and whale.to.
The spurious claims about vax go on for 4 pages and at last check they were still there. (I’m actually surprised it is still up given the criticism Weiner has been under of late. Perhaps his cognitive dissonance is so strong that he thinks he is right. Sadly, I suspect this is the case).
But whether Weiner thinks he is right and that vaccines are bad “in his opinion” is irrelevant when it comes to his role a health care professional, especially when dealing with kids. Remember he’s a pediatric chiropractor dealing with kids as young as one-day-old.
And science is not formed via opinion, it’s based on evidence and there is no evidence for just about everything he claims (even chiropractic subluxations actually).
The fact that the CCNSW thinks it’s okay says a lot about their responsible approach to chiros under their jurisdiction and patients.
This story was covered in Australian Doctor today and rest assured, we have not seen the last of the Weiner files. More to come very soon.
The Weiner Files
The last few months haven’t been great for pediatric chiropractor and owner of Newtown Community Chiropractic, Nimrod Weiner.
It all came to a head last week when his anti-vaccine “rants” were covered by our national media when The Australian newspaper and Radio National both took him to task over his public anti-vaccine lectures. The stories came after Australian Doctor published the audio of his talk online, against his wishes but in what they say was in the public interest.
Why is it in the public interest? Because Weiner gives talks to parents, pregnant mothers and young mums and effectively scares them into not vaccinating. Also, he’s the Vice President of the Chiropractors Association of Australia (CAA) NSW branch of whom Australian Doctor have previously accused of “fundamentalist ideologies” and “pseudoscientific dogma”. He’s also on the board of the Australian Spinal Research Foundation where he contributes content for the newsletter. So effectively, he’s a high profile chiropractor.
But leading up to the bad news week for Weiner was a heck of a lot of work behind the scenes. I thought it might be interesting to track the chronology of events which resulted in him getting pwned all over the media. Hopefully, it will give readers an understanding of the value of grass roots scepticism and how a little bit of investigation, like asking questions at the Mind Body Wallet Festival or spending two hours in a chiropractors clinic can result in exposing dangerous quackery. And anti-vaccine quackery is particularly dangerous.
Let’s begin.
November 14th, 2010. My mate Richard Saunders came across this flyer at the Newtown Festival last year where Newtown Community Chiropractic had a stall. He twitpicked it and we decided to go along (Richard didn’t end up going – we can’t remember why).
November 25th, 2010. Meryl Dorey sends out warning to chiropractors as part of her newsletter
December 4th, 2010. I attended the 2 hr free seminar with a friend and blogged it here the same day. Or watch it on the YouTube (thanks to the kind soul who made it).
March 8th 2011. A journalist from Australian Doctor contacted me as part of researching a feature on CAM published as Exploring the Alternatives (I eventually wrote a guest editorial). He was curious about chiropractors and their views on vaccination and knew I had been to listen to Weiner. He booked to go along to the seminar in March. He recorded the seminar, identified himself as from Australian Doctor and asked Weiner if he could post it on-line. Weiner declined.
(Note: according to the Australian Doctor article – which is paywalled – Weiner claims he’s done five years of a medical degree. I was unable to confirm this).
Literature handed out at Nimrod Weiner's December 2010 seminar
To provide you with some context for what happened next, chiropractors were copping it around this time for treating babies.
March 18th 2011. The first stories about a chiropractic clinic at a Victorian University treating babies and kids appears in national newspaper The Australian. Spearheaded by Loretta Marron, academics and health professionals including Simon Singh and Edzard Ernst petition the government to close the clinic down.
March 28th 2011. The British medical journal covers the story
April 27th 2011. Australian Doctor are the first to link chiropractors with the anti-vaccine group the AVN revealing that 130 of professional members of the AVN are chiropractors. This includes clinics run by the CAA president Simon Floreani, the association’s treasurer Taylor Vagg and board member Anthony Croke.
“Mr Floreani….insisted AVN was a valuable resource for patients: “For me it’s about critical thinking. You are only going to get one biased side of the debate from the medical profession. Can you trust the claims that the vaccines are safe when one-fifth of all deaths are related to medical error?
“The AVN has links and resources to an enormous amount of information that you don’t find elsewhere. As a registered health professional, your role is to help patients. I don’t think [of the AVN] as anti-vaccination. It is more pro-choice.”
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May 28th 2011. More bad publicity for baby-cracking chiros, where Marron says, “I would not have written a submission if the chiropractors were treating adults for lower back pain,” she says. “Pediatric chiropractic is a form of faith healing and it should be in theology, not health science.”
July 2nd 2011. A feature story on chiros treating kids appears in The Australian with another “pro-choice” chiropractor, Warren Sipser. (note: this the same one who commented in an article which Meryl Dorey went onto refer to as “vaccination is akin to rape with full penetration.”
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The decision sparked a reaction from the anti-immunisation movement in Australia, with one sceptic, paediatric chiropractor Dr Warren Sipser, saying the judgment was “dangerous” and some children could have severe reactions.
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18 reasons to not vaccinate. Literature from December 2010 seminar
July 11th 2011. The CAA sent a media alert out to their members about damage control, directing their members to send all media enquiries to a PR firm.
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“We wish to alert you to an article that may be appearing in this weekend’s edition of The Weekend Australian…..As always, we continue to make every effort to mitigate negative press that at times is being played out in the media, as well as our attempts to generate positive media..”
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July 23rd, 2011. A bunch of concerned citizens and some members of SAVN attended Weiner’s talk. They were “…criticised by the audience for doing such dreadful things as pointing out errors made by the speaker.”
July 24th 2011. I received a call from a journo who was investigating how widespread anti-vaccine beliefs were amongst chiropractors. The story was published a few days later.
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“Of the (AVN) network’s 198 professional members, 128 are registered chiropractors. Many are members of the professional body the Chiropractor’s Association of Australia, or CAA.”
