Terra Sigillata

Quackwatch founder Stephen Barrett takes on health care reform myths

Posted by Abel Pharmboy on September 7, 2009
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Stephen Barrett by nando Harry Lynch.jpg

. . . or as Dr Barrett refers to it more accurately, Insurance Reform.

On Friday, Sarah Avery of the News & Observer reported on her interview with the now-retired Pennsylvania psychiatrist who started the Quackwatch.com website in 1996 following years of investigating fraudulent health practices.

From the Quackwatch Mission Statement:

Quackwatch is now an international network of people who are concerned about health-related frauds, myths, fads, fallacies, and misconduct. Its primary focus is on quackery-related information that is difficult or impossible to get elsewhere. Founded by Dr. Stephen Barrett in 1969 as the Lehigh Valley Committee Against Health Fraud (Allentown, Pennsylvania), it was incorporated in 1970. In 1997, it assumed its current name and began developing a worldwide network of volunteers and expert advisors.

Avery reports that Barrett has been particularly effective in drawing attention to the quackery and dangers of chiropractors:

Call the American Chiropractic Association, mention Barrett’s name, and the response is a groan.

“Uhhhg,” said spokeswoman Caitlin Lukacs, “I’ll try to find someone to comment.”

No one called.

A Google search for chiropractors lends a possible explanation. Barrett’s Quackwatch page pops up as the fifth site listed out of 6.5 million, indicating it’s one of the most frequently visited among people looking for chiropractics.

He loves it.

“It’s good to be in the top 10,” he says and grins.


In his “retirement,” Dr Barrett and colleagues are now providing critical information to debunk myths about health care reform at Insurance Reform Watch. As Avery reports:

Now he has put together a health reform truth squad, a group of fellow retirees that includes a past admissions officer at Harvard University, a UNC-Chapel Hill academic, a doctor, two dentists, an economist and a one-time New York City insurance fraud investigator.

Their mission: to vet some of the wilder claims of those opposed to current health-care proposals and publish them on the Internet.

“Most of it is sheer baloney,” Barrett says.

In essence, Insurance Reform Watch is applying the same basic critical thinking tenets of Quackwatch to the health care debate:

John Hammond, a professor emeritus of pathology and lab medicine at UNC-Chapel Hill, says the group decided recently to go public with its findings as the debate grew more rancorous and certain assertions began to be repeated.

“All this garbage needs to be debunked,” Hammond says, pointing to one claim that older Americans will lose access to their doctors if more people are covered. “That’s so morally bankrupt you can’t even begin to consider it as a rational response.”

Beyond Avery’s article itself, the comment thread there is worth reading briefly as it deteriorates almost from the start with the accusations that since Dr Barrett is a registered Democrat and physician, he cannot be objective. Coupled with the “some alternative medicine works because Duke and UNC have acupuncturists on staff” and you’ve got all the makings of epileptic seizures for my colleagues, Orac and PalMD.

Welcome to our little slice of heaven, Dr Barrett. Bora Zivkovic and I look forward to coffee with you.

Watch Insurance Reform Watch as the site is updated during continued national debate on this topic.

Photo credit: Harry Lynch, News & Observer

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Comments

  1. #1 Joe
    September 8, 2009

    “Call the American Chiropractic Association, mention Barrett’s name, and the response is a groan.”

    Yes, chiros are reflexive in spewing venom whenever he is mentioned. More than that, ca. 6 years ago PBS (Scientific American Frontiers) broadcast a program that featured the danger of chiropractic neck manipulation (strokes). The head of some chiro association wrote to PBS complaining that they had been misled by Dr. Barrett- who had no connection to the show! (Wallace Sampson, M.D., had been the consultant.)

  2. #2 Joe
    September 8, 2009

    I meant to add the irony that, unlike me and despite the chiro hatred for him, Dr. Barrett thinks chiro can correct itself and be done rationally. Thus, he is only opposed to their irrational practices. However, there’s a joke that the difference between a rational chiro and a large pizza is the pizza can feed a family of four.

