Isaac’s Golden Moment

Three weeks ago I attended a public lecture entitled Medicine and Homeopathy.

The latest from Melbourne University Health Initiative, the lineup included homeopath Isaac Golden and chiropractor Simon Floreani to present the argument for homeopathy. Public health physician and medical activist Dr. Ken Harvey and GP Dr. Stephen Basser, one of Australia’s most accomplished critics and analysts of alternatives to medicine, held the fort for medicine.

All but Stephen Basser feature in this video examining claims made by Isaac Golden about homeoprophylaxis. I was confident Golden would pull off a pleasant well meaning presence and equally confident Floreani would flounder and fall. As it turned out he never arrived, leaving Golden to retrace the tired old footsteps he’s been doing for years all by himself.

There’s a few things that I found novel. Golden was quick to label the Cuban homeopathic immunisation study (see video above) as “an intervention”, not a trial. This in one swipe silenced many a prepared question including my own over how the “immunised” demographic returned to levels of Leptospirosis infection similar to those found elsewhere in Cuba (non “immunised”). The “intervention”, which is quoted by homeopaths as hard evidence of efficacy is often criticised for poor methodology, lacking a control group and inexplicably failing to randomise subjects.

So by renaming it an “intervention” Golden could proclaim to have “evidence” and dismiss questions raised about its veracity being flawed due to poor trial practice. Throughout the “intervention” paper the rest of Cuba (RC) is presented where and how a control would normally be presented in a trial. Defenders of the caper point to RC as a quasi-control when it suits the need to convey comparative difference. Thus, Isaac has invented a nifty escape clause from defending poor methodology.

Another point (in fact an inexcusable failing) was Golden’s inability to address what is at once one of the least complex problems, but perhaps the most important. The entire Cuban scam is not Hahnemannian homeopathy. By no means am I the first to note this. It’s more of what I call Supercalifragilistichomeoprophylaxis.

During the evening Isaac Golden made much of remaining true to Samuel Hahnemann’s Law of Similars and Law of Infinitesimals. The Law of Similars is sometimes known as “like cures like” and states that a mother tincture should be made from a substance which produces symptoms similar to that produced by the disease.

Yet in the Cuban study they used four dead – completely inactive – strains of Leptospira bacteria to make the mother tincture. The paper refers to “highly-diluted strains of inactivated leptospiras”. However the paper title is, Large-scale application of highly-diluted bacteria for Leptospirosis epidemic control. Plainly that is misleading in itself.

So I pointed out to Isaac that in view of his insistence upon the law of similars, and noting that the Cuban mother tincture didn’t contain a substance that could produce any symptom like those experienced with leptospirosis (the bacteria were always dead), he had a problem. Confident, he responded that no, it’s not like a traditional vaccine.

Another audience member ran it by him again. Isaac was confused. Ken Harvey explained the problem also. Then I spelled out the obvious. Without the Law of Similars, there’s no Law of Infinitesimals. But he didn’t hear. Clearly stumped, his mind was cranking over. Eventually he produced the claim that the dead bacteria still had the “energy shape” or “energy signature” and were thus still viable. Quickly he turned and selected another questioner.

I was delighted. Isaac Golden had just told me an “energy shape” could produce similar symptoms to live bacteria. But even better, he’d made it up on the spot. After earlier signing his name to the Law of Similars, he then denied its necessity. I still wanted to press the point as this excuse couldn’t explain the “blood, puss, discharge, urine, flesh, causal organisms…”, and other organic goo used in highly dilute nosodes.

No Law of Infinitesimals either with no Similars. We never really made it to discuss that point. But I already had my answer in that he had no answer. For the record, the beaker for the most dilute agent was washed out 9,999 times. On the 10,000th refill it was called a homeopathic immunising agent. That’s not highly diluted – that’s washed away. The less potent (less dilute) was washed out 199 times.

It was Supercalifragilistichomeoprophylaxis if ever I’d seen it. Remember dear reader a nosode is a homeopathic dose. Golden had earlier used the term. Its definition – in this case – demands “causal organisms”. Energy shape just didn’t make it. The audience member who helped Isaac understand wrote, “Get out of jail free” on his notepad and slid it my way. I had to agree. We know homeopaths make it up as they go along, but it was really nice to be there to see that actually happen.

It was truly a Golden moment.

Other points deserve a mention. Already referring patients to conventional doctors, Isaac came across as keen to extend conventional connections and is striving to make something of a research base. He does not entertain the “us and them” combative mindset of the Monika Milka’s and anti-vaxxer types we know and love, and appeared genuinely keen to reciprocate with bilateral trials. One concern was his allusion to conspiracies, when it was pointed out that if efficacy was truly and constantly demonstrable that widespread use and marketing would already be apparent.

