Education

On the "integration" of quackery into the medical school curriculum

oracknows — Wed, 11 Oct 2017 07:20:33 +0000

On the "integration" of quackery into the medical school curriculum

QEDCon is fast approaching (indeed, I can't believe I have to leave for Manchester tomorrow night), and because my talk there will be about the phenomenon of "integrative medicine," I've been thinking a lot about it. As I put together my slides, I can't help but see my talk evolving to encompass both "integrative" medicine and what I like to refer to as quackademic medicine, but that's not surprising. The two phenomenon are related, and it's hard to determine which has a more pernicious effect on science in medicine.

One aspect of quackademic medicine that I probably don't write about as much as I should is the "integration" of quackery into the curricula of medical schools. Part of the reason for that, I suspect, is that I am fortunate enough to be faculty at a medical school and cancer center that remain relatively untouched by the pseudoscience of integrative medicine. True, our medical school does have at least one credulous lecture about "complementary and alternative medicine" (CAM) that the medical students have to imbibe, but it really is pretty close to the bare minimum required by the accrediting agencies. Oh, yes. Proponents of integrative medicine have been so successful that one requirement for accreditation by the Liaison Committee on Medical Education (LCME) is that there be adequate instruction about CAM. Actually, that's not quite true. Among the educational objectives in the LCME requirements is ED-10: "The curriculum of a medical education program must include behavioral and socioeconomic subjects in addition to basic science and clinical disciplines." This is where CAM and integrative medicine are slipped in. That's because the Academic Consortium for Integrative Medicine and Health successfully lobbied the LCME to include CAM in its list of topics addressed in the LCME Medical Education Database relative to accreditation standard ED-10. Unfortunately, how that is done in practice is often in the form of entirely credulous teaching of CAM.

Last month, when I wrote about the $200 million donation to the University of California, Irvine (UCI) by the billionaire couple Susan and Henry Samueli to create a college of health sciences that will encompass several UCI schools, including its school of medicine and nursing school, dedicated to "integrating" quackery at all levels into medicine thusly:

The Samuelis’ gift will provide $50 million toward construction of a facility to house the college and $5 million for state-of-the-art technology and labs – forming the foundation of a national showcase for integrative health. It also earmarks $145 million to create an endowment for:

Up to 15 faculty chairs across the medicine, nursing, pharmacy and population health disciplines for senior, midcareer and junior faculty with expertise in integrative health

Integrative health training and mentoring for interested medical school students

Scholarships and fellowships for undergraduate and graduate students planning careers in related fields

Innovative curricular development and campuswide interdisciplinary research projects

Ongoing clinical services, research and education in the Susan Samueli Integrative Health Institute, including investigations of nonconventional interventions as part of medical treatment and educating medical and lay communities about benefits and risks associated with new healthcare approaches

What I didn't talk about so much was number 3: "innovative curricular development." That's CAM-speak for teaching CAM alongside real medicine as though homeopathy has scientific validity. This brings us to an article by noted cheerleader for "integrative medicine" Glenn Sabin, Integrative health's place in the medical school curriculum. If you want to know where Sabin's coming from, consider my previous discussions related to his promotion of alternative medicine, such as his "history" of the integration of quackery with medicine and his advocacy for anecdotal evidence disguised as "N-of-1 trials" over clinical trials in determining if various alternative medicines "work." He also first got my attention for openly admitting that integrative medicine is a brand, not a specialty. Also consider this paragraph from his latest:

My colleague, John Weeks, wrote a terrific response in Huffington Post to the media’s shameful coverage of the visionary and game-changing Samueli gift to UCI. He cogently supports his position with actual research, facts, and developments that illustrate just how out-of-touch these dwindling skeptics are—and how a few media outlets took the bait that led them down a narrow-minded narrative centering on one controversial therapy: homeopathy.

For me, though, the back-and-forth with the cynics is not worth the expended energy. This is not just about acupuncture or chiropractic or massage or dietary supplements. It’s much bigger.

The Samueli gift is about the future of health, led by the doctors of tomorrow, like my nephew, Max, who is in his first year of medical school at George Washington University.

Homeopathy is not "controversial." It is rank pseudoscience. This is not even in dispute. Just look at the way UCI started furiously scrubbing its websites of references to homeopathy as soon as critics started looking at the Samuelis' gift in detail. Clearly, the administration was embarrassed. I also note that one earlier gift agreement between the Samuelis to UCI explicitly mentioned that it was to be used to promote research into homeopathy, among other pseudoscientific modalities and that until recently UCI advertised the services of a naturopath and homeopath on its website. Even proponents of integrating quackery into medicine are embarrassed by homeopathy.

When discussing the "integration" of quackery into medical school, I like to discuss another "George" university namely Georgetown. In many ways, it was a "trailblazer" in "integrating" quackery into medicine. I recounted its history just a couple of years ago, citing a 2003 Georgetown brochure:

One of the reasons CAM is usually offered as an elective is that there’s just no time or room in U.S. medical schools to fit in one more massive subject,” says Michael Lumpkin, Ph.D., professor and chair of the department of physiology and biophysics at Georgetown. “When the course is an elective, a self-selected group – maybe 10 or 20 students in a class of 180 medical students – will take it,” Lumpkin says. “What we’ve tried at Georgetown is rather than create all new courses, we take relevant CAM issues and modalities and weave them seamlessly into existing courses.

The “seamless” weaving of CAM into existing classes includes, for instance, a presentation by an acupuncturist on the “anatomy of acupuncture” in the gross anatomy course for first-year students. The same lecturer explores acupuncture’s application in pain relief in the neuroscience course…

Haramati and Lumpkin say Georgetown’s program is distinct from CAM initiatives in other medical schools in two ways: The school is integrating CAM education into existing course work across all four years of each student’s medical education, and the initiative includes a mind-body class to help students use techniques to manage their own health and improve self-care.

Yes, fourteen years ago, Georgetown was "integrating" pseudoscience into its medical school curriculum at every level, starting from day one. Twelve years later, it was celebrating pseudoscience on the cover of the medical school's magazine. That's not all, though. Reflexology is taught as fact, along with prescientific medical systems, such as traditional Chinese medicine (TCM), "energy healing" like reiki and therapeutic touch, and pretty much every "integrative" quackery you can think of. In 2007, Georgetown partnered with the naturopathy school Bastyr University to train the next generation of integrative medicine practitioners.

This is the sort of future of medicine that Weeks and Sabin so strongly desire.

It's also not as though George Washington University isn't itself a bastion of quackademic medicine. Three years ago, I wrote about all the quackery advertised on its website. GWCIM's list of services includes acupuncture (of course!), chiropractic, craniosacral therapy, infrared light therapies, glutathione infusions, Myers’ Cocktail, naturopathy (again, of course!), reiki, intravenous high dose vitamin C, and genetic profile results that include “customized interpretation of 23andme.com genetic profile results with specific accent on methylation and detoxification profiles.” It’s a truly horrifying website to contemplate, given how little of it has any resemblance to science-based medicine and how much of it includes outright quackery like reiki. In addition, its website’s descriptions of various alternative medicine modalities are depressingly and similarly credulous. Acupuncture is described as being used for “for treatment of respiratory, digestive, urinary and reproductive systems, as well as the disorders of muscle tone, hormone production, circulation, and allergic responses” plus “pain relief, gynecological conditions and symptoms, insomnia, anxiety, and to enhance wellness.” Naturopathy is described as a “comprehensive approach to health and healing that combines modern scientific knowledge with traditional and natural forms of medicine,” with naturopaths addressing “the mental, emotional and physical aspects of an individual, and aim to treat the root causes as well as the symptoms of illness.” According to GWCIM, naturopaths are “trained as primary care doctors at accredited four-year naturopathic medical schools.”

No. They. Aren't.

I also can't help but note that John Weeks' article was really nasty broadside against critics of the Samuelis' gift to UCI in which he accused them of having "blood on their hands." Apparently, Sabin approves of such rhetoric, as long as it's directed against his opponents.

Sabin's article is yet another example of how "integrative medicine" rebrands science-based modalities, such as nutrition, exercise, and lifestyle modification as somehow "alternative" or "integrative" and then uses them as the vehicle in which quackery is also "integrated" into medicine, while trying to dismiss anyone who points out the pseudoscience as the "old guard—the few out-of-touch, aging critics pushing back." (I note that Sabin and Weeks aren't exactly spring chickens themselves.) Naturally, he tries to push back against the critics' narrative:

These same integrative health and medicine naysayers essentially conflate quackery—which ought to be called out and confronted—with the larger, progressive, and impactful, integrative health and medicine movement.

Critics also purport that nutrition, physical activity, and stress reduction are already consistently applied (or taught) clinically—that it’s already ‘part of medicine’. These few critics are wrong. Their view is incorrect. Their statements are patently false. We know this because, if these truly preventative measures were applied—if this was remotely the case—our healthcare delivery system would be consistently delivering ‘health care’, not ‘chronic disease care’.

Proponents of integrative medicine always try to sweep all the quackery their specialty embraces under the rug. Pay no attention to that quackery behind the curtain, they say. We're all about nutrition, lifestyle, and stress reduction. They somehow never manage to address the question: Why is quackery so associated with integrative medicine? If integrative medicine really were about "nutrition, lifestyle, and stress reduction" and nothing else, the quackery would be unnecessary. Homeopathy, naturopathy, acupuncture, "energy healing," functional medicine, bogus allergy testing, and more forms of pseudoscience and quackery than I can list here (but have discussed over the years on this very blog) would not find such a comfortable home in "integrative medicine." That they do fit so nicely in "integrative medicine" is by design, not accident.

Consider this. Let's, for the sake of argument, concede that Sabin has a point. Perhaps nutrition, physical activity, and stress reduction are not sufficiently consistently applied in clinical medicine. If that is indeed the case, the answer is to develop strategies to change this shortcoming in medicine. Those strategies, assuming they're science based (as they should be), will not involve embracing pseudoscience and quackery. Sabin and Weeks go on and on and on about promoting the "nutrition, physical activity, and stress reduction" aspect of medicine, but fail to explain why a separate specialty is needed to emphasize these health promotion activities more. That's because they can't. The entire unspoken rationale that they cannot admit is that "nutrition, physical activity, and stress reduction" function, in essence, as a Trojan horse for hardcore quackery. Integrative medicine shows up at the gates of academic medicine looking like ""nutrition, physical activity, and stress reduction," but once the horse is pulled into the ivory tower of academia, out jumps the real quackery, like naturopathy, homeopathy, acupuncture, functional medicine, and the like.

Also unspoken is that the reason integrative medicine proponents want so badly to insinuate their specialty and thinking into medical school is because they want "nutrition, physical activity, and stress reduction" forever linked with the quackery that they also champion. At schools like GWU and Georgetown, it's working, too. I fear, however, that UCI will soon far surpass both GWU and Georgetown as bastions of quackademic medicine.

oracknows Wed, 10/11/2017 - 03:20

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Skepticism/Critical Thinking

Susan and Henry Samueli College of Health Sciences

Susan Samueli

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https://m.youtube.com/watch?v=fHrvWqN2TkM

Does anyone have access to fitness and exercise advice prescribed by the "integrative" crowd?

I'm ready to bet £5 that it's all about tai-chi, yoga and "be careful not to exert yourself" types of exercise, rather than strength training or anything close to a sport or planned training with measurable performance or objectives.

To be fair, some forms of yoga can be very vigorous. I used to do vinyasa and ashtanga at a studio in Ann Arbor, and it was definitely difficult and good exercise. There are "goals," like being able to attain certain postures or getting better at "easy" ones, holding things for longer, etc.

Sure, we can be a really proficient Yogi in the same way that someone can be a really good golfer, volleyball player or anything else.

My perspective though, is that there are sports and exercise endeavours that are more conducive than others to improving people's fitness in a measurable way.

My anecdotal experience is that alt-med types are keen to praise fitness and food advice but such advice is not even that great.

This:

Is not exactly golf. But whatever.

Sure, we can be a really proficient Yogi in the same way that someone can be a really good golfer, volleyball player or anything else.

Don't confuse the popularized "Swedish gymnastics" version of yoga with that connoted by the yogi/yogini title.

From the course descriptions, it looks like my med school hasn't yet integrated quackery into its curriculum.

It did recently get a huge cash donation, but the only visible consequence as far as I can tell is that they renamed the med school after the donor.

@ The Vodka Diet Guru:

To be truthful, a few woo-meisters** DO provide information about cardiovascular and strength training and advocate their usage - as well as yoga et al -
HOWEVER they often present realistic material in self serving ways or exaggerate its effects on health and longevity
.
They present themselves as examples and hint that their products will allow followers to achieve similar spectacular results to their own. Yep, they're elite athletes/ specimens.

They misrepresent what is indeed even feasible for most people in the real world ( which none of them inhabit)-
e.g. one hour of CV a day and one hour of weights most days plus meditation; doing physical work on a ranch or farm.
All while eating extremely restricted, arcane diets ( vegan, mostly raw or paleo, organic etc).

They promise incredible non-verifiable results like adding 6 years to your life, reversing menopause or eliminating/ curing most serious illnesses. You should remember that most of these guys ( and they are mostly men) sell videos, books and supplements/ superfoods whilst one has a holistic retreat/ spa to hawk.

** Mercola, Null, Adams

Sadly, CAM has been integrated into the nursing curriculum for the entire state of North Carolina community college system via the CIP program in 2007.

How well its been integrated depends on the individual instructor. I wouldn't teach that crap in my classroom. But some of my colleagues did on a regular basis, especially when it came to acupuncture and aromatherapy.

When I was in the psych ward at St. Joe's, they once offered some kind of ridiculous ear acupuncture. I considered doing it just for the chance to get off the locked ward, but instead I said "I don't believe in that stuff" and went and made some coffee or something. (They actually let us have real coffee at the two places I was at in Michigan.)

MSM has a Trojan Horse problem because apparently it f'ed up the "nutrition, physical activity, stress reduction angles" so badly, that it even still exists as a CAM thorn, after 50-80 years of MSM and diatetic failures.

The hostile comments here to discussion on higher dose vitamin D and (IV) vitaman C show how badly various strata of MSM misunderstand some biochemical subjects and mistreat (potential) customers.

Although thin on high cost evidence, there are a number of phenomena not well addressed in MSM recognized by legitimate MDs, PhD and independent thinkering patients with as much horsepower as the average MD or better. It's that simple.

Why do I do on about C and D? Because they are amongst the better described areas historically that an outsider can even begin to technically address various issues independently and their being ignored and misstated all these years have had substantial life and death consequences throughout society.

Fix the real problems or quit bitching and go extinct as "they" occupy and displace, even if part of them create more problems.

@prn

Er, no they're hostile to the fact that people like you say that extra vitamins "Can Cure All Your Ills" and other blather like that, when in fact the only thing you're getting rid of is your money.

PRN: I think part of the hostile reaction you personally are getting is that you act like a porcupine on meth. Asking for proof isn't the same as challenging you to a duel at dawn, but you act like it is.

I'm an alumnus of two prominent medical schools (MD, residency), and it pains me to see that both offer acupuncture, chiropractic, reiki, chinese herbal medicine, and other quackery.

prn: actually, no. Modern medicine has not "f'd" up nutrition. Quacks have co-opted it and sell a load of baloney. Not the same thing.

When you can prove your claims, come back. We've pressed you again and again for EVIDENCE you never provide.

"On the “integration” of quackery into the medical school curriculum"

Do you still teach?

And no...once again, you're wrong. I'm not Travis...

Panacea, #14: the original statement has a few missing words:

Modern medicine has “f’d” up the profitability of the quackery surrounding nutrition.

Hope that helps.

LOL. Conventional "modern medical professionals" are certainly not widely known for their independent thought or creativity. To be fair, the "standard of care" binds them, in order to avoid liability. Lifespans are longer at the moment than they were a century ago, but the quality of that extended life is generally not one that people would consider desirable. And the youngest generations are not predicted to live so long, with children plagued by obesity, arthritis, diabetes, cancer, and other chronic health problems. It doesn't take a rocket scientist to realize better answers must be out there. Kudos to the practitioners who are willing to explore them

LOL. Conventional “modern medical professionals” are certainly not widely known for their independent thought or creativity.

BTW, Honeybunch, you might want to have your freak radio tuned into the 16th.

^ "LOL"

^^ Oh, dear, G-d, I actually again tried sitting through one of Gindo's "Wal Thornhill" videos, which exist because LIGO makes him constipated,* or something. My machine actually crashed immediately after he barfed up the axiomatic nature of Euclidean geometry.

* If anybody has the spare time, there must be a wormhole theory to be had here.

@NWO

Well you're one to talk about "independent thought" and "creativity" when all you antivax snobs parrot out the exact same lame, pathetic excuses as to why you hate science and love to pad your wallets with the money of ill-informed people.

Is it just me or do all of the antivax people here all spout their own tropes over and over ad nauseum?

Okay apparently NWO has emerged from the void to ruin another comment section

@NWO

You're one to talk about a lack of creativity when all you antivax snobs parrot out the same excuses as to why you hate science and love to ruin people's lives.

Narad: "A braver man than I.."

I'd hoped NWO had figured out she's not welcome here, but alas, she's back.

(And no, I'm not going to her site. I just got this machine working again. In case you all have been wondering, I've been using my tablet most of the week.)

As far as creativity goes, I don't think most people want creativity from their doctors. Usually, people go to a doctor because they have a problem they want resolved. And 99% of the time, a relatively straightforward solution can be found.

As long as you're here, Ginny, I still want an answer. Did any European royalty die of smallpox or other diseases? Why isn't Europe full of immortal royalty?

Kudos to the practitioners who are willing to explore them

Some people who call themselves "practitioners" are exploring by selling things to ignorant people. They're exploring, all right-- prospecting for gold.

Other people are exploring by subjecting new ideas to high standards of evidence, and sharing the ones that work with real practitioners.

I know which group of practitioners I prefer: the ones who stick to evidence-supported treatments. Even if they are boring old uncreative fuddy-duddies (which they're not).

Heyy it's NWOR, ready to ruin another post.

Ohhkay sorry for all those dumb posts my stupid computer wasn't showing that they posted and I thought they got lost in the internet void

God this is so embarrassing....

This guy is full of crap - there is hard core FACTUAL EVIDENCE of curing of degenerative diseases - INCLUDONG CANCER - with ALTERNATIVE HEALING METHODS. When did he write this article of QUACKERY? Over the last 20 years - it has been PROVEN over and over again that big pharma, FDA, medical schools and health organizations are all HAND IN HAND keeping the medical industry afloat and in business! If we get CURES for these degenerative diseases without pharmaceuticals - what happens? There is no medical industry! See, there’s no $$ to be made in LIFESTYLE changes, foods that are good for you or in Mother Earth. Why would quacks like this say anything good about what we SHOULD do to be healthy - or how to get rid of or prevent disease? If they did that, they would lose billions! To find out more - read the book POLITICS IN HEALING!!

prn@10: MSM has a Trojan Horse problem because apparently it f’ed up the “nutrition, physical activity, stress reduction angles” so badly, that it even still exists as a CAM thorn, after 50-80 years of MSM and diatetic failures.

The hostile comments here to discussion on higher dose vitamin D and (IV) vitaman C show how badly various strata of MSM misunderstand some

Panacea@14: ...Quacks have co-opted [nutrition] and sell a load of baloney. Not the same thing.

Both parts can be true.

P@14We’ve pressed you again and again for EVIDENCE you never provide
I've provided sources for overviews *of what there is*.
You're greatly biased and (a) behind.

IV vitamin C in acute disease, a subject obstructed by generations of medical biases, is largely summarized in those two books, Levy's Curing the Incurable: Vitamin C, Infectious Diseases, and Toxins- and McCracken's Injectable Vitamin C and the Treatments of Viral and Other Diseases although a few important papers for working hypotheses are missing.

Vitamin D3 is a (re-)emergent area, what's available is largely viewable with vitaminDwiki.com

Oh, so you admit the High Vit C crowd sells baloney? Nice to know.

I said provide evidence, not nonsense.

PRN: See my remarks re:your attitude and maybe, you might see why you're getting a "hostile reaction." It's one thing to present bad facts; its another thing entirely to present bad facts and sneer and snarl while you're doing so. Maybe drop the dukes a little and open up those ears.

PGP: Bad facts are in the eye of the beholder. I'm past trying to "prove" things to those of narrow and very dense, concrete perspectives. The problem I deal with here is to find which facts or concepts are at variance in a certain way. Sometimes I do try inject a little reality or perspective into the conversation, whether its in an FDA approved factoid or not.

Occasionally I get nice useful bits of science or history - e.g. Kerbiozen was the most frequent with his lab based experiences, sometimes Narad has useful original content that I've never seen, even when it's ad homeniem dirt on someone.

@prn

There are no such things as "bad facts", moron. You sound like those idiotic knuckleheads who came up with "alternative facts."

A fact is a fact, and just because you do not like it, or it comes from somebody/thing you do not like, does not diminish its factualness. Arrogant fluff-brain.

Epsilon, you sound like a grammer nazi that has little experience in the real world and with laboratory work. "Facts" can be very slippery things even in various technical environments due to inadequate specification, description or measurement of conditions, context, misuse, abuse, and yes, politics.

People will often quote some basic random error stats in their data when their systematic errors and biases are eating them alive by orders of magnitude larger. In fact this latter point is central to a number of disputes between CAM and MSM, with profound examples from both "sides". Whether these larger errors are merely unknown, unrecognized or (willfully?) unacknowledged is another area that often colors the conversation.

I'll go one further on the oxymoron of "bad facts":
they come in several flavors.

When, pray tell, did I ever try to correct your grammar? Yes, I did state that you were wrong, and I admit I went off a little, but I never even paid attention to your grammar. (But I will correct your spelling here: it's "grammar" not "grammer," doofus)

Another thing I will admit, unlike you, is that no, I do not have experience in medical fields or laboratory workings; I have not reached that part of my life yet.

If you are true, and there are "bad facts," then they are not facts, but lies. Also, you're one to talk about biases, so don't lecture me on them sweetie.

@Suzy

Uhh yeah there's tons of money to be sold in altie medicine. Just look at the overpriced vitamin C supplements prn is probably hawking. Look at how much money it costs to eat healthy, and how much you have to pay to get into altie "cancer treatment" clinics that are just oh-so conveniently out of the country to avoid restriction.

prn: I’m past trying to “prove” things to those of narrow and very dense, concrete perspectives. The problem I deal with here is to find which facts or concepts are at variance in a certain way.

First thing, see that second half of the first sentence? That's exactly what I mean when I was talking about your attitude and the way you come in swinging.

Secondly, you don't have any facts. You've never provided any proof of anything, and haven't managed to provide or find a single citation by anyone reputable. You just assert "these things are fact," and demand that you be taken seriously on your word alone. And you've done this for years.That's just not going to fly.

You really don't know how science works, do you?

There's no such thing as bad facts. A conclusion is either correct, or incorrect.

The sky is blue. It may vary in its shade of blue for a wide variety of factors, but it is still blue. It is not green. It is not red. It is not yellow.

prn makes a grand claim about errors of magnitude but since he NEVER gives verifiable examples of what he means by that, he takes the language of science and turns it into a Star Trek like technobabble that isn't nearly as interesting or enjoyable as Star Trek.

To a Troo Believer™ like prn, a fact is 'bad' when it differs from the imaginings [s]he desires to consider as if it were reality. 'Bad facts' are the equivalent of trump's 'fake news'.

there is hard core FACTUAL EVIDENCE of curing of degenerative diseases – INCLUDONG CANCER – with ALTERNATIVE HEALING METHODS

I'm not sure where it's going to prove useful, but I'm definitely adding it to my vocabulary.

@Narad

Maybe it's a secret term like covfefe or heel. :p

It's a portmanteau, and I've heard it used in Thailand.