  3. #3 Charles
    September 8, 2009

    On the surface with a quick glance Barrett’s “Quackwatch” is a noble endeavor by a group protecting patients from unsavory practices. But on just a bit deeper of inspection we find that the quackwatch group looks at healthcare and the protection of the public with one eye shut or at least jaundiced.

    With any reasonable view of healthcare the aspects of risk benefit ratios are essential to weed out valuable information versus slogans and propaganda. These risk benefit ratios could be:

    1. The risk of one procedure versus an alternative one.

    2. How much risk is allowable for the benefit possibly received by an intervention?

    3. What are the costs of one procedure versus an alternative one?

    Pulling back the proverbial curtain on the “Wizards of Quackwatch,” we find that when it comes to medical, pharmaceutical, or “non-alternative” healthcare they have no concern for the public’s best interest. In this arena high costs, low benefit, and high risks are ignored. The alternative healthcare methods that Barratt fights against routinely offer low risk or low cost, as discovered routinely in our emerging research evidence base.

    Why would the Quackwatchers not protect us against the medical, hospital, and pharmaceutical abuses that cost the public untold billions and cause deaths or disabilities many many magnitudes greater than the alternative healthcare they “champion” against?

    If we follow the money and where they focus their attention this group warrants deep profound concern and their motives dissected for all to see.

  4. #4 jre
    September 8, 2009

    That last comment is virtuosic in its seamless intermingling of the straw man argument and begging the question. But, while I may admire Charles’ style, I have to note a certain lack of substance. Has Quackwatch said anything unfair or untrue about any alternative treatment? Have the risks or drawbacks of any conventional treatment been minimized or whitewashed? Has any practice or institution been defended when it should have been criticized? And is there any sign of a conflict of interest among its contributors or supporters?

    As best I can tell: no, no, no and no.

    Charles is of course welcome to offer examples of misconduct at Quackwatch, but I bet he comes up dry. In essence, his complaint is that Quackwatch is pointedly critical of alternative treatments that do no good — or do actual harm. Sorry, but that is exactly what Quackwatch ought to be doing.

  5. #5 Joe
    September 8, 2009

    Charles | September 8, 2009 3:23 PM wrote “The alternative healthcare methods that Barratt fights against routinely offer low risk or low cost, as discovered routinely in our emerging research evidence base.”

    Low risk and low cost are not proven. Chiropractors kill people (neck-snap leading to stroke). They also charge lots of money for unnecessary, “maintenance” procedures (which may also be lethal).

    Where is your “research evidence base?” Keep in mind, that quack literature does not count.

  6. #6 Charles
    September 9, 2009

    Wow, naively didn’t realize this would become so charged so quickly. But I do suppose this is characteristic of the Quackwatch chronies. Here is a very very brief glance at the emerging evidence base I mentioned in my prior post.

    Let’s look at alternative conservative methods of care in relatonship to “traditional” methods for surgical interventions for lumbar disc herniations:

    “In our experience, recurrent lumbar disc herniation occurred in more than 10% of patients and was associated with substantial health care costs. Development of novel techniques to prevent recurrent lumbar disc herniation is warranted to decrease the health care costs and morbidity associated with this complication. Prolonged conservative management should be attempted when possible to reduce the health care costs of this complication.

    “Diagnosis and management of recurrent disc herniation were associated with a mean cost of $26 593 per patient, and the mean cost was markedly less for patients responding to conservative treatment ($2315) compared with those requiring revision surgery ($39 836) (P < 0.001).

    “Of 141 primary lumbar discectomies performed at our institution with the patients followed for 1 year, the total cost associated with the management of subsequent recurrent disc herniation was $452 083 ($289 797 per 100 primary discectomies).

    “The mean cost was substantially less in patients responding to conservative therapy compared with those requiring further surgery ($2315 versus $39 836).”