One couldn’t miss however that the totality of discourse and questioning was biased toward examining the claims made by Isaac. He did after all kick off by stressing he heals the “entire person”. This means mental, physical, personal, spiritual and probably “quantumal” for all I know. This was “natural medicine” to Isaac. Getting the human healing abilities to function on these levels.

We were promised lots of evidence but regrettably a few excuses related to third parties were raised. Aside from the Cuban standard, Isaac brought in the Swiss “study”. Written by pro-complementary medicine interests for governmental review and favouring popular demand it was a poor choice as the material is known to be highly selective in favour of homeopathy. Isaac appealed to popularity and use as equating to efficacy a number of times.

Dr. Stephen Basser’s deconstruction of why homeopathy is so widely used, sought after and applied by medical professionals was excellent. It highlighted the factors outside of efficacy that drive uptake and continued use of demonstrably non efficacious options. Patient request or demand, choice of placebo, doctors’ role in monitoring complex patients, marketing, what it’s actually used for and the context of these figures.

I’ve noted here before how chiropractors boast how many Aussies per day use chiropractic – after signing them into treatment contracts. Purchasing 100 doses of a homeopathic preparation doesn’t support it being entirely used. Nor do uptake figures represent clearly articulated failures – and dissatisfaction. What is regular? What is novel or first time? And so on. In short there is no association between popularity and efficacy. Or between demand and documented efficacy.

Ken harvey brought up the point I’d have guessed most would have asked at question time. Golden claims to have completed his PhD successfully in homeopathic immunisation. In Golden’s abstract we read:

The effectiveness of the program could not be established with statistical certainty given the limited sample size and the low probability of acquiring an infectious disease.

This didn’t stop Golden from then claiming:

However, a possible level of effectiveness of 90.3% was identified subject to specified limitations. Further research to confirm the effectiveness of the program is justified.

Despite defending the semantics on the night, it’s clear this air guitar of a PhD has only mused over a possibility.

One thing agreed on at the beginning was to not discuss the mechanisms of homeopathy. In other words, to avoid raising the fact it is physically impossible. This did allow the discussion to move forward. In essence, Golden was awarded a huge concession with respect to reality. Something of a microcosm of the larger homeopathic industry perhaps.

All up it was an interesting night given that no new evidence popped up to support homeopathy. Like many homeopaths Isaac really believes in it.

He just needs to conclude that ones belief is not truth.

Essential addition to understanding the importance of keeping up pertussis vaccination/s and not succumbing to antivax fear mongering. Remember, whilst only 5% of children are not vaccinated against pertussis they make up close to 30% of infections.

And that’s on top of being up to four times less likely to visit a conventional doctor and be diagnosed in the first place!

kill3rtcell's avatarThe LymphoSite

Before reading this post be aware that as of April 2014 we now know that Australian strains of B. pertussis have largely lost expression of the protein whose variation is a key feature of this piece. An explanation of that study can be found here.

Summary

Whooping cough is a potentially deadly infectious disease. While vaccination against it has managed to significantly reduce the incidence of the disease, it still remains a global presence.

Recent coverage in the mainstream media and from anti-vaccine proponents has suggested that the whooping cough bacterium has evolved around the current acellular vaccine. Such reports occurred following publication of a paper attributing over 80% of Australian cases to a new strain apparently not well covered by the vaccine.

This review analyses these claims. Careful examination of the current literature indicates that while the bacterium’s genome does appear to have changed in response to…

View original post 5,952 more words

The Real Australian Sceptics

A short time ago the Skeptic community received a delightful tickle on the collective ribcage.

A rather intellectually dishonest blog appeared with the title The Real Australian Sceptics under the pretence of “critiquing” articles. It was, predictably, Meryl Wynn Dorey’s latest shot at the ontology of her assumed foes. Those worshippers of evidence and scientific consensus: The Skeptics. It’s an old tactic. If you can’t sustain an argument attack the party that holds an opposing viewpoint.

This isn’t the post to dissect the intellectual absurdity of Ms. Dorey’s attack on Skeptics. Suffice to to say – again – this game of provocation wherein Ms. Dorey futilely seeks to alienate and besmirch skeptics has it’s genesis within stratospheric errors she has made in the wake of being held to account.

The blog itself is monumental dreck. To date it’s emerging as a rehash of all the disproved antivaccination creeds and attacks on accepted evidence. Magically, everything old is new again. The usual rules of ultra-strict comment censorship apply.

