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Complementary health warning

Timble

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Even the only Professor of Complementary Health in the UK is a bit dubious about some of the claims.


At: http://news.bbc.co.uk/1/hi/health/3527138.stm

Warning on complementary therapy[/]

Complementary therapies can be dangerous
The public must not place too much faith in the ability of complementary medicines, a leading expert has warned.
Edzard Ernst, the UK's only professor of complementary medicine, said most therapies were unproven.

Some of the few that had been vigorously tested did work, but others did not, he told a briefing on Monday.

Professor Ernst highlighted cancer websites peddling potentially dangerous therapies, and the risk of herbal medicines damaging conventional drugs.

He said: "If it sounds too good to be true, then it probably is. Don't believe ridiculous claims."..........continues.
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Hmmmm...but whilst he is poo-pooing the 'really' wacky pseduo-medicines, he is still claiming the 'main' ones are valid

"Some of the few that had been vigorously tested did work, but others did not..."

I'm sure he counts acupunture, homeopathy etc. as ones that 'have' been vigorously tested. But have they...?

Personally, the only difference between quack sciences such as acupuncture, homeopathy et al, and those such as phrenology, iridology et al, are the numbers of people that 'believe' in them.

ie. more people believe in acupuncture, hence it is mainstream. less people believe in iridology, so it is somewhat side-lined.

From what I have read, there is no more evidence that one works better or worse that any other.

Cheers,
Don
 
don9999 said:
I'm sure he counts acupunture, homeopathy etc. as ones that 'have' been vigorously tested.
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[Larsen mode]
Evidence, please?
[/Larsen mode]

What makes you so sure? He does nothing of the sort. In spite of having trained for some time in a homoeopathic hospital he appears to think it's complete BS and is the author (or an author) of some of the best null-effect homoeopathy trials of recent years. This one for example.
CONCLUSIONS: This study provides no evidence that adjunctive homeopathic remedies, as prescribed by experienced homeopathic practitioners, are superior to placebo in improving the quality of life of children with mild to moderate asthma in addition to conventional treatment in primary care.
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I don't know about his opinion of acupuncture, he doesn't have quite such a vocal stance on that.

I heard him on the radio a few months ago explaining how homoeopathy was a placebo effect, and the BMJ had a nice profile of him which I can no longer find since they rearranged their web site. The best bit I remember went something like "the alternative medicine community thought they had gained an advocate, but discovered they had in fact acquired an impartial scientific critic." The altmedders hate his guts with a violent loathing.

Rolfe.
 
I noticed careful phrasing there ... whilst they had listed some 'natural' remedies with proven efficacy they di not go on to suggest they were a better option to regular medication.

In other words, Feverfew might help with a migraine. Doesn't stray in to how it compares against paracetemol, ibuprofen etc. Also doesn't discuss the side-effects and contra-indications and how they compare.

I think the article works well as it picks out the clear woo stuff and holds it up for everyone to see.

Exploiting cancer patients is a particular concern.

Oh, and your mailbox is full, puss.
 
While I was hunting in vain for the BMJ profile, I found some pages suggesting Professor Ernst is less anti-acupuncture than he is anti-homoeopathy. Which is not necessarily surprising as it's not so obviously magical (sticking needles in the body obviously does have physiological effects) and there is a lot of evidence that acupuncture produces a very pronounced placebo response both in human patients and animal owners.

But for sure he's a homoeopathy-hater.

I shouldn't have thrown out the paper copy I had of that profile, so much for thinking "it'll always be on-line if I want it...."

Rolfe.
 
Bear in mind that "complementary therapy" is a term which implies that the patient is using "alternative medicine" in addition to conventional medical treatment, and includes some practises which are fairly well accepted by the medical community as having some benefit as well as those which are "out there".
 
As far as I recall, Professor Ernst has published a few studies of particular herbal remedies suggesting that there is some efficacy there. I don't recall his ever saying they were as effective as the regular stuff though.

Rolfe.
 
While I was looking out references for the other thread about acupuncture, I realised that my two favourite anti-acupuncture pages are actually discussions of literature reviews by Professor Ernst. Acupuncture for back pain?
The question is whether this review provides evidence of lack of effect, or lack of evidence of effect. The inability of the four highest quality blinded trials to show a statistically significant short-term improvement must be worrying for those providing acupuncture services, and for the health services or individual who purchase acupuncture. A sceptical view seems to be most appropriate until trials of high quality prove that to be wrong.
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Also Harm from acupuncture:
This refreshing little review points out that the seemingly innocuous, if done improperly or without care, can result in serious harm. The numbers of patients harmed by acupuncture in this literature review is difficult to assess, but runs into the hundreds. Choosing acupuncture because it is deemed harmless may be a poor choice.
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There are several more where these came from.