    [McGirt MJ, Ambrossi GL, Datoo G, Sciubba DM, Witham TF, Wolinsky JP, Gokaslan ZL, Bydon A. Recurrent disc herniation and long-term back pain after primary lumbar discectomy: review of outcomes reported for limited versus aggressive disc removal. Neurosurgery. 2009 Feb;64(2):338-44.]

    Looking at cost benefit comparison analysis of conservative care such as chiropractic care:

    "Comparing self-selected chiropractic patients to self-selected medical patients,.. In 6 of the 8 comorbid conditions studied, the rates were lower in the cohort with chiropractic coverage compared with the group without coverage. The rates of comorbid conditions in self-selected chiropractic patients were lower in all 8 categories compared with self-selected medical patients. They concluded that, The inclusion of a chiropractic benefit in a health plan produces a modest favorable selection processes resulting in a slightly younger patient population with fewer comorbidities. At the level of patient self-selection, chiropractic patients are considerably younger and healthier than comparable medical patients."

    [Nelson CF, Metz RD, LaBrot TM, Pelletier KR. The selection effects of the inclusion of a chiropractic benefit on the patient population of a managed health care organization. J Manipulative Physiol Ther. 2005 Mar-Apr;28(3):164-9.]

    And in this study they found:

    "For the treatment of low back and neck pain, the inclusion of a chiropractic benefit resulted in a reduction in the rates of surgery, advanced imaging, inpatient care, and plain-film radiographs. This effect was greater on a per-episode basis than on a per-patient basis."

    [Nelson CF, Metz RD, LaBrot T. Effects of a managed chiropractic benefit on the use of specific diagnostic and therapeutic procedures in the treatment of low back and neck pain. J Manipulative Physiol Ther. 2005 Oct;28(8):564-9.]

    Ahhh and the old tried and true, “Chiropractors kill people (neck-snap leading to stroke).” I suppose if you keep saying this enough times all the research that refutes this is supposed to go away. If you are not a quackwatcher then you have been taken in by a masterful scam.

    THERE WAS NO DIFFERENCE IN PATIENT STROKE INCIDENCE BETWEEN ALLOPATHIC AND CHIROPRACTIC PATIENTS IN THE FOLLOWING STUDY. If you read this landmark article you will see the issue is that patient with impending strokes are seeing their doctors for head pain and chiropractors commonly treat patients with head pain and headaches. The allopathic physicians are not adjusting patient's neck yet still their patient's also have a similar incidence.

    The most recent powerful study “Risk of vertebrobasilar stroke and chiropractic care: results of a population-based case-control and case-crossover study,” published in Spine (journal) on chiropractic and stroke by Cassidy et al concluded that, “vertebrobasilar artery (VBA) stroke is a very rare event in the population. The increased risks of VBA stroke associated with chiropractic and primary care physician visits is likely due to patients with headache and neck pain from VBA dissection seeking care before their stroke [1].” They found NO “evidence of excess risk of VBA stroke associated with chiropractic care compared to primary care [1].”

    In a groundbreaking study conducted to determine if vertebral artery dissection (VAD) and stroke are found following chiropractic office visits as part of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. According to the Task Force President Scott Haldeman, DC, MD, PhD, looking at the association between chiropractic office visits and the incidence of vertebral artery strokes. "current research suggests that dissections are probably multifactorial in origin [2]." He continued that "They appear to occur in a person with a genetic predisposition to arterial dissection. They also appear to require a second factor such as viral infection or possibly estrogen. They can then be triggered by a minor head movement, including activities of daily living, an adjustment or an examination of the neck [2]."

    In another related study they sought to “estimate the risk of serious and relatively minor adverse events following chiropractic manipulation of the cervical spine by a sample of U.K. chiropractors. The “data were obtained from 28,807 treatment consultations and 50,276 cervical spine manipulations. There were no reports of serious adverse events. They concluded, even though no adverse event occurred in this study, “Although minor side effects following cervical spine manipulation were relatively common, the risk of a serious adverse event, immediately or up to 7 days after treatment, was low to very low [3].”