If you’re keen for your daily dose of Merylisms, The Real Australian Sceptics doesn’t disappoint, opening with an attempt at selective deception in the first sentence.

According to the Oxford English Dictionary, a sceptic is defined as, “a person inclined to question or doubt accepted opinions”.

Actually the Oxford English Dictionary entry reads:

1 a person inclined to question or doubt accepted opinions.

  • a person who doubts the truth of Christianity and other religions; an atheist.

2 Philosophy: an ancient or modern philosopher who denies the possibility of knowledge, or even rational belief, in some sphere.

Meryl appears to take advantage of the phrase “accepted opinion”, by omission of the widely accepted opinion of theistic persuasion as a working example. Furthermore the second entry refers to philosophical denial of the possibility of knowledge or even rational belief. Having falsely defined “sceptic”, this then leaves the door open for Meryl to potter about on the very fringes of rationality and knowledge, wearing the guise of evidence whilst ranting about science.

Surely even with limited use of “accepted opinions”, we must include Naturopathy, Homeopathy, Home Birth, Vaccines causing Autism, Vaccine Dangers, Pharmaceutical bias, etc, etc. These are all irrefutably on the scale of accepted opinions. An opinion moves toward fact or mere belief based upon the amount of evidence that sustains it. The subtitle of Dorey’s blog is Accept Nothing. Question Everything. Apparently then, this is applied only to suit the author.

I think we can see, straight out of the blocks as it were, problems with her method of attack. Like two Meryls in a particle accelerator one is shooting off counter-clockwise at the speed of light confident those Wascally Skeptics will finally get theirs. Another Meryl is shooting clockwise questioning everything, accepting nothing… including the existence of the other Meryl. Eventually they collide head on in a great splattering mess.

Meryl also takes a shot at “the American spelling”: Skeptic. Wrong again. In doing this she’s really having a go at the Skeptic movement. Nothing new here, and as we’ll see her tactics are also copied and pasted from others whose beliefs have failed to endure scientific scrutiny. Skepticism is not cynicism or denial as we might associate these concepts with climate science denial, vaccine denial, HIV/AIDS denial and the steadily growing denial of conventional medicine.

Colloquially, Skeptics can be said to seek the evidence, consider existing evidence or ask for evidence when presented with certain claims. Skepticism is the rejection of predetermined ideas that aren’t supported by evidence. Skeptical activism may be described as where evidence, science and consumer and/or human rights overlap. Under What Is Skepticism? Brian Dunning writes in part:

The true meaning of the word skepticism has nothing to do with doubt, disbelief, or negativity. Skepticism is the process of applying reason and critical thinking to determine validity. It’s the process of finding a supported conclusion, not the justification of a preconceived conclusion… The scientific method is central to skepticism. The scientific method requires evidence, preferably derived from validated testing. Anecdotal evidence and personal testimonies generally don’t meet the qualifications for scientific evidence, and thus won’t often be accepted by a responsible skeptic; which often explains why skeptics get such a bad rap for being negative or disbelieving people. They’re simply following the scientific method.

Okay. So Skepticism is not Accept Nothing, Question Everything. It revolves around the scientific method and evidence. Yet in attacking science Dorey clumsily raises the notion of “true scepticism”.

There are those in Australian society today who call themselves sceptics (or skeptics – which is the American spelling of that word). Yet by their actions and stated beliefs, they are far removed from true scepticism.

Now we can see the purpose of the second definition in the Oxford Dictionary. I doubt Meryl is aware of the metaphilosophy of True Scepticism, most commonly associated with David Hume, the 18th Century Scottish Philosopher. Nonetheless in a roundabout sort of way Meryl has painted herself into a very tight corner wherein she is seemingly defending denial of knowledge and rational belief, as a means to critiquing scientific arguments and articles.

Oh my.

We need a term for these traitors of true scepticism of course. Some time back on her Facebook page Meryl spotted the term pseudo-skeptic. She decided there and then it was “a keeper”. Unfortunately it was already being kept and here is where it all gets a little more silly.

RationalWiki has an entry on Pseudoskepticism. Interestingly is does not describe anything like Meryl’s contention. There is Legitimate use. The use by those who deny climate change science, vaccine success, etc. In fact it does a good job of describing Meryl Wynn Dorey. The description includes:

In this case the word is simply a synonym of denialism, as there is a vast amount of real evidence which is simply willfully ignored by these pseudoskeptics. The use of the phrasing “I am skeptical of X” is to sound more rhetorically reasonable that “I don’t accept X and never will regardless of the evidence”, even if the latter is more accurate.