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August 8th 2011. After obtaining legal advice, Australian Doctor posts the audio of Weiner’s talk online with commentary, even though Weiner did not agree to it. They state; “… we believe it is in the public interest, particularly given Mr Weiner’s profile within the chiropractic profession.”
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We…reported on accusations against the Chiropractors Association of Australia – the profession’s peak body – that it has turned its back on science to peddle “fundamentalist ideologies” and “pseudoscientific dogma”. The CAA has strenuously denied the claims.
On the issue of vaccination, it says the profession’s role is to educate the public on health issues – the risks and benefits of vaccinations is just one of those issues. So here we offer a talk on vaccinations given to members of the public by Nimrod Weiner…..vice-president of the NSW Chiropractors Association of Australia and ..on the board of the Australia Spinal Research Foundation, a self-styled scientific research body.
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August 15th 2011. Another journo, again from The Australian newspaper emailed to ask me about the Australian Doctor audio, since he knew I had blogged about the talk. A story entitled “Call to probe anti-vax rant” was published on August 17th (seen by approximately 128,985 people) where Weiner’s comments were described as “outrageous” by the Australian Medical Association who called on the CAA to intervene.
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Mr Weiner declined to comment, referring questions from The Australian to a PR company, which said the Chiropractors Association of Australia (NSW) had no position on vaccination and “any comments that Nimrod Weiner may have made would be his private opinions, not those of the association”.
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August 18th 2011. The following day, the story appeared on Radio National on the back of Australian Doctor audio and The Australian newspaper article.
August 19th 2011. Another critical article appeared in the press
Interestingly, shortly after these national stories broke, a link on Weiner’s website to his vaccine talks was showing a 404 but it could be found in Google cache. Today, as I was researching to write this article I again found the page, but it appears an attempt to hide it has been made, as indicated by the “_offline” text at the end of the url. You can still get the page though if you do some digging, but it has been moved thus breaking all previous links.
I guess the question now is will Weiner continue to give these seminars. According to this screenshot he has previously charged for the seminars.
UPDATE: Another critical article appeared in Australian Doctor today, where the Chiropractic Board of Australia is calling on people to complain about Weiner;
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The chair of the chiropractic board is urging people to make a formal complaint about high-profile chiropractor Nimrod Weiner over his public seminar on the alleged dangers of vaccines.
Phillip Donato stressed that chiropractors had a duty under the profession’s code of conduct to provide up-to-date, evidence-based information. He said: “It appeared at the very least he is misinformed and may be providing misleading information to the public. We would encourage notifications so that we can have a look at the case properly.” Australian Doctor understands that notifications have already been made.
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Indeed a complaint made to AHPRA then passed onto the Chiropractic Council of NSW was dismissed in June this year. The complainant flagged anti-vaccination material on Weiner’s website as being in breach of section 10.2 of the Code of Conduct for Chiropractors, which states; “good practice involves: c) understanding the principles of immunisation against communicable diseases.”
The complaint was dismissed on the grounds that “The Council considered that Dr Weiner was entitled to put his opinion forward and that this did was not in breach of the Code.”
I don’t think we’ve seen the end of this saga. I’ll be sure to keep you posted.
Sleeping in “the most haunted building in NSW”
Things fell very quiet after the publican locked the front doors and left the hotel for the night, just after 12:30 am. We had arrived very late at the Wisemans Ferry Inn after travelling up from Sydney to spend the weekend.
The atmospheric halls of the Wisemans Ferry Inn
As I paid for 2 nights accommodation the publican noted, “you’re the only couple upstairs, everyone else is in the rooms out the back” – which was fine with me, I like my privacy and it meant there would be no waiting to use the shared bathroom.
We lugged our stuff up the narrow staircase and through the saloon-like gate at the top marked “private” and settled into our room. The hotel fell quiet except for the occasional hum of the generator kicking into life.
Staircase leading to our room where we will sleep alone. Woooo!
We settled back to enjoy a drink after a long drive (and a flight for my partner) and as self confessed web-addicts, my partner checked-us in to the Wisemans Inn on Facebook (cause, ya’know, it’s critical that my friends know where I am every second of the day right?).
It was then that I got Twitter message from a friend asking me if I had seen the ghost yet. “What ghost?”, I enquired to which she responded that the Wisemans Ferry inn was known to be haunted. In fact, it’s famous for it.
According to an article from the Daily Telegraph,
“Villagers have reported female ghosts swishing their long frocks along its corridors. The shadowy form of founder and ex-convict Solomon Wiseman’s first wife Jane has been seen rising from an old vault in the garden. A young convict, refused a ticket-of-leave by “Governor” Wiseman to see his sweetheart and tried to swim to freedom across the Hawkesbury, who was pulled beneath the water by his leg-irons and drowned.”
And “A veteran ghost hunter has recommended Wisemans Ferry Inn as one of the state’s most haunted buildings. Villagers have reported female ghosts swishing their long frocks along its corridors.”
Se here we were, in a haunted hotel in the dead of night, alone, with no one else to haunt. It was then that the significance of “you’re the only couple upstairs” began to dawn on me. Maybe nobody else wanted to stay upstairs because that’s where the ghosts hang out!
It was well after 02:00 by the time we went to sleep. No ghosts appeared. I considered that some are shy and only show themselves in photos, so tonight I took some pics around the Inn. If you can see anything paranormal, let me know in the comments, but I was stumped.
After our disappointment of last night, we took a trip out to the local cemetery today to take more photos. I’m hoping a ghost or two has followed us back to the Inn but I guess we’ll just have to wait and see.
A haunted wagon wheel?
We have one more night to stay upstairs – alone – in the “most haunted building in NSW”. I’m not holding my breath.