    While a patient with head and neck pain will not usually chose to do nothing for their discomfort of one of the most common options is usually over the counter pain non-steroidal anti-inflammatories (NSAIDS) . Similarly relating to low back pain, non-steroidal anti-inflammatories (NSAIDS) have not been found any more effective than spinal manipulation for the treatment of neck pain [4]. In fact the research has shown that spinal manipulation is safer by as much as a factor of several hundred times compared to the use of NSAIDS [5].

    One concern is that no matter how safe a procedure might be if it offers no discernable benefit then any risk is unwarranted. Manual therapies such as chiropractic have been found to be as effective as NSAIDS [6] and even more cost effective when compared to physiotherapy or general medical care [7].

    From the conclusion of a study by Rubinstein et al they found that with chiropractic care, “Adverse events may be common, but are rarely severe in intensity. Most of the patients report recovery, particularly in the long term. Therefore, the benefits of chiropractic care for neck pain seem to outweigh the potential risks [8].”

    1. Cassidy JD, Boyle E, Côté P, He Y, Hogg-Johnson S, Silver FL, Bondy SJ. Risk of vertebrobasilar stroke and chiropractic care: results of a population-based case-control and case-crossover study. Spine. 2008 Feb 15;33(4 Suppl):S176-83.

    2. DC Staff. Chiropractic and Stroke Risk: Setting the Record Straight. Dynamic Chiropractic, Sep 24, 2007; 25(20). [http://www.chiroweb.com/archives/25/20/05.html last accessed June 18, 2008]

    3. Thiel HW, Bolton JE, Docherty S, Portlock JC. Safety of Chiropractic Manipulation of the Cervical Spine: A Prospective National Survey. Spine. 2007; 32(21):2375-2378.

    4. Dabbs V, Lauretti WJ, A risk assessment of cervical manipulation vs. NSAIDS for the treatment of neck pain. J Manipulative Physiol Ther 1996;8:530-6.

    5. California Division of Workers Compensation Medical Unit (formerly the Industrial Medical Council): http://165.235.90.100/IMC/guidelines.html.

    6 Hoving JL, Koes BW, de Vet HCW, van der Windt AWM, Assendelft WJJ, van Mameren H, Deville WLJM, Pool JJM, Scholten RJPM, Bouter LM, Manual therapy, physical therapy, or continued care by a general practitioner for patient with neck pain: A randomized controlled trial. Annals of Internal Medicine 2002;136(10): 713-22.

    7. Korthals-de B, Ingeborg BC, Hoving JL, van Tulder MW, Rutten-van Molken MPMH, Ader HJ, deVetHCW, Koes BW, Vondeling H, Bouter LM, Cost effectiveness of physiotherapy, manual therapy, and general practitioner care for neck pain: Economic evaluation alongside a randomized controlled trial, British Medical Journal 2003;326(7395): 911.

    8. Rubinstein SM, Leboeuf-Yde C, Knol DL, de Koekkoek TE, Pfeifle CE, van Tulder MW. The Benefits Outweigh the Risks for Patients Undergoing Chiropractic Care for Neck Pain: A Prospective, Multicenter, Cohort Study J Manip Physiological Therapeutics. Jul 2007;30(6): 408-18.

  7. #7 Joe
    September 9, 2009

    @Charles | September 9, 2009 12:39 AM

    McGirt et al 2009 compares two kinds of surgery, chiroquacktick is absent.

    Then you cite two (typically crappy) articles in JMPT; which is written by, and for, quacks. Let me help you- they are not randomized, controlled trials. Your magazine has not joined the twentieth century. One doesn’t look for gold in an iron mine.

    You cite more quack, and unrefereed or poorly refereed sources (yes, “Spine” is unreliable); including your fanzine “Dynamic Chiropractic” (DC). However, here is an article in DC that acknowledges that chiros cause strokes http://www.chiroweb.com/archives/23/04/18.html Also, look at this review by a chiro http://www.sciencebasedmedicine.org/?p=1037

    While there are a couple of your cites in which I am interested; given your overall lack of perspicuity, you should not hold out much hope. I probably just don’t remember rejecting them in the past.