Then there’s the delightfully headed paragraph on Usage By Woo Promoters, which also describes Meryl Wynn Dorey:

It is perhaps more often used as a loaded term by promoters of woo to dismiss skeptical criticism of their beliefs as unfounded… Given the difficulty of absolutely disproving even the most absurd hypothesis they then go on to maintain that all those who ask for evidence are “pseudoskeptics”.

Oh, snap!

We seem to have established Meryl’s hijacking of terms for the purpose of provocation and revenge. With the greatest of respect to Meryl is must truly be the nadir of her two decade assault upon scientific knowledge. The world is full of those who despise the notion of skepticism because it quite simply requires evidence for ones claims. Dorey has no evidence. She deals in falsehoods. Very lucrative falsehoods. Scams.

The abuse of authority or the demanding of privilege based upon certain claims crumbles before skepticism’s quiet and calm request for evidence. Meryl’s fraudulent donation campaigns, subscriptions for a non existent magazine, promised vaccine tests and boasts of phoney “protection” from mandatory vaccination evaporate in the presence of just one skeptic.

In some strange anger driven fever, Ms. Dorey seeks to discredit the Skeptic movement by making absurd claims about the nature of reality and science. Suddenly claiming something isn’t true does not make one a skeptic. Nor does it remotely undermine the accepted notion of Skepticism. Accepting nothing cannot be any further removed from the outcome of scientific research. Science, as skeptics understand and accept it, is not about belief. It is about conclusion. The weight of evidence.

There is nothing wrong with doubting and questioning. Far from it. Yet at some point we need a method from which to exploit our knowledge – not a mangled pseudoskepticism that denies knowledge exists in the first place. That method is the scientific method. Proper doubt and proper questions are what give us scientific consensus.

Because of doubt, questions and the demands for evidence that skeptics and scientists continually entertain, scientific consensus can and does change. Because it can change it is arguably fragile and unfairly criticised by opponents of skepticism. Yet because of what is required to change scientific consensus, it makes for an incredibly robust source of evidence. Thus “accept nothing” is naught but a position of intellectual paucity.

Accept Nothing, Question Everything is sheer, utter denial. It demands to be seen for the intellectual cowardice it really is: Shirk Certainty.

Meryl Dorey is happy to quote Hippocrates when it suits her. I hope she is aware of this quote:

There are in fact two things, science and opinion; the former begets knowledge, the latter ignorance.

The Real Australian Skeptics is an emerging cornucopia of contrary, provocative nonsense based upon grossly misunderstood notions of evidence, opinion and philosophy. Whatever it is intended to be, it is certainly not a place for truth.

It is presently the very home of Ignorance.

Scientific consensus is a myth and flu vaccine infects with influenza

I was astonished to read this tweet today from well known anti-vaccination identity, Meryl Dorey:

Certainly, I agree that science never “proves” anything. Mathematics and logic have “proofs”, but not science. Which is why scientific consensus provides us with invaluable insight into evidence that applies to matters of science. More so, it is the flexibility of scientific consensus that gives one confidence in science. Dorey’s proposed infinite loop of unending testing is a semantic trick, designed to convey a feel of impotent stasis.

Scientific consensus provides the best explanation from the very best and most reliable of all possible theories. It has after all, extended lifespan and quality in the developed world. Surely there must be more to this reworking of reality. Facebook rewarded my curiosity.

I see. Further application of what we consulted just recently. Meryl’s Equation: < 100% = 0%.

Thalidomide was a watershed in how drug trials are conducted. The tragedy forever changed the way trials proceed before drugs are released onto the market. Vioxx – Merck’s COX-2 inhibitor – is equally concerning. Yet Vioxx represents regulator apathy and a triumphant change in scientific consensus. The FDA approved it in April 1999 and it was recalled completely by Merck in September 2004. There was no “ignoring evidence that their consensus is wrong”.

I’m not seeking to whitewash either event but they do not render scientific consensus as a valuable and crucial notion, suddenly useless.

I imagine mentioning “mercury” is aiming to cast the removal of thimerosal from childhood vaccines, in response to unfounded fears and a drop vaccination rates, as evidence it was causally related to autism or other horrors. In fact, speaking of consensus this remains a topical point. Many insist it was foolish to pander to the anti-vaccine lobby as it may be abused to legitimise their false claims. Such is exactly what we see here.

Depending upon what it is confirming, scientific consensus may come under attack as its relationship to the scientific method is open to exploitation and abuse. Denial of anthropogenic climate change, vaccine efficacy and promotion of intelligent design (biblical creationism), rely heavily on trying to undermine the fact of overwhelming scientific consensus. A key weapon here is in producing “their” scientists to attack the work of others and advance a sham alternative.