Some people say ghosts won’t show themselves to skeptics. But I want you to know ghosties, I am willing to change my mind. I’m open to the idea that you do exist and like all good skeptics/scientists, if evidence to the contrary is presented to me, I will modify my position.
We’re in room 8, see you upstairs later.
Australian government draft report: homeopathy “not efficacious”
Last week was World Homeopathy Awareness Week or WHAW, a time where homeopaths all over the world do their best to spam the Ten23 hashtag on Twitter and bleat “QUANTUM! IT’S QUANTUM!!” in defence of their nonsense.
If you follow the process, no doubt you’ll know who trolls the internet leaving this statement anywhere someone criticises homeopathy;
“Real is scientific homeopathy like Conventional Allopathic Medicine (CAM). Evidence-based modern homeopathy is a nano-medicine bringing big results”
Firstly, wha??
Only one person can dish up quality woo like this. It’s Not-a-Doctor Nancy Malik of course. And what exactly is “scientific homeopathy”? Best you ask Dr Malik about that.
So given that it was WHAW, many science-based bloggers and tweeters took it upon themselves to make people “aware” that homeopathy is nothing more than an expensive placebo. In most cases, the liquid or sugar pills you buy from your pharmacist in fact contain nothing at all. Thus, the catch phrase of Ten23; “Homeopathy, there’s nothing in it”.
My best mate Richard Saunders did his bit, in the form of an epic slap-down story on Adelaide’s Today Tonight where Brauer “Natural Medicine” came in for a bollocking. As Phil Plait so eloquently put it, this story was unique for the token homeopath not the token sceptic, the latter being the usual way things work on commercial television. If you haven’t seen this video, take the 10 minutes to watch it – it’s great. Richard delivers some succinct and pointed sound bites which really bring the message home (and I’m not too coy to say I was sitting off camera coaching him for this part!).
But, like many sacred cows, homeopathy is an unsinkable rubber duck and despite 200 years and 200 clinical trials, there is still no evidence that homeopathy works (see how homeopathy works here). This leaves homeopaths mumbling excuses like “RCTs don’t work for homeopathy” or “one day quantum physics will solve it”.
Do not pass go, do not collect $200.
So it was with great delight that I opened my Australian Doctor email today to find an article by Paul Smith (whom I highly respect) with the headline; “National Health and Medical Research Council (NHMRC) declares: homeopathy ‘not efficacious’”. It’s a subscription based article so I can’t copy paste it here, but I can provide a summary.
“The NHMRC’s position is…it is unethical for health practitioners to treat patients using homeopathy, for the reason that homeopathy – as a medicine or procedure – has been shown not to be efficacious.”
This is currently a draft statement, apparently drawing on several issues; claims that “homeopathic vaccinations” are an effective substitute for vaccines, recent deaths (see here and here) in Australia where homeopathy was implicated and the findings by the UK Science and Technology Committee in 2010 which concluded that the UK National Health Service should cease funding homeopathy.
This is the first time the NHMRC has spoken out against homeopathy and the implications are significant. As Paul says;
“If the public statement is formally adopted by the council, the major health insurers – Medibank Private, HCF, NIB and MBF – will have to justify why it is using taxpayers’ money to fund “unethical” homeopathic treatments.”
Three billion dollars of taxpayers money is provided every year to fund private health insurance rebates by the government and this includes homeopathy. Should the NHMRC declare it “unethical”, health funds will be under pressure to pull funding for quack remedies like homeopathy.
It’s too early to tell at this stage if this will happen, since the statement is still a draft, but it is tantalising to think that science and rationalism could win this one.
I encourage the NHMRC to formalise this statement and declare homeopathy unethical and devoid of efficacy. Of course people will still be able to buy it, but at their own expense instead of that of the tax payer.
And maybe, just maybe, this will see the end of doctors prescribing it and pharmacists selling it. And wouldn’t that be a huge win for science and scepticism.
The full article (subscription required) can be found here
Homeopathy Plus! jumps a flotilla of sharks
It is said that disasters bring out the best and the worst in people, and sadly, there has been plenty of opportunity to witness this play out of late.
In Australia, the east coast experienced the worst floods since 1974, quickly followed by Cyclone Yasi ravaging as far inland as Mount Isa. Then there was the terrible earthquake in Christchurch where many died across the pond. And then on Friday a massive 9.0 earthquake exploded under the North Pacific Ocean, sending a huge tsunami smashing into the north-east coat of Japan.
The Japanese are suffering terribly, not just because tens of thousands are missing feared dead, but they also face bitter cold as snow is dumped on the devastation. And even worse, 4 nuclear reactors which took the brunt of the tsunami and earthquake are now at risk of meltdown. Although the reactors are built to withstand earthquakes, the combination of such a huge event coupled with a massive tsunami wiped out back-up systems required to keep the fuel rods cool. As water levels dropped the rods heated up, some producing enough hydrogen gas to cause explosions and subsequently the release of radioactive gas into the air.
Authorities are madly dumping sea water from helicopters onto the rapidly heating fuel rods, and as a precaution have set-up an exclusion zone in a 30 km radius around the plant. However, if the meltdown cannot be prevented, there is a risk of the release of radioactive gas clouds which could drift into populated areas.
Enter the vultures.
Several days ago Australian Skeptics Vice President Richard Saunders circulated an email from Homeopathy Plus! describing homeopathic remedies for radiation sickness and poisoning. It described how homeopathy offered “key remedies that have been used either in research or historically to prevent or treat radiation poisoning..”.
Two emails sent on March 13th and the 16th described;
“If at risk of radiation exposure, any one of the above remedies may be taken as an emergency response, three times a day in a 30C potency.”
The remedies referred to are cadmium iodide, cadmium-sulph, phosphorus, strontium-carbonicum and X-ray.
That’s right, homeopathic preparations of X-rays.