    The next person you fleece, or cause a stroke, won’t be me.

  8. #8 Joe
    September 9, 2009

    Yeah, just as I expected, the BMJ paper (2003) and the AIM paper (2002); I’ve seen them before, they do not refer to chiropracty. It is typical for your kind to try to attach yourselves to legitimate therapy that kinda sounds the same.

  9. #9 Charles
    September 10, 2009

    So glad we can have a respectful scientific evidence based dialogue. When someone responds with some ethics and integrity to what I have shared I would be happy to dialogue with them. No matter how many times someone from Quackwatch signs in with different names the dialogue is always the same.

    You ask for evidence and then play the game of summarily dismissing peer reviewed pub med journals. You have the same tried and true things you use to support your position and ignore anything else. I am open to unbiased scientific well written literature. Anyone in the evidence based arena understands the limitations of randomized controlled trials.

    I am open to dialogue but your comments are just plain sillyness.

    Isn’t there anyone out there not from Quackwatchers that wants to have an educated dialogue and not use this blog as a public forum to spew their unscientific venom?

  10. #10 Abel Pharmboy
    September 10, 2009

    Charles, I can assure you that both Joe and jre are not associated with Quackwatch, they are real people with whom I have had e-interactions with for over three years. There is no toying with multiple IP addresses as I have access to this information in the comment tagging information via Moveable Type. They raise very critical points, particularly the fact that all peer-reviewed literature is deserving of post-publication criticism.

  11. #11 Charles
    September 10, 2009

    Dear Abel Pharmboy,

    “They raise very critical points, particularly the fact that all peer-reviewed literature is deserving of post-publication criticism.”

    I am not sure where you have studied raising critical points on post peer-reviewed published literature but in the scientific circles I have traveled the past 30 years the following is not the way:

    “Then you cite two (typically crappy) articles in JMPT; which is written by, and for, quacks. Let me help you- they are not randomized, controlled trials. Your magazine has not joined the twentieth century. One doesn’t look for gold in an iron mine.

    “You cite more quack, and unrefereed or poorly refereed sources (yes, “Spine” is unreliable)…” [Joe]

    The whole scientific process is founded on being open, being eternally critical, and attempting to resist biases. Summarily dismissing quality respected journals after asking for evidence is not any scientific process but is quite characteristic of the Quackwatch group.

    Let’s see another “critical point” that was raised by Joe was “Yeah, just as I expected, the BMJ paper (2003) and the AIM paper (2002); I’ve seen them before, they do not refer to chiropracty. It is typical for your kind to try to attach yourselves to legitimate therapy that kinda sounds the same.” [Joe]

    Again this is typical of the Quackwatch mantra. Anyone in the field of manipulation which can include osteopaths, manual therapists, physiotherapists and chiropractors know that the chiropractic profession has the most extensive training in spinal manipulative therapy of all the groups. So if a study discusses manipulative therapy in a positive light someone with greater training would not only be expected to attain a similar response but, to any reasonable mind, would expect even better results.

    And even one more “critical point” that was raised by Joe supporting your contention that “the fact that peer-reviewed literature is deserving of post-publication criticism.”

    “The next person you fleece, or cause a stroke, won’t be me.” [Joe]

    The general consensus of the published peer reviewed literature has clearly shown NO causal relationship between cervical manipulation and stroke. The fact there is a coincidental one was discussed by the Cassidy study in Spine [1]. This focused on the fact that primary care allopathic (non-manipulation) and chiropractors (manipulation) both had patients with the same incidence of stroke. Their findings determined that the reason was because patients with an impending stroke will have head or neck pain and seek care for this pain.[1].

