The importance of critical thinking in discerning reputable sources

The volume of material published and shared by anti-fluoride, anti-vaccine, pro “alternative” health – all which fall under the deceptive catch phrase of “pro-choice” – is notably bereft of critical thinking.

No doubt there will always be some attracted to the notion of oppressive governments and dark conspiracies. Research indicates the psychological predisposition to conspiracy theory is highly resilient. Yet the persistence of the claim vaccines are the cause of a host of childhood ailments, that homeopathy is effective or that fluoride is a poison added to water supplies, may in part indicate poor cognitive manipulation of available information.

It is not uncommon to find preposterous claims circulating as a purported superior health choice. Such material is favoured by those who contend they are exercising “pro-choice” as a result of having “done my research”. It’s clear that no independent, accredited source has evaluated this “research”. It is more evident that the person has not sought reputable source material or thoroughly investigated critiques of the main aspects of their research. Let’s try claims by one so-called alternative. Homeopathy.

A good example would be claims made by homeopath Isaac Golden. Golden claims homeoprophylaxis (homeopathic immunisations) are a safe and effective alternative to vaccination. In a very short time one can find that homeopathy has not been shown to offer any measurable effect beyond placebo.

Consider the National Health and Medical Research Council statement on homeopathy [PDF].

The media release opens:

The National Health and Medical Research Council today released a statement concluding that there is no good quality evidence to support the claim that homeopathy is effective in treating health conditions. Its release follows a thorough review of the evidence, conducted as part of NHMRC’s responsibility to provide advice and support informed health care decisions by the Australian community.

The conclusion is based on the findings of a rigorous assessment of more than 1800 papers. Of these, 225 studies met the criteria to be included in NHMRC’s examination of the effectiveness of homeopathy. The review found no good quality, well-designed studies with enough participants to support the idea that homeopathy works better than a placebo, or causes health improvements equal to those of another treatment.

A little more time reading evidence based material will reveal the mechanism of homeopathy to be impossible. In short it simply cannot work without rewriting aspects of physics and chemistry. Homeopaths often actually admit this – while being dishonest about observed effects.

Homeopathy Plus

Golden himself makes much of having completed a PhD in homeoprophylaxis, leaving the uneducated listener or reader under the impression that this thoroughly discredited pseudoscience is in fact a safe option in health science. Or as opponents of vaccination insist: a Choice. Indeed Golden claims homeopathic vaccines are an option which is “comparably effective but which is non toxic, which provides no danger, no long term side effects”.

In June this year “Dr. Isaac Golden’s Academy” was offering a YesCourse.

IsaacGolden_YesCourse

Yet in his PhD abstract Golden admits;

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.

Indeed. Not to mention the reality of an ethics committee. Let’s be clear. No success was demonstrated with this paper. So Golden also writes:

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.

Possible efficacy, subject to specified limitations, that requires further research is a very, very clear way of documenting no effect. I apologise but there are no prizes for guessing Golden has not gone on to search for, much less publish, the possible efficacy. This won’t prevent him waxing lyrical on “my own PhD” as a source in defence of homeoprophylaxis.

Furthermore Golden’s work has been cited by Fran Sheffield of Homeopathy Plus in defence of her own business. The danger of Golden’s ambitious work and lax clarification can be summed up in Sheffield’s marketing. Referring to his inability to establish efficacy to any degree, she advertised:

Dr Isaac Golden confirmed that homeoprophylaxis provides the same degree, or better protection, than vaccines with none of their side effects or complications

In 2010, following a complaint from Dr. Ken Harvey, the TGA’s Complaints Resolution Panel ordered that a Retraction be published on site. Sheffield ignored the request. Regarding the TGA Therapeutic Goods Advertising Code, Sheffield was also noted to have acted in a misleading manner, abusing the trust and exploiting the lack of knowledge of consumers. A summary and key details can be found here at the Skeptics’ Book of Pooh-Pooh.

The notion that parents who choose alternatives are not actually researching or seeking reputable advice on their apparently “informed choice” is in this case further highlighted by ongoing offending by Fran Sheffield and Homeopathy Plus! In May 2012 the ACCC announced it had responded to complaints from the medical industry about bogus claims on the Homeopathy Plus! website. Namely that the pertussis vaccine was ineffective and that Homeopathy Plus! offered an effective homeopathic immunisation for pertussis.

On February 21st 2013 the ACCC instigated Federal Court proceedings against Homeopathy Plus! as the pseudoscience recalcitrant persisted in endangering the health of Australian children and infants. The claims made were in breach of the Competition and Consumer Act 2010, and were misleading and deceptive. The ACCC media release included;

The Australian Competition and Consumer Commission has instituted Federal Court proceedings over allegedly misleading claims on a homeopathy website regarding the effectiveness of the whooping cough (pertussis) vaccine.

The ACCC has taken proceeding against Homeopathy Plus! Australia Pty Ltd and against the owners of the Homeopathy Plus! website.

The claims on the Homeopathy Plus! website include statements that the whooping cough vaccine is “unreliable” and “largely ineffective” in preventing whooping cough and that homeopathic remedies are a safe and effective alternative for the prevention and treatment of whooping cough.

On December 23rd, 2014, the ACCC reported that the Federal Court had found both Homeopathy Plus! and Frances Sheffield had engaged in misleading conduct and made false or misleading representations regarding the effectiveness of the whooping cough vaccine and homeopathic remedies as an alternative in breach of the Australian Consumer Law. Sheffield and Homeopathy Plus! had engaged in misleading and deceptive conduct. Put simply, Fran Sheffield had continued to use her website to lie to unfortunate visitors who were not in the habit of critically investigating such claims.