But before you get worried that more X-rays might not be just the best thing to treat radiation burns, let’s take a look at precisely what 30C means. This is a common homeopathic dilution – one you might find on your local pharmacy shelf and means the original substance has been diluted 10 to the power of 60 times (in simple terms, 1 with 60 zeros after it). At a dilution this great, in order for you to come into contact with even one molecule of the original X-rays, you would have to give two billion doses per second to six billion people for 4 billion years. Or to put it another way, a 30C dilution is the equivalent of placing 1 mL of liquid into a cube of water measuring a million million million metres per side.
Impossible and also preposterous. But there’s more.
“If radiation sickness has developed, your homeopath is the best person to advise on treatment dosages and potencies as these will depend on the symptoms you are experiencing and their severity.”
But not just any homeopath. Apparently some people are confused by the number of remedies being offered by different homeopaths. (Apparently they can’t agree amongst themselves).
But never fear! Homeopathy Plus! will only recommend you;
“remedies whose effects are also supported by research and/or confirmed with clinical successes as reported by doctors and physicians dealing with radiation exposure during the Great World Wars.”
But what if you can’t get your hands on a super dilute one to the bajillion dilution of X-rays? No worries, you can take a more concentrated dose of X-rays but you just need to take it more frequently.
Yes, you read that correctly, if the preparation is more concentrated you just need to take it more often.
According to the helpful HP! Newsletter, this means
“…taking a more frequent dose for lower potencies (4-6 times a day) and a less frequent dose (1-2 times a day) for higher potencies.”
This is because homeopaths believe that the more dilute the preparation, the stronger it is. You couldn’t make this stuff up. Well, actually you could but no-one would believe you.
So as you might expect HP! have copped a bit of flack for this irresponsible nonsense. The story was reported in The Australian newspaper, on The Punch website, by Phil Plait in his Bad Astronomy blog, by Brian Dunning on Skepticblog and by Ben Radford on the Discovery website. Adam Cresswell from The Australian asked some experts about the claims that homeopathy can treat radiation burns and got a predictable response –
Victorian GP Bill Williams, who is also a nuclear safety expert, said there was “absolutely no evidence” for any of the remedies being promoted by HP! being useful in treating radiation sickness.
“It’s not really very helpful for people to be promoting treatments in a dire situation like this, which could give people false comfort,” Dr Williams said.
Nuclear radiologist Peter Karamoskos said the claims that were made by Homeopathy Plus were “rubbish”.
“Such claims are dangerous in that it might compromise proper treatment and give false security.”
Sadly this is not the first time HP have spouted rubbish on the unsuspecting public. The Homeopathy Plus newsletter and clinic are both run by homeopath Fran Sheffield who is also good mates with the AVN (birds of a feather and all that.)
In 2010, the TGA instructed Ms Sheffield to remove claims that homeopathy was an effective substitute for vaccination from her website and publish a retraction. She refused to do so on the grounds that she didn’t agree with the decision. And, as with approximately 30% of those served with a TGA retraction order, nothing was done to enforce the finding. In fact the TGA told ABCs Lateline programme that no legal action has ever been taken over non-compliance. Which makes the complaints system look like a complete farce.
Indeed following the Lateline report Fran Sheffield jumped a flotilla of sharks and published a piece on her website called “Lateline: can homeopathy safely protect against epidemic and infectious diseases? Can homeopathy treat serious diseases such AIDS and cancer?”. It was a veritable Gish Gallop of references purporting to show that indeed, it can. So, not only did she refuse to remove false and misleading information from her website, when challenged she simply added more.
A few months prior she sent out an email alert entitled “homeopathy as good as chemotherapy for breast cancer and non-toxic”, based on a paper published in The International Journal of Oncology. Firstly the paper had not made such a claim – it was only a cell study – and secondly it was a terrible piece of bad science chock full of dodgy data. So much so that one of the authors left a comment on my blog where I had taken the paper to pieces, dissociating herself from the work saying “…I asked to not be included (on the paper) because I did not think it was a sound study..”
Still, Ms Sheffield continues to claim that magic vibrating water can cure everything. In a flyer sent out for a workshop last year she stated “homeopathy works for autism, infections, anxiety, allergies, insomnia, coughs and colds, depression, irritable bowel syndrome and much much more..”
Sorry Fran, but there is no evidence that homeopathy works for anything, except maybe for hangovers. I love a nice cold drink of water when I’m hungover. But claims that homeopathy can be used for the treatment of radiation burns or illness are complete rubbish and prey on the vulnerable and desperate.
The full emails can be found here and here.
The Australian Government needs to wise up about homeopathy
Apparently this week has been MedicineWise Week in Australia.
I didn’t know this until out of curiosity I went to a website which has been heavily advertised over the last week on Australian television – the NPS website. I knew of this Australian government organisation since I follow them on Twitter but only after visiting the website did I discover they provide information on medicines for consumers and health professionals alike. Plus they are behind MedicineWise Week from January 30th – February 6th, 2011.
In light of the worldwide Ten23 campaign conducted all over the world this weekend – in fact every continent including Antarctica was represented – I thought I would pose as a consumer and search for information about homeopathy.
Like homeopathy itself, what I turned up was minimal and not very useful. I’ll explain more about this a bit later but first, as I was surfing around the NPS site, I found a press release about a survey of Australians’ knowledge of medicines.
Fifteen hundred consumers were surveyed and the results reported that 65% had used a prescription medicine in the last three months, 60% had used an over-the-counter medicine and 45% had used an alternative or herbal medicine.
When it came to alternative medicines and supplements, of those surveyed, less than half considered certain vitamins and herbs to be medicines: multivitamins (23%), echinacea (24%), fish oil (32%). Awareness of Chinese herbal remedies as medicines was slightly higher at 41%.