All of which makes me wonder why I was seeing Professor Ernst cited in one or two pro-acupuncture pages. Maybe they don't actually read what he's written?

Rolfe.
 
I recall reading an on-line interview with Dr. Ernst about a year ago, though don't remember who conducted it. The following is how I remember the interview:

He said he grew up in a German (or perhaps Austrian) home where both homeopathic & traditional medicine were practiced. I believe he said his father was a physician and/or there were a lot of his physicians in his background. Apparently, his first assignment as a physician was in a Homeopathic hospital, and while at first he was impressed with the results he saw there, later experience & years tended to reassess this & lean more toward a placebo effect.

He didn't say that he personally used homeopathic remedies on himself, but he did say that he used them on his French wife, as that was what she was used to. However, he never mentioned what her health problem(s) were.
 
Rolfe, I am happy to stand corrected. I had made an assumption about Professor Ernst that may have been wrong. As a professor of complimentary medicine, I had made the assumption (possibly incorrect) that he supported all complementary medicine.

The referred to article says that Ernst had said "...most therapies were unproven." and "Some of the few that had been vigorously tested did work..."

This seemed to me that he was suggesting that some complimentary medicines had been tested, and proven to work. Which ones, were not mentioned.

I refer back to a quote reported by Randi a few months ago, made by author Chris Mooney:

"There cannot be two kinds of medicine – conventional and alternative. There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work….. If it is found to be reasonably safe and effective, it will be accepted. And if it's found to be otherwise, it should be rejected. By everyone."

Based on evidence I have read about so far, I see no proof of the efficacy of any current 'alternative' therapy such as homeopathy, acupuncture etc..

Cheers,
Don
 
I think when Professor Ernst talks about "alternative" therapies that have been shown to work, he's referring to certain specific herbal remedies that have tested out as doing something.

I heard him on the radio last night, and he was giving credence to this latest acupuncture study. However, as I said, he's also published some very anti-acupuncture stuff in the past, including the only safety evaluation, which wasn't positive, to put it politely. When I heard him interviewed once before, I'm fairly sure he said that it was at the homoeopathic hospital that the penny dropped, as one of his senior physicians there explained it was all placebo feel-good effect.

I sort of get the impression that he's treading a tricky political tight-rope. He needs the woos to co-operate in a spirit of reasonable friendliness or he won't get any research done. So he doesn't come out and denounce the lot as fraudulent snake-oil, and he almost seems relieved to have the odd positive study to talk about as if to show that he's not such a bad chap really.

But he's certainly approaching it as a scientist, and in my opinion he's doing quite a lot of good.

Rolfe.
 
Wow, I'm impressed. We need more like him, a lot more. Sometimes I think there is a seed of hope out there, but I'm very scared to think so.

Will there ever be a day when things that don't work aren't so freakishly defended? Will there ever be a day that everyone can see through the manipulation of sCAMmers? The appeal to the heartstrings with anecdotes, the magical tales of the soceror, and the conspiracy theories - all ignored finally?

Dare I dream?
 
Kess said:
I'm beginning to quite like Prof Ernst...
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Although that page has disappeared, I've found a fairly extensive quote from the BMJ profile of the good professor which was published in May of last year.
At the core of his approach is rigorous science. This caused dismay to many practitioners. Ernst was puzzled. "It sounded to me so inoffensive that it was a huge surprise that people were up in arms. Some claimed that their individualised and holistic methods defy testing by randomised clinical trial. When I'm being polite I say this is based on a misunderstanding of what science is about. When I'm being less polite I say these people are mad."

.....

His relations with the complementary community remain troubled. "Virtually from the word go I've had problems with the complementary camp. Sometimes it subsides. But then as soon as we publish a negative result it flares up. We are champions so long as we produce positive results, but enemies when we produce negative ones." And many of the department's findings have, it must be said, proved negative.

His critics argue that he is too inflexible in his application of orthodox research methods; that most of his comments on complementary medicine seem unduly pessimistic; and that he should be using more subtle methods of assessing its effects. Above all he's charged with not recognising its uniqueness. But that is precisely his point.

When his chair was created, the complementary medicine community thought it was getting an advocate. Instead it got a detached analyst. It was disappointed. "Seriously disappointed," says Ernst.....
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It's a shame this has gone from the Internet. I did find it buried in a semi-readable pdf file more recently, but I can't even seem to find that now.

Rolfe.
 
Rolfe said:
Although that page has disappeared...
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Has it? Strange, it still works for me. I've copied the text below as it's quite good...

TELEVISION health expert Gillian McKeith is today accused of exaggerating her professional qualifications and misleading the public. The 45-year-old host of hit diet show You Are What You Eat uses the title Doctor Gillian McKeith and describes herself as the "world's top nutritionist".