@Suzy you are right. Conventional medicine sent me home to die after 20 doctor's and untold number of hospital's could not figure out I had Lyme disease.
That was in 2005. A Chiropractic Physician saved my life and correctly diagnosed my condition on the first visit.
Herbs and homeopathic remedies are true medicine.
RX drugs are just a mask or bandage on the wound.

I'm off all RX drugs and have never looked back.

In all fairness, if you get a broken bone, burst appendix or need open heart surgery then I say go to they specialist. I am not against doctor's. They have their place and are good for certain things.

Marjean: sent you home to die?

What hyperbole.

A false diagnosis of Lyme disease might be good for at least 20 followup visits to the chiro.

"Antibiotics just mask the problem dearie, you need a comprehensive set of adjustments."

Ugh, really? Physical manipulation cured your Lyme?

More like your chiro cured you of the dreaded disease called "wealth".

Worse - it was "physical manipulation" and homeopathy....which equals - "monetary manipulation."

Western Medicine is paramount for people to survive. Naturopathic Medicine is paramount for people to survive with vitality and an overall quality of life.

To negate Integrative medicine is small minded thinking. Yes, Western Medicine is groundbreaking but it’s missing ONE HUGE ingredient in it’s majority of it’s production.
PREVENTATIVE CARE.
This is because Big Pharma runs you guys and if you can’t see that then you’re either feeble minded or simply not willing to look.

So calling Naturopathic Medical Doctor’s a quackery is nothing but a cry out for your own shortcomings.

Let them bring the quality, the complimentary quality to the Western medicine world because we need it as long as you don’t offer it as a standard.

Gee, should I cancel my appointment, in about 2 weeks, for a long visit for preventative care, with a real doctor instead of a Not-a-Doctor? Should I not take the meds I take for the purpose of preventative care, since they were prescribed by a real doctor instead of an ND?
What, oh what, should I do????

Lady, this is a science blog, not the ad section of a tabloid. Go peddle your nasty snake oil elsewhere.

I hear Natural News welcomes your type. You'll love 'em. You both seem to love nature and ignoring decades of research for "treatments" that would make any respectable nurse or doctor facepalm.

Silly me. For years I've been teaching nursing students about the 3 levels of prevention. But I guess I don't know anything about that, according to Elizabeth.

Oh wait! Vaccines are prevention.

I could have sworn that naturopathy was a product of the Occident.

My doctor prescribed an update to my TDaP as a preventative measure today for a burn on my hand.
There’s a lot of skin that needs to heal and I don’t want my grandson to get pertussis!

Elizabeth: Scuse you. I just had a quarter size chunk dug out of me in the name of preventative medicine, because everyone concerned wanted to stop whatever it was cold. And every one of the medical professionals i saw was really serious about preventing any infection. No one pushed any more treatment on me than I needed. (for the record, I'm fine, no malignancy detected.)

Squirrelite: Congrats on the grand kid. We have a nib in the family, and I'm so happy I got my flu shot. (I updated my tdap before nib was born.)

John Weeks accuses Orac of having "blood on his hands" for criticizing the Samuelis' $200 million gift to UC-Irvine. Orac responds.

oracknows — Fri, 29 Sep 2017 05:00:17 +0000

John Weeks accuses Orac of having "blood on his hands" for criticizing the Samuelis' $200 million gift to UC-Irvine. Orac responds.

John Weeks has long been an activist for what is now known as "integrative medicine," earlier known as "complementary and alternative medicine"(CAM). Basically, for many years Mr. Weeks has been at the forefront of encouraging the "integration" of quackery with real medicine and promoting what I like to refer to as "quackademic medicine," a perfect term to describe the increasing encroachment of pseudoscience and quackery in medical academia in the form of—you guessed it—integrative medicine.

Despite his having zero background in scientific research or the design and execution of experiments and clinical trials, for some bizarre reason in May 2016 he was appointed editor of the Journal of Alternative and Complementary Medicine (JACM), even though he has zero background in science or medicine of a type that one would expect in a journal editor. Once there, he wasted little time comparing doctors advocating science-based medicine and opposing pseudoscience in medicine to Donald Trump.

Fast forward a year and a half, when the University of California, Irvine (UCI) accepted a $200 million gift from Susan and Henry Samueli to vastly expand the integrative medicine offerings at UCI (which were already quite extensive) in the form of establishing the Susan and Henry Samueli College of Health Sciences, with the current Susan Samueli Center for Integrative Medicine becoming the Susan Samueli Integrative Health Institute.

Amazingly, it wasn't just skeptics like Steve Novella and myself writing negative articles about this development. Michael Hiltzik of the LA Times wrote an article in which Dr. Novella and I were quoted with a lovely headline, A $200-million donation threatens to tar UC Irvine's medical school as a haven for quacks. Elsewhere, Usha Lee McFarling over at STAT News chimed in with a story with a somewhat less critical but still quite unflattering headline, A $200 million gift promotes alternative therapies at a California medical school — and critics recoil.

Both articles contrasted the claims by Dr. Howard Federoff, CEO of UC Irvine’s health system that the new institute and college will be rigorously evidence-based with the reality of the homeopathy offered by UCI. Hiltzik, amusingly, pointed out how UCI was trying to send references to homeopathy on its website down the memory hole and failing miserably. Meanwhile, Rick Seltzer at Inside Higher Ed quoted Steve Novella as he asked, Does $200 million quack? (My answer: Yes. Very loudly.) I, of course, used this observation to point out that UCI has long embraced homeopathy and that, because all naturopaths are trained in homeopathy, you can't have naturopathy without homeopathy.

Those of us who know how deeply "integrated" (couldn't resist) quackery is in naturopathy couldn't help but point out that Dr. Federoff's claim that UCI's new integrative medicine effort will be rigorously evidence-based is complete and utter bullshit unless UCI gets rid of naturopaths, at least as a start. Also, given that the Samuelis are very much believers in homeopathy, so much so that they mentioned support for research into homeopathy in one of their gift agreements with UCI in 2004, I highly doubt that UCI could dump homeopathy very easily even if Dr. Federoff wanted to.

Indeed, given Dr. Federoff's long history of integrating quackery into medicine at Georgetown, which was his gig before he moved to UCI, I doubt that Dr. Federoff is particularly serious about getting rid of the quackery, anyway. It's now too entrenched. This sort of coverage clearly enraged poor Mr. Weeks, who goes to great lengths to project a facade of civility in comparison to all the "anger" he portrays on "our" side. Indeed, his facade slipped so much that he misspelled Mr. Hiltzik's name alternatively as "Hitzig" and "Tiltzig" in a post published—where else?—that original wretched hive of scum and quackery, The Huffington Post, in the form of an article entitled Shameful Media Response to the Samueli’s Visionary $200-Million Integrative Health Investment at UC Irvine, in which he refers to critics of integrative medicine as "antiscience" and as "having blood on our hands."

You can get a taste from the introduction:

The response of the LA Times, STAT, Medpage, and most media to the visionary $200-million integrative health investment of Susan and Henry Samueli at UC Irvine has been a shameful display of media descent into Trump-like, polarizing tweets. Worse yet, the coverage has been a profoundly anti-science. These media, and others, have chosen to provide platforms to a small handful of individuals who for decades have denied the evidence of acupuncture, chiropractic, mind-body and multiple other integrative approaches.

Mr. Weeks is nothing if not predictable. These days, to him any criticism of integrative medicine is "Trump-like" and "polarizing." This is the schtick he came up with last year, before the election and continuing after it. To this recent but now familiar trope, Mr. Weeks adds a new epithet: "Anti-science." In essence, he is doing exactly what climate science denialisms and anti-vaxxers do: Try to flip the narrative and portray themselves as the true defenders of scientific inquiry and their critics as close-minded dogmatic skeptics who will not consider all the evidence.

This is, of course, nonsense when anti-vaxxers and climate science denialists do it, and it's no less ridiculous when Mr. Weeks does it. Also, note how Mr. Weeks also tries to minimize the criticism by minimizing the critics, referring to us dismissively as a "small handful of individuals," in order to portray us as being a tiny minority who can safely be ignored. Elsewhere in his article, he refers to Medscape "bleating" out a link to McFarling's article in STAT. (Get it? We're sheeple.)

Sadly, Mr. Weeks' tactics are all mind-numbingly obvious, but at this point in his jeremiad, Mr. Weeks turns out to be just getting started. It doesn't take him long to work himself into a fine lather:

From his LA Times podium, Michael Hiltzig first gives voice to David Gorski and then to Steven Novella, long-time colleagues and back-slapping companions as anti-integrative medicine vigilantes. Hiltzig quotes Gorski first, shaping the Samueli’s investment this way: “The only reason ‘integrative medicine’ exists is to integrate quackery into medicine.” Tiltzig immediately turns to Novella to use the Trumpish, name-calling term that Gorski himself favors: “In a blog post, Novella flayed UCI’s establishment of an integrative medicine curriculum as ’quackademic medicine.’”

"Back-slapping companions as anti-integrative medicine vigilantes"? I laughed out loud when I read that line. Maybe I should change the name of the blog from Respectful Insolence to Anti-Integrative Medicine Vigilante. On second thought, "Respectful Insolence" rolls off the tongue much more nicely. The whole "vigilante" charge, though, is meant to further demonize Steve and me, who slap each other on the back like dudebros after each new takedown of integrative medicine. Maybe next he'll portray us as bumping chests and shouting. (Seriously, could Mr. Weeks be any more obvious?) The answer, apparently, is no:

It would be one thing if this were just journalistic laziness. Sure, go ahead and run polarizing copy based on a tweetish view of the universe that makes a story fit for afternoon TV. In fact, however, these media have chosen to trumpet fake news. They promote this polarizing grandstanding rather than honor the emerging scientific consensus that is yet poorly integrated into health professional education and practice - and that utterly backs the Samuelis’ investment and direction at UC Irvine:

He then cites four references that actually show how deeply embedded quackery has become in medicine, thanks to the efforts of people like Mr. Weeks. For instance, he mentions the Joint Commission's 2015 revision of its pain management standard that recommends nonpharmacologic approaches to pain, and mentions acupuncture, chiropractic, and osteopathic manipulation. Now, I've discussed many times before how integrative medicine mavens have latched on to the opioid crisis as an opportunity to expand their influence by rebranding CAM/integrative medicine as "nonpharmacologic approaches to pain." Indeed, the National Center for Complementary and Integrative Medicine (NCCIH) enshrined this in its 2016-2021 strategic plan.

Ever since the opioid crisis inserted itself into the national consciousness, proponents of integrative medicine have seen a golden opportunity to use it to further the integration of quackery into medicine. Only they want to be seen as science-based; so when programs like the one at UCI are caught advertising The One Quackery To Rule Them All, homeopathy, they scramble to hide the evidence of it. Mr. Weeks makes a great show of mentioning guidelines published by the Mayo Clinic, which, if anything, showed that the "complementary" approaches to pain examined do not have an effect greater than placebo.

Truly, it was an awful review article. Predictably, he also mentioned American College of Physicians guidelines for low back pain. I can't help but note that those recommendations characterized evidence base for acupuncture, for example, as low quality evidence, moderate at best, and cited the GERAC Study, which basically showed that acupuncture does not work. Another mixed "electroacupuncture" (which is basically TENS) with acupuncture. Truly this was thin gruel for the ACP. Finally, he referred to the National Academy of Medicine's review on nonpharmacological approaches to pain. I perused it. It misrepresents the evidence base for acupuncture in a far too favorable a fashion, for instance claiming that recent "reviews and meta-analyses examining the effect of acupuncture on musculoskeletal pain (neck and back pain, osteoarthritis, chronic headache and shoulder pain, fibromyalgia) have found that overall, acupuncture is superior to sham and no acupuncture, but with relatively modest differences between true and sham acupuncture."

Yes, the NAM cited the Vickers meta-analysis, which showed that acupuncture doesn't work, with no clinically significant effect on pain, although the conclusion was spun to be the exact opposite. Yes, Mr. Weeks is doing what any "thought leader" in integrative medicine has to do: Exaggerate or even misrepresent the evidence base supporting the quackery that integrative medicine is seeking to add to medicine.

Up until now, Mr. Weeks didn't actually piss me off. Rather, he amused me, as he recycled the same tired, dubious arguments that he's always used, complete with his dismissive comparison of critics of integrative medicine to Donald Trump, which he's now done so often that to me it's a cliché. Indeed, I'm half tempted to make a drinking game out of Mr. Weeks' references to Donald Trump as a means of denigrating his opponents: Take a drink each time he compares our writing to Trump or to Tweets. The only problem is that I'd probably be at risk for alcohol poisoning if I were to play that game.

Here's where Mr. Weeks actually managed to piss me off. It's hard for an apologist for quackery to do, but Mr. Weeks managed it:

The roundhouse, condemnatory, “quackademic” perspectives of Gorski, Novella, Caulfield and their like toward complementary and integrative health and medicine need to be treated and dismissed by the LA Times and others as the anti-science that they are. Sure, discussion can be engaged over specific approaches or therapies. Yet giving a platform to this broad dismissal of the Sameulis’ investment is no different than repeatedly quoting non-believers in climate change at the top of an article about a massive, exciting effort to correct human environmental degradation. And while the scale is different, both forms of science denial have blood on their hands. The residual, reactive, medical ideology of these anti-integrative careerists to which the LA Times and others give a platform is a barrier to potentially lifesaving directions toward which the Joint Commission-Mayo/NIH-American College of Physicians-NAM-Attorneys General jointly urge us - and the Samueli investment would propel us.

Fuck you, Mr. Weeks. Longtime readers know that I pretty much never drop the F-bomb on this blog other than when quoting others, such as Jenny McCarthy's famous quote about the MMR and autism. In this rare case, however, I think an exception to that rule is more than justified. When you accuse Steve Novella, Tim Caulfield, me, and those who make the same arguments as we do of having "blood on our hands," telling you to fuck off is the only appropriate reaction.

We're doctors. Mr. Weeks is not. We save lives. Mr. Weeks does not. I'm a medical researcher. Mr. Weeks is not.

I can deal with his unwarranted attacks on us as "antiscience." I can laugh at them, even. I know we have the data, the science, and reason on our side. Also, contrary to how we are portrayed, we do not dismiss massage, mindfulness, exercise, diet, or other lifestyle aspects of integrative medicine. We merely point out that they are more appropriately a part of science-based medicine and that integrative medicine is "rebranding" them as somehow being "alternative" or "integrative" and then throwing in quackery like acupuncture, reiki, naturopathy, and the like. The purpose, of course, is to legitimize quackery.

That's why I say that there is no reason for integrative medicine to exist other than to provide a vessel through which quackery can be integrated into medicine. As for being an "anti-integrative medicine careerist," I view this as a thinly disguised variant of the "pharma shill" gambit, in which Mr. Weeks insinuates that we must be biased because we've made a career out of being "anti-integrative medicine." Would this sort of thing were even possible! Seriously, though, Mr. Weeks should look at my publication record. Only two of my publications indexed on PubMed can be characterized as even being about integrative medicine. However, Mr. Weeks' little tirade has med me think that maybe I should try much harder to publish more of this in the peer-reviewed scientific literature. The reason I haven't is because I'm not an "anti-integrative medicine careerist." Maybe I should become one, except that I'd call it being a pro-science careerist.

To get an idea of where Mr. Weeks comes from, he repeats a number of anti-medicine tropes. For instance, he does his best to paint critics of integrative medicine as a discipline as not caring about prevention. That's an old chestnut, because integrative medicine proponents have tried very hard to rebrand any sort of interventions to prevent disease as their bailiwick. He also cites a BMJ paper concluding that medical errors result in 251,000 deaths per year and are the third largest cause of death in the US, clearly having selected that particular paper because it has one of the largest numbers of deaths estimated anywhere in the literature. (Über-quacks Mike Adams, Gary Null, and Joe Mercola would be proud.)

As I pointed out when this study was published in 2016, the methodology used to calculate this number was highly questionable, at best, and basically custom-designed to inflate the number of deaths due to medical error, particularly through misattribution of the cause; i.e., mischaracterization of complications that had nothing to do with medical error as being due to error. Mr. Weeks then defends the poor, put-upon Samuelis as being philanthropists of the highest order, listing their charitable donations over the last two decades. No one is denying that the Samuelis have made worthwhile charitable donations over the last 25 years. It is not those particular donations that I and people like Steve Novella and Tim Caulfield have a problem with.

Rather, it is the Samuelis' repeated donations in the cause of furthering integrative medicine that we criticize. Remember, as has been pointed out in multiple articles, the Samuelis are true believers in The One Quackery To Rule Them All, homeopathy. Does Mr. Weeks think that homeopathy is science-based? I'm sorry, but you cannot credibly claim the mantle of science if you believe in homeopathy. Period. You just can't. You can try, but you will be called out, even laughed at—and deservedly so. Homeopathy is quackery based on concepts of vitalism and sympathetic magic.

Mr. Weeks concludes:

Reporters: stop giving a platform to anti-science. Do us all a favor and get serious, and scientific, about your reporting of an investment of the Samuelis at UC Irvine that - despite this apparently necessary stone throwing - may prove to be the most influential philanthropic investment in the substantial course correction that US academic medicine and medical industry need.

Actually, that's what I'm afraid of, that the Samueli investment will be the most influential philanthropic donation in medicine. I agree that reporters should stop giving a platform to antiscience. What that means is not at all what Mr. Weeks thinks it means. As much as he thinks otherwise, it is he who is promoting antiscience. Indeed, the reporting on the Samueli donation represents one of the times that the mainstream press that bothered to pay attention to this story actually got it mostly right about integrative medicine. Mr. Weeks doesn't like this, not one bit. That's why he's lashing out now.

oracknows Fri, 09/29/2017 - 01:00

Categories

https://www.youtube.com/watch?v=hopNAI8Pefg

As a science-based physician who has done research, I will also say "fuck you" to Mr. Weeks for his accusation that you have "blood on your hands" along with all the other anti-science and anti-medicine bullshit he spouts in his Huff-Po screed.

Do quacks bleed when a potential source of revenue is squeezed? If true, you'd have to grab them by the purse to have "blood on your hands".

I, too, will join in the fuck youing.

I am not a doctor or a researcher. I did pass my grade school chemistry class. I still am baffled how anyone else who has taken even the most basic class in chemistry can accept homeopathy as a science.

Orac writes,

We’re doctors. Mr. Weeks is not. We save lives. Mr. Weeks does not. I’m a medical researcher. Mr. Weeks is not. I can deal with his unwarranted attacks on us as “antiscience.” I can laugh at them, even. I know we have the data, the science, and reason on our side.

MJD says,

Q. What do Orac and Col. Nathan R. Jessup have in common.

A. They're a few good men.

Mr. Weeks has a lot of nerve accusing anyone of journalistic laziness when he misspells the name of the journalist he's criticizing not once, but twice. Within the same paragraph, no less.

What idiot made him the editor of a journal? Part of an editor's job is to spot and correct errors like that.

While Orac and Chris are rightly irritated by the "blood on their hands" comment, I would point out Weeks only went there because his argument is otherwise so weak as to be nonexistent. He has to resort to hyperbole to get any traction.

Pathetic.

Mr. Weeks has a lot of nerve accusing anyone of journalistic laziness when he misspells the name of the journalist he’s criticizing not once, but twice. Within the same paragraph, no less.

And with two DIFFERENT misspellings, no less. I mean, I know I make a fair number of typos (you try cranking out 2,000 words a day in your spare time and not making typos), but Weeks is a frikkin' EDITOR.

Also, which may be quite telling, is the fact that Mr. Weeks was the AANP's first "Exective Director", and that may fit well with the observations above regarding what I often term a 'reversal of values.'

After all, it is naturopathy by way of the AANP that still quite falsely terms homeopathy a "medicinal science."

So if you like physics and vectors, if "science" is the actual value, what we have in Mr. Weeks is deviation and indistinction:

"-science".

-r.c.

There is a profound difference between Trump and those criticized by Weeks. Pretty much all available evidence demonstrates that Trump is profoundly ignorant about nearly everything. Orac et al actually know things.

I have a suggestion for a title for a regular "column" by Weeks: Weeks Sauce.

Despite his having zero background in scientific research or the design and execution of experiments and clinical trials

More likely, because, not despite. Their publication couldn't survive a pro-science bias.

Here is an open challenge to this Mr. Weeks:

We will inject you with the rabies virus. You have two choices: 1. Follow the science based cure and get the rabies vaccine or 2. Follow the homeopathy/naturopathy cure method(s).

I can bet which choice you will make. Choice 2 leaves you dead, choice 1 will let you live.

I won't say F/U to you because the time and effort with no pleasure wouldn't be worth it. Crawl back into some dark corner and continue to play with yourself. Unfortunately you are proof that the Peter Principle isn't true, you have raised way beyond your competency.

What does Mr. Weeks say about using alternative medicine for cancer? (If he wants to talk about the effects on saving people's lives).

I'd be very surprised if he speaks up against them. I'll try to run a search after teaching.

They’re a few good men.

Yeah, but you think Vinu is a good person, so it's obvious you don't understand the concept.

Johnny
The Bad One

The misspellings and lack of eighth-grade-level copy editing should have consigned this little rant to the round file. I stopped reading HuffPo years ago when it lost its editorial direction, but this kind of sloppiness is inexcusable in something that still has such a large audience. I'm almost as disappointed that the mainstream press is providing cover for his ridiculous false-balance argument. Who reads his journal? Is it indexed anywhere? Who's paying for it? A supplement manufacturer? A woo peddler? Is anyone asking those questions? There are hundreds/thousands of garbage/front journals. Why give a garbage journal editor any voice at all?

To give Weeks credit, "anti-integrative medicine vigilante" is a bit more creative than "polarization-based medicine bloggers", a term he used in the course of this outpouring of verbal diarrhea:

https://www.integrativepractitioner.com/whats-new/all-news/april-2015-j…

I suspect part of his angst stems from Orac's lack of respect for NDs (Weeks is married to one).

Climate-change denialist? Wait till he calls you a holocaust denialist.

What idiot made him the editor of a journal? Part of an editor’s job is to spot and correct errors like that.

That's not the job of an EIC. I have no idea whether the new SnuffPo has putative comma jockeys (PLOS doesn't), but even copyeditors need copyediting. On the other hand, the misspellings could be deliberate.

. . . On the other hand, the misspellings could be deliberate.

And therefore juvenile, at best.

@ Johnny (#12),

No, I think Vinu is a "great" person based on creativity and effort.

You (Johnny) are also a "great" person based on creativity and effort.

Therefore, you have fallen off the top100 list of Orac's minions:

98) helpmeplease
99) Willtodie
100) David Corcos
101) Johnny

After twenty years of steering clear of the subject, Weeks struggles mightily to keep both buttocks on the middle of the fence when considering "the most sacred of cows in U.S. medicine".
https://www.integrativepractitioner.com/whats-new/all-news/furies-vacci…

Pusillanimous ignorant creep.

@doug #8: LOL. I broke Rule #1.

@Narad: It actually is the EIC's job, the buck stops with him. But I'll grant you, the role has become much more ceremonial than it used to be, which probably explains the declining quality of print publications in general nowadays.

MJD: no one is fooled by your pathetic attempts to suck up.

In other news: Tom Price has resigned...

No loss. Though, at this rate the Orange Cheeto will have to replace his entire cabinet, and he hasn't even been in office a full year yet.

The bonus is, Price is out of Congress for at least a couple of years.

You round-earth fanatics are so polarising with your refusal to even consider the flat-earth evidence. What is wrong with an integrative approach that combines the complementary aspects of both cosmologies?

MJD,

Therefore, you have fallen off the top100 list of Orac’s minions

You actually keep tabs of Orac's minion?!?!

@ herr doktor bimler (#24),

You Schwarzbier fanatics are so polarising with your refusal to consider Dunkel.