NPS clinical adviser Dr Danielle Stowasser said, “The first step to being medicinewise is knowing what is a medicine. Medicines include tablets, vitamins, herbs, eye drops, creams and gels. Medicines don’t just come on prescriptions but include things bought in a pharmacy, supermarket and other stores, and from naturopaths and herbalists.”
But thinking back to homeopathy, here’s where I began to get concerned:
Encouragingly, when asked where they would go to find accurate information about medicines, most respondents said a pharmacist (64%) and/or a doctor (60%). However, when asked if they did ask questions of their doctor or pharmacist the last time they received or purchased a medicine, 60% said no and 48% said they did not tell their doctor or pharmacist about other medicines they were taking.
Sixty four percent said they could get accurate information about their medicines from a pharmacist? I’m sure this is true for most conventional medicines – but I have repeatedly asked pharmacists about homeopathy and only once was I given an accurate description of what it is and what it does. ONCE. And in a certain pharmacy in Newtown, I have been (not so politely) shuffled to the door when asking too many questions of the shop assistants about homeopathy.
So, sadly in my experience, consumers cannot rely on pharmacists to accurately advise them on homeopathy.
So, I expected that a quick trip to the heavily promoted NPS website would do the trick. A search for “homeopathy” turns up one link to a generic page on complementary medicines where homeopathy is cited but not explained. A search for “homeopathic” turns up a link to a video which likewise doesn’t address homeopathy directly and in fact could even be construed as misleading. An excerpt from the transcript appears below:
“Manufacturers of non-prescription medicines sold in Australia must ensure that their products meet certain quality and safety standards, however when it comes to providing evidence of their effectiveness, they’re not tested as thoroughly as prescription and pharmacy medicines. The less thorough testing does not mean that these medicines don’t work, rather it means that the manufacturers don’t have to provide as much scientific evidence as they do for prescription and pharmacy medicines.
When you are choosing a traditional or herbal medicine obtain as much information about it and it’s use as you can.”
I doubt there would be any confusion that homeopathic “remedies” are not prescription medicines, but they could certainly be considered pharmacy medicines. After all, they are sold in pharmacies alongside the science-based remedies. So this video implies that since homeopathy – for all intents and purposes – is a pharmacy medicine, then it is tested just like prescription medicines.
Of course this is simply not true. In fact, some homeopathic remedies are exempt from the Australian Register of Therapeutic Goods (ARTG) which is a list of approved medicines and devices, because – in many cases – they are so dilute that they no longer contain active ingredients. Thus, there is nothing to regulate if there is nothing in the “medicine”.
The TGA website states homoeopathic preparations are exempt from the ARTG if :
“(they are) more dilute than a one thousand fold dilution of a mother tincture and which are not required to be sterile; and which do not include an ingredient of: a) human origin; or b) animal origin, if the ingredient consists of, or is derived from, any of the following parts of cattle, sheep, goats or mule deer.”
So unless you started with a mother tincture derived from animal or human sources, the government is not particularly interested in your product. And if it’s more dilute than 1000 times then they’re also not bothered. Makes sense I guess, since sugar pills and water with a dash of alcohol won’t do you any direct harm. (But, this does not mean they don’t do you harm.)
Even more bizarre is that when homeopathy is not sold through pharmacies, it is exempt from the TGA’s own advertising standards.
“A homeopathic product can carry claims which do not comply with the Therapeutic Goods Advertising Code and may still be listed in the ARTG. However, the label on the container and on the primary pack must include a statement to indicate that the indications have not been “approved” by the TGA.”
The description of homeopathy on the TGA website is also not very helpful to uninformed consumers.
“Homoeopathic preparation” is defined by the Therapeutic Goods Regulations as a preparation:
- formulated for use on the principle that it is capable of producing in a healthy person symptoms similar to those which it is administered to alleviate; and
- prepared according to the practices of homoeopathic pharmacy using the methods of:
- serial dilution and succussion of a mother tincture in water, ethanol, aqueous ethanol or glycerol; or
- serial trituration in lactose.
Wouldn’t it be much simpler to say “there’s nothing in it” (which they allude to further down the page anyway) and “there is no evidence that it works?“. Do they really think consumers are going to know what “sucussion” and “serial trituration” means? Like pretty much all of homeopathy, it’s goobledigook.
But, the facts remain that homeopathy is indeed listed on the ARTG, meaning it is assigned an official looking government number, which lends it legitimacy. For example, Brauer Natural Medicine Children’s Cold Flu Relief is listed as AUST L-132568. The fact sheet for this product states that all the ingredients exist at a 1000 fold dilution (1 µL in 1 mL)*.
Finally, a use for homeopathy. Photo courtesy of David Barwick
I found 37 listings for Brauer homeopathic “medicines” including childrens’ cough relief, hangover relief oral spray, and natural medicine burn cream. Interestingly, sleep and insomnia relief – (see left) the sleeping tablets popular amongst Ten23 overdose participants – are not listed on the ARTG since the active ingredients are diluted much more than 1000 times.
So whilst homeopathy is sold in pharmacies, many pharmacists don’t know what it is. They, like many consumers, think it is herbal (whilst it may have started out herbal, it’s certainly not by the time it gets to the shelf of your local chemist).
So what have I learnt in MedicineWise week? Firstly, the Australian government seems confused about homeopathy. I was unable to find a clear and concise explanation of what it is on their official websites, they appear to be bundling it in with pharmacy medicines, thereby implying that it works and further, they are lending it legitimacy by designating it official looking numbers on the official register of government approved Australian medicines.
No wonder the public remains confused. And no wonder it is left to the #ten23 campaign to increase awareness that, Homeopathy There’s Nothing In It.
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*The onus is on the user to verify the current accuracy of the information on the document subsequent to the date shown”. The sheet is dated accurate as at November 2006.