But The Sun can reveal she has NO medical background. She holds a "worthless" PhD in holistic nutrition gained via a postal course at a backwater US college.

Last night Channel 4 chiefs stood by McKeith who has earned a fortune advising stars like Demi Moore and selling health products. Her book from the series is a No1 bestseller. But as they vowed to continue with a second series, health experts dismissed her theories and warned her "advice" could put fans at risk.

Dr Edzard Ernst, professor of complimentary medicine at Exeter University, blasted McKeith - often seen "examining" patients and performing medical procedures like colonic irrigation. He said: "In the show I saw there was a total lack of real medical issues. Her theories on food-combining are perfect rubbish."

Amanda Wynne, senior dietician at the British Dietetic Association, said: "We're concerned. Some of the things she says just aren't true."

Management for Scots-born McKeith, who lives in Hampstead, North London, claim she has a PhD and MSc from the American College of Nutrition, among other qualifications. In fact, her primary nutrition-based PhD is from Alabama's Clayton College of Natural Health. A spokesman admitted: "This PhD is not comparable to those from other colleges."

However, the General Medical Council said ANYONE with a PhD can call themselves a doctor - because the title is not protected.

McKeith last night said her management team had supplied an incorrect list of qualifications. She said: "I think I know who sent this. There was a Spanish guy on work assignment over summer, it must have been him."

She expressed surprise anyone thought she was a medical doctor, adding: "I've never claimed to be."
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Never claimed to be? Yeah, right. So why is EVERY single use of her name on her home page preceded by the word Dr. but nowhere does she mention it's a PhD - to me that seems to be a deliberate ploy to make people assume she's a M.D. rather than a PhD-type doctor.

Silly woman!
 
Sorry, I meant the text of the BMJ profile of Professor Ernst had gone. But in fact I've found it again - I think the journal has been reorganising and it has finally appeared in a different (careers) section. Here.

But thanks for posting a bit of the newspaper article anyway. I read a similar one on the Herald on Wednesday, but they only leave their text accessible for two days, the cheapskates! (They were pretty bloody scathing, I have to say.)

I did think she was a real doctor gone woo. They certainly go out of their way to give the impression that she's a doctor on the programme, whatever they're now claiming. Well, now we know. And so does the entire country.

Rolfe.
 
They certainly go out of their way to give the impression that she's a doctor on the programme, whatever they're now claiming. Well, now we know. And so does the entire country.
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I wonder if this revelation will make any difference whatsoever to the TV programme makers (and her gullible customers) who are happy to use and endorse her? I doubt it somehow.
 
Prof. Ernst has been mentioned here before, including this article he wrote for The Guardian back in March.
Those who reject complementary medicine as a matter of principle are misguided. There simply are no good reasons why we should not be able to find a few gems among the 400 or so different therapeutic approaches used under this umbrella. Just because we don't understand how something works, does not mean that it doesn't work. And the tools of evidence-based medicine are well suited for identifying the gems among the rubble.

But many providers of complementary medicine are still overtly or covertly against the scientific investigation of their patch. They insist that complementary therapies are too subtle, holistic or individualised for rigorous research. If this were true, they should be honest and admit that this takes complementary medicine into the realm of religion - medicine, by definition, does not defy science.

Research into complementary medicine should be considered a priority. We know that about a quarter of the UK population uses it and spends roughly £1.6bn per year doing so. We also know that some treatments show considerable promise and others are associated with significant risks. To me, these indisputable facts indicate that research is an ethical imperative. And the two most important research questions clearly relate to efficacy and safety.
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The only bit I'd take issue with is whether research into CAM should be a "top priority" - There are surely many better things to research than, say, Therapeutic Touch or Crystal Healing; perhaps that's not what the Prof had in mind.
 
Dragon said:
Prof. Ernst has been mentioned here before, including this article he wrote for The Guardian back in March.The only bit I'd take issue with is whether research into CAM should be a "top priority" - There are surely many better things to research than, say, Therapeutic Touch or Crystal Healing; perhaps that's not what the Prof had in mind.
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It's a "top priority" when people are spending money on CAM treatements that are unproven and dangerous, or people are using sham treatments for serious illnesses when there are far more effective medical alternatives available.

The more legitimate research done on these topics, the less likely the public is to be deceived or swindled. There will always be those susceptible to the woo-woo message, but there's a middle ground that might swayed by legitimate science proving (or disproving) a treatments's effectiveness.
 
Point taken - I agree that these treatments can be inherently dangerous or dangerous because real medicine is spurned - I just think that some of them are not worth spending valuable research money on.
In any case how many of those likely to use, say, the phoney "energy" type healings such as TT or crystals would be influenced by proper studies?
 
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