Friday night cheers, cosmological friend!

Alain (#25) asks,

You actually keep tabs of Orac’s minion?!?!

MJD says,

I certainly do, the list has grown considerably over the last seven years.

You (Alain) have moved up on the list (#97) due to Johnny's Orac-less disposition lately.

Congratulations Alain!

Pgp, don't be too hard on MJD. His posts help me keep "obsequious" on the tip of my tongue - with "simpering", 'sappy' and other s-words slightly astern. Alas "exsanguinated sequoia" images intrude into my imagination. Irritating.
Don't let his lame litter lead to lament - Rubus replies recommended.

I have a quarter-inch diameter canker sore on my uvula.

In misery, please recommend a science-based treatment.

I've tried hydrogen peroxide and chloraseptic (1.4% phenol) but continue to suffer.

Please advise...

Orac, this article reads as if it were a guest posting by your and our esteemed 'friend', Dr Gorski, rather than by our revered blinky-light box.

So, I did some googling. Weeks is basically self taught, no degree, somehow worked his way to editing an alternative health journal, runs an alternative health blog, and is married to a naturopath? How did he get to the "forefront of encouraging the “integration” of quackery with real medicine?"

This is one of my problems with the alternative health industry - what Dr Offit calls the "false prophets."

UCI, which is my alma mater, will lend respectability to alt health with this donation, Weeks is right. That is a real shame. I wish there was some way for them to turn this down and stick to good science.

What do the Samuelis have that wins such devoted defenders? $200 million to give away! That's all you need to know.

I’ll grant you, the role has become much more ceremonial than it used to be, which probably explains the declining quality of print publications in general nowadays

EICs haven't been proofreaders in nearly half a century. Please don't try to teach your grandmother how to suck eggs.

It's not only $200-million. It's a visionary $200-million investment!
And you can same the same visionary investment in ludicrous high-tech precision medicine. When quackery triumphs, it means that there is no hope for the patient.

sorry, you should read;
you can MAKE the same

For the Washington Post, or JAMA, I'll agree with that.

For small, serious journals with small budgets, nope. The EIC is still involved in the process.

Believe me, I learned this the hard way when I published in a small journal earlier this year. They still managed to leave in errors I told them to correct after I reviewed the galley proofs.

I'm afraid that I do have to agree with Weeks on one thing. Ant-Science screeds should never get the coverage in the media that they do. False balance has done more to harm science education and policy in North America than just about anything else. But if a policy to ban that was put into effect, Weeks would be ranting about censorship.

I really wish our anti-hate laws could be used to keep the NDs from advertising in Dr COS-play dress in Ontario. It does serve to remind me why I don't watch broadcast television.

@28 Doug: You forgot moronic and imbecilic, both highly appropriate when referring to MJD.

Anonymous Pseudonym (#35) writes,

You forgot moronic and imbecilic, both highly appropriate when referring to MJD.

MJD says,

I found some relief from the canker sore on my uvula (comment #29) and it comes from an article in Reader's Digest.

https://www.rd.com/health/wellness/stop-canker-sore-pain/

I thought about going to the doctor but a Google search presented an article with a multiplicity of natural remedies described above in the Reader's Digest article.

I saved a lot of $ by avoiding the doctor and continue to be thankful, in some situations, that there are alternatives to science-based medicine.

Big thanks to Google and artificial intelligence.

Schwartzbier is #FAKEBIER created by liberals.

Schwartzbier is #FAKEBIER created by liberals.

It's no Apex Predator, but I'll take a $4.99 four-pack of Köstritzer happily.

Believe me, I learned this the hard way when I published in a small journal earlier this year. They still managed to leave in errors I told them to correct after I reviewed the galley proofs.

And this demonstrates that the EIC is also the Comma Jockey in Chief how, exactly?

Orac IS an "anti-integrative medicine vigilante", a badge methinks he wears with pride. So what Orac doesn't get into is how much division and contention there is within the rubric of IM. Weeks isn't just an IM propagandist. He's a propagandist for the worst sorts of IM. He's not out to legitimate what Orac calls "quackademic medicine". TPTB there (places like Mayo) don't need him, and probably don't want him either. He's out to legitimate IM as a specialty practiced by autonomous individual providers – in essence re-branding the neighborhood naturo-quack. This is far different from and vastly more expansive than what the "quackademic" programs do – a good number of which limit the CAM to a few 'modalities' employed for pain management and supportive therapy (in which placebos are actually useful), and all that I know of have any CAM providers working under and limited by qualified MDs.

This is NOT what Weeks wants. Or should I say it's not what the grifters he shills for want. He makes his living by representing alt-med companies and interest groups. And for this cabal, IM isn't about helping folks get through chemo or distracting them from musculo-skeletal pain rather than dosing them with opiods. No, it's all about "prevention"! or IOW supplement scams. Weeks being in bed with firms like XYMOGEN which pile a variety of shady business practices on top of manufacturing dubious products to begin with.

I don't buy that he's genuinely outraged and offended by Orac's critique of UCI on principle. His attempt to run a Turdblossom on 'anti-science' is transparently calculated and cynical. My bet is he's trying to use the controversy Orac and Novella have generated for his own agenda and/or his clients' agendas. Maybe he's trying to ingratiate himself with an institution that now has $200 million to spend. Maybe he hopes to pull the new UCI program into an even quackier direction. Maybe he just wants to use the prestige of the UC system to promote legitimacy for his own brand of IM, as if they were the same thing. Which they're not, no matter that Orac may find both unacceptable...

There are two editors for the journal. Both have equal responsibility for all aspects of publication. It's a really small, new journal that publishes once a year. My article came out in Issue 2.

Yes, it's peer reviewed. No, it's not a predatory journal (it's sponsored by my university). But the editors actually have to edit.

Hey, MJD, here’s a poem for your next book -
*Not safe for work*
https://youtu.be/HhGuXCuDb1U

And try as I like, a small crack appears in my diplomacy-dike.
"By definition", I begin,
"Alternative Medicine", I continue,
"Has either not been proved to work, or been proved not to work.
Do you know what they call 'alternative medicine' that's been proved to work?
Medicine."

@Johnny (#44),

When science-based medicine fails, hope is clearly derailed.
When 'alternative medicine' fails, a hope silently prevails.
When all else fails, there is no hope.

The canker sore on my uvula is waning (comment #38), I'm hopeful that the use of natural remedies made a difference.

@ 42 Panacea

But the editors actually have to edit.

Clearly your business model needs some fine tuning.

http://deevybee.blogspot.ca/2017/07/breaking-ice-with-buxom-grapefruits…

I believe the poem MJD provided is by the acclaimed British poet Paula Nancy Millstone Jennings of 37 Wasp Villas, Greenbridge, Essex, GB10 1LL.

@ Johnny (#47),

Allow me to add a condescending enhancement with respectfully-insolent intent:

When science-based medicine fails, hope is clearly derailed.
When ‘alternative medicine’ fails, a hope silently prevails.
When all else fails, there is no hope you DOPE.

Paula N. M. Jennings can't take credit for that, Johnny. :-)

@jrkrideau: I guess I'm having an Aspie moment. I'm not sure what you mean to say with your link.

@49 Panacea

Editors are supposed to charge "page fees" not read the paper!

Title of paper:
[b]Breaking the ice with buxom grapefruits: Pratiques de publication and predatory publishing [/b]

In this case, it does not appear that anyone even read the title. And in this case the "editor" did not even get the cash.

Oh, silly me!

Heaven forfend there actually be any editing.

When science-based medicine fails, hope is clearly derailed.

Something something Jesse Fuller something.

Johnny:Snicker. It's hilarious to me that neither MJD or NWO read books, despite both of them being older than me. Well, supposedly in NWO's case, as I'm not convinced they aren't actually a twelve-year-old.

David Brin, who I find always worth reading even when I don't agree with him (https://davidbrin.blogspot.com/) speaks of there being a war against the fact-using professions, and I think this is just another example of that.
I can't describe it as well as he does, so go read him.

I'm trying to picture the respectable Dr. Gorski and Dr. Novella bumping chests and shouting. I think that would be a perfect way to commemorate next years 10 yr NECSS anniversary! :)

Kat -- D'you think they could get Dr Lance O'Sullivan teach them how to do a haka? That would be awesome.

https://www.youtube.com/watch?v=W235oVNy2bs

May I suggest The rock if Dr O'Su,llivan is not available?

[youtube https://www.youtube.com/watch?v=l7E3Sph45z8?rel=0&w=560&h=315]

Which one gets to wear the pink, Gorski or Novella?

Integrative medicine is trying to hitch a ride on the coattails of actual medicine. I'm reminded of a con artist who wants credit for mixing an occasional truth in with his lies.

MJD,

May I suggest a hydrochloric acid throat gargle. That should get rid of your canker together with your entire uvula, tongue, throat, and the ability to speak. A marked improvement you'd have to agree.

Billyjoe: Careful there. MJD's dumb enough to actually do that.

Actually, since simple canker sores typically heal by themselves in about a week,
https://www.webmd.com/oral-health/guide/canker-sores#1

it's quite likely that any alternative treatment MJD uses will "work".

Acids are not recommended, though.

It's been five days, so how is your sore doing, Michael?

Have you visited your dentist? I'll probably need to see mine soon myself.

You know what you are? You are an anti-integrative medicine careerist and a big pharma shill.

Yawn:
http://scienceblogs.com/insolence/2013/02/14/the-pharma-shill-gambit/

Homeopathy at UC-Irvine: The administration can run but it can't hide from its history of embracing quackery

oracknows — Tue, 26 Sep 2017 04:01:40 +0000

Homeopathy at UC-Irvine: The administration can run but it can't hide from its history of embracing quackery

Last week, the University of California, Irvine (UCI) announced that Susan and Henry Samueli were donating $200 million for it to set up a massive new integrative medicine initiative. The plan would basically transform biomedical sciences and medical education at UCI—and not in a good way.

Remember what "integrative medicine" is. What is being "integrated" into medicine is, of course, quackery. Oh, sure, integrative medicine also emphasizes lifestyle modification, such as diet and exercise, but that is part of "conventional medicine" already.

There is no good scientific or medical rationale for a separate specialty devoted to just that. What integrative medicine does is that it rebrands perfectly science-based modalities, such as diet and exercise, as somehow "alternative" and then "integrates" quackery, like naturopathy, acupuncture, functional medicine, applied kinesiology, homeopathy, and basically any form of quackery you can think of. Without the quackery, there is no integrative medicine.

Worse, the phenomenon has resulted in a most pernicious effect in medical academia, the infiltration of outright quackery into the research and education efforts there, a phenomenon I like to refer to as "quackademic medicine."

Of course, The Very Serious Academics In Very Serious White Coats who have come to believe in integrative medicine to the point of devoting their careers to it would vehemently disagree with my characterization. I'm referring to the sort of doctors who present at conferences of learned academics and write what they claim to be evidence-based care guidelines for breast cancer patients. Perhaps the best thing to mention to rile up serious academic advocates of integrative medicine is homeopathy. Any mention of homeopathy is guaranteed provoke paroxysms of self-righteous denial.

"Oh, no," they'll say, "homeopathy is pseudoscience! It's quackery. Integrative medicine is evidence-based, and we would never do anything that isn't evidence-based!" Sadly, as I've pointed out time and time again, you can't have naturopathy without homeopathy, as homeopathy is an integral part of naturopathy. As long as you have naturopaths, you will have homeopathy. Oddly enough, many of these The Very Serious Academics In Very Serious White Coats are utterly oblivious to this simple fact, even ones who write Very Serious Clinical Guidelines with naturopaths and welcome naturopaths into their Very Serious Medical Society.

ll of this brings me back to UCI, because yesterday there was a story by Michael Hiltzik for the LA Times about this very phenomenon. Well, not exactly. Rather, it's about the relationship between UCI and homeopathy and how UCI seems rather—shall we say?—touchy about the subject:

As of late last week, visitors to the website of UC Irvine Health, that institution’s clinical arm, could learn that among its services to patients was “homeopathy.” That was a problem, because homeopathy is a discredited and thoroughly debunked “alternative medicine.” Even Howard Federoff, UCI’s vice chancellor for health affairs, agreed that the scientific basis for homeopathy was “lacking.” The issue is important because the donors of a $200-million gift to UCI’s medical schools, the billionaire couple Susan and Henry Samueli, are sworn believers in homeopathy and supporters of a raft of other “integrative” health treatments. As I reported, some medical authorities have raised questions about whether the Samuelis’ beliefs and their rare generosity will undermine UCI’s explicit commitment to science-based medicine. So it’s interesting that after I raised questions about the treatment’s listing on the website, it mysteriously disappeared. As of this writing, a UCI spokesman hasn’t gotten back to me with word on when it was removed, or whether its removal means that homeopathy no longer will be offered to patients, or merely that UCI is keeping it quiet. The listing was present as recently as last Wednesday, when I asked Federoff about it in connection with my column about the Samueli gift, which appeared online Friday; its presence can be seen on an archived version of the website dated Sept. 19.

Ah, yes. The light of national attention due to the Samuelis' enormous donation to promote pseudoscience must have rattled UCI. After all, even the most avid proponents of integrative medicine are profoundly uncomfortable with homeopathy, even Dr. David Katz, whose "more fluid concept of evidence" led him to try homeopathy in a patient.

That's because homeopathy is quackery.

Indeed, there's a reason I routinely refer to homeopathy as The One Quackery To Rule Them All. To recap, homeopathy is based on two laws. One states that to treat a symptom you use something that causes that symptom. The other states that a homeopathic remedy becomes stronger with dilution. Neither are based in evidence. Indeed, many homeopathic remedies are 30C or greater in dilution, where C is a 100-fold dilution. Thus 30C means diluting the solution 100-fold thirty times, which results in a dilution of 10^-60.

Given that Avogadro's number is on the order of 6 x 10²³, a 30C dilution is more than 10³⁶-fold greater, which means that it's incredibly unlikely that a single molecule of original remedy remains. Most homeopathic remedies are just water or ethanol diluent. Even the most die-hard advocate of quackademic and integrative medicine has to admit that, which is why even they are so uncomfortable when homeopathy is brought up and so loudly and self-righteously deny that integrative medicine would ever have anything to do with homeopathy.

Amusingly, Hiltzik noted a web page that looked very, very familiar to me, that of Dayna Kowata, ND, LAc. Yes, she's a naturopath and acupuncturist. She also expresses an interest in homeopathy. What's so familiar about Not-a-Dr. Kowata? Well, I used her UCI webpage in talks about quackademic medicine several years ago, and I've even mentioned her on two different occasions on this very blog, albeit not by name. At the time, I didn't know that Susan Samueli is strong believer in homeopathy, but I do now.

I wonder what Ms. Samueli will think if Dr. Federoff actually does eliminate homeopathy from UCI. I rather suspect that she won't be happy. I particularly wonder this based on the original gift agreements between the Samuelis and UCI when the Samuelis first founded the Susan Samueli Center for Integrative Medicine (SSCIM) at UCI. The original gift was $20 million in 1999. Now here's where it gets interesting. In 2003, the board of directors of the Samueli Center was formally founded in the UCI College of Medicine.

You can read the whole thing if you like, but this is the key paragraph:

The proposed Center will build on the considerable knowledge and experience of its faculty to study the efficacy of various therapeutic modalities considered to be part of complementary and alternative medicine, including herbs and homeopathic medicine, as they relate to areas such as cardiovascular, autoimmune and neuromuscular diseases, cancer treatment and prevention; and menopaus and ageing. In addition, the proposed center will foster UCI's emergence as a leader in the area of acupuncture by supporting basic and clinical research into the mechanism of action and the efficacy of acupunctxure as a modality. The proposed Center will encourage and foster multidisciplinary studies that involve appropriate faculty from across the campus as well as from other institutions.

That's right. Homeopathy was baked into the Samueli Center from near the very beginning. I can't help but wonder what would be found in the formal gift agreement for the Samuelis' $200 million donation. Perhaps a Freedom of Information Act request would shed some illumination on this question. On the other hand, I note that homeopathy was only mentioned in one of the gift agreements.

Perhaps then, as now, UCI and the Samuelis learned that homeopathy brought too much embarrassment to the university—and rightly so—and that's why homeopathy hasn't been mentioned in any of the Samuelis' gift agreements since 2003. Alternatively, most of the gift agreements after that had to do with setting up fellowships and endowed chairs and gave UCI administration the latitude to use the gifts for whatever purposes it judged most consistent with the wishes of the donors.

Contrary to what Dr. Federoff claims, quackery is deeply embedded at UCI. It's the raison d'être for the SSCIM. He might be in denial about it, but it's true. That's why I was amused to read Hiltzik's observation:

The on-again-off-again appearance of homeopathy on UCI’s website and among its clinical offerings underscores the difficulties the university may face in navigating the inconsistencies between the world view of its biggest donors and its explicit commitment to rigorous scientific standards in its medical teaching, research, and clinical treatment. The Samuelis, after all, will have their names on UCI’s main on-campus medical building, and their gift will endow up to 15 faculty members, all of whom will have to demonstrate some “expertise in integrative health.” We reported over the weekend that “integrative health” is interpreted by many in the medical profession as code for introducing unproven and debunked nostrums into a curriculum that should be based exclusively on scientific evidence. Although Federoff says science will govern at UCI, that hasn’t necessarily been the case at the Susan Samieli Center, which was established in 2001 with a $5.7-million donation from the couple and will be converted into the Susan Samueli Integrative Health Institute and absorbed into the university’s entire medical complex under the terms of the gift.

I can't help but note that Dr. Federoff came to UCI from Georgetown University. Why is that significant? Georgetown was one of the "pioneers" (if you will) in quackademic medicine. Basically, Georgetown was the first to "integrate" quackery into all phases of medical education beginning in the first year of medical school, with acupuncturists giving lectures in gross anatomy class. I kid you not.

By the time Dr. Federoff left Georgetown in 2015, quackademia reigned supreme at Georgetown, even to the point where Georgetown credulously teaches homeopathy to its medical students. Dr. Federoff was there when it began and took hold. You'll pardon me if I call bullshit on his claims that the SSCIM will be rigorously based in science. It won't. That's not what the donors want, and that's not what the culture at UCI will support.

Thanks to the Samuelis and the credulous culture they have built at UCI and fueled by the enormous $200 million gift given by the Samuelis, quackademic medicine will reign more supreme than ever at UCI and serve as an example for the metastasis of the cancer that is integrative medicine.

oracknows Tue, 09/26/2017 - 00:01

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University of California Irvine

Categories

http://www.webmd.com/balance/tc/homeopathy-topic-overview

I wonder what she will think if Dr. Federoff actually does eliminate homeopathy from UCI.

He's just diluting the curriculum to make it more effective.

I always find it stunning that someone can have a very scientific mind and have invented/patented multiple devices of incredible complexity and then turn around and buy into something as ridiculously stupid as homeopathy. But smart in one area never means smart in all areas.

"smart in one area never means smart in all areas."

Just can't leave Ben Carson alone, huh?

Wait, they're going to use homeopathy to treat heart disease, cancer and autoimmune diseases? That's what they're saying?

Chris Hickie (#2) writes

But smart in one area never means smart in all areas.

MJD says,

But, being creative (i.e., invented/patented) in one area often means creative in other areas.

It appears Henry Samueli is simply being creative with his $ based on the love and affection he has for his wife.

Remember the Taj Mahal?

It was commissioned in 1632 by the Mughal emperor, Shah Jahan (reigned 1628–1658), to house the tomb of his favourite wife, Mumtaz Mahal.

The Taj Mahal didn't change world architecture and, in parallel, UCI's $200 million from Mr. Samueli will not change science-based medicine.

@ Orac,

Stop whining and let it play out.

MJD: The Taj Mahal didn’t change world architecture.

Oh man, every time I think you can't be more wrong, you prove me wrong. Obviously, you've never been to Southeast Asia. Or seen a Russian orthodox church. Or Aladdin.

"UCI’s $200 million from Mr. Samueli will not change science-based medicine."

That's about as ridiculous as saying that Russia has no influence in the US. Do you know where doctors come from? Medical schools. If one medical school is teaching inaccurate and just plain bad medicine, the practice will spread to other medical schools and hospitals. California already has a huge problem with quacks and people who abandoned their medical degrees (see "Dr" Gordon and "Dr" Sears.) So no, Orac can't just let this one 'play out.'

PGP writes,

So no, Orac can’t just let this one ‘play out.’

MJD says,

If Orac wants to confront Dr. Gordon and Dr. Sears that's fair.

But, the billionaire couple Susan and Henry Samueli are NOT medical professionals and can most definitely be appreciated for their charitable contributions to UCI.

@ Orac,

If UCI made a disclaimer that homeopathy is intended to be researched as a supplementary-treatment would you back off?

In the spirit of freedom-of-choice, homeopathic medicine may have a theatrical placebo effect that may improve the quality-of-life for some individuals dealing with science-based medicine.

I wonder if UCI will apply homeopathy methods for teaching their med students. Think how fast you can turn out docs if you dilute each course by 30c. I think they may need to start with a blood sample from a real doctor before they begin their dilutions.

I can just see the RonCo knock-off: Become a MD for only 49.95 but wait if you order right now get the second one for only process and handling.

Wandering in from my respite...

PGP: " Every time I think that you can't be more wrong, you prove me wrong"

Agreed.

Srsly, MJD telling Orac to "stop whining" truly illustrates self unawareness at its most ironic
.
It's like Mike Adams bemoaning the current state of education
or AoA's Managing Editor discussing poor writing or Jake Crosby investigating anything

MJD: But, the billionaire couple Susan and Henry Samueli are NOT medical professionals and can most definitely be appreciated for their charitable contributions to UCI. "

Nope. Still wrong. If they'd donated a no-strings attached gift to UC Irvine, that'd have been fine and no one would find fault with them. Unfortunately their "gift" came with more strings attached than you'd find on the entire Muppet cast of Sesame Street.

What a ridiculous article. Everything is prejudged and makes mockery of basic human knowledge. Pharna lobby seeing a danger to its business is out in the open.

@Ash

Oh, to be blissfuly clothed in the raiments of ignorance.

"If UCI made a disclaimer that homeopathy is intended to be researched as a supplementary-treatment would you back off?"

I hope not - nobody should, since the fact that homeopathy is discredited means there is no evidence that it benefits anyone except the quacks who practice it and pocket the checks. People who understand science and reality understand that. Given your history of comments it's no surprise that you don't understand it.

Ash: "Everything is prejudged and makes mockery of basic human knowledge."

What basic human knowledge? A couple of big pharmaceutical companies are Boiron and Hylands. You may have actually bought some of their special little pills in the tiny bottles. So to save from the tyranny of supporting Big Homeopath Pharm, I present you this way to make your own:

Recipe for Nat Mur or Natrum Mur or Natrium Mur or Natrum muriaticum:

1) Take ½ teaspoon of sea salt and dissolve into 1 cup of distilled water in a bottle.

2) Shake well.

3) This is a 1C solution (ratio 1/100).

4) Take ½ teaspoon of the 1C solution and put it a bottle with 1 cup of distilled water, throw out the 1C solution.

5) Shake well.

6) This is a 2C solution (ratio 1/10000).

7) Take ½ teaspoon of the 2C solution and put it a bottle with 1 cup of distilled water, throw out the 2C solution.

8) Shake well.

9) This is a 3C solution (ratio 1/1000000).

10) Take ½ teaspoon of the 3C solution and put it a bottle with 1 cup of distilled water, throw out the 3C solution.

11) Shake well.

12) This is a 4C solution (ratio 1/100000000).

13) Take ½ teaspoon of the 4C solution and put it a bottle with 1 cup of distilled water, throw out the 4C solution.

14) Shake well.

15) This is a 5C solution (ratio 1/10000000000).

16) Take ½ teaspoon of the 5C solution and put it a bottle with 1 cup of distilled water, throw out the 5C solution.