Science comes back to bite Power Balance
Alt medders love to use sciencey sounding words to make their products sound more legitimate. Quantum, frequency, energy, infrared, if you can put it in a hat, they’ll pull it out at random and stick it on their packaging.
One company who likes to use “science” to sell their products is Power Balance. They love the big science words like mylar, hologram, frequency and hertz. But after today, I’m not sure Power Balance and science are gonna be such good friends. You see, some researchers busted their magic hologram silicon bracelet using well, science.
In fact it was a team of chiropractors – a profession not universally known for evidence based practice. Indeed, some* chiropractors believe some pretty weird things like in the existence of subluxations. Put simply, this term is commonly used by chiropractors to describe signs and symptoms of the spinal column, yet evidence that these even exists remains controversial.
In May 2010, the General Chiropractic Council, the statutory regulatory body for chiropractors in the United Kingdom, issued guidance for chiropractors stating that the chiropractic vertebral subluxation complex;
“is not supported by any clinical research evidence that would allow claims to be made that it is the cause of disease or health concerns.”
A similar stance is taken by the National Health Service:
“There is also no scientific evidence to support the idea that most illness is caused by misalignment of the spine.”
This emphasis on woo in the chiropractic profession always struck me as kinda odd, since in Australia, chiropractic is a 2 year post graduate course meaning students have 3 years of undergraduate science education under their belts before they even begin.
But it’s clear that evidence-based practice is not the general rule (again please see *), as evidenced by a cursory glance at any of their websites. Chiropractors claim to treat a wide range of conditions including colic, asthma, sleep disorders, ear infections and ADHD. I addition to this, many chiropractors are also anti-vaccination, and I have blogged about one such in particular in the past.
So I was somewhat surprised today when the results of the Power Balance trial being conducted by the Discipline of Chiropractic in RMIT’s School of Health Sciences in Melbourne were announced, and the results were negative.
When I first heard about this trial several months ago, I was not confident the results would come out the right way – and by that I mean that Power Balance is an expensive rubber band, and nothing more, as the company itself admits.
I had already been disappointed by the gushing testimony of another chiropractor on the Today Tonight story where Richard Saunders showed the magic bands could not be distinguished from placebo.
Melbourne chiropractor, Dr. Matt Bateman, said he had tried it on hundreds of his patients, and even staked his reputation on it.
“I felt it for myself. There is so much you can fake – I am not faking 500% strength and stability, which is what I felt – I can’t fake that,” Dr. Bateman said.
No word yet from Dr Bateman on whether he wishes to retract his statements.
But, in what is another nail in the coffin for the reputation of expensive rubber band, the study found there was no statistically significant change in balance performance brought about by the silicon wristbands.
The randomised, double-blind controlled trial tested 42 volunteers on a computerised dynamic posturography device that measures balance and stability. The test was performed three times: once with no wristband, once with a placebo wristband (where the holograms were replaced with two stainless steel discs of the same dimensions and weight) and once with a Power Balance wristband.
“We saw no difference in people’s balance whether they were using the wristband, wearing a placebo or wearing no wristband at all,” study showed Chief investigator, Dr Simon Brice.
“…given this study strongly refuted the primary balance benefit of holographic wristbands, the validity of other purported benefits seems highly unlikely.”
Another author on the study. Dr Jarosz explained:
“They think it will work, therefore they feel like it’s working.”
The study will be published in the Journal of Bodywork and Movement Therapies , which is PubMed indexed and published by Elsevier. I say kudos to the team for publishing the first scientific study looking at the claims of Power Balance.
Just goes to show, if you abuse science for nefarious purposes, it might just come back to bite you. How ya liking science now Power Balance?
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* I say this based on my research, experience and the contact I have had with chiros. I wish to stress, I do not apply this statement the entire profession.
Not-a-doctor Wakefield still a threat to childrens’ health
The news just keeps getting worse for (not-a-doctor) Andrew Wakefield.
First he got struck off the medical register in the UK, then his favourite paper was retracted from the Lancet, then the anti-vaxers favourite paper got withdrawn (which they still cite BTW*), then he was quietly removed from his job at Thoughtful House. Following his move to Texas in 2010, the phrase going around the internets was he “lost his career and his country”. Not only that, he also lost all respect from the scientific community and the chance to ever publish in the mainstream scientific literature ever again.
If you reap what you sow, then it appears Wakefield’s chickens have come home to roost – and these are not small chickens either. Imagine Brian Deer in a chicken costume, sitting aloft Wakefield’s tower, watching every move with beady eyes (well that was what I imagined anyway). Brian Deer of course being the “UK investigative journalist who exposed Wakefield’s Lancet work for not just “bad science” but for deliberate fraud. Deer has been on Wakefield’s case for some seven years now and was the first guy to blow the whistle on the now infamous paper which kicked-off the worldwide vaccines-cause-autism scare.
I’ve been following this case for a long time, so I knew the background well, but even I was shocked when I read the three part series published by the BMJ last week.
Deer provides evidence that Wakefield fabricated the clinical data for the 12 kids to make it appear they had suffered neurological disorders soon after they received their MMR. Wakefield had a business plan to set-up a company making kits to detect ulcerative colitis which was projected to make 72.5 million pounds a year. Wakefield received almost $AUD700,000 (plus expenses) from lawyers assembling a class action suit against the manufacturers of the MMR. The same lawyers had paid 50,000 pounds to fund the Lancet study. Wakefield had a patent for a single measles vaccine, which was projected to make him a very wealthy man once he had discredited the triple version.
And none of this was revealed to the journal before he published the paper. This constitutes a huge conflict of interest.
Of course, the reaction from the anti-vaxers has been predictable. Even Wakefield himself referred to Deer as hit-man sent by “them”. On Anderson Cooper in the US, Wakefield claimed it was an effort by the medical community to quash valid research into the safety of vaccines.