The relationship between scientific consensus and the scientific method is perhaps poorly understood. Thus, it befalls us to educate ourselves about the sources of proposed consensus. And by that I really mean finding reputable sources and knowing how to spot disreputable sources. I found myself recently struggling to explain these notions to a friend.

In Australia a documentary aired called I can change your mind on climate change. Presenting both “sides” (denialist rehash vs evolving facts) it was followed by an episode of QandA that offered a terribly worded poll. The question was “Would you change your mind on climate change”? By itself, my answer to that question is an unhesitating Yes. Availed of convincing evidence and a change in consensus I have no problem answering that I “would”.

Yet I suspect the question was worded to be seen in the context of the programme. In which case it should have read “Would you change your mind on climate change given the pathetically, preposterous, piffle to poke at the periphery of your predisposition to weigh dissenting views?” Er… No.

Nonetheless I spent a futile half hour attempting to explain to my friend that whilst I need no convincing of anthropogenic climate change, those very views are important to me because of the relationship between the scientific method and scientific consensus. It is because the scientific method makes scientific consensus so potentially frail, that I back the notion of anthropogenic climate change.

So it is with any consensus arrived at within science. The scientific method is the weapon of choice with which consensus is changed. Little wonder then, an anti-vaccination crusader seeks to demean both.

Prior to this another tweet had caught my eye:

This is pure nonsense. Being infected with influenza is “one of the most common side effects” of vaccination against influenza? I think not.

In fact the NCIRS have a handy Fact Sheet on influenza vaccination. Influenza vaccines used in Australia are inactive. Influenza cells in vaccines cannot cause infection. They have lost their mojo.

As Julie Leask pointed out, in what a betting person might argue was the catalyst for Meryl’s merriment, only 1% – 10% of recipients report symptoms of mild infection for “a day or two”. In fact the article entitled Monday’s Medical Myth: the flu vaccine will give you influenza also noted other reasons for claims of inefficacy-by-infection.

  1. Anyone vaccinated might get another virus that feels like influenza.
  2. Some people’s immune system does not respond to the vaccine.
  3. Anyone vaccinated may get another strain of influenza.
  4. (As mentioned) less than 10% have mild flu-like symptoms for up to 48 hours.

Other strains of influenza exist because at the time production began, the vaccine strains targeted were calculated to be in circulation months later. This isn’t always correct. Combined with the other issues influenza vaccine is suboptimal. And suboptimal is manna for application of Meryl’s Equation.

Leask points out that we under-react to the risk of influenza. Costing Australia $115 million annually, it kills 3,000 and hospitalises over 13,500 people over 50 each season.

Nonetheless a visit to Facebook was a definite must.

Writing in Science-Based Medicine about problems associated with suboptimal flu vaccination Mark Crislip touches on “vaccine goofs” prone to Meryl’s Equation (<100% = 0%).

So it’s a suboptimal vaccine.  And that’s a problem. One, because it will make it more difficult to prove efficacy in clinical studies and two, there is a sub group of anti vaccine goofs who seem to require that vaccines either be perfect, with 100% efficacy and 100% safe, or they are not worth taking.

The CDC have this to say:

At least two factors play an important role in determining the likelihood that influenza vaccine will protect a person from influenza illness: 1) characteristics of the person being vaccinated (such as their age and health), and 2) the similarity or “match” between the influenza viruses in the vaccine and those spreading in the community. During years when the viruses in the vaccine and circulating viruses are not well matched, it’s possible that no benefit from vaccination may be observed. During years when the viruses in the vaccine and circulating viruses are very well matched, it’s possible to measure substantial benefits from vaccination in terms of preventing influenza illness.

NCIRS:

[In older people] influenza vaccine is about 30– 40% effective in preventing symptoms of the flu, 50–60% effective against hospitalisation due to influenza, and 70– 80% effective against death from complications of  influenza. Influenza vaccination also appears to reduce the risk of heart attacks and strokes. When there  is a good match between the influenza strains in the vaccine and those causing current disease, the vaccine can prevent illness in about 70–90% of healthy children and adults. The vaccine is less effective in those with an impaired immune system

Certainly then there is no evidence that the influenza vaccine doesn’t work or as claimed, “causes the flu”.

I don’t quite know what sparked this most recent attack on “skeptics” and science in general but I would hope to see better from a so-called “health educator” able to raise funds as a charity.

For now the scientific consensus is sound and overwhelmingly in favour of mass vaccination.

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