17) Shake well.

18) This is a 6C solution (ratio 1/1000000000000).

19) Take ½ teaspoon of the 6C solution and put it a bottle with 1 cup of distilled water, throw out the 6C solution.

20) Shake well.

21) This is a 7C solution (ratio 1/100000000000000).

22) Take ½ teaspoon of the 7C solution and put it a bottle with 1 cup of distilled water, throw out the 7C solution.

23) Shake well.

24) This is an 8C solution (ratio 1/10000000000000000).

25) Take ½ teaspoon of the 8C solution and put it a bottle with 1 cup of distilled water, throw out the 8C solution.

26) Shake well.

27) This is a 9C solution (ratio 1/1000000000000000000).

28) Take ½ teaspoon of the 9C solution and put it a bottle with 1 cup of distilled water, throw out the 9C solution.

29) Shake well.

30) This is a 10C solution (ratio 1/100000000000000000000).

31) Take ½ teaspoon of the 10C solution and put it a bottle with 1 cup of distilled water, throw out the 10C solution.

32) Shake well.

33) This is a 11C solution (ratio 1/10000000000000000000000).

34) Take ½ teaspoon of the 11C solution and put it a bottle with 1 cup of distilled water, throw out the 11C solution.

35) Shake well.

36) This is a 12C solution (ratio 1/1000000000000000000000000).

37) Take ½ teaspoon of the 12C solution and put it a bottle with 1 cup of distilled water, throw out the 12C solution.

38) Shake well.

39) This is a 13C solution (ratio 1/100000000000000000000000000).

40) Take ½ teaspoon of the 13C solution and put it a bottle with 1 cup of distilled water, throw out the 13C solution.

41) Shake well.

42) This is a 14C solution (ratio 1/10000000000000000000000000000).

43) Take ½ teaspoon of the 14C solution and put it a bottle with 1 cup of distilled water, throw out the 14C solution.

44) Shake well.

45) This is a 15C solution (ratio 1/1000000000000000000000000000000).

46) Take ½ teaspoon of the 15C solution and put it a bottle with 1 cup of distilled water, throw out the 15C solution.

47) Shake well.

48) This is a 16C solution (ratio 1/100000000000000000000000000000000).

49) Take ½ teaspoon of the 16C solution and put it a bottle with 1 cup of distilled water, throw out the 16C solution.

50) Shake well.

51) This is a 17C solution (ratio 1/10000000000000000000000000000000000).

52) Take ½ teaspoon of the 17C solution and put it a bottle with 1 cup of distilled water, throw out the 17C solution.

53) Shake well.

54) This is an 18C solution (ratio 1/1000000000000000000000000000000000000).

55) Take ½ teaspoon of the 18C solution and put it a bottle with 1 cup of distilled water, throw out the 18C solution.

56) Shake well.

57) This is a 19C solution (ratio 1/100000000000000000000000000000000000000).

58) Take ½ teaspoon of the 19C solution and put it a bottle with 1 cup of distilled water, throw out the 19C solution.

59) Shake well.

60) This is a 20C solution (ratio 1/10000000000000000000000000000000000000000).

61) Take ½ teaspoon of the 20C solution and put it a bottle with 1 cup of distilled water, throw out the 20C solution.

62) Shake well.

63) This is a 21C solution (ratio 1 in 10^42 or 1/1000000000000000000000000000000000000000000).

64) Take ½ teaspoon of the 21C solution and put it a bottle with 1 cup of distilled water, throw out the 21C solution.

65) Shake well.

66) This is a 22C solution (ratio 1 in 10^44 or 1/100000000000000000000000000000000000000000000).

67) Take ½ teaspoon of the 22C solution and put it a bottle with 1 cup of distilled water, throw out the 22C solution.

68) Shake well.

69) This is a 23C solution (ratio 1 in 10^46 or 1/10000000000000000000000000000000000000000000000).

70) Take ½ teaspoon of the 23C solution and put it a bottle with 1 cup of distilled water, throw out the 23C solution.

71) Shake well.

72) This is a 24C solution (ratio 1 in 10^48 or 1/1000000000000000000000000000000000000000000000000).

73) Take ½ teaspoon of the 24C solution and put it a bottle with 1 cup of distilled water, throw out the 24C solution.

74) Shake well.

75) This is a 25C solution (ratio 1 in 10^50 or 1/100000000000000000000000000000000000000000000000000).

76) Take ½ teaspoon of the 25C solution and put it a bottle with 1 cup of distilled water, throw out the 25C solution.

77) Shake well.

78) This is a 26C solution (ratio 1 in 10^52 or 1/10000000000000000000000000000000000000000000000000000).

79) Take ½ teaspoon of the 26C solution and put it a bottle with 1 cup of distilled water, throw out the 26C solution.

80) Shake well.

81) This is a 27C solution (ratio 1 in 10^54 or 1/1000000000000000000000000000000000000000000000000000000).
(the zeros are running off of the page!)

82) Take ½ teaspoon of the 27C solution and put it a bottle with 1 cup of distilled water, throw out the 27C solution.

83) Shake well.

84) This is a 28C solution (ratio 1 in 10^56 or 1/100000000000000000000000000000000000000000000000000000000).

85) Take ½ teaspoon of the 28C solution and put it a bottle with 1 cup of distilled water, throw out the 28C solution.

86) Shake well.

87) This is a 29C solution (ratio 1 in 10^58 or 1/10000000000000000000000000000000000000000000000000000000000).

88) Take ½ teaspoon of the 29C solution and put it a bottle with 1 cup of distilled water, throw out the 29C solution.

89) Shake well.

90) This is a 30C solution (ratio 1 in 10^60 or 1/1000000000000000000000000000000000000000000000000000000000000).

And then you are done! To make the pills, go to baking center of your grocery store and get some plain cake decorating sprinkles. You can try dropping some of the solution on the sprinkles, or just set the bottle next to the solution for it to absorb the energy (which is the typical method used for over the counter homeopathic remedies).

dean (#13) writes,

Given your history of comments it’s no surprise that you don’t understand it.

MJD says,

It is written, "Homeopathy is based on the idea that "like cures like." That is, if a substance causes a symptom in a healthy person, giving the person a very small amount of the same substance may cure the illness. In theory, a homeopathic dose enhances the body's normal healing and self-regulatory processes.

Q. Doesn't allergy shot immunotherapy, which is science-based, falls within the parameters of homeotherapy.

Example, low dose of a natural allergen with repeated exposure to decrease sensitivity to that allergen.

https://www.aaaai.org/conditions-and-treatments/treatments/allergy-shots-(immunotherapy)

In this instance, conventional medicine and integrative medicine overlap.

I don't know how much experience anyone here has with college/university development offices, but those folks are usually glad-handing snakes. Their job is to get as much money from donors first, and then see that the fewest strings are attached to it so the school administrators can use it any damn way they please. In this, they are expert are snowing both the faculty and the donors. They have lots of tricks for this – making it look to the donor like the money will go to one thing when it actually goes to something else, and then forcing the faculty into continuing the ruse through the years...

Which is not to say that $200 million doesn't buy a lot of influence. Just that how much influence and where it lands is a complex negotiation, and PR releases can't be trusted to give a proper indication of how it all will play out. My guess would be that most of the The Susan and Henry Samueli College of Health Sciences will be giving only lip service to IM, and continuing the re-branding of useful stuff they were already doing as "integrative". That is, very little of the $200 million will be going to 'quackery'. But, on the other hand, the old Susan Samueli Center for Integrative Medicine is being upgraded and more firmly anchored institutionally within UCI along with the renaming to the Susan Samueli Integrative Health Institute.

Another way to put it: $200 million buys getting your name on a school, but it's probably not enough to dictate everything that goes on inside, (or even all that much of it...). Academic institutions much smaller than the UCI med school are as easy to turn around as the Titanic, and declarations of 'new cutting edge program!!' are more often than not puffed up with hype while most day-to-day business stays pretty much the same.

That's my experience anyway in my corner of academia, which I admit is far away from health sciences, but it seems pretty common, fwiw. Of course, things could be different at Irvine ("Zot! Zot!"), but of all the news I'll read this week, this is likely to worry me the least.

Spectator @12: Oh, that is brilliant. May I borrow it when the need arises?

#15 Michael J. Dochniak, September 26, 2017

MJD says,
It is written, “Homeopathy is based on the idea that “like cures like.” That is, if a substance causes a symptom in a healthy person, giving the person a very small amount none of the same substance may cure the illness.

FTFY.

Q. Doesn’t allergy shot immunotherapy, which is science-based, falls within the parameters of homeotherapy.
Example, low dose of a natural allergen with repeated exposure to decrease sensitivity to that allergen.

The difference is that the low dose is a low but non-zero dose; where the homœopathetic dose is diluent only, a dose of zero.

The other fallacy of your simile is that the extremely low dose of active ingredient in the anti-allergy treatment is designed to produce a subtle effect, teaching the patient's immune system that the allergen really ain't anything to be askeered of. That's why the dose is small rather than non-zero.

OTOH, the homœopathetic "dose", with no remaining active ingredient, is claimed to produce a profound effect, curing whatever the symptom might be.

The similarity you imagine vanishes upon examination.

What is this zot thing everyone keeps going on about?

PGP, you should look up UC-Irvine's mascot for the answer.

Sadmar: I think you're underestimating the influence donors can have on a school.

Why go to the Susan and Henry Samueli College of Health Sciences when you can be taken for a more enjoyable ride at nearby Disneyland?

Despite the classic Hahnman infinite dilutions theme, historical connection or popular association with herbal, natural or nutritional treatments exists with (some?) homeopathic doctors.

So I'm unclear what percentage of lay persons saying that they want homeopathic treatment are really buying into the infinitely dilute treatments superstition.

Go Eaters! Zot!

Quackademic medicine now reigns supreme at UC-Irvine

oracknows — Tue, 19 Sep 2017 04:55:38 +0000

Quackademic medicine now reigns supreme at UC-Irvine

It's not infrequently that, whenever I complain about the increasing infiltration of quackery and pseudoscience into medicine, I sometimes lament that skeptics and supporters of science-based medicine are massively outgunned, because we are. Thus, we have the continued growth of what I like to refer to as "quackademic medicine," the infiltration of pseudoscience into medical academia in the form of whole divisions, departments, and institutes dedicated to studying fairy dust like acupuncture, naturopathy, and other "unconventional" treatments that are then "integrated" into medicine. It's not for nothing that I refer to "integrative medicine" as integrating quackery with medicine.

Unfortunately, I was reminded yesterday of what an uphill battle it is to counter the increasing pseudoscience in medicine when I learned that wealthy donors Susan and Henry Samueli just donated a whole bunch of money to the University of California, Irvine (UCI) to establish an institute dedicated to pseudoscience:

The University of California, Irvine today announced the largest gift in its history: $200 million from Susan and Henry Samueli, longtime campus supporters, to name a first-of-its-kind College of Health Sciences focused on interdisciplinary integrative health. The far-reaching donation – the seventh-largest to a single public university – positions UCI as a bold, new leader in population health, patient care, education and research. “This gift catalyzes UCI’s belief that human health and well-being requires a science-based approach that engages all disciplines in caring for the whole person and total community,” said Chancellor Howard Gillman. “Susan and Henry Samueli’s dedication, their vision for what is possible and their deep generosity will help UCI set a standard that, over time, other medical centers in the U.S. can follow.”

Thanks to the Samuelis, unfortunately UCI has long been a prominent force in the brave new world of integrative medicine. Now, it appears to be taking this "integration" a step further, by "integrating" the pseudoscience across not just the new institute. Behold:

The Susan and Henry Samueli College of Health Sciences will be the first university-based health sciences enterprise to incorporate integrative health research, teaching and patient care across its schools and programs. Integrative health redefines the relationship between the practitioner and patient by focusing on the whole person and the whole community. It is informed by scientific evidence and makes use of all appropriate preventatives, therapeutic and lifestyle approaches, and healthcare professionals and disciplines to promote optimal health and wellness. The existing Susan Samueli Center for Integrative Medicine will become the Susan Samueli Integrative Health Institute and will focus on improving medical care by supporting multidisciplinary research, education, clinical service and community programs. Faculty and students in computer science, engineering, social sciences, business and other areas will collaborate within the institute to study the future of human health.

Of course, the whole paragraph about integrative health "redefining" the relationship between the practitioner and patient by focusing on the "whole person" is the usual blather that quacks everywhere. As I've said so many times before, it is not necessary to "integrate" pseudoscience into medicine in order to take care of the "whole patient." A good science-based primary care doctor takes care of the "whole patient," with no need to resort to appealing to magic like acupuncture, reiki, reflexology, homeopathy, and the like. And if you don't think this is about all of the forms of quackery I just mentioned, take a look at how the Samuelis became interested in "integrative" medicine:

Susan Samueli caught a cold while visiting France more than three decades ago. Instead of the usual medicines, a friend suggested aconite, a homeopathic remedy derived from a plant in the buttercup family. She was cured — and became a lifelong advocate of homeopathy and other alternative healing methods to complement conventional medicine. Her husband, Henry — the billionaire co-founder of Broadcom, the Irvine semiconductor maker — says he was initially skeptical but found the integrative health approach helped him easily shake off colds and flus and kept their children healthy without antibiotics. Now the couple’s passion for integrative health has led to the largest donation ever made to UC Irvine.

As an origin myth, This is just downright silly. Colds are self-limited, and the homeopathic remedy Mrs. Samueli took almost certainly had no effect on the course of her cold. She just got better, as the vast majority of otherwise healthy adults with colds do. As for Mr. Samueli's apparent belief that homeopathy and other "integrative" approaches helped him shake off colds and flus, the same thing is going on. Colds are self-limited. So is the flu for most people, although what most people call the "flu" isn't really the flu but much milder "flu-like illnesses" caused by other viruses. (The real flu can easily knock you on your posterior for a week or even more.)

Basically, this story is a load of confirmation bias and good old-fashioned regression to the mean being confused with therapeutic effect. Yet, that's all it takes for otherwise intelligent people to become believers. Humans are pattern-forming animals. If we take something and then get better we'll say that what we took caused us to get better, whether it really did or not.

Of course, supporters of "integrative medicine" will no doubt become indignant at my description of their favored new medical specialty. They will point to how diet and exercise are an important part of integrative medicine, how integrative practitioners emphasize prevention and healthy lifestyle. The problem, of course, is that diet, exercise, healthy lifestyles, and prevention are all part of conventional medicine. There is no need for a separate specialty for them, any more than there is a need for a separate specialty in order to take care of the "whole patient."

The reason "integrative medicine" exists is not to promote science-based prevention, lifestyle, and exercise interventions, but rather to provide a vessel into which quackery can be poured and mixed with the science-based care until it becomes difficult to tell which is which. That's the idea, whether physicians who have become integrative medicine practitioners will admit it to themselves (or others) or not. So here's how this next stage of "integration" will go.

The Susan and Henry Samueli College of Health Science will eventually include the existing Samueli Center plus the following schools at UCI:

School of Medicine
Sue & Bill Gross School of Nursing
School of Pharmacy (currently the Department of Pharmaceutical Sciences)
School of Population Health (currently the Program in Public Health)

And here's where the money will go:

The Samuelis’ gift will provide $50 million toward construction of a facility to house the college and $5 million for state-of-the-art technology and labs – forming the foundation of a national showcase for integrative health. It also earmarks $145 million to create an endowment for:

Up to 15 faculty chairs across the medicine, nursing, pharmacy and population health disciplines for senior, midcareer and junior faculty with expertise in integrative health

Integrative health training and mentoring for interested medical school students

Scholarships and fellowships for undergraduate and graduate students planning careers in related fields

Innovative curricular development and campuswide interdisciplinary research projects

Ongoing clinical services, research and education in the Susan Samueli Integrative Health Institute, including investigations of nonconventional interventions as part of medical treatment and educating medical and lay communities about benefits and risks associated with new healthcare approaches

That last bullet point is critical. The whole point of "integrative medicine" is to integrate "nonconventional interventions as part of medical treatment." That means quackery. There is no other reason for integrative medicine. Just think about the evolution of the naming of integrative medicine. First, it was known as alternative medicine. But "alternative" implied that the "nonconventional interventions" weren't medicine (or weren't good medicine, which they weren't).

So the name evolved to "complementary and alternative medicine," or CAM. However, that wasn't good enough either, because the name mean that the quackery was "complementary" to real medicine. It wasn't real medicine itself (or at least it wasn't as effective or important as real medicine). It was just "icing on the cake." So a new name was coined, "integrative medicine," in which all the quackery was (and still is) portrayed as co-equal with conventional medicine and "integrative medicine" as "the best of both worlds." And here we are. A wealthy couple has donated $200 million to a public university to promote their vision of pseudoscience, and the university has eagerly accepted, even though it will utterly reshape its medical school and all its biomedical sciences for decades to come.

I find it helpful to look at what UCI's Samueli Center already offers. I first took note of the school just shy of 10 years ago, when I added the Susan Samueli Center for Integrative Medicine as part of an early version of my Academic Woo Aggregator.Really long time readers of this blog know that for a time I maintained a list of medical schools that had embraced quackademic medicine. I only maintained the list for a relatively brief period of time, not because I didn't think it was a worthwhile endeavor, but rather because there were just too many schools for me to keep track of alone.

Quackademic medicine has become the norm, not an outlier. It's schools like mine, where I'm faculty, that have little or no quackademic medicine that are the outliers. So what does Samueli Center offer? It's basically the same slate of "integrative medicine" that most quackademic "integrative medicine" centers offer:

Acupuncture & traditional Chinese medicine
Ayurvedic therapies
Functional medicine
Massage therapy
Meditation
Mindfulness
Nutritional counseling
Physical medicine & rehabilitation
Preventive cardiology
Sports medicine & osteopathic manipulation
Tai chi
Vitamin infusion therapy
Women's health
Yoga

Of course, traditional Chinese medicine and Ayurvedic medicine are prescientific systems of medicine based on mysticism and vitalism. Functional medicine is a bit of "make it up as you go along" quackery that combines the worst of conventional medicine on steroids (e.g., massive overtesting) with quackery. Vitamin infusion therapy, of course, is also not scientifically supported. As for the rest, Tai Chi and yoga are nothing more than exercise. Massage therapy makes people feel better, but specific therapeutic claims are to be treated with skepticism.

If you want to get an idea of the level of pseudoscience going on here, it's useful to look at what UCI says about various modalities. For instance, "functional medicine" turns out to be all about naturopathy as well:

Functional medicine, which is based on naturopathic principles, takes a more comprehensive approach. At the Susan Samueli Center for Integrative Medicine, our highly trained naturopaths:

Identify and treat the root causes of illness

Harness the healing power of nature

Treat the whole person

Emphasize disease prevention

Encourage self-responsibility for health

Explore alternatives to drugs and surgery

And, based on functional medicine, UCI might offer:

Based on your individual needs, we develop a treatment plan which may include:

Detoxification

Dietary and lifestyle changes

Exercise therapy

Herbs and dietary supplements

Homeopathy

Manipulative therapies

Psychotherapy and counseling

Stress reduction

There you go. "Detoxification" is virtually always the purest of quackery. Then, of course, there's homeopathy, or, as I like to call it, The One Quackery To Rule Them All. If you don't know why that's the case, I refer you to any of a number of my previous posts, like this one. Of course, one aspect of "integrative medicine" is bias. Basically, its adherents don't ask whether it will help patients and result in better outcomes. Rather, they confidently predict that they will be vindicated in their beliefs:

“As a preventive cardiologist and researcher, I cannot stress enough the critical need for society to adopt a truly integrative approach to health, whether we are talking about community health, nutrition, prevention or appropriate medications. It must start with those who provide care and guidance,” said Dr. Shaista Malik, director of the Susan Samueli Center for Integrative Medicine and the endowed chair of integrative medicine. “Through this exciting new college, we will demonstrate to everyone involved in the health system – from patients to providers to policymakers – the value of an integrative approach.”

And:

Fundamental change in thinking about healthcare and how it’s delivered will take time, a steady stream of new evidence and strong academic leadership. The Samuelis’ transformational gift is the first step toward creating an expanded health sciences campus, integrating the affiliated schools and programs of the college as well as new teaching, research and clinical spaces. “Susan and I have supported healthcare research for nearly 20 years, and over that time, we have seen a significant expansion of the scientific evidence demonstrating the value and efficacy of integrative health. This evidence base is critical as UCI – a young, innovative institution – takes this big and influential step,” said Henry Samueli, Ph.D., an engineer and co-founder of Broadcom Corporation. “We are very excited for the UCI College of Health Sciences to become a national model for integrative health. We believe this model will eventually become the standard approach for promoting health and well-being in our society.”

That's right. Adherents of "integrative" medicine "believe" that it will eventually become standard of care. What evidence do they base this belief on? Certainly not on evidence. I do note that advocates of integrative medicine are quite honest about their goals, as you can see from this article in the the LA Times:

The Samuelis said they hope their financial support for research will help build evidence for alternative therapies that would convince insurers to pay for them, thus letting more people benefit. Acupuncture, for instance, has been widely documented to ease migraines, according to Howard Federoff, a specialist in neurodegenerative disorders and UC Irvine’s vice chancellor for health affairs. But not all health plans cover the treatment.

No, acupuncture is nothing more than a theatrical placebo. When I say that skeptics and supporters of science-based medicine are at a profound disadvantage, this development at UCI is exactly what I'm talking about. What we have is a ragtag band of physicians and skeptics alarmed at the infiltration of pseudoscience into medicine versus very wealthy believers like the Samuelis willing to donate far more money than we can imagine.

Sure, we have science on our side, but will it matter? We have to make it matter.

oracknows Tue, 09/19/2017 - 00:55

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University of California Irvine

Categories

https://www.forbes.com/sites/williampbarrett/2016/12/14/the-largest-u-s…

"Quackademic Medicine now reigns supreme at UC-Irvine"

But aren't you an "Assistant Professor" in Michigan?

Oh, Travis, you're several years behind the times. I was promoted to full professor last year and had been an associate professor for several years before that. You must be reading J.B. Handley.

I would like to think there are faculty at the UC Irvine School of Medicine who are upset about this--because if there are not then things are much worse than feared. Why do these faculty not speak out against this pseudoscience? Some of them must be tenured, which should grant the ability to speak openly on such nonsense. Then again when I was doing my residency at the University of Arizona, I never saw anyone openly oppose Andre Weil and his nonsense, which has openly infiltrated many of the residency training programs there since I finished my training.

Shruggies. The vast majority of physicians are shruggies. https://sciencebasedmedicine.org/a-shruggie-awakening/

In a Forbes article titled, "The Largest U.S. Charities for 2016" a quick calculation indicates ~ 7 billion dollars donated to medical organizations that are predominantly science-based.

I'm thankful for their generosity...

It has to be said that to some extent, physicians have nurtured this entire movement--not because they don’t care or are ignorant of what constitutes a healthy lifestyle, but because the truth of these thing just isn’t what people want to hear. I am as guilty of this as anyone else. When I ask my doc about some diet-related thing and she gives me a half page blurry handout on her way out the door, I am grossly offended, but because I know that there is no magic, I accept it. Had she been a naturopath, the interaction would have gone very differently and if I weren’t so steeped in skepticism, I would tend to be much happier with the naturopath, even more so if I were not a skeptic.

It is one thing to acknowledge that “there are problems in medicine” but it is time to offer some real solutions to them instead of bemoaning the success of the quacks in addressing people’s need to interact with their health provider on a more personal level. And don’t say there’s no time because I’ve had providers who achieve a level of care that addresses “the whole person” in the same amount of time that most utterly fail. I accept a level of care that falls short of better experiences because I am an informed skeptic, but most people aren’t and that’s why they respond so well to the woo.