Which is interesting. Really interesting.
Because what was so revealing to me – out of all the revelations in the papers from the BMJ – was the fact that Wakefield was offered the chance to reproduce the results from the Lancet paper.
From “How the vaccine crisis was meant to make money“
“…UCL volunteered to support his work. It offered him continuation on the staff, or a year’s paid absence, to test his MMR theories. He was promised help for a study of 150 children (to try to replicate his Lancet claims from just 12) and, in return for withdrawing from the January London conference, he would be given the intellectual property free.
“Good scientific practice,” the provost’s letter stressed, “now demands that you and others seek to confirm or refute robustly, reliably, and above all reproducibly, the possible causal relationships between MMR vaccination and autism/“autistic enterocolitis”/inflammatory bowel disease that you have postulated.”
Then this:
“At the time, Wakefield agreed. Then his employer waited. It prompted, waited longer, and prompted again. “Three months have elapsed,” Llewellyn-Smith wrote to him in March 2000, asking for “a progress report on the study proposed” and “not to make any public statements” in the meantime.
But the study did not happen. The 1998 Lancet research had been a sham. Trying to replicate it with greater numbers would have been hopeless.
So Wakefield’s claims of “trying to quash valid vaccine research” are lies. He was given the opportunity to reproduce his work – he never did. And it all becomes clear why. A complex lie based on 12 children when amplified in 150, just becomes a bigger lie.
But it didn’t stop Wakefield from spiralling further down the rabbit hole. I hoped he might have retreated into a corner somewhere, maybe to slap out some more fictional books with forwards by our favourite Mommy warrior, Jenny McCarthy. But given that the man has an ego the size of a buffet in Vegas, sadly, this has not happened.
Instead, yesterday it was revealed on Twitter by @sthmnookin and @doctorblogs that he’s back stomping the pavements trying to recruit patients for his next favourite woo autism therapy. This time, instead of parents recruited by a law firm, he’s targeting the Somalian population of Minnesota who reportedly have a higher than usual occurrence of autism.
On January 18th it was announced that the CDC, the NIH and Autism Speaks National would begin a study to investigate this anomoly among Somali-Americans in Minneapolis. The Minnesota Department of Health released a report in 2009 confirming higher rates of Somali-American kids participating in special education classes for children with autism in Minneapolis. But it’s still unclear whether these data are real or artificially inflated because Somali parents prefer to enroll their children in school-based programs, as opposed to seeking help from autism specialists in the medical community. You can read more about it here.
So Wakefield, given that he is incapable of understanding he is a danger to children, has jumped on the bandwagon, sticking his fraudulent nose where it doesn’t belong and addressing a group of parents at a local restaurant in an effort to recruit patients for his own study.
This screen cap was published on Twitter by @doctorblogs and retweeted by @sethmnookin
So essentially Wakefield wants to use the Somali kids as more guinea pigs – as he did in his Lancet study – with the unproven and potentially dangerous therapy of hyperbaric chamber treatment for autism. According to the newspaper clipping, many parents have already signed up. And why wouldn’t they. There is no cure for autism, we don’t even know yet what combination of factors cause it. So of course desperate and vulnerable parents are only willing to agree to participate, even if it potentially puts their kids’ health at risk and in the knowledge that Wakefield is a fraud.
How much more harm can Wakefield do? Sadly, it seems a lot.
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Click to read Part 1, Part 2 and Part 3 of the Lancet’s investigations.
*when a paper is withdrawn or retracted it can be for a number of reasons, including the work has been published elsewhere, something fundamentally wrong with the data has been detected or the data is deemed to be fraudulent. Only under exceptional circumstances will a paper be retracted or withdrawn. When it happens, it means you can no longer refer to it or “cite” it – it has essentially been scratched from the scientific record (even if it is cached on InfoWarriors).
Chiropractors making more ridiculous claims
Regular readers of this blog will be well aware of the trouble chiropractors have been getting into of late.
The backlash from the BCA decision to sue Simon Singh back in 2009 resulted in a huge Streisand Effect for the profession. Attempting to silence Singh with legal chill had many knock-on effects including one in every four chiropractors in the UK being investigated for making false claims in their advertising. To avoid prosecution, the McTimoney chiropractors emailed all their members and instructed them to take down their websites and “remove information leaflets that state you treat whiplash, colic or other childhood problems in your clinic..”.
Here in Australia we haven’t seen anything as hysterical as this, but our paranoid friends over at the AVN were clearly worried, issuing a warning in their Nov 2010 newsletter that sceptics were posing as clients and reporting chiros to the authorities.
To me, this seems like a silly way to go about reporting chiros – paying them. It’s much simpler to just take a look at their websites or promotional material. Just like the anti-vax handouts I was given by Nimrod “I’m not anti-vaccine, i just don’t recommend it” Weiner, whom I’ve blogged about previously.
Of course, none of this would be a problem if they simply operated within their code of conduct and stuck to cracking backs.
So I suppose I shouldn’t have been surprised to see this claim in a leaflet sent to me by a friend earlier today:
The text says; IQ – A study demonstrated an increase in visual perception, motivation, performance and 100% of the sample group showed an increase in IQ.
One hundred percent of the sample group showed an increase in IQ? Wow, what an extraordinary claim! You’ll note there is no reference provide for this “study”, but if you want one, why not contact them through their website. (The page above is taken from a newsletter from October 2007).
As @cactopos suggested on Twitter; “I guess you could argue that alternative medicine increases everyone else’s IQ thru a process of natural selection?”. Touche Cactopos.
Wakefield called a fraud, journo hangs up on Dorey and a class action filed against Power Balance.
Well, well. Another week has gone by here in the land down under and there is yet more good news to report. And plenty of it.