    The present call to the chiropractic profession and any healthcare provider treating patients with head or neck pain is to be aware of the signs of patients with red flags (# 1 & 2) indicating an impending stroke so they can be immediately referred to an emergency room, as well as yellow flags (#3 &4) which indicate co-treatment with an allopathic physician may be needed.

    These types of signs include but are not limited to:

    1. Patient dizziness, drop attacks, blurred vision, difficulty speaking, swallowing, or walking, along with nausea, numbness, and nystagmus. Also any grouping of these signs with a patient having had a history of an infection [2,2], particularly an upper respiratory tract infection should heighten alertness for the doctor.

    2. If a patient says “I have a pain in my neck and/or head unlike anything I have ever had before.” Also we will need to increase any investigation if the patient has posterior head pain that is “throbbing, steady or sharp.”

    3. We need thoroughly to investigate young women patients who report a new onset (within the past year) of probable migraine with visual aura, who smoke, and take oral contraceptives [4].

    4. Blood laboratory analysis showing increased levels of c-reactive protein [5,6], homocysteine [7,8], and LDL versus HDL [9] warrant dietary modifications and exercise as well as in unresponsive cases of allopathic cotreatment.

    Mr. Pharmboy if these are the types of “real people” with whom you “have had e-interactions with for over three years,” I would be careful with what information you are gleaning from them and how much credence you offer these interactions. Their comments have nothing to do with, “peer-reviewed literature … deserving of post-publication criticism.” They seek to be nothing but inflammatory and venomous.

    1. Cassidy JD, Boyle E, Côté P, He Y, Hogg-Johnson S, Silver FL, Bondy SJ. Risk of vertebrobasilar stroke and chiropractic care: results of a population-based case-control and case-crossover study. Spine. 2008 Feb 15;33(4 Suppl):S176-83.

    2. Forster K, Poppert H, Conrad B, Sander D. Elevated inflammatory laboratory parameters in spontaneous cervical artery dissection as compared to traumatic dissection: a retrospective case-control study. J Neurol. 2006 Jun;253(6):741-5. Epub 2006 Mar 6.

    3. Guillon B, Bethet K, Benslamia L, Bertand M, Bousser MG, Tzourio C. Infection and the risk of spontaneous cervical artery dissection. A case-control study. Stroke 2003; 34(e):79-81.328.

    4. MacClellan LR, Giles W, Cole J, Wozniak M, Stern B, Mitchell BD, Kittner SJ. Probable migraine with visual aura and risk of ischemic stroke: the stroke prevention in young women study. Stroke. 2007 Sep;38(9):2438-45. Epub 2007 Aug 9.

    5. Tanne D, Benderly M, Goldbourt U, Haim M, Tenenbaum A, Fisman EZ, Matas Z, Adler Y, Zimmlichman R, Behar S, C- Reactive Protein as a Predictor of Incident Ischemic Stroke Among Patients With Preexisting. Cardiovascular Disease. Stroke. 2006 Jul;37(7):1720-4.

    6. Cao JJ, Thach C, Manolio TA, Psaty BM, Kuller LH, Chaves PH, Polak JF, Sutton-Tyrrell K, Herrington DM, Price TR, Cushman M. C-reactive protein, carotid intima-media thickness, and incidence of ischemic stroke in the elderly: the Cardiovascular Health Study. Circulation. 2003 Jul 15;108(2):166-70.

    7. Cui R, Moriyama Y, Koike KA, Date C, Kikuchi S, Tamakoshi A, Iso H; JACC Study group. Serum total homocysteine concentrations and risk of mortality from stroke and coronary heart disease in Japanese: The JACC study. Atherosclerosis. 2007 Dec 27;

    8. Tanne D, Haim M, Goldbourt U, Boyko V, Doolman R, Adler Y, Brunner D, Behar S, Sela BA.. Prospective study of serum homocysteine and risk of ischemic stroke among patients with preexisting coronary heart disease. Stroke. 2003 Mar;34(3):632- 6.