We have done well at outlining the problem, but very little to address it on our own side. My favorite example is that my PCP, a lovely woman who has been my doctor for seven years, has not ONCE asked me how I am--something the dietician (my fave provider) always does. If I bring up mental health (just everyday type of mental health, not serious impairment), she stiffens, mumbles about a psychiatrist or a psychologist (ack!) if I “just need to talk”. This is not an isolated example; I have been through a number of providers at this medical center and it’s all pretty much the same. I’m currently seeking a smaller institution, but that is difficult in my state. My friends find various integrative quacks instead. I used to argue, but I’ve become somewhat of a shruggie these days, given my own state of dissatisfaction with the system. Mind you, I’m not seriously ill or anything, but isn’t that the demographic that is so ripe for the picking by the quacks?

Don’t misunderstand my horror at the goings-on at UCI, but we have to do more than bemoan it. If diet and exercise are “part of medicine”, more needs to be done to make regular people aware of that. Saying “30 minutes a day” or “25 grams a day” and a handout with stick people for back pain are not enough, even though that may be the actual truth of things.

I’m sorry if this comment relies too heavily on personal experience, but I use it to amplify interactions that I have on an almost daily basis over many years. Although I am educated, I don’t travel in academic circles anymore, and as you all know, that is no guarantee anyway that one will not encounter woo--hence today’s sad tale of UCI.

Clearly you need a new primary care doctor. No, I'm serious. The one you have clearly isn't meeting your needs. I haven't had that problem with my last two PCPs; so I'll counter your anecdote with mine.

A bit off topic, please.

I noticed that someone (maybe Mike Adams?) has changed the referenced image in comment #70 of Orac's post titled, "Does the Flu Vaccine cause miscarriages?"

Orac and Mike Adams are matter and antimatter, I appreciate both!

Chris@3: Never mind the faculty, what do the accreditation people think of this? From where I sit, it looks as though UCI is in thrall to a couple of big dollar donors who are encouraging the medical faculty to practice a form of medicine that the donors themselves, let alone the faculty, either know or should know does not work.

I can understand the reluctance of soft money faculty to speak up. They may be dependent on the university for things like bridge funding and lab space, and are therefore not as free to speak their minds as faculty should be. But the accreditation board is designed to be independent of a university's donors. They have no excuse for not pushing back at the first opportunity.

I am a PCP, and have been for 25 years (damn, that is hard to type!) What I have found is that in order to counter this movement you need to be familiar enough with the woo to discuss it with some knowledge. If your patent asks your opinion on massage or chiropractic and you roll your eyes and tell them they are idiots, the interaction will not go well. It does require time spent reading sites that reek of stupid so you know of what they speak, but if you can build a relationship, it is possible to counteract a lot of this. The major drawback is that it takes time, both in reading and talking, and most of us are very pressed for time. Nonetheless, I have a fairly huge antivax population and have been successful at getting the majority of them to get at least some shots. Is that a win? I think so. The latest is everyone needs lip and tongue ties lasered. (!) No clue where this came from, but with research I have talked several down from that ledge. It's all about knowing your patient and your stuff.

"$5 million for state-of-the-art technology and labs" State of what art? And of course they need labs to conduct imaginary tests to produce imaginary results that require imaginary interventions to treat imaginary symptoms, no doubt.

Looking into the accreditation process and registering complaints is a good idea. Also, mingling state and federal funds with these donations should be investigated as well. Contacting your California congress member about your taxes going to support this kind of nonsense if you live in California is a good place to start.

The fact that some science based medicine practitioners are not communicative is not the fault of science based medicine, it is the fault of those practitioners, but yes, we do need to be more proactive towards people that pursue peudo-medical solutions. It won't make you any friends, though. A friend of mine has a little local paid ad service and he regularly allows ads from other friends who advertise the whole spectrum of pseudo-medicine, but he won't allow me to run ads that debunk pseudo-medicine, citing the controversy that would result for him. I think it is mainly because, he too, is a believer. He suggested a juice fasting book to me and said I just didn't want to face the unpleasantness of fasting when I told him it was bull$hit. He's right to an extent, I really don't want to face the unpleasantness of starving myself by consuming just vegetable juice for one or two weeks, especially since it has no positive effects on one's body other than dramatic although temporary weight loss.

@ Eric #9: good point. I have wondered this as well. I suspect the accreditation folk look more at a school meeting the requirements of what they want taught and turn a blind eye to the rest . I don't know if there's a "things you can't teach and get accreditation list" out there, but there ought to be.

What really upsets me is that as the pseudoscience gets embedded over time, the physicians being graduated--unless they have a solid background in science prior to medical school--are going to take all this pseudoscience at the same level of truth as their lectures on anatomy, physiology and pathophysiology. That is not good. Not good at all.

"Is this the shape of medicine to come?"

Can it get much worse than mainstream medical quackery?

Bioinformatics analysis links type 1 diabetes to vaccines contaminated with animal proteins and autoreactive T cells express skin homing receptors consistent with injected vaccines as causal agent
https://www.researchgate.net/publication/319592904_Bioinformatics_analy…

Oddly enough, I just saw an ad here at RI for "relaxation, meditation" as tools in " your arsenal" and clicked it in order to see which woo-fraught institution was advertising its wares and lo! and behold! it was
the AIRFORCE. trying to get health care professionals.

Because I live in an area with money ( mostly) I notice how much regular doctors ( MDs. DOs) as well as DCs advertise all the usual woo ( acupuncture etc) as well as newer ( possibly SB) options like
lasers.
Is this just a way to make potential clients feel that their so-called individual needs will be addressed or a way to earn more?

Heh. Vinu cites an article he wrote himself, that contains references to articles he wrote him self, that contains references to articles he wrote himself, that contains references to articles he wrote himself... and there I grew tired of the exercise, but it's Vinu all the way down.

When you cite your own work more than all other people cite your work, I would think professional help may be indicated.

Funny - the only person he ever cites is himself.....

Oh, come on, Johnny. How is Vinu supposed to gain any credibility unless he's referenced in other articles? So by referencing himself in more articles he's written and then repeating it ad nauseum , the impact factor on his articles goes WAY up...or at least rises above zero.

@Vinu: when no reputable person (outside of yourself, for all I know you are reputable in other parts of your life) references your writings, maybe you should take a look at the reason.

MJD: " In a Forbes article titled, “The Largest U.S. Charities for 2016” a quick calculation indicates ~ 7 billion dollars donated to medical organizations that are predominantly science-based."

And? Why do you care about this? You don't even care about science.

the whole person, the whole person, the whole person... magic, wishful thinking, wooly bullshit... the whole person, the whole person.. blah de bah.. behhhe, sheep noise, behhhe.. gobble, gobble.. grovel, grovel.. GI'Z THE BLOODY MONEY!!!

Is this just a way to make potential clients feel that their so-called individual needs will be addressed or a way to earn more?

These options are not mutually exclusive. It's probably both: a floor topping and a dessert wax.

@ #14 Denice Walter.

I suspect it is both revenue enhancement and virtue signalling of some sort. I first encountered the "revenue enhancement" term in connection to use of certain devices and procedures related to some surgeries I was checking on. The links were to sites directed to hospitals and physicians. Sort of chips away at one's faith in the profession.

PGP (#17) writes,

And? Why do you care about this? You don’t even care about science.

MJD says,

I knew you'd be the first minion to initiate a conversation with a personal question. :-)

For the record, I care about science.

For example, I think vinu arumugham (#13) is a creative and well-respected vaccine-safety-advocate who is science-based.

A bit off-topic but of great concern because of the misleading post above about $7 billion going to science-based medical organizations.

Who says they are science-based? You? The 501 (c) 3 structure for charities in the US is highly porous and has almost no meaningful oversight. I suspect there are many, many fake charities and science-y-sounding front groups set up by supplement manufacturers and vitamin/quackery hustlers who have figured out either how to get phony IRS charity status or qualify for it under even more porous state charity laws as a tax dodge for their profits.

The house organ publications and "research" entities I've seen at some of these quackpot web sites strongly suggest they are gaming the system in some very sophisticated ways to evade financial oversight and confuse the gullible about their wonderfully magnanimous efforts to advance public health and conduct legitimate research--all the way to the bank.

"She was cured — and became a lifelong advocate of homeopathy and other alternative healing methods to complement conventional medicine. Her husband, Henry — the billionaire co-founder of Broadcom, the Irvine semiconductor maker — says he was initially skeptical but found the integrative health approach helped him easily shake off colds and flus and kept their children healthy without antibiotics."

As emphasised, Mrs S was not 'cured' of anything by homeopathy - and neither were their children spared 'antibiotics', which of course have no effect on viruses.

Surely it shouldn't be possible for a billionaire to influence the progress of medicine in the US in this way? Surely he would be laughed out of the consulting room? Whatever next? A billionaire with bizarre ideas as President? Surely not.

Lots of acupuncturist were put in jail before Dr Lok Yee Kung in 1973. It was so unfair . It was an unhill battle fought in Nevada. Finally Dr Lok Yee Kung and his supporters won the decisiive battle. Since than Acupunctuirist recognized. Many states soon follow to open up and recognized Acupuncturists as health professionals. Lots of evidence shows Acupuncture works and it is matter. The patients became their own judge.

"Oh, Travis, you’re several years behind the times."

Wrong again, duck.

Then again, it's not really at all surprising.

"Oh, Travis, you’re several years behind the times."

Wrong again, duck.

Then again, it's not really at all surprising...

"Oh, Travis, you’re several years behind the times"

Wrong person yet again, oh duck. It's really not surprising; not in the least bit.

It must so terrible being such a paranoid quack.

Heads up for Orac: Check the spam filter, and tell other ScienceBloggers to do the same. The disappearing post issue is back.

For the record, I care about science.

For example, I think vinu arumugham (#13) is a creative and well-respected vaccine-safety-advocate who is science-based.

MJD,

That would be your own version of science.

This inquiring mind here want to know how your version of science is in accordance with:

1-: Scientists' definition of science?

2-: Philosophers of science definition of science?

Alain

"Interdisciplinary" in this context also really rubs me wrong. Which disciplines are being combined?

And what will happen if the research shows these other methods don't work?

Perhaps MJD has a point, and I may have been a bit harsh in my response to Vinu.

Vinu was complaining about medical quackery, and, unlike many commenters, offered up a prime example of quackery. He pointed us to a quack paper, written by a quack, full of quack ideas.

I appreciate when people provide examples, references, and citations, and wish to encourage such behavior.

I do disagree, however, that Vinu is 'science based', and believe that MJD's endorsement of those ideas proves PGP's point quite nicely.

I like when universities accept money to promote blatant quackery, otherwise people are unable to judge how corrupt they are.

MJD: "For the record, I care about science.
For example, I think vinu arumugham (#13) is a creative and well-respected vaccine-safety-advocate who is science-based."

How can you not see how contradictory those sentences are? As others have pointed out, Vinu's got nothing. His so-called research is pulled, whole cloth, out of his rear end. So are your 'theories.' You wouldn't know science or writing skills if they BIT you.

I, too, laughed out loud when I read MJD's comment.

Thank you for writing on this. Any ideas on getting my university held accountable for such nonsense?
https://ufhealth.org/integrative-medicine/integrative-medicine-consulta…
http://smallanimal.vethospital.ufl.edu/clinical-services/integrative-me…

PGP (#24) says,

Vinu’s got nothing.

MJD says,

Mathematics was stagnant before the initial conceptualization of zero (e.g., nothing) was discovered.

Therefore, nothing can lead into something amazing.

Keep up the outstanding work Vinu (#13).

What a long article to say UCI got a lot of money and I'm jealous. The Samuelis can do whatever they want with their money

Listen and become one of Orac's minions.

https://www.youtube.com/watch?v=8HqyEHqEYho

The only time mjd seems to care about science is when he needs to look its spelling up in the dictionary. The rest of the time he doesn't think about it.

Mathematics was stagnant before the initial conceptualization of zero (e.g., nothing) was discovered.

Well no, it wasn't. Apparently you are as ignorant of mathematics as you are science. I'd say you should take some of my classes but I wouldn't be able to tolerate your dishonesty.

Obviously, homeopathy is a bunch of bs. However, in the "origin myth" she talks about taking homeopathic aconite for a cold, and mentions that it's related to buttercup. Buttercups are pretty, right? What she took (suggesting there were theoretically any molecules of it in the preparation to begin with) is wolf's bane. It's also known as the queen of poisons. I will never understand how these people can be terrified of vaccine adjudivants, but will willingly take poison.

Mathematics was stagnant before the initial conceptualization of zero (e.g., nothing) was discovered.

Well no, it wasn't. Apparently your denial of science extends to unfamiliarity of mathematics.

MJD,

Zero in math does not equal nothing. Zero is a discreet point on a number line. Because a number line is infinitely long any point maybe considered the zero point.

When we get to real life yes, zero has taken on the meaning of nothing in a material sense.

Not to mention that the ancient Egyptians, who had a concept of zero, would beg to differ. They left us the pyramids as proof.

MJD: Unsurprisingly, you know about as much about math as you do everything else. I hope you didn't pay for that 'education.'

I just want to know what this purported "stagnation" is supposed to comprise. Coordinates are enough of a nuisance as it is.

Therefore, nothing can lead into something amazing.

Um, no.

Add or subtract nothing to something, you don't get anything more or anything less - you aren't lead anywhere.
Start with nothing, multiply or divide it by something, and you lose everything. Despite popular belief, deux fois rien ('twice nothing') is still nothing.
Take something, pull it up to the power of nothing, and you go back to step one.
In the rare case when you start with nothing and put it to the power of nothing, you end up staring at oneself. It's a bit navel-gazing.
Have something, divide it by nothing, and now you are contemplating not infinity, but insanity.
And despite your best wishes, it doesn't get better when nothing is applied to imaginary numbers.

Throughout history the rich have patronized their favorites causes. Sometimes society wins like when Carnegie funded libraries. Unfortunately it can also lead to legitimization of quackery such as this.

Mathematics was stagnant before the initial conceptualization of zero (e.g., nothing) was discovered.

Well no, as others have pointed out, that is not at all true. But I'm not sure whether you mean the concept of zero as (roughly) "no amount" or its use as a place holder for large number. Symbols in cuneiform exist in numerals that play the same role as 0 in our numerals like 640002.

Either way, it's clear you don't have any understanding of the issue, which is consistent with your lack of understanding of science and the related statistical issues. I'd suggest you should study to catch up, but you've shown no interest in learning anything, so that won't work.

And if you subtract something from nothing, you are now either in debt or in the basement.

Perhaps MJD should review Billy Preston's research on the subject.

https://youtu.be/G_DV54ddNHE

I agree more with #6 darwinslapdog. A lot of this reflects MSM failures, often hubristic and massively profitable. Failures to achieve, retain, extend, parse out, or at least accurately explain in many areas, often old. You guys don't even have the vitamin C and D stories remotely correct.

However manifold the faults of various integrative practices, it is the ongoing failures of medicine that largely have brought this about. Perhaps analogous to "those who fail to learn history are doomed to repeat it".

The cynical parts of me certainly worry about the medical versions of Willie Sutton going where the money is, as well as MSM exploitation of charlatans to establish even more repressive Medical Authority and exploitation of the public, again.

Wow, with PRN here, we've got almost the full cadre of armchair, rear-based scientists. I wonder if NWO or Thingy want to chime in.

oh good lord, that is my alma mater. Some anteaters died at this news. Zot. Sigh. I am appalled. Just appalled.

I have to add that this does not surprise me about Orange Co California. There is are a reason Bob Sears has his practice there and that is pretty much antivax central. A lot of OCers are completely ignorant of science and rational thinking. I grew up there. I moved north for a reason!

Turf wars!!! Science have been killing off people for a few decades now. LMFAO. How do you justify that? Moron!!

I misspoke. Evidently we were missing a Fendlesworth chimp.

Kathy: I thought the creators of BC were hard-core rightwingers and allergic to facts.

Have any academic medical centers cashed in yet on health woo for members of the armed forces? Big bucks await those who can take battlefield acupuncture to the next level.

https://www.facebook.com/photo.php?fbid=1433197313382128&set=p.14331973…

dean (#42) writes,

Apparently your denial of science extends to unfamiliarity of mathematics.

MJD says,

Maybe you can add this to your teachings.

https://www.livescience.com/27853-who-invented-zero.html

Provide a brief summary of this article dean and I'll grade it with total objectivity.

Shame! Another front in the libertarian war on the FDA: Rational Vaccines' unethical offshore herpes vaccine clinical trial

oracknows — Tue, 29 Aug 2017 07:00:15 +0000

Shame! Another front in the libertarian war on the FDA: Rational Vaccines' unethical offshore herpes vaccine clinical trial

I've caught a fair amount of flak over my opposition to so-called "right-to-try" laws. Right-to-try laws have proliferated throughout the US like so much kudzu over the last three and a half years, to the point where 37 states now have some version of these profoundly anti-patient laws on the books. At the federal level, three weeks ago the Senate passed a federal version of right-to-try, with the House scheduled to take up the bill when Congress returns from recess next week. Granted, it's watered down and therefore less horrible than the original version, which Senator Ron Johnson (R-WI_ has been trying to pass for two years, but it's still plenty bad. In this post and a post later this week, I'm going to show you more circumstantial evidence that I was right all along. The first example you've almost certainly heard of, namely the offshore testing of a new herpes vaccine funded in part by über-Libertarian Peter Thiel. The second you probably haven't heard of, and I'll save it for later, given how long this post is.

But first, you need to understand what I mean about right-to-try. Basically, right-to-try laws rest on the false premise that the FDA is so slow and so bureaucratic that cures are being kept from terminally ill patients, or at least drugs that might hugely extend their life expectancies. The situation is presented as so dire that "right-to-try" is necessary, which basically allows terminally ill patients to bypass the FDA and receive experimental therapeutics from companies developing them without having to go through the FDA's Expanded Access program (which basically does the same thing, providing access to experimental therapeutics before they are FDA-approved). It's an idea promoted by a Libertarian think tank, the Goldwater Institute, and the branding has been very successful, to the point where, politically, opposing right-to-try is viewed as the equivalent of taking the terminally ill's last chance away from them, wanting them to die horribly, all while pissing on an apple pie and burning an American flag. (I exaggerate, but not by much.) The Goldwater Institute and right-to-try advocates achieved this effect by cynically parading families of patients with terminal illnesses who were convinced that right-to-try would give their loved ones a shot at life in front of legislators, making it very difficult for them to vote no. Meanwhile, industry and medical groups that might have been able to persuade lawmakers that right-to-try is a terrible idea that is bad for patients, despite the optics created by the Goldwater Institute were cowed and remained silent until very late. For example, the American Society of Clinical Oncology (ASCO), an society to which I belong, spent the last three and a half years saying basically nothing. It was only four months ago that ASCO finally issued a statement opposing right-to-try, when it was basically far, far too late.

I've also caught flak for characterizing right-to-try as being part of a broader war against the FDA (indeed, as part of a broader war against regulation in general) by libertarian-leaning free market fundamentalists, some of whom claim (literally) that the FDA is killing people. Lots of people. How can you say that? proponents of right-to-try would ask, drawing themselves up in their best self righteous fury. This is about helping terminally ill patients! Maybe. But, as I've said before, the FDA already has a Compassionate Use program that achieves the same purpose and rarely turns requests down, a program that's been improved over the last couple of years to be speedier and more responsive, with much less application time. Consistent with its libertarian origins, right-to-try tries to cut the FDA out of decisions between a drug seller and patients, but at the cost of eliminating many protections for patients. For instance, unlike the case in "expanded access" or "compassionate use," the institutional review board (IRB), an ethics panel that oversees clinical trials does not oversee patients in right-to-try. There is no financial help; so only patients whose families are rich or can raise a lot of money fast are likely to be able to benefit. Even worse, as I've described, most right-to-try bills not only do not require insurance companies cover experimental therapeutics (and why should they?), but allow insurance companies not to cover charges for complications from using experimental therapeutics. However, perhaps the most egregiously false argument made by right-to-try advocates is that the laws' allow use of experimental therapeutics after they've been "proven safe" through phase I testing. Yes, you read that right. As I’ve discussed multiple times, there is the requirement that the drug or device has only passed phase 1 trials, which, given how few drugs that have passed phase 1 actually make it through to approval, is a really low bar, especially since most phase 1 trials involve fewer than around 25 patients.

Although not commonly seen as such, right-to-try laws are of a piece with libertarian and radical fundamentalist free market views, some of which claim that the FDA is basically unnecessary or that its role should be vastly constrained. You can see it all there: Minimal requirements for safety testing (phase I), no ethical oversight, the decision entirely up to the company and patient, and, of course, the patient is totally on his or her own. People with such views were even in consideration for the post of FDA Commissioner, for example, two cronies of the aforementioned Peter Thiel, both of whom believe that the FDA stifles their holy grail of "innovation." The first was Jim O'Neill, who has advocated that the FDA test new drugs only for safety, not efficacy, thus returning the FDA to its pre-1962, pre-thalidomide role. The second was Balaji Srinivasan, a Silicon Valley entrepreneur who advocated basically doing away with the current system of FDA regulation and replacing it with online reviews, basically a Yelp or Über for drugs and medical devices. When asked "How do you prevent quacks?" Srinivasan replied, "Scaled Internet reputation systems. Works at massive scale in other areas." So clueless were both of these men that it was a relief when a relatively normal Republican pharma shill named Scott Gottlieb was ultimately appointed. He was the "least bad," most conventional choice, someone any conservative Republican administration might have appointed. Yes, he wants to "streamline" the process by which, for example, vaccines are approved, but he's actually pretty conventional. He's even decided to http://www.npr.org/sections/health-shots/2017/08/28/546719842/fda-crack….

Stymied at the FDA, apparently Peter Thiel is now waging his war on the FDA by other means:

Defying U.S. safety protections for human trials, an American university and a group of wealthy libertarians, including a prominent Donald Trump supporter, are backing the offshore testing of an experimental herpes vaccine.

The American businessmen, including Trump adviser Peter Thiel, invested $7 million in the ongoing vaccine research, according to the U.S. company behind it. Southern Illinois University also trumpeted the research and the study’s lead researcher, even though he did not rely on traditional U.S. safety oversight in the first trial, held on the Caribbean island of St. Kitts.

Neither the Food and Drug Administration nor a safety panel known as an institutional review board, or an “IRB,” monitored the testing of a vaccine its creators say prevents herpes outbreaks. Most of the 20 participants were Americans with herpes who were flown to the island several times to be vaccinated, according to Rational Vaccines, the company that oversaw the trial.

“What they’re doing is patently unethical,” said Jonathan Zenilman, chief of Johns Hopkins Bayview Medical Center’s Infectious Diseases Division. “There’s a reason why researchers rely on these protections. People can die.”

Indeed it is. What Peter Thiel and Rational Vaccines, a company founded by Agustín Fernández III and William Halford (formerly of Southern Illinois University who died recently of cancer) did and are doing is patently unethical—shockingly, horrifyingly so. The very function of the IRB is to protect human subjects in clinical trials. Usually, when a clinical trial is proposed, it goes through two committees, first the scientific review board, or SRB, which determines whether the trial is scientifically justified and soundly designed. The second is the IRB, which is charged with protecting the human subjects. Its function is to examine the clinical trial design and to determine whether it is ethical and whether the risks to human subjects do not outweigh the potential benefits; e.g., that there is clinical equipoise. Once it approves the trial, the IRB continues to monitor the trial, examining reports of adverse events, both serious and minor, and sometimes demanding changes in the trial or even canceling it if it judges that there are too many adverse events or that one group is doing so much better than the other group that it would be unethical to continue the trial. These protections for human subjects flow from the Belmont Report and the Common Rule, both of which were designed to prevent the abuse of human research subjects like what the Nazis did and underlie all the federal regulation regarding human research protection. Unfortunately, these protections are not universal, as they only apply to organizations with federal funding (such as universities) or entities applying for FDA approval for one of its investigational drugs or devices.

