A quackfest at the University of Toronto

I always thought that the University of Toronto was a great school, but lately I've been starting to have my doubts.

My doubts began three years ago, when I noticed that Autism One Canada, which is basically the Canadian version of the yearly antivaccine biomedical quackfest held every Memorial Day week in the Chicago area, was being held at the University of Toronto. As I said at the time, "Say it ain't so!" As it turns out, it wasn't so, at least not exactly, in that the University of Toronto wasn't sponsoring the quackfest. Rather, Autism One had rented a hall at the University of Toronto and was shamelessly using UT's cachet to promote the conference, implying that its antivaccine quackfest was somehow endorsed by the university. It wasn't. In fact, when inquiries were made to the Dalla Lana School of Public Health at UT, Autism One was promptly warned to stop using the Dalla Lana or UT name to promote its conference. Such is the price a university can pay in terms of its reputation when it rents out its lecture halls to groups promoting pseudoscience.

Unfortunately, although UT ultimately disavowed the conference, it turns out that the SickKids Foundation, a charity linked with UT's children's hospital (The Hospital for Sick Children) had supported the conference by funding Autism Canada with a $5,000 grant. Meanwhile, the grants officer Pam Gilliland responded to inquiries and expressions of dismay at the SickKids Foundation having supported antivaccine quackery with a weasel-worded letter proclaiming that the SickKids Foundation "takes a neutral stance on complementary and alternative health care" and that it has "a history of funding research on complementary and alternative health care for paediatrics," the latter of which excuse is as good a reason as I can think of not to contribute to the SickKids Foundation, particularly when coupled with its previous support of Autism One Canada. Let's just put it this way: A children's hospital charity that knowingly supports an antivaccine conference is a children's hospital charity that I would not recommend donating to. Be that as it may, it's been nearly three years since this particular debacle of quackademic woo; so maybe in the interim UT has learned its lesson. At least, I hoped that it had.

Apparently I was wrong.

I recently became aware of a conference that will be held at the University of Toronto in November. The conference is being organized by the Canadian Interdisciplinary Network for Complementary and Alternative Medicine Research (IN -CAM) and is called the IN-CAM Symposium. The woo is strong—very strong—in this conference. How strong, you want to know? I'll show you.

I noticed that one of the keynote speakers is a woman named Claudia Witt, MD, MBA. On the program, she is listed as President of the International Society for Complementary Medicine Research (ISCMR), Professor for Medicine and Vice Director of the Institute for Social Medicine, Epidemiology and Health Economics at the University Medical Center Charité in Berlin, Germany, the Carstens Foundation Distinguished Professor for Complementary Medicine Research, and Visiting Professor at Center of Integrative Medicine at the University of Maryland School of Medicine. She's supposed to be speaking about "Effectiveness" during the symposium.

Now, take a look at what she's doing before the symposium at the official Pre-Symposium Event. She's speaking at something called the HomeoNet Forum, which is part of the Pre-Symposium Event. Yes, it's a homeopathy forum, and she is listed there as having "published numerous seminal works in the area of homeopathic medicine research." So basically, what we have here is a homeopath speaking about homeopathy before the Symposium and speaking about woo during the Symposium. Lovely. Among these "seminal works," apparently, is a study published in BMC Public Health a few years ago:

How healthy are chronically ill patients after eight years of homeopathic treatment? – Results from a long term observational study. BMC Public Health 2008, 8(1):413).

I must say. If Dr. Witt thinks this is a "seminal" paper, I'd hate to see what she considers to be a crap paper. The only good thing about this study is that it was prospective. Other than that, it's an uncontrolled, unblinded study that looked at patients who underwent their first consultation with a homeopathic physician and followed them with questionnaires at 3, 12, and 24 months. Ultimately, these patients were followed eight years, and this paper presented the eight year data. Its conclusion?

Our findings demonstrate that patients who seek homeopathic treatment are likely to improve considerably, although this effect must not be attributed to homeopathic treatment alone. These effects persisted for 8 years.

No kidding. Since many conditions are self-limited and get better on their own and because nearly half the patients in this study used conventional therapy as well:

Nearly half of the patients (n = 1118, 41.1%) reported to have consulted another CAM therapist (not homeopathic) during the study period, including naturopathic doctors, physicians for Traditional Chinese Medicine, and non-medical therapists (German "Heilpraktiker"). Four in ten patients were treated with conventional remedies, this rate being considerably higher in adults than in children (table 2). Similarly, children used less frequently other CAM therapies (table 2). Differences between those who stopped homeopathic treatment and those who continued were small in children. However in adults patients who stopped treatment used more frequently conventional medication (53% vs. 38%).

One wonders whether the reason those who stopped homeopathic treatment tended to be the ones who were using conventional medication is because the conventional treatment was what was actually responsible for the alleviation of their symptoms, one does. Whatever the reason, without some sort of control group, this study is utterly meaningless and useless for determining whether homeopathy actually has a favorable effect. What we could be seeing is people normally getting better, learning to live with their symptoms, or regressing to the mean. After all, the vast majority of patients studied sought homeopathy for conditions that are in usually not life-threatening and that have variable and relapsing courses, such as allergies, anxiety, exczema, migraines, other headaches, allergic rhinitis, sleep disorders, and the like. One would expect that they would probably get at least somewhat better over the course of a few years.