Where to start? Well how about with the darling of the anti-vaccine movement, Andrew Wakefield who took another mighty blow yesterday. The BMJ revealed they are to publish a series of articles by Brian Deer alleging that Wakefield was deliberately fraudulent in his 1998 research, which began a worldwide scare that the MMR vaccine was linked to autism.
An editorial in the British medical journal referred to “that paper” as it has become known, as an “elaborate fraud”. Worse still, the investigation concluded that Wakefield misrepresented or altered the medical histories of the 12 children to fit his hypothesis that MMR was associated with regressive autism. When Deer compared the reports in the paper with the medical records he found they did not match.
The editor-in-chief of BMJ said Wakefield’s work “was based not on bad science but on a deliberate fraud.”
And finally, the media seems to be losing their patience with the anti-vaxers (although recall they were completely complicit in spreading the fear about MMR safety, so they need to cop some of the flack here).
Anderson Cooper of 360 on CNN, interviewed Wakefield via Skype from the Vaccine Safety Conference, held in Jamaica from January 3-8 at the Tryall Club, Jamaica, West Indies. Wakefield refers to the conference in the interview as a “meeting of experts on vaccines from around the world who are extremely concerned about the safety of vaccines”. Looking at the speaker’s list I am skeptical that Barbara Loe Fisher & Russell Blaylock constitute “experts on vaccines” – certainly they constitute experts on vaccine conspiracy. Some of the other speakers had me confused, for example Beatrice Golomb (MD, PhD) is speaking on “Representation of drug benefits versus harm: the impact of conflict of interest”. (Read: Irony).
“Fears of global pandemics have been used by the World Health Organization and governments around the world to push for increasingly aggressive vaccination programs. While questions about vaccine safety continue to be raised, concerns have largely been downplayed by governments, regulatory agencies, and the pharmaceutical industry…The conference conclusions can be expected to have a profound impact on the development of health policies concerning vaccines and will serve to provide a science-based overview for the general public.”
Pre-amable for Vaccine Safety Conference.
Speaking of the media losing their patience with the antivaxers, a journalist in Australia today not only tossed away the book on false balance but tore it in half, set it on fire and stomped on it too.
In an interview about the Wakefield findings, Tracey Spicer of Radio 2UE constantly interrupted Meryl Dorey and eventually hung up on her declaring she would never be on the station again with her “dangerous, disgusting, disgraceful information”. It was one of the most refreshing interviews I’ve ever heard with Dorey, who is usually pandered to by the mainstream media in the interest of “balance”. Watch the video below for the full audio.
When the audio made it to Twitter, there was an explosion of interest and pretty soon “Tracey Spicer”, #stopAVN and Meryl Dorey were top trending topics in Australia. Very quickly the word spread globally and retweets from Simon Singh and Phil Plait appeared. Late last night, PZ Myers blogged the audio. The old adage all publicity is good publicity does not really apply to being ridiculed or pharyngulated on PZ Myers website.
Meryl has since responded with a blog post and an interview in the Northern Star entitled “Dorey backs fraud medico” where she explains why she “support(s) Andrew Wakefield 100%.…I applaud his integrity, ethics and desire to help children nobody else will.” (Which is odd because when she was asked if she still supported Wakefield as recent as July 2010, she had trouble answering that question).
From interview with the 2Murrays, 2UE, 130710. Full interview here.
.2Murrays: You’d know the name of a guy called Andrew Wakefield
MD: I do know Andrew Wakefield.
2murrays: Do you guys still support him?
MD: We support any research….
2murrays: No, no, no, no, no. Do you still support him?
MD: Do I support him? I don’t give him any money of that’s what you mean
2murrays: No but verbally, aw, you support him? (his ideas) Because he was stuck off the UK medical register.
MD: We know many cases where people have been struck off because they didn’t agree with the medical community…
Prof Booy from the NCIRS described her claims that there are dozens of peer reviewed studies showing a link between vaccines and autism as “laughable”. After what the BMJ revealed this week, on top of all the other evidence against Wakefield, those who continue to cling to him succeed only in making them selves irrelevant.
So finally, there was trouble in the Power Balance camp this week as the ACCC story eventually hit international headlines, when popular magazine Gizmodo tweeted “power balance admits their wristbands are a scam”.
PB have been laying pretty love since the ACCC findings came down on December 22, quietly removing the link to the Australian store from their website. But as the news spread and people start tweeting questions about whether this news was true, they went into a kind of damage control, just not a very good one. Picking up on “power balance admits their” they tweeted a series of comments completing the sentence. For example “power balance admits their international fans are awesome” and “power balance admits their products are worn by the top athletes in every sport across the globe” (neither of which provide any evidence that they work).
But then PB did something very strange. They tweeted
# The existing reports out there r fundamentally incorrect. We did not make claims that r product doesnt perform. We stand behind r products
# Power Balance works, we guarantee it.
Which simply opened the flood gates for satire as people began to suggest ideas as to why the magic hologram only didn’t work in Australia. Perhaps it didn’t like being upside down, some suggested. Maybe we’re just too smart for it.
But then overnight news came down that a class action suit has been filed in the US. According to TMZ, the class action lawsuit, filed this week in federal court in L.A., alleges consumers were duped into believing the hologram-embedded band was scientifically proven to enhance balance, flexibility and strength. Now on the back of the admission to ACCC that they had “no credible scientific evidence that supported the representations” the suit alleges unfair business practices and false advertising.
It will be interesting to see how this plays out. Power Balance have apparently sold around 3 million units since 2007. Will this be the end of a hugely successful marketing campaign? Only time will tell. Despite this, people are still tweeting asking where they can buy a PB bracelet. As the old saying goes “a fool and his money are soon parted.”
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@lizDitz is compiling a list of news articles reporting on Wakefield’s fraud.
You can find a pdf with 41 studies showing no link to vaccines and autism here