Like right-to-try, Peter Thiel's and Rational Vaccines' offshore clinical trial of a new herpes vaccine is an attack on the FDA. Libertarians and free market fundamentalists even admit as much:

The push behind the vaccine is as much political as medical. President Trump has vowed to speed up the FDA’s approval of some medicines. FDA Commissioner Scott Gottlieb, who had deep financial ties to the pharmaceutical industry, slammed the FDA before his confirmation for over-prioritizing consumer protection to the detriment of medical innovations.

“This is a test case,” said Bartley Madden, a retired Credit Suisse banker and policy adviser to the conservative Heartland Institute, who is another investor in the vaccine. “The FDA is standing in the way, and Americans are going to hear about this and demand action.”

These are exactly the sort of arguments made by right-to-try advocates. Indeed, as I've often pointed out, state-level right-to-try laws are completely toothless because federal law supersedes state law and the FDA regulates drug approval. The real reason for their existence is to put pressure on the FDA and to pressure federal legislators to pass a federal law. Sadly, it appears to have worked, as I doubt that the House will block the right-to-try bill passed by the Senate earlier this month. It will very likely become law next month.

There's also the same sort of snake oil being used to push this approach to Rational Vaccines' approach, which before this trial had resulted in a previous small preliminary trial:

For the initial trial, Halford and Rational Vaccines co-founder Fernández were unable to get federal funding or IRB approval, which oversees human safety. After testing out the vaccine on themselves for safety, they moved the trial to the Caribbean island. They flew 17 patients with pre-existing genital herpes cases there to get three shots of the vaccine. Halford reported that they experienced on average a three-fold reduction in days with symptoms on followup at four to six months after vaccination. Overall, the pair claimed that the trial and self-tests proved the safety and promise of the vaccine.

But when Halford attempted to publish the results, scientific reviewers were ruthlessly critical of the data and lack of safety precautions. One reviewer concluded: “This manuscript is partly a vision, partly science, and partly wishful thinking.”

I read the reviews of the manuscript, and I've rarely seen such critical comments from reviewers, ever. Interestingly, the authors apparently tried to slip their clinical trial data into a Perspectives article, rather than as a scientific or clinical report, and they inserted all sorts of extraneous rants and proselytizing into the manuscript, such that Reviewer 2 proclaimed it "part autobiography, part criticism of the herpes vaccine field, part description of autoinoculation studies with the author’s herpes vaccine candidate vaccine, part advertisement for the author’s vaccine company, and part description of preliminary results of a phase I trial." One reviewer explicitly wondered if this was "an end run around the FDA."

Why, yes. Yes it was and is. Very obviously so. So is the current trial. Even so, it's hard to see how this works. Both Both Office for Human Research Protections (OHRP) and FDA regulations explicitly require that clinical trials used in support for an application to approve an investigational new drug (IND) be approved and monitored by an IRB. Even Dr. Gottleib can't change that without changing the regulations (a long and onerous process), and I doubt that even he would want to try, his prior advocacy of "streamlining" the drug approval process notwithstanding. Thus, like state-level right-to-try laws, this stunt by Thiel and Fernández is designed to put pressure on the FDA and lawmakers.

If you don't believe me, listen to Fernández, a former Hollywood filmmaker, himself:

Even so, Fernández, a former Hollywood filmmaker, said he and his investors plan to submit the trial data to the FDA in hopes of getting the vaccine approved for treatment. If the FDA does not respond favorably, he said, the company will continue its trials in Mexico and Australia. Fernández said he hopes to set up an IRB for these next trials. No matter what, he plans to manufacture the vaccine offshore. However, without U.S. approval, the challenges to market such a vaccine in the United States remain significant.

Manufacture and sell the vaccine offshore no matter what the FDA says? This is what quacks do.

Perhaps the worst thing about this is the involvement of the Southern Illinois University. Not only does SIU make excuses, it basically tries to wash its hands of the whole thing, even after having published a glowing press release about the research, promoting it despite how utterly unethical the research was. Now, here's what SIU says:

Nonetheless, Southern Illinois University officials said they had no legal responsibility to ensure safety measures were in place because the university has an arms-length relationship with Rational Vaccines. Fernández said the company licensed two patents related to the vaccine from the university.

“SIU School of Medicine did not have any involvement in Rational Vaccines’ clinical trial,” said Karen Carlson, the university’s spokeswoman. “But we are confident that as the chief scientific officer of Rational Vaccines, Dr. Halford followed safety protocols appropriate to the clinical trial.”

But other researchers said they were appalled by what they described as the university’s complicity in ignoring more than 70 years of safety protocols.

As am I. For shame, SIU:

Hey @SIUC there's only one thing to say... https://t.co/u0si3ALnzn #bioethics #research #vaccine pic.twitter.com/sk2xZ2OXJo

— Alison Bateman-House (@ABatemanHouse) August 28, 2017

One can only wonder whether the feds can do something about SIU's involvement in this, given that the university receives federal funding. Of course, in the anti-regulation governmental era that President Donald Trump has ushered in, I doubt that the FDA or the OHRP will do anything at all, even though SIU richly deserves it for its lack of ethics and disingenuousness. For example:

However, after questions about the lack of IRB approval (a federal requirement), the spokesperson said that the university would “take this opportunity to review our internal processes to ensure we are following best practices.”

Yeah, I hope so. Because clearly SIU wasn't following "best practices" before. Remember OHRP and FDA regulations apply to any faculty of any university receiving federal funds, regardless if the faculty member used federal funds to carry out a clinical trial. SIU dropped the ball here, big time.

There is a multi-pronged war being waged on the FDA by ideological and business interests whose belief in the free market (and profit) as the adjudicator of the value of all things has deluded them into believing that all federal regulation is harmful and represents an undue brake on "innovation," which basically seems to mean whatever people like Peter Thiel want to do to make money, regardless of scientific plausibility and ethics. (The passage of the 21st Century Cures Act is a less egregious example of another front in this war.) If Thiel and Fernández get away with not just taking their clinical trials offshore (which many drug companies do) but of so blatantly flouting FDA and OHRP regulations by not forming an IRB for these trials (which basically no drug company seeking to market a drug in the US does) and manage to win FDA approval for their vaccine, it will be a stake in the heart of the FDA, which is exactly what Thiel wants.

[Next time, to conclude this two-part series: If a federal right-to-try law passes, here's what's likely to be next.]

oracknows Tue, 08/29/2017 - 03:00

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http://www.ageofautism.com/2012/10/spotlight-on-gardasil.html

This is so dangerous in so many ways. First to the participants, of course. But more broadly to the feeding of anti-vax drama as well. Cranks can claim that this stuff is poorly tested, on vulnerable people, and they'll be right.

And if it doesn't work or causes later problems? It will only be more reason to inflame anti-vax sentiment. Which will harm the perception of the whole field too.

I understand that people who are desperate want hope. But we created a lot of ring-fences around these things for real and legit reasons.

I agree that this is extremely bad. A herpes vaccine would be good to have, but the way this is done is so bad, long and short term.

If an IRB didn't approve it, there was likely a good reason.

I hope the FDA stands firm on this.

And can anyone explain why it's being tested on patients that already have herpes? Aren't vaccines preventive?

Both Office for Human Research Protections (OHRP) and FDA regulations explicitly require that clinical trials used in support for an application to approve an investigational new drug (IND) be approved and monitored by an IRB. Even Dr. Gottleib can’t change that without changing the regulations (a long and onerous process), and I doubt that even he would want to try, his prior advocacy of “streamlining” the drug approval process notwithstanding.

Unfortunately, Congress can change the rules, and I don't see anything preventing them from doing that. There are too many on Capitol Hill who have drunk the libertarian Kool-Aid.

Since the guy I infer was PI of this misbegotten study is dead, there is no way to punish him directly. But as long as the regulations allow them, the FDA should indeed stand firm, and mete out the maximum institutional penalty on SIU that the regulations allow. Cutting off the flow of facilities and administrative costs should get the attention of the SIU administration.

Halford's manuscript and cover letter are also posted on that site.

Um, "Patient CE‐27 shows a '60 cm2 area of inflamed epithelium'"? Yikes.

@Dorit: from the reviewer's comments, it appears this vaccine is to prevent future outbreaks of herpes, and also "cure" the person of having the virus, therefore eliminating the risk of outbreaks.

Thank you, Dawn.

A stray thought crossed my mind as I read that the “trial” was carried out by ferrying 17 Americans to St. Kitts and shooting them up. Did the Government of St. Kitts have any idea that a “clinical trial” was being carried out?

Would any of the medical team be licensed to practice there?

Did the St. Kitts Gov't just think it was another US vacation tour group?

OT a bit but have you seen this controversy? It does not speak directly to the “right to try “ issue but it seems strange. http://blogs.discovermagazine.com/neuroskeptic/2017/08/25/eteplirsen-cu…

Dorit: yes, vaccines are supposed to be preventative, but sometimes they're given when someone has been exposed with the hope of beating the disease to the punch. Immunoglobulins also serve this purpose. It's why people who get the flu after getting a flu vaccine don't typically get as sick as someone who wasn't vaccinated for it.

I find it hard to believe they got data showing a decrease in symptoms since herpes comes and goes out of remission. They'd have to vaccinate someone at the start of an outbreak to get that data. I call BS.

I also call BS that the PI's vaccinated themselves with an unproven herpes vaccine. I want to see the titer before I'll believe it. They could just as easily have injected themselves with saline, and anyone so unethical to run a trial like this is not above lying about something like this.

@ Dorit

And can anyone explain why it’s being tested on patients that already have herpes? Aren’t vaccines preventive?

My guess would be a rationale similar to the one for the treatment for rabies - the vaccine is providing antigens which the immune system may have trouble to find otherwise, because it's confronted to an aggressive virus (rabies) and time is of the essence.
In the case of herpes, it would be more because it is an elusive virus. The vaccine may be supposed to strengthen/re-awaken the existing immune response and help keep the dormant virus in check.
That's would be my theory, anyway. But I'm not sure it's even proven that a vaccine injection is helping a patient with rabies (it's not like there have been many successful stories).
There may be other illness where a curative treatment is tried by using a vaccine. There were some trials in Canada a few years ago with a vaccine for people with cat's allergy. But again, I'm not up-to-date on this.

tl;dr: there may be some legit theory behind the use of a vaccine as curative treatment, but I don't feel that confident...

@ jrkrideau

I suspect the government of St. Kiss could care less about unethical medical trials. St. Kitts is one of those islands that boasts at least 2 non-accredited "medical schools" (I use this term very loosely) for US students which are basically money making honey potts for crooks who try and convince people who couldn't get into a US-accredited medical school to spend a lot of money on a shady medical degree with long odds of getting into a US residency.

It’s why people who get the flu after getting a flu vaccine don’t typically get as sick as someone who wasn’t vaccinated for it.

That assertion may be bolder than is warranted:

"Flu vaccination also may make your illness milder if you do get sick."

I think I've seen Vincent Racaniello completely dismiss the proposition, but I have to pack this machine up and head to an airport, so I can't go digging.

Did the Government of St. Kitts have any idea that a “clinical trial” was being carried out?

Was there any reason for them to have suspected? If the participants looked like ordinary tourists from the US--especially if they arrived separately, which sounds perfectly plausible to me, the government need not have suspected anything was up until the manuscript became public. US citizens can visit for up to 90 days without a visa.

There is also the example of herpes zoster or shingles. The vaccine is given to people who have already been infected with the chickenpox virus to prevent an outbreak of shingles later in life when their immunity is waning.

Yes, the herpes viruses love to hide out in nervous system reservoirs and reactivate, and a vaccine can be useful in reducing those reactivations - as in shingles.

Given the variability, I don't know how a trial that small, with no control arm, can say anything about the vaccine's effect...

Here's a thing I've noticed about these libertarian approaches to business: so far they don't seem to go after aerospace, and I have to wonder if that is because aerospace and airlines are at least as heavily regulated as pharma.

These libertarians genuinely don't seem to understand that there is a *reason* why Pharma and biomedical research are highly regulated. And I think it's because they're coming from very lightly regulated industries.

If you mess up your code for eBay or PayPal? Somebody doesn't get their 1978 Matchbox car, or doesn't get paid. If you mess up the manufacture of your drug? People could die. You mess up the design of your airplane? People could die. Often a regulation is also a tombstone.

Either they don't know or they don't care, but either way they have to be stopped before they kill a whole bunch of people.

These libertarians genuinely don’t seem to understand that there is a *reason* why Pharma and biomedical research are highly regulated.

They understand perfectly well that the FDA is there to protect consumers. They just see that as a problem.

Meanwhile:

Federal authorities raided a California stem cell clinic and seized a smallpox vaccine that is reserved only for the military and high-risk populations, as the Food and Drug Administration expressed “serious concerns” about how the clinic obtained access to the vaccine at all.

The U.S. Marshals Service seized five vials of the smallpox vaccine, which is not commercially available, the FDA announced Monday. Four of the vials — which each hold 100 vaccine doses — were unused, but a portion of the fifth vial had been used.

The treatment mixed some of the vaccine with stem cells taken from a patient to create an injectable — and unproven and unregulated — cancer treatment that was targeted directly at the patient’s tumors, the FDA said. The FDA, which learned of the treatment after inspections, said the injection could have caused inflammation and swelling of the heart.

The treatment belonged to San Diego-based company StemImmune Inc., and was given at California Stem Cell Treatment Centers in Rancho Mirage and Beverly Hills. U.S. marshals seized the product on Friday.

The process you are describing in that 'clinical trial' are quite literally the ones that Quacks have been using for decades in the Third World to foist homeopathy, acupuncture, Miracle Mineral Solution and other nostrums to people who are desperate for effective healthcare. Why, because the bogus trial results make great advertising in the West.

At least this time it's happening in the US's backyard and it seems that the people behind it made the mistake of sending their paper to a real journal.

# 11 Chris Hickie

Does that mean that my degree from the Ross University School of Veterinary Medicine may not be a valuable as I thought? Oh dear.

On the other hand, a rogue medical trial pays no taxes and , if anything goes wrong probably leaves the St Kitts' Gov't to clean up the mess.

# 13 Eric Lund

Was there any reason for them to have suspected?

Exactly, if I was the St Kitts' Gov't I'd be a bit annoyed for several reasons— including American arrogance, and see above re tax, etc.

I am going to put this date on my calendar, as I believe this is the first time I have agreed with any post from this blogger on the subject of vaccines. I commend the thoughtful criticisms of this so-called "clinical trial" and all of its ethical failings.

What amazes me though is the completely myopic perspective demonstrated here. If what is being done with this herpes vaccine is wrong, then you also need to appreciate that this type of thing has been happening all the time throughout the history of vaccines. Are you open-minded enough, and brave enough, to direct the same criticisms to very similar episodes which occurred during the development of many of the vaccines which are in use today?

There are new stories about unethical clinical trials throughout the developing world, many of them sponsored by the Bill and Melinda Gates Foundation, coming almost weekly.

Many vaccines have been fast-tracked, much of the so-called "safety studies" are completely bogus, and the notion of informed consent has been completely dispensed with for many of these trials.

Look up the history of the anthrax vaccine. The development of the polio vaccine was the beginning of everything that was to become totally wrong about vaccine development, vaccine policy and vaccine politics (we call it Political Immunology). Look at the history of the MMR vaccine, where earlier versions caused meningitis outbreaks but the vaccine was still licensed for use, and in some countries like the UK it became licensed even *after* the meningitis risk was known. Even after it was pulled from use in the UK it was then sent to developing countries...no reason to waste perfectly good product! Even our current MMR vaccine is under scrutiny as Merck is fighting a lawsuit from two whistleblowers who are claiming that they were asked to falsify clinical trials data in order to make the mumps portion of the vaccine appear to be more effective.

The story of the development and licensing of Gardasil is a perfect example of fraudulent testing which left us with a vaccine which is killing and injuring children all over the world:

I know that the majority of you will simply see Age of Autism and dismiss this, but if you actually take the time to read it, you will see that Mark and Dan uncovered many of the same ethical problems that Orac discusses here.

Mr. Foster: "Look at the history of the MMR vaccine, where earlier versions caused meningitis outbreaks but the vaccine was still licensed for use, ...."

The Urabe mumps strain has never ever been used in the USA. The Jeryl Lynn mumps strain was in the original American version licensed in 1971. The new improved version was introduced in 1978 with a better rubella strain.

Your version of history is very flawed. In fact, the UK removed both Urabe mumps strain MMR versions in 1992. In fact the effect of Wakefield's stupid evidence free video press recommendation in 1998 to use separate caused this issue:
MEDICINES CONTROL AGENCY TO OBJECT TO IMPORTATION OF UNLICENSED SINGLE URABE STRAIN MUMPS VACCINE

This alone is enough to ignore anything by you and the other idiots at AoA.

we call it Political Immunology

"We"?

I didn't realize that it was possible to have "outbreaks" of aseptic meningitis.

David Foster,

Please provide creditable citations for some these unethical trials being sponsored by the Bill and Melinda Gates Foundation. Age of Autism is not a creditable source. Remember you are making the claims of unethical trials, so must provide the creditable references.

I have my doubts that you can actually provide the source material but as they say the horse may be able to sing.

Well, at least in one respect, he's right. Clinical trials do take place all over the world - because many countries require their own approvals and oversight of vaccines used within their borders.

Not to mention (though I will), that countries like India have their own domestic vaccine manufacturers, who are required to perform clinical trials and receive approval from the relevant government regulatory agencies as well.

@David Foster:

Mark and Dan uncovered many of the same ethical problems that Orac discusses here.

Ha.
Ha, ha!
Ha, ha, ha, ha!
HAHAHAHAHAHAHA!!!!
Dan Olmsted once claimed that there were no autistic Amish. His "research" and "journalism" skills were so weak he failed to learn about the "Clinic for Special Children", which catered to the Amish, and which had autistic residents.
That you view him as reliable tells me all I need to know.

David Foster is AWAK3 and thinks we are SHEEPL3.

(yawn)

Dr. Hickie, he is just a clueless fool.

Being a Brit he does not realize there was an MMR in use for seventeen years before the UK licensed three versions in 1988.. and then removed two in 1992.

It is like his view of medical history does not extend west or east of the UK.

@Chris:
Are you denying that a version of MMR which was already known to cause meningitis was in fact licensed in the UK before being pulled? That was my only point, that they knew there were issues with the vaccine yet still licensed it and used it for years before pulling it.

@Narad:
We.
An "outbreak" does not necessarily need to be an infectious disease, though my use of the word was not very precise. I should have used "epidemic".

@Rich Bly
I am not going to write an entire essay on this just to convince those of you who will likely never decide to investigate this for yourselves...it would be a waste of my time. The Bill and Melinda Gates Foundation has found itself in trouble many times due to its clinical trials, in fact it is currently involved in lawsuits in India. I bring this all up in the hopes that perhaps some of you will look into this for yourselves. I already have.

@Chris Hickie
My point was that while I agree with Orac's post regarding this particular vaccine trial, the very same problems he brings up occur quite often with regard to previous and current clinical trials, especially those conducted in other countries. The history of vaccines is replete with ethical failures like this.

@Julian Frost
You seem to be one big walking talking logical failure. Dan Olmsted's investigation into the Amish was preliminary, he did not fool himself into believing he was doing an epidemiological study. But what he found was very interesting, though not absolute. Your assumption that what he found is meaningless simply because there are some autistic Amish children is silly, but it is amusing to see how easily the pseudo-skeptics can convince themselves of a fallacy.

Mr. Foster: "Are you denying that a version of MMR which was already known to cause meningitis was in fact licensed in the UK before being pulled?"

Do you have reading comprehension problems? Please directly quote where the denial occurred. Especially since I actually explained to you the entire history and included this little issue caused by Wakefield:
MEDICINES CONTROL AGENCY TO OBJECT TO IMPORTATION OF UNLICENSED SINGLE URABE STRAIN MUMPS VACCINE

By the way, the above article has to do with laws in the United States of American, not the United Kingdom. So I will repeat again that the only mumps vaccine strain used in any American MMR is the Jeryl Lynn strain going back to 1971.

Okay, deer Davey, some simple arithmetic: 1988 - 1971 = 17 ...

Which is the number of years the MMR vaccine was used in the USA before the UK. And since you have trouble retaining information: The USA has only used the Jeryl Lynn vaccine strain.

Some more simple arithmetic: 1998 - 1992 = 6 ....

Which is the number of years between the UK pulling the two MMR vaccines with Urabe and Wakefield's fraudulent lying Lancet paper.

Since an epidemic is

a widespread occurrence of an infectious disease in a community at a particular time.

and aseptic meningitis
http://emedicine.medscape.com/article/1169489-overview

Aseptic meningitis syndrome ... has a number of other etiologies as well, both infectious and noninfectious.

I suggest you stick to the term outbreak.

The WHO has a good list of references on Mumps and vaccines.
http://www.who.int/immunization/Refs_Mumps_25_Jan_2007.pdf

If you scroll down and read Nokes et all from 1991, you'll find that

In communitybased
programmes, the greater apparent safety of the Jeryl Lynn vaccine (fewer vaccineinduced
complications) is offset by the greater apparent efficacy of the Urabe Am 9 vaccine
(fewer complications due to natural infection). The findings suggest that it may not always be
in the interests of the community to use the vaccine with the lowest complication rate.

so there was a tradeoff made and the UK chose the vaccine with greater efficacy against the primary cause of aseptic meningitis, mumps itself.

As I recall, there was also an availability issue as well, but perhaps Chris can clarify that. As the side effect concerns became clearer and the Jeryl Lynn strain became available in the quantities needed, the UK switched vaccines.

Perhaps, David, you could clarify for us.

An unethical trial that only had 20 participants and probably couldn't have demonstrated much of anything was snuck overseas to avoid the restrictions and requirements that have been put in place in the US and many other countries to protect patients because of mistakes that were made 30 to 50 years ago, therefore what?

@David Foster, responding to me:

Your assumption that what he found is meaningless simply because there are some autistic Amish children is silly

Way to miss the point. Dan Olmsted loudly proclaimed that the Amish did not vaccinate, and did not have autistic children. He was wrong with both arms of his claim.
My point was, if he made such an easily provably wrong claim, then he can't be trusted to get things right.

@Narad:
We.

Who would yall be?

An “outbreak” does not necessarily need to be an infectious disease, though my use of the word was not very precise. I should have used “epidemic”.

No, you should have used "cluster in Nottingham."

squirrelelite: "As I recall, there was also an availability issue as well, but perhaps Chris can clarify that. As the side effect concerns became clearer and the Jeryl Lynn strain became available in the quantities needed, the UK switched vaccine"

Some of has to do with costs. Though from my reading after Japan developed the Urabe mumps vaccine, it was about the time mumps vaccination was coming to Europe, in the 1980s. Especially since the Rubini mumps strain was deemed ineffective.

I think it may have been more of a cost issue than an availability issue: Mumps Outbreaks in Canada and the United States: Time for New Thinking on Mumps Vaccines

Which says:

Money should not be the only decisive factor, but it allows one to rank vaccines in certain order: a single-dose vial (according to the price for the US-manufactured vaccine) costs $.90, $1.20, and $2.50 for MMR vaccine containing L-Zagreb, Urabe, and Jeryl Lynn strains, respectively [96, 97].

You can see that the Jeryl Lynn strain costs slightly more than double of the Urabe strain.

Okay, another one of my comments has gone into the ether. I had just put in this quote: "Money should not be the only decisive factor, but it allows one to rank vaccines in certain order: a single-dose vial (according to the price for the US-manufactured vaccine) costs $.90, $1.20, and $2.50 for MMR vaccine containing L-Zagreb, Urabe, and Jeryl Lynn strains, respectively [96, 97]."