The Pre-Symposium Event also includes a naturopath named Paul Sanders who is also a certified Classical Homeopath and completed his "chelation board examinations" from the International College of Integrated Medicine in 1998. Horror of horros, I had no idea that such a thing existed as "chelation board examinations." One might as well say that Sanders is board-certified in quackery, particularly if he uses chelation therapy for autism or heart disease. Oh, wait. He's a naturopath and a homeopath; so I guess he'd be board-certified in quackery regardless of whether he uses chelation therapy in his practice. In my opinion, of course. Depressingly, Sanders also touts his membership on a study section for the National Center for Complementary and Alternative Medicine (NCCAM). I weep that NCCAM allows such a person on its study sections, but, sadly, it is not unexpected. One wonders why NCCAM director Josephine Briggs puts up with this. If this is the sort of thing she meant when she promised to place NCCAM on a more solid scientific footing, I'd hate to see what she considers quackery.

Also, at the Pre-Symposium Event there is a woman named Aileen Burford-Mason, PhD speaking about natural health products. She is described thusly:

Dr. Burford-Mason is an immunologist, cell biologist and orthomolecular nutritionist with a deep interest in the evidence base for nutritional health. She regularly gives seminars to both professional and lay audiences, and is known for her ability to take complex nutritional research and translate it into concise, evidence-based guidelines for the safe, effective use of supplements.

She is formerly Assistant Professor in the Department of Pathology in the Faculty of Medicine, University of Toronto, and Director of the Conacher Head and Neck Cancer Research Laboratory at The Toronto Hospital. She has a private practice in orthomolecular nutrition in downtown Toronto.

"Former" assistant professor? At least UT got it right that time. Looking at her picture, I'm guessing that it was probably at least a decade or two ago that she left. Too bad Burford-Mason is apparently trading her former connection with UT to give herself scientific authority. One wonders why she left UT. My guess: She couldn't get funded and couldn't get tenure, given that she was an assistant professor. In any case, how she got involved with "orthomolecular medicine," the same form of pseudoscience that ensnared Linus Pauling with its belief that, in essence, if a little bit of a vitamin is good then lots and lots of it must be better, I don't know. It is, however, a massive embarrassment to the University of Toronto that homeopathy, naturopathy, and orthomolecular medicine feature so prominently at a UT event.

Oh, well. That's just the Pre-Symposium Event. What about the symposium itself? Well, there's the aforementioned Dr. Witt. Then there's someone named Herb Emory, who is a professor of health economics. He's supposed to be discussing the cost-effectiveness of CAM. I've always wondered how one can do that for something like homeopathy. Certainly the cost is low, but the effectiveness is zero because it's nothing more than water. In any case, I couldn't find much to indicate an interest on Professor Emory's part in CAM; so one wonders upon what he'll base his discussion of its alleged cost-effectiveness. Then there's Dr. Heather Boon, who is apparently an Associate Professor and the Associate Dean – Graduate Education at the Leslie Dan Faculty of Pharmacy, University of Toronto, as well as the President-Elect of the International Society of Complementary Medicine Research (ISCMR).

If I had to guess, this is how IN-CAM got invited to UT for its 2012 symposium. Take a look at Dr. Boon's faculty page, for example. She's one of the principle investigators for a research project entitled "A Pilot Trial of Homeopathic Treatment for Attention Deficit Hyperactivity Disorder (ADHD)." Yes, you heard me right. She's studying homepathic remedies for ADHD, and this study was funded by the SickKids Foundation, which apparently hasn't learned from its Autism One debacle. She also touts a study about pharmacy practice described thusly:

Dr. Boon is the Principal Investigator on this project that asks the question: What are the legal, ethical and practice responsibilities of pharmacists with respect to natural health products (NHPs), including vitamins/minerals, herbal products and homeopathy? Many herbal products are purchased in pharmacies and it has been argued that pharmacists are in the best position to provide patients with evidence-based information about NHPs, especially regarding potential interactions with conventional medications. However, others argue that pharmacists do not have enough knowledge about NHPs to adequately counsel patients. These assertions are being explored through documentary collection and analysis, as well as interviews with key stakeholders, focus groups with practising pharmacists and consumers, and a survey of practising pharmacists. Funding for this study is provided through a CIHR Partnerships for Health System Improvement grant as well as by the Ontario Ministry of Health and Long-term Care.

With respect to homeopathy, I'd say that it's the responsibility of pharmacists to tell their clients that homeopathy is pure quackery. As for herbal products and vitamins/minerals/supplements, their responsibility is to provide science- and evidence-based recommendations, which rarely jibe with what manufacturers say about their products. I'm not optimistic about the outcome of this study if Boon's website CAMline is any indication. For instance, look at the quack Miranda warning right at the top of the entry for homeopathy.

Finding out about this symposium was truly depressing. That a once-reputable university like the University of Toronto would sign on for this nonsense is an utter embarrasment. And, make no mistake, the University of Toronto Leslie Dan Faculty of Pharmacy is listed as a sponsor on the front page, right there with Smith's Pharmacy (touted as "Canada's Natural Pharmacy"), the Canadian College of Naturopathic Medicine, and the Massage Therapists Association of Alberta. Even more distressing, Health Canada is listed as a founding sponsor. Truly the tendrils of quackademia run deep at the University of Toronto and in Canada.

I wonder if Larry Moran knows about this.