    9. Amarenco P, Steg PG. The paradox of cholesterol and stroke. Lancet. 2007;370:1803- 1804.

  12. #12 Joe
    September 10, 2009

    In my previous post, I dismissed your citations, with reasons for doing so. I did not just discount your quack literature, in several cases I explained why I did so. In particular, many cases you offered citations that were not relevant to chiro.

    It is not my business to sort through articles that you hope will pass the tests of legitimate research. Let me cut to the chase- your ref. #9 concerns “cholesterol and stroke”; are you suggesting that chiro influences cholesterol?

    Don’t dump irrelevant articles, do cite studies that you think are compelling. So far, you have failed on both fronts.

  13. #13 Charles
    September 10, 2009

    Dear Joe,

    I must admit I am not familiar with blogs and the jokes they can become. I suppose you just looked at the references and ignored what I had written. If you had read what I had written you would have noted that in the course of an examination of a patient that along with patient history – cholesterol HDL/LDL ratios, homocysteine and c-reactive protein levels are all yellow flags regarding stroke issues.

    By the way I completely dismiss everything and anything you have posted so far because they have absolutely no substance, are pathetic attempts to deflect issues, and refrain from respectful scientific dialogue.

    You can have the last comment since I am no longer checking this blog for anything.

  14. #14 jre
    September 10, 2009

    Mr. Pharmboy if these are the types of “real people” with whom you “have had e-interactions with for over three years,” I would be careful with what information you are gleaning from them … They seek to be nothing but inflammatory and venomous.

    Well, I would like to speak for my own reality (of course, I would say that even if I were not real).

    As to Quackwatch, I have no connection. I noticed the site in the mid-1990s, when I was researching claims made for miracle foods such as Blue-Green Algae. Everything I found on Quackwatch turned out to be readily confirmed by independent and reliable sources. Since then, I have gone back to Quackwatch many times, and have never found anything there that struck me as untrue or unfair. So, yes — my impression of Quackwatch, formed over more than twelve years, has been very positive.

    Now, I hold no brief for or against chiropractic, but I did sense a certain … ummm … hostility in Charles’ first comment that made me wonder if he is not, perhaps a disinterested seeker after truth. I also objected to the style of argument, e.g.

    Why would the Quackwatchers not protect us against the medical, hospital, and pharmaceutical abuses that cost the public untold billions and cause deaths or disabilities many many magnitudes greater than the alternative healthcare they “champion” against?

    — which seems to assume a whole bunch of facts not in evidence.

    Speaking of evidence, I did a cursory search on PubMed for “cervical manipulation stroke” and found many of the same articles cited above. Conspicuous by its absence in those papers Charles has cited is Miley et al. 2008, which concludes

    Weak to moderately strong evidence exists to support causation between CMT and VAD and associated stroke. Ultimately, the acceptable level of risk associated with a therapeutic intervention like CMT must be balanced against evidence of therapeutic efficacy.

  15. #15 progressiveinsurance
    September 24, 2009

    Why would the Quackwatchers not protect us against the medical, hospital, and pharmaceutical abuses that cost the public untold billions and cause deaths or disabilities many many magnitudes greater than the alternative healthcare they “champion” against?

  16. #16 jre
    September 24, 2009

    Just when you think you’ve seen all the simple spambot scripts, someone comes up with a new one!

  17. #17 Chris
    November 13, 2009

    I just came across your blog while doing a bit of a search on said Mr Barrett ( I say Mr as he may no longer be a doctor ).

    As usual there is much argument, so insted of getting riled up myself I thouhgt I’d draw your attention to others posts on Mr Barrett

    http://campaignfortruth.com/Eclub/190707/quackbusterbusted.htm?in_article_id=460896&in_page_id=1774

    http://www.quackpotwatch.org/

    http://www.raysahelian.com/quackwatch.html

    And a short 402 page list of health frauds not mentioned on his sites, that really should be!

    http://www.garynull.com/articles/BigPharma102009Final.pdf

    Happy reading

    Chris