From a paper titled: "Mumps Outbreaks in Canada and the United States: Time for New Thinking on Mumps Vaccines"

Published on 15 August, 2007 in Clinical Infectious Diseases

Okay, try for the reason why I used that quote... Europe started to vaccinate for mumps in the 1980s, after the Urabe mumps vaccine strain was developed in Japan. Especially since the Rubini mumps vaccine strain was not terribly effective.

As you can see from the quote, the Jeryl Lynn strain costs slightly more than twice that of the Urabe strain.

@Rich Bly
I am not going to write an entire essay on this just to convince those of you who will likely never decide to investigate this for yourselves…it would be a waste of my time. The Bill and Melinda Gates Foundation has found itself in trouble many times due to its clinical trials, in fact it is currently involved in lawsuits in India. I bring this all up in the hopes that perhaps some of you will look into this for yourselves. I already have.

If proof of the Gates Foundation naughtiness existed, It would have been easy to link to it. Instead you spent time writing an entire essay on why you were not writing an entire essay, and instead Leaving it as an Exercise For the Reader.

The last couple of hours have been crazy making. At least four of my comments to this blog have been sucked into void, we lost power for over an hour, and now I am gritting my teeth listening to Michael Marshall interview a crackpot on Be Reasonable (very similar to the NWO Troll). At this point of the podcast she is promoting MMS.

"Go look yourself." The constant idiotic refrain from the typical anti-vaxer.

It just so happens that I have looked - and you're full of crap.

Forgot about this:

Even after it was pulled from use in the UK it was then sent to developing countries…no reason to waste perfectly good product!

Viral meningitis "occurs in about one in seven cases of mumps." Compare this with "1 in 10,000–15,000 doses," from the American Journal of Epidemiology paper linked above.

Of course, this assertion is once again quite vague, so there's no telling which countries it was "sent to" (the assertion may be that UNICEF had Urabe availability until 2014 [PDF], for all I know).

Dan Olmsted’s investigation into the Amish was preliminary, he did not fool himself into believing he was doing an epidemiological study.

*blink*

HDB,

Thanks, I wrote a short rebuttal but it got sucked into the void. All I can say is at best Foster is just an over inflated hot air bag and will not lower myself to call him what most probably he is.

@Narad,

There was also the 1997 cluster in Salvador, Brazil with an estimated risk of 1 in 14,000 for Urabe MMR.

Just for the hell of it, I looked up the Gates Foundation being sued in India. The article was from Vaccine This (appears to be an anti-vax site). The law suit was really against Merck over guardasil. The Gates Foundation was involved because they provided grant monies. Of course this article was fro 2014, so is way out of date.

There was also the 1997 cluster in Salvador, Brazil with an estimated risk of 1 in 14,000 for Urabe MMR.

Yes, I saw that (PDF), but the question of comparative risk hinges on incidence, and I just wasn't up to trying to calculate something.

Just for the heck of it I looked up the law suit against the Gates foundation in India. It actually was Merck being sued about Guardasil and the Gates Foundation was involved because they provided grant monies. The article was from a group called Vaccine This, which appears to be an anti-vax group. The article was dated 2014.

There is a legit therapeutic herpes vaccine in the clinical trial pipeline, about to enter P3 at the end of this year. Check out geneocea biosciences...

A new nomenclature for auricular acupuncture: The ultimate in Tooth Fairy science

oracknows — Fri, 25 Aug 2017 01:44:03 +0000

A new nomenclature for auricular acupuncture: The ultimate in Tooth Fairy science

Acupuncture is nothing more than a theatrical placebo.

I wish I could take credit for the term "theatrical placebo" to describe acupuncture, just as I wish I could take credit for coining the term "quackademic medicine" to describe the unfortunately increasing infiltration of quackery into academic medical centers and medical schools and as I wish I could take credit for the term "Tooth Fairy science" to describe doing scientific studies on a phenomenon that has not been proven to exist, but alas I cannot. I can, however, use the terms as I see fit, even if it might annoy some believers in acupuncture and other alternative medicine modalities that have no definable, demonstrable effect on any disease or medical condition detectable in randomized controlled clinical trials.

I can take credit, however, for pointing out that the history of "traditional Chinese medicine" was retconned by Chairman Mao Zedong. (I don't think anyone thought to borrow a term from comics and TV to describe the rewriting of history that Mao did to portray TCM as somehow being a single unified ancient and powerful system of medicine, so that he could sell it to his people (and later the world) as a viable alternative to "Western" medicine that should in fact be "integrated" into it. It's a process that's still going on today. Indeed, as I like to say, Chairman Mao was the father of "integrative medicine," at least with respect to "integrating" TCM into science-based medicine despite the lack of evidence that much, if any, of it worked, except for the occasional lucky guess.

However, as ridiculous as acupuncture can be, with its basis in ideas rooted in prescientific vitalism that claim that sticking needles into anatomically nonexistent "meridians" can somehow redirect the flow of "life energy" (qi) to heal, there is a form of acupuncture that is even more ridiculous than that, and it's auricular acupuncture. Basically, the idea behind auricular acupuncture is that there is a homunculus of the human body on the external ear, usually with the head near the earlobe and the feet near the triangular fossa (the upper part of the ear). Basically, in auricular acupuncture, an acupuncturist sticks smaller, shorter needles into the external ear, the location determined according to the homunculus to target the organ or body part that is diseased or in pain. This mapping generally corresponds to similar maps developed for that other form of homunculus-based quackery, reflexology. These are a couple of excellent examples of Tooth Fairy science, in which one studies the amount of money the Tooth Fairy leaves per tooth or the phases of the moon when she is most likely to come but never bothered to show that the Tooth Fairy exists in the first place. In this case, it is the existence of a homunculus mapping different organs to areas on the external ear that has never been demonstrated.

Sadly, auricular acupuncture is the preferred form of acupuncture that's been adapted to "battlefield acupuncture" (I kid you not), where our military (yes, our military) is training medics and other healthcare providers in its ranks to use auricular acupuncture right on the battlefield. Meanwhile, military hospitals and the VA medical system are rapidly adopting the same quackery.

Here's an example of such a homunculus (click to embiggen):

Of course, alternative medicine being alternative medicine and quacks being quacks, there is no evidence for the above homunculus, and other maps have appeared, some quite complex, like this one:

So naturally, given the rapidly expanding complexity of their quackery, the quacks practicing auricular acupuncture need a new homunculus. They need a new system that can incorporate the rapidly expanding list of areas to map to the ear. Not surprisingly, there are quackademic medical "researchers" who are more than willing to provide just such a system. Behold, published online ahead of print in that repository of quackademic medicine, The Journal of Alternative and Complementary Medicine, a "study" that provides just what cutting edge auricular acupuncture researchers need, a New Universal Nomenclature of Auriculotherapy. (No, I didn't capitalize that. The authors did. Humble, aren't they?) The authors, David Alimi, MD, and Jacques E. Chelly, MD, PhD, MBA, are both based at the University of Pittsburgh, in the Departments of Anesthesia (Alimi and Chelly) and Orthopedics (Chelly). I do find it appropriate that Dr. Chelly has an MBA, because, of course, the business possibilities for auricular acupuncture are endless.

So what is the justification for needing a new system of nomenclature for auricular acupuncture? I'll let Alimi and Chelly explain:

Auricular acupuncture (Auriculotherapy) has gone through the centuries, and, in particular, the last 40 years, going from traditional to modern. By word of mouth, from empirical practice to efficient medicine, it was slowly approved, thanks to neuroimaging progress, and has become, at least, a part of neuroscience.

Since the rediscovery of Auriculotherapy by Paul Nogier in 1957 in Lyon (France), and his brilliant vision of a fetus curled up in the ear pavilion, presaging the understanding of his somatotopic bases, modern neuroscientific knowledge has allowed us, as neurophysiologists, to bring understanding of the neurophysiological bases of its action.

Since this scientific certification, its development, universal propagation, and academic education have never stopped developing, just like the multiplication of clinical and experimental study publications.

After Dr. Paul Nogier's initial cartography of the ear, multiple cartographies have been developed by different authors/countries/schools. Until recently, the construct of these cartographies was anatomically based. Basically, the ear was divided in anatomic zones (helix, Antihelix, Tragus, Lobule, etc.) and each zone was subdivided in areas. This led to the description of each point by a letter referring to the zone and a number referring to an area within the zone.

The World Health Organization (WHO) recognized it in 1987 and developed its first International Nomenclature in 1990 (Fig. 1). Its continuous development currently requires an update of its international standardization.

The WHO? Et tu, WHO? Sadly, it's true. The WHO did come up with a nomenclature for auricular acupuncture, which was published in 1991. It's a simultaneously depressing and hilarious read, pure pseudoscience, a blot on the WHO forever. Fortunately, I haven't been able to find anything on the WHO website like it that's more recent, other than a couple of papers that have references about auriculotherapy or auricular acupuncture in them.

But what about Paul Nogier? Who is he? Or, rather, who was he, given that he died over 20 years ago? Well, helpfully, there is a website that tells all about him and how he "discovered" auricular acupuncture. I got a bad feeling about Nogier from the very first paragraph:

The XIXth and the XXth centuries were the centuries where the chemistry was omnipotent and where the medical therapy was based upon this chemistry. For every disease, a chemical drug. For every symptom, a molecule. It was very rare in the XXth century that someone explored new physical paths for therapy. Dr. Paul NOGIER, who received a formation as an engineer, looked at the individual with an eye of a physicist. He understood that the biological systems were not only sensitive to active chemical substances but also to physical stimulations. Therefore he systematically tried to find physical therapies to be used in the treatment in order to avoid the secondary effects of the chemical drugs. As soon as he graduated in medicine in Lyon, he focused his interest on homeopathy, as the homeopathic granule liberated from any chemical substance, finds its action through the physical electromagnetic information. Afterwards, he studied manual medicine and later acupuncture.

Yep. Even though he was a physician, Nogier was a practitioner of The One Quackery To Rule Them All, homeopathy. He was also into other forms of woo, like "energy medicine." Indeed, he claimed to have discovered "through painstaking research with the subtle energies of the body" three frequencies that "stimulate the creation of our body tissues." His "finding" with respect to this was described by Dr. Charles McGee, who attended one of Nogier's lectures in 1975:

He must have been astounded by the orderliness of a pattern he discovered. He found that specific body tissues were in resonance with specific frequencies according to their embryologic origin. … I believe this single finding will one day be recognized as one of the greatest discoveries of medicine, possibly worth a Nobel Prize for Nogier.

Vibrations. It's always the vibrations with quacks. I know I've said that before. Maybe I should say: Le vibration. C'est toujours le vibration. Oddly enough, poor Dr. Nogier died without ever being awarded a Nobel Prize.

Vibrations or not, this next part will sound very familiar to those of you familiar with the history of chiropractic and how D.D. Palmer "discovered" chiropractic:

In 1951, Paul NOGIER received in his consultation a patient, who explained to him that he was relieved from a sciatica pain by a cauterisation on the ear carried out by a quack in Marseille, Madame BARRIN. Following this observation, Paul NOGIER examined the external ear and tried to understand why this strange cure took place. It will take him more than 30 years to ascertain the mechanisms of the ear properties.

Yep. A patient with a "miracle cure," although this miracle cure isn't as impressive as what Palmer claimed, the cure of someone almost deaf by a "pop" in his spine. Poor auricular acupuncture. It can't even come up with an impressive origin story, either. However, just like every good quack who invented a medical treatment (or, in this case, almost a system of medicine) out of whole cloth, Nogier has been portrayed as laboring many years to figure out that there supposedly exist points in the ear like acupuncture that appear as soon as "pain or functional disorder is provoked" in the body. Supposedly, these points can be detected either by pain sensitivity or with equipment designed to detect electrical impulses in the skin. According to Alimi and Chelly, it is known (obligatory Game of Thrones reference) that the surface of the external ear carries areas of lower resistance that appear in the case of the presence of a functional disorder. It is (also) known that "every point on the ear corresponds to a well defined part of the body" and that a "real cartography is present on the ear."

Using that idea as a jumping off point, man, oh, man can the adherents of auricular acupuncture do up some sciencey quackademic medicine studies to justify their woo! In this case, Alimi and Chelly reported on how they used electronic database searches from 1958 to 2012 to find different formulations of Auricular Acupuncture Points (AAPs). They then claim to have studied brain dissections and to have "proved the neurophysiological correlations existing between auricular displays and their brain correspondences." Hilariously, they claim to have found that the middle of the corpus callosum (the structure that connects the two hemispheres of the brain) is the "epicenter of the somatotopic organization of the brain homunculus." Funny, but that's news to neuroscientists, I'm sure! In any case, the authors used this risibly unbelievable analysis to propose a new way to divide up the ear for purposes of auricular acupuncture. It involves a semicircle of an angular value of 180°, which they divided into 20 equal angles (that is, 9°. The called this the “Segmentogram,” which covers the totality of the surface of the auricle. Overall, this system divides the lateral ear in 189 areas and the medial ear in 89 areas. It's easier just to look at the illustrations (click to embiggen):

And these areas of the ear supposedly map to organs and body parts (click to embiggen):

It's really complicated; so it must be right, right?

Wrong.

There are no neuroanatomic correlates to suggest that there is any sort of mapping between body parts and organs to specific areas on the external ear. This is the ultimate in Tooth Fairy Science, which is basically doing studies on a phenomenon that has not yet been shown to exist. Sadly, there's a lot more where that came from in quackademic medicine.

oracknows Thu, 08/24/2017 - 21:44

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https://www.facebook.com/drzschokke/

The shamelessness of the fraudulence is somehow impressive.

I just thought of a test one could perform for this.
Point 5 is (supposedly) attached to the eyes, and is also the area where most ear piercings occur.
So, we take a group of people who are about to get their ears pierced. Given how many people who have their ears pierced, there would be thousands. Then we test their eyesight before the piercings. Then we wait a few weeks after the piercings and test their eyesight again.
I know this is ridiculous, but I couldn't resist.

"Ear Acupuncutre"? Dear Lord, what wingnuttery is this?

A Question!

Do these points decuss at the pyramids, like other sensorimotor pathways? Or are they ipsilateral, like spinal reflexes?

These people claim to be neurophysiologists, after all, so they should know.

fusilier
James 2:24

Rebecca@2: It's second-order woo, combining the nuttiness of acupuncture with the nuttiness of reflexology.

He found that specific body tissues were in resonance with specific frequencies according to their embryologic origin.

Putting the lie to any claims that M. Nogier was looking at the problem like a physicist. As every physicist (and for that matter every musician) knows, resonant frequencies decrease as the size of the object increases. There are other factors involved as well, but anybody who claims that a specific tissue will always have a specific frequency is selling you garden fertilizer by the truckload.

Containing the words aurum and cul, Auriculotherapy seems to be a way to gild one's ass,

So I lost a hunk of nose to skin cancer. Before the Mohs surgery I was presented with three possibilities--a nose with a patch, a smaller nose with thin, stretched skin, and what one might call a Micheal Jackson nose--small children won't scream at you but that's about it.

Now I ended up with a smaller nose, but there was a great deal of anxiety and reading of surgical journals. (There was much ecstasy and song when the doctors told me I was group two.) In the third case, they remove all that curly stuff in your ears, leaving you with what looks like two funny shaped soup bowls and a strong desire to wear your hair long. The little bits of cartilage are stitched into sort of a tent, but it's too small and wobbly and never the perfect shape. As said though, small children will not scream and run.

I'm just wondering what this would do to my aural fetus, and what dire and drastic symptoms others who are not so lucky have experienced. Why don't they study those?

It’s second-order woo, combining the nuttiness of acupuncture with the nuttiness of reflexology.

I realise that, but they can't even spell it!

I now understand why ranchers ear notch their cattle. It keeps the cows from having bad ankles. Any takers on the bet that I am being sarcastic?

My favorite "explanation" offered by auricular acupunturists is that the ear "is the only organ with all 3 tissue types". As if that were adequate to account for all their claims. In their world, embryonic origins of tissues confers life long connectivity of those tissues with or without any demonstrable connection.

Apparently you can make this stuff up.

Dr. Paul NOGIER, who received a formation as an engineer, looked at the individual with an eye of a physicist.

Thus giving a bad name to out-of-field physical scientists the world over.

He found that specific body tissues were in resonance with specific frequencies according to their embryologic origin.

A physicist wonders why these studies don't include any spectroscopy. A simple question to ask is "What frequency is that?" This screams "graph!" or at the very least "table!"... frequency versus embryonic line. No Nobel awarded without real quantitation. I regret that I looked into that review for some evidence of spectroscopy and found none.

So, when I'm scrubbing my ears in the shower, is that beneficial or negative for my body? What about those annoying ear itches?

Christine, sorry about your cancer. What a choice! I hope that your great sense of humour helped you through it.

Which reminds me, wasn't cutting off ears a punishment in the past? Why didn't the victims just up and die after losing their aural fetus? Rather than wishing they were?

So what happens if you're one of those people who don't have earlobes?

Where is the spot that maps to pain in the outer ear?

What part of the body does ear hair correspond to?

There are things this makes me wonder about.
If you burn your ear during ear candling, do you need to be admitted to a burn center?
Did all the people who ever told me "Stick it in your ear" actually care about my health?
Will Gwyneth Paltrow start recommending cervical acupuncture?
If parts of the ear correspond to the genitals, can you have aural sex? And is this what "stick it in your ear" really means?

What about boxers with cauliflower ears? How do you approach all that extra tissue? Or people with super gauged holes in their earlobes?

It's the equivalent of Terry Pratchett's Reverse Phrenology. Decide what state of physical health you seek, and stretch your ears correspondingly.

Just asking for a friend - a sort of follow up to ORD at #16 - can you tonify a certain area (male) instead of using the too expensive & risky Viagra?

Speaking of stretched ears, I remember "older" women who wore heavy earrings having stretched, extra long earlobes. How does that affect this accupuncture system?

Oh, the unanswered questions!

So, if all body parts are represented on the ear homunculus, then the homunculus ear itself should also be represented on the real ear, right? But does that create a map within a map? Like, is there a never-ending series of tiny ear homunculi within tiny ear homunculi? My goodness, where does it end?!
Or, if the homunculus somehow does not have an ear, then how can I possibly cure my outer ear ailments? There would be no way to access my ear using this totally amazing and revolutionary miracle cure! I'll just have my quiet existential crisis over here.

It's turtles homunculi all the way down!

Ah, so the traditional punishment of a slap along the ear in fact constitutes a very efficient whole-body treatment?

Well, the cop who got his ear cut off in Reservoir Dogs expired soon after. So maybe there's something to this after all.

cheers,
Dr. Blonde

Speaking of movies, I'm reminded of the Woody Allen character's response to Diane Keaton's ex (and purported demon lover) in Manhattan -. "But he's a a a.... homoculus!"

I have medium-large gauge lobes, and an assortment of other smaller metallic piercings, and yes - I have had hippie/woo practitioners tell me in all seriousness, uninvited and unprovoked, that I have 'ruined' my ears and potentially my health. One stopped me in a shop to tell me so.

So one wonders what happens when the foot section of the ear is needled at the same time that the reflexologist stimulates the ear area of the foot. Self-immolation? The body being sucked into its own black hole? Or just laughing from the tickles?

Feedback loop and DIVIDE BY 0.

MsV - I don't really care for gauges or multiple piercings in my heart of hearts, (but I had my nose pierced in the 70's, but took it out when was looking for real work in the 80's. Oh, and lots of ear piercing) but I hope that you live forever in excellent health and all happiness just to spite those self righteous dingbats.

I am saddened at your post and would love to speak with you. Where are you located Sir?

Do you see the words written in blue letters, Raeann? Those are links to other websites. Do you think there is a reason the author's name is in blue letters?

Perhaps you should tell everyone here why you are sad about this post. Perhaps provide actual verifiable scientific evidence to prove the author wrong.

Or do you just want to yell obscenities at him?

Wow! Chris it’s amazing you wanted to assume I wished to yell anything. Breathe deep, in through your nose and out through your mouth, you obviously need to relax a bit.

Yahoo, more condescending new age twits.

Raeann,

I think there are a couple of reasons people are confused here. First of all, Orac's bio is available by clicking on the blue link ("by Orac") at the top of the article. He is in a hospital in Detroit.

Second, why do you wish to find him in person? It would be inappropriate for you to head out to his workplace and get arrested. (If there's any place you don't want to mess with, it's a hospital in Detroit.) That's why you were asked about yelling. If you actually want to dialogue with him, you shouldn't be asking for his physical location.

Finally, you are unlikely to convince him that ear acupuncture is a thing unless you understand why he is convinced that it is not a thing. You ought not assume that you know more about it than he does.

Raeann, Orac's identity is one of the internet's worst kept secret. If you had done due diligence you would have looked at other articles he has written on his blog.

In fact, much of the information you asked about have been linked to in his most recent posts because this site is moving. It has links to his new blog, where he wrote about his history online.

By the way, Orac has been stalked. One particular young man attended a talk he was given only to rant at him about something he disagreed with. So, yeah, there is precedent.

If you wish to civilly state your disagreement with the article, then you would post the PubMed indexed papers that support your position. If those do not exist, then you should design a study, get it approved by an Independent Review Board for compliance with the Belmont Report, gather some funding, do the study, write it up and then submit it for publication in a reputable medical journal. Because neither Orac nor us minions are going to take just your word that something works.

Could it be Raeann makes money selling this procedure to customers? M-m-m-m-m-m?

Perhaps Raeann should add this therapy to her practice:
http://scienceblogs.com/insolence/2010/12/13/pulling-reflexology-out-of…

Why can't chiropractors stick to the one thing that they might actually be qualified to do, relieving lower back pain? Why do they always have to pile on other non-scientific nonsense services like reiki, acupuncture, cranial-sacral whatever, homeopathy, supplements, etc.?

I know the answer: to boost the revenue stream from customers who are already vulnerable to nonsense and predisposed to believing in magic. Their customers are "pre-qualified," to use a sales term.

Could it be Raeann makes money selling this procedure to customers?

That would be hilarious:

"TRT is a non-linear, non-mechanistic, neurological method of testing and adjusting. A low-force high velocity instrument called the Integrator is used to remove subluxations that cause nerve interference and restore the body’s function at its highest potential."

Torsion. You keep using that word.

Oh, and she believes in subluxations too!

I actually did acupuncture for a couple of years, courtesy of my Mom, who is normally a smart woman. They did my ear one time: they had to pull the needle out immediately, because it hurt.

Woo Fighter: well, they chased off this former customer. I do think a chiropractor did help my neck pain after I got rear ended.

Then I moved, and my new chiropractor was heavily into woo. I didn't believe for a minute that adjusting my back would have any impact on my GI system, but when he started talking about spinal adjustments on newborns, I was done.

Then I started reading more about chiropracty and the risks involved in adjusting the neck.

Never. Again.

Panacea,

I'm glad you saw the light before you were either a) injured or b) drained of any more money.

I was really referring to the alt crowd that avoid "allopathic" (sic) doctors in favour of chiropractors, who typically appeal to the anti-vaccine, natural, "wholistic" audience. Once you believe in one thing they sell, it's easy to sell you other magical services. "Since chiropractic seems to have re-energized the vital forces in your torso, thus clearing up your asthma, we do offer this follow-up treatment called " ... (whatever)" that can polish your chakras and bring your entire being into focus.You wouldn't want to start the job of total harmonic alignment and not finish it, would you?"

Oh, and she believes in subluxations too!

It's not entirely clear to me how a device styled as "The Integrator" is supposed to remove something, but whatever.

It effectively removes cash from wallets.

In response to Peter (Oz) Jone #19 there is a opening picture in Dr. Paul Nogier's Treatise on Auricular Therapy of Hieronymus Bosch painting Garden of Earthly Delights with an ear where a demon spear ponts to a point on the anterior helix now know as the Bosch point. This is point is used in auriculotherapy for it "viagra like effects." However the tail of the spear point to the another named after Saint Jerome and has an anti-aphrodisiacs effect. The large arrow goes through a major point Shen men or "Spirit's Door" and there is a knife/phallus projection from these two ears. This most famous painting is over five centuries old.

Having read most of Dr. Paul Nogier's writings I can't recall seeing any references to skeptics favorite straw dog homeopathy. Plenty of references to the various cranial nerves running to the different surfaces of the ear: a parasympathetic branch going to the concha, trigeminal going to the earlobe for example. Also discussion of thalamic nerve tracts for pain sensations. He describes a second class of points that anatomically correlate to neurovacular bundles including dendritic cells (cells of Langerheim.) His use of "frequencies" come from a study of these new points that show a response in the sympathetic vagal tone. Charts of these frequencies are available however very few auriculotherapists know how to use them.

Parasympathic branch of the vagus, named a century ago as Arnold's vagus branch. Also see Aroold's reflex.

But doesn't the fact that the various nerves to the ear come from various directions contradict the whole idea? There's no direct nerve to the genitals for example (no acupuncture Viagra). At that level, all the nerves at all the body parts can be traced to another body part.

If the claim were that you can do experimental vagus nerve stimulation (to treat seizures) with a device in the ear, well that's actually happening. The claim that poking a spot that seems to be the homunculus gall bladder will treat gallstones, not so convincing.

Christine Rose: while the thought of acupuncture is bad enough, Viagra acupuncture is more than cringe worthy. The pain, oh the pain.

Paging Alain.

^ Wrong thread, sorry.

Narad,

Thanks for the ping :)

Alain

“He couldn’t tolerate injustice”: Remembering Dr. Herbert Needleman

cmonforton — Wed, 26 Jul 2017 09:00:50 +0000

“He couldn’t tolerate injustice”: Remembering Dr. Herbert Needleman

My favorite way to capture students’ attention about lead poisoning is to tell them about Dr. Herbert Needleman and his use of children’s baby teeth. In the late 1960's, Needleman recruited school teachers in Chelsea and Somerville, MA to collect their young students’ deciduous teeth when they fell out. It was a non-invasive way----no needlesticks, no bone biopsies---to get data on lead burden in children.

Needleman’s team analyzed the teeth for lead which helped them establish a population distribution of tooth lead levels. (It did not exist up to that time.) In 1972, he published the findings as lead exposure prevalence among the school children in the journal Nature. He built on that research with his investigations of the relationship between children’s lead levels and IQ. That research also involved school teachers. The landmark paper: “Deficits in psychologic and classroom performance of children with elevated dentine lead levels,” was published in the New England Journal of Medicine in 1979.

In an interview with historians David Rosner and Gerald Markowitz, Needleman reveals his enthusiasm for scientific inquiry rich with community involvement:

“We had posters placed around the city in store windows. My secretary’s husband was a commercial artist. He drew us a tooth that looked like Mickey Mouse. It had a missing tooth, and it said, “I gave.” …We gave as a reward a little kit—toothbrush, toothpaste—and a badge."

“The teachers were wonderful. They each had a shoe box filled with coded envelopes. On the envelope was a diagram of the human mouth with a big smile. They would look in the kids’ mouth, find the space, and then mark the space on the envelope.”

At the time of Needleman's initial work in the late 1960's, children with a blood lead level of 60 ug/dL of blood were considered to have lead poisoning. His work was instrumental in identifying the relationship between lead exposure and intellectual impairment, school performance, and behavior disorders. By 1980, the threshold for childhood lead poisoning was 30 ug/dL of blood. Needleman's inquiries with colleagues continued and their findings were essential in securing greater protections for the public from lead, including action by the EPA and Congress to ban lead in gasoline, paint, plumbing, and other uses. The CDC's current action level for blood lead in children is 5 ug/dL of blood and the recognition that no level is considered safe.

Needleman published more than 60 papers about the adverse health effects of lead. His research, however, threatened the economic viability and public image of makers and users of lead. Needleman was vigorously attacked for his work by EI DuPont, the Ethyl Corporation, and others. Assertions of scientific misconduct by Needleman were hurled by scientists on the industry's payroll. The accusations led to investigations by the National Institutes of Health and the University of Pittsburgh where Needleman was a professor of child psychiatry and pediatrics.

Needleman discussed the professional assault in an interview with Rosner and Markowitz, in particular, the University's practice of holding academic integrity proceedings behind closed doors. Needleman said:

"The major issue was having an open hearing. I knew that if we went in to executive session, I was through—I mean, just judging by the report that the inquiry committee wrote. I campaigned to get it open, and the university faculty senate was behind me 100%. It became a big issue here. The chancellor was challenged in public. About 400 scientists from around the country petitioned. The hearings were then declared open, at which point Sandra Scarr and Claire Ernhart [researchers for the lead industry] said they would not come. They did not want to be questioned in public."

Needleman wrote about the experience in "Salem comes to the National Institutes of Health: Notes from inside the crucible of scientific integrity," for a 1992 issue of Pediatrics.

Philip Landrigan collaborated frequently with Needleman. Landrigan told Sean Hamill of the Pittsburgh Post-Gazette:

“It was a terrible time in his life. The people who raised the questions used a small discrepancy to undermine him. More than 90 percent of the scientific community had long accepted his findings and the only people who didn’t were on the payroll of the lead industry.”

Historian Rosner remarked:

"He accomplished a lot. He suffered a lot. And he inspired a lot of people. His main goal was to inspire a generation of researchers, and he obviously has done that. He was just a great man.”

A testament to Needleman's inspiration comes today from the front lines. Upon his death, pediatrician Mona Hannah-Attisha, who exposed the lead-poisoning epidemic in Flint, Michigan tweeted:

"So much of our knowledge about lead and children flows from Dr. Needleman's work and tenacity. He was attacked, fought back, and forced change. RIP."

Needleman's fierce advocacy for children went far beyond lead. A tribute written by David Wallinga describes Needleman's role on an EPA advisory committee examining exposures to pesticides.

His son, Joshua Needleman, MD, said his father's passion for social justice grounded all of his work.

“He just couldn’t tolerate injustice and could not stop seeking the truth.”

What an appropriate motto for anyone in public health! Thank you Dr. Needleman.

cmonforton Wed, 07/26/2017 - 05:00

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Excellent piece Celeste!

Thanks for the knowledge.......

Well done.

Thank you - thank was good to read.
Concise, accurate, and passionate.

Dr. Needleman,
I am sorry for your family's loss. It is a joy to share with my students the important work of your father.

A good article about a great man.

For more about Dr. Needleman, and geophysicist Clair Patterson, I recommend Lydia Denworth's book Toxic Truth.

A physicist clueless about cancer lectures cancer biologists on...cancer!

oracknows — Tue, 18 Jul 2017 01:24:28 +0000

A physicist clueless about cancer lectures cancer biologists on...cancer!

There's a good rule of thumb about headlines (other than Betteridge's Law of Headlines) that I use when perusing articles. It's particularly useful for evaluating headlines about medical and science stories. Basically, if a headline says something like, "everything you know about X is/might be/could be wrong" or "everything scientists know about X is/might be/could be wrong," it's a highly reliable indication that much of what is in the article that follows is very likely to be unmitigated, grade-A bullshit. I realize that it might be confirmation bias on my part (I am, after all, a skeptic), but it's a rule of thumb that has rarely let me down. It is, after all, a very lazy trope on the part of editors and journalists designed to pique the reader's interest and imply that there's been some sort of radical new finding that's overturned much of what scientists thought about a topic before. Science, of course, doesn't usually work that way. Findings that totally overturn a scientific paradigm are rare; most new findings are evolutionary, not revolutionary. This is good for science. It's not so good for news stories and headline writers.

My rule definitely didn't let me down yesterday, too, as I started seeing on my social medial an article in Newsweek by Jessica Wapner that definitely follows it. Oh, sure, there's a paragraph or two out of a very long article presenting one scientist criticizing the crank idea presented, but for the most part the article is all credulous praise. Entitled, A New Theory on Cancer: What We Know About How It Starts Could All Be Wrong, the title fits the pattern, as does the article that follows. It is unmitigated, grade-A bullshit. Not only that, to the lazy trope of lionizing a "scientific maverick" (whose ideas are, of course, what show us that "what we know about how cancer starts could all be wrong") who is most unworthy of lionization. Unsurprisingly, it is a theoretical physicist. It could be confirmation bias on my part again, but it sure does seem that physicists seem particularly prone to entering a new field, coming up with a new "insight" in it, and then wondering why all the scientists there hadn't thought of the insight he's had and indeed reject it. In any case, it's a physicist we have met before, Paul Davies, who three years ago with his partner in crime Charles Lineweaver (another physicist, in this case an astrophysicist) made a splash with his idea that cancer is a throwback to an ancient genetic “sub-routine” where the mechanisms that usually instruct cells when to multiply and die malfunctions, thus forcing the cells to revert back to a default option that was programmed into their ancestors long ago, or, as it's called, an atavism, a "reawakening" of ancient genetic subroutines. I wrote about it then. I described why his ideas are wrong and how they've inspired a quack. So did biologist P.Z. Myers (multiple times) Nothing's changed since then, except that Wapner cranked up the worship of the Brave Maverick Scientist to a cringe-inducing 11.

Behold:

Paul Davies knows what’s wrong with cancer research: too much cash and too little forethought. Despite billions of dollars invested in fighting this disease, it has remained an inscrutable foe. “There is this assumption that you can solve the problem by throwing money at it,” he says, “that you can spend your way to a solution.” Davies, a theoretical physicist at Arizona State University (ASU)—and therefore somewhat of an interloper in the field of cancer—claims he has a better idea. “I believe you have to think your way to a solution.”

Bloody hell. As a cancer surgeon and biologist, I couldn't help but be monumentally pissed off when I read this paragraph. The hubris just oozes from every word of Davies' quoted. So does the condescension and contempt for us poor, poor, oncologists, surgeons, and cancer biologists, who (or so Davies apparently thinks) are so deeply embedded into the existing paradigm that they can't appreciate the brilliance of his insights. ""I believe you have to think your way to a solution"? What does he think cancer biologists have been doing for well over a century now, dating back to the 1800s? Sitting around in their labs waiting for that sweet, sweet grand money to flow in, so that they can do whatever experiment that pops into their heads on any given day?

He also betrays the bias of his background as a theoretical physicist. Let me give him an education. To make progress against cancer takes a lot more than "thinking." Yes, thinking is important, but it's worthless without actual experimental evidence from the laboratory, which is then translated into the clinic and validated through clinical trials. This is a process that can take decades, of which "thinking" is only the first step. The hard work of cancer biology, like any science, is not necessarily coming up with ideas and insights. The real thinking that has to be done is to design strategies to assess which ideas lead to testable hypotheses that can result in a better understanding of cancer and, at least as importantly, identify mechanisms that can be targeted for therapy. The hubris that Davies demonstrates is breathtaking, and Wapner doesn't call him out on it in the least.

If you don't believe me that Davies is peddling grade-A bullshit, then check out this next passage:

Over the course of several years spent pondering cancer, Davies has come up with a radical approach for understanding it. He theorizes that cancer is a return to an earlier time in evolution, before complex organisms emerged. When a person develops cancer, he posits, their cells regress from their current sophisticated and complex state to become more like the single-celled life prevalent a billion years ago.

But while some researchers are intrigued by the theory that cancer is an evolutionary throwback, or atavism, plenty more think it’s silly. That theory suggests that our cells physically revert from their current form—a complex piece in the even more complex puzzle that makes a lung or a kidney or a brain—to a primitive state akin to algae or bacteria, a notion that seems preposterous to many scientists. Yet gradually, evidence is emerging that Davies could be right. If he is—if cancer really is a disease in which our cells act like their single-celled ancestors of eons ago—then the current approach to treatment could be all wrong.

"Gradually evidence is emerging that Davies could be right"? No. It's not. Really, it's not. Nothing Davies has thought of is remotely new. As I discussed a long time ago, it is not surprising that the hallmarks of cancer described by Douglas Hanahan and Robert Weinberg in 2000 and updated in 2011. The original six hallmarks were:

sustaining proliferative signaling
evading growth suppressors
resisting cell death
enabling replicative immortality
inducing angiogenesis
activating invasion and metastasis

Cancer biologists have known for a long time that the genes involved in developing cancer control cellular processes like these, and these processes are very ancient ones. Just because these processeas are ancient, however, does not mean that Davies is correct. His first line of argument is that cancer is found in virtually all multicellular organisms have cancer, which is true but basically irrelevant. Then he argues:

The evidence that cancer is an evolutionary regression goes beyond the ubiquity of the disease. Tumors, says Davies, act like single-celled organisms. Unlike mammalian cells, for example, cancer cells are not programmed to die, rendering them effectively immortal. Also, tumors can survive with very little oxygen. To Davies and his team, which includes Australian astrobiologist Charles Lineweaver and Kimberly Bussey, a bioinformatics specialist at ASU, that fact supports the idea that cancer emerged somewhere between 1 billion and 1 and a half billion years ago, when the amount of oxygen in the atmosphere was extremely low.

Tumors also metabolize differently from normal cells. They convert sugar into energy incredibly fast and produce lactic acid, a chemical normally resulting from metabolism that takes place in the absence of oxygen. In other words, cancer cells ferment, and scientists don’t know why. This phenomenon is known as the Warburg effect, named for Otto Warburg, a German biochemist who won a Nobel Prize in 1931 for his discoveries about oxygen and metabolism. Up to 80 percent of cancers display the Warburg effect. Researchers know that many cancers depend on the Warburg effect for their survival, but they don’t know why. To Davies, the strange way in which tumors metabolize also speaks of cancer’s ancient past: They are behaving as if there were no oxygen available.

Yes, tumor cells are not programmed to die (a process called apoptosis, or programmed cell death), an essential process in building multicellular organisms, particularly of keeping cells under control and from proliferating outside of control of the organism. However, as P.Z. Myers notes, there are normal cells that have the same ability, such as germ line cells. As a cancer biologist myself, I can't help but note that another relevant cell type is the stem cell. Stem cells are cells that can differentiate into any cell type and have in essence unlimited replicative potential. It would make more sense to say that cancer cells in some ways resemble stem cells, and, yes, cancer stem cells are a hot (if controversial) area of research. Just ask Max Wicha, a pioneer in the field. Unlimited replicative ability is not an atavistic property.

As for surviving in very little oxygen, mammalian cells do the same thing. It is not an atavistic property. When oxygen tension is low, they revert to glycolysis, which doesn't require oxygen. The disadvantage is that glycolysis produces much less energy per molecule of glucose than oxidative metabolism does. It is true that many tumor cell types do "prefer" glycolysis over aerobic metabolism. It's something that Otto Warburg observed back in the late 1920s, and it's the reason that PET scans work. PET scans use radiolabeled glucose Tumor cells, because of their dependence on glycolysis, use a lot of glucose, which means that areas with tumor cells "light up" on PET, allowing the detection of tiny tumor deposits. I've discussed the Warburg effect on multiple occasions. Again, there's nothing "atavistic" here.

It's also not as though we don't understand some of these things as well. The Warburg effect is associated with the PKM2 isoform of a key enzyme in glycolysis, pyruvate dehydrogenase. Attempts to use inhibitors of aerobic glycolysis in the clinic or other drugs that target the Warburg effect have not been dramatically successful.

Although PZ did a fine job deconstructing this nonsense, but, being a cancer physician, I found one part that really stood out to me:

Davies thinks the moneyed and narrow focus on targeted therapeutics is misguided. These new drugs tend to focus on attacking cancer’s strengths rather than its weaknesses; its muscle rather than its Achilles’ heel. For example, a medication might be designed to stop the abnormal protein that is allowing a cell to divide without stopping.

I laughed out loud when I read this. How stupid we are, we cancer biologists. We never would have thought of this without a genius like Davies to lead the way. Oh, wait. We did think of it. Long ago. Targeting mechanisms of that allow cancer cells to evade apoptosis is a major focus of cancer research. It's even listed as one of Hanahan and Weinberg's hallmarks of cancer! Bloody hell! The contempt Davies must have for the long history of cancer research is palpable. Small armies of scientists, postdocs, and graduate students have been working on just this problem for decades! Let's put it this way. I started graduate school in 1990, and apoptosis was a major focus of research. I could show Prof. Davies my Cancer Biology class notes from then if he likes. (I'm pretty sure I still have them somewhere.) Davies makes it sound so easy, doesn't he? Oh, and it's not "the abnormal protein" that allows cells to divide without stopping. It's proteins, as in many, and there are other forms of programmed cell death besides apoptosis.

It gets worse:

But, says Davies, for as long as cell division has existed, so have threats to it. “Life has had 4 billion years to evolve responses to those threats,” he says. Tumors are incredibly adept at circumventing the stress of a new drug by developing genetic abnormalities that preserve their ability to divide. Cancer patients know this strength all too well: Many once-potent therapies stop working because tumor cells become resistant, eventually exhausting all treatment options.

The atavistic theory portends new approaches. Drugging tumors with the lowest possible dose could prevent the evolution of therapy-resistant pathways that would otherwise enable the cancer to spread around the body. “You don’t have to get rid of it,” says Davies, “you just need to understand it and control it.”

Bloody hell times a thousand! Yes, tumor cells become resistant. It's what they do. They're genetically unstable and have a high rate of mutation, which leads to a lot of tumor heterogeneity, with the cells different parts of tumors often being quite different from each other, upon which selective pressures can work. Chemotherapy and other drugs are a powerful selective pressure that forces them to evolve resistance.

As for using low dose chemotherapy, Davies is behind the times, too. Has he never heard of metronomic chemotherapy? I have. Robert Kerbel first proposed it at least 15 years ago, and it is exactly what Davies describes, using the lowest possible dose of chemotherapy administered continuously or frequently. Of course, the goal here is not to keep resistance from developing. It's actually based on Judah Folkman's pioneering work on tumor angiogenesis (the ability of tumor cells to induce the ingrowth of blood vessels to supply its nutrient and oxygen needs. The idea is that low dose chemotherapy is antiangiogenic and targets the endothelial cells lining the blood vessels. There is a form of chemotherapy based on evolutionary considerations, though, known as adaptive chemotherapy. These ideas all long predate Davies' leaping into the field of cancer research as the Great Physics Hope here to save us dumb physicians and biologists from our own stupidity.

Speaking of angiogenesis, if there's a characteristic of tumor cells that is not the least bit atavistic, it's the cancer cell's ability to induce angiogenesis to feed itself. Single cell organisms have no need for angiogenesis. Nor do they have the need for the ability to evade an immune system. These are characteristics of multicellular organisms that cancer cells retain. Moreover, if you get into the weeds, you find that cancer cells interact with normal host cells and each other, and that that interaction is necessary for its spread and survival. There was just an interesting paper earlier this month that shows how cancer cells interact with host blood vessels and immune cells in order to invade the vasculature and spread via the bloodstream. When tumor cells arrive at other organs, it's their ability to adhere to the surrounding collagen and cells and begin to grow that determines whether they turn into metastases. There's a whole field known as tumor microenvironment that studies the interaction of cancer cells with the surrounding cells, structural proteins, and circulating signaling molecules of the host.

To shamelessly paraphrase Douglas Adams, cancer is complicated. Really complicated. You just won't believe how vastly, hugely, mind-bogglingly complicated it is. I mean, you may think it's a complicated to figure out your computer, but that's just peanuts to cancer. Basically Davies cherry picks aspects of cancer that are shared with ancient single-celled organisms and ignores all the characteristics that are not. He dismisses the "existing paradigm" that cancer is primarily a genetic disease and ignores very old observations that certain tumor suppressors and oncogenes are directly associated with cancer. In some cancers, targeting these genes is an effective treatment. Gleevec, for instance, targets a single abnormal protein.

Then he has the audacity to complain:

Many oncologists are skeptical that it ever will. Evolutionary biologist Chung-I Wu, at the University of Chicago, calls the atavistic theory “an extreme position.” Scientists have also criticized Davies’s reference to the discredited “recapitulation theory” that human embryos develop temporary vestigial organs—gills, a tail, a yolk sac—as support for the atavistic model. “I’ve been ridiculed by the biology community,” says Davies.

Yes, Davies has been ridiculed. I'm ridiculing him now. He richly deserves it. Like all good cranks, though, Davies views the ridicule as evidence that he's right:

Davies is unfazed by the objections. “My feeling is, Who cares? The idea was to come in from the outside and lend a fresh perspective,” he says. Davies sees the criticism as largely rooted in territoriality and financial concerns. “Cancer is a multibillion-dollar industry that’s been running for decades. There’s a lot of vested interests out there.” After five years with the NCI program, Davies is now funded by NantWorks, a sprawling private health care company owned by scientist and billionaire investor Patrick Soon-Shiong (who made his fortune reworking the breast cancer drug paclitaxel to be more effective) to continue his work developing the atavistic model.

Ah, yes. The last refuge of the crank. When scientists ridicule your ideas, attack big pharma and the "territoriality" of cancer researchers. Now, don't get me wrong. Scientists are human. They can be territorial. They sometimes protect their turf. They can have financial interests. But notice something. Davies had a National Cancer Institute grant to pursue his vision. The clear implication in the paragraph above is that he doesn't have it anymore, which means that he likely failed to renew it, which means that the NCI found his reapplication wanting. Why might that be? In fairness, NIH grants are hard to get, but the implication is that Davies failed to produce enough promising data with his approach to convince the NCI to renew his grant. So now he's in bed with big pharma himself! I wish he'd tell me: Why is it so horrible for scientists he dismisses as in the thrall of the existing paradigm and protecting their turf to be—dare I say—colluding with big pharma, but it's perfectly fine for him to be funded by a billionaire's health care company?

Of course, it's not just Davies. There's an oncologist, Mark Vincent, who should really know better but unfortunately seems to be trying to out-Davies Davies:

Vincent, who had his first atavism insight at around the same time as Davies, is also pursuing the theory. Vincent takes the single-celled phenomenon one step further, believing that cancer could be its own species. The stark difference between our healthy cells and cancerous ones looks more like a jump across the evolutionary tree rather than a hop to another branch. “It seems to me to be a different form of life,” he says. Vincent acknowledges that DNA mutations often cause cancer, but he sees the genetic paradigm as “very incomplete.”

Um, no. Cancerous cells are not their own "species." For one thing, they can't live on their own outside of the body. Yes, their genomes are screwed up. Real screwed up. And scientists would be the first to admit that the genetic "paradigm" is incomplete (although probably not "very incomplete"), because there are contributions to cancer from metabolism and the tumor microenvironment that we don't yet understand. It is, however, interesting how many of the genes mutated in cancer are intimately involved with DNA repair.

Basically, what Davies proposes is nothing more than a 100 year old idea that he resurrected and tarted up for the 21st century. Because he doesn't have a background in cancer, after finding this shiny new (to him) toy he became utterly fascinated with it and couldn't understand why cancer biologists don't find it as fascinating as he did. The reason, of course, is because it's a 100 year old idea that was found long ago not to be consistent with the data. Pesky that!

Look, I don't mind people from other disciplines becoming interested in cancer. Insights from physics, chemistry, and other sciences can be valuable and can shake things up. However, what makes cancer researchers grind their teeth when reading an article like this lionizing someone like Davies is being lectured by someone who didn't have the humility to actually learn the history of the field he's claiming to transform. If he had bothered to do that, maybe he wouldn't have made such a fool of himself. Or maybe he would have. He was widely castigated by evolutionary biologists and cancer researchers in 2014 when he first published his ideas, and in the interim he apparently hasn't developed any humility.

I might have to look into his tow or three most recent publications to see if his arguments have gotten any better, but PZ took care of one of those already. They haven't.

oracknows Mon, 07/17/2017 - 21:24

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