Harking back to the echo of Isaac (My own PhD) Golden we read (emphasis mine);

The Court also found that Homeopathy Plus! and Ms Sheffield engaged in misleading and deceptive conduct and made false and misleading representations to the effect that there was an adequate foundation in medical science for the statement that homeopathic treatments are a safe and effective alternative to the whooping cough vaccine, when in fact no such foundation exists and the vaccine is the only treatment currently approved for use and accepted by medical practitioners for the prevention of whooping cough.

I should be clear. This is only one arm of a notable junk science making as a matter of course outrageous claims. To see that so many can be fooled into believing plain water can protect from disease in a manner no-one can explain, is to some, mind boggling. But to be even clearer the information to debunk such nonsense and thus protect yourself and family is there to be found.

It is plain that scam artists, conspiracy theorists and so on cannot be swayed by the findings of official investigations or years of scientific consensus. Thus it is better to ignore those who claim to hold an apparent truth or a wonderful therapy and subject their claims to robust and varied critique.

Critiques can be made for all of the pseudosciences purporting to offer a superior or natural alternative to evidence based medicine. The same applies to the unwarranted attacks on vaccines, fluoride, medical intervention and so on. A far better way to approach these topics is to do so with the confidence to review material from a bipartisan standpoint. Where claims of conspiracies or corporate corruption for profit are made be very skeptical.

Make a habit of visiting consumer advocacy groups, such as Choice. Spend some of that research time looking over the Therapeutic Goods Administration and the Australian Competition and Consumer Commission. We looked at both of these and the NHMRC, above. Let’s say the best your new friends at Essence Of Moonbeam are offering in response is a claimed conspiracy, the mocking of “sheeple” or bemoaning the trampling of rights (or that “informed choice”). I’d say you’re pretty safe in concluding genuine evidence has caught up with debunking their claims.

No-one can develop the skills or knowledge base from the Internet to argue that “my research” on one topic is sufficient to make decisions that are traditionally overseen by specialists or experts. The skill we can develop is that by which we can discern between a reputable source and a disreputable source. And this process should include discussions with genuine, experienced practitioners.

There is too much information on individual areas of health to allow us to investigate fully and believe we may come away educated and/or able to advise others. Where new trends are jostling for our attention and money there are recurring themes that help reveal them to be useless.

The skills we develop in discerning the reputable from bogus information sources are increasingly the skills that will benefit us in more ways than seeking optimal health.

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2015 anti-vaccine tour of Australia – the Tenpenny caravan of hurt

If I was a certain type of nincompoop I might argue that Sherri Tenpenny coming to our shores is “un-Australian”. Or worse, an affront to “Team Australia”.

In reality her own history – and her devotees – underscore the problem here. Tenpenny is a very unpleasant, dangerous and monumentally dishonest person. I’ve written about Isaac Golden (at least) here and here.

You can gather everything else you need to know from Hank’s post, below.

reasonablehank

Anti-vaccinationists have their own anti-Hippocratic oath: first do harm. First and foremost they must evangelise, like any fundamentalist organisation. First and foremost they must persuade vulnerable parents – those sitting on the fence – that vaccines are dangerous, poisonous, unsafe, untested…you know the drill. Time and again they are shown to be nothing but brazen liars; not by people who merely disagree with them, but, by evidence.

We have just been advised that US anti-vaccine campaigner Sherri Tenpenny is coming to Australia to do a series of seminars with a host of other anti-vaccine campaigners. Among them is Isaac Golden, the homeopath recently torn to shreds in the Federal Court, in the humiliating Homeopathy Plus! case. That’s quality information for you right there.

If you haven’t heard of Tenpenny, she’s one of the leaders of the global anti-vaccine cult. She’s like the duchess, to Barbara Loe Fisher’s queen. She is…

View original post 889 more words

Complementary medicines’ problem with evidence

Evidence aplenty for complementary medicines-by ex-head of the AMA-Take THAT Friends of Science-enemies of truth!

Anti-vaccine lobbyist Meryl Dorey seizing legitimacy from Dr. Kerryn Phelps

Last week Dr. Kerryn Phelps wrote an article for The Australian defending the view that alternatives to medicine are in fact, a type of medicine.

The article’s heading, Evidence aplenty for complementary medicines itself touched on a unique feature of the massive Wellness Industry. Semantics. We have witnessed natural medicine become alternative medicine become complementary medicine become integrative medicine or more frequently complementary and integrative medicine. These are semantic costume changes designed to market integrity. To divert attention away from the fact that evidence for the efficacy of alternatives to medicine is lacking. Simply put, this is not medicine.

Dr. Phelps criticised Friends Of Science In Medicine [FSM], suggesting their “agenda was a declaration of war”. Yet I would conclude FSM are providing a long overdue and organised response to the rise of demonstrably non efficacious and potentially dangerous practices gaining undeserved academic credence. These have always shared a hostility toward evidence based medicine and science itself.

FSM president Professor John Dwyer writes:

We strongly support sound research to determine the effectiveness or otherwise of any biologically plausible areas of ‘alternative’ interventions. We do not seek to prevent consumers from making informed choices about alternative interventions, but wish to see the public better informed and therefore protected from false claims.

I do not doubt for a moment that Dr. Phelps and many other GPs who support alternatives to medicine are above reproach. Nor am I suggesting that all naturopaths and chiropractors (for example) are incapable of establishing a meaningful patient-focused reciprocal relationship with conventional medicine. What I am suggesting is that they are a minority and it is thus in error to suggest alternatives to medicine are generally based on evidence. Dr. Phelps’ insistence that these practices “compliment” or effectively “integrate” with conventional medicine is simply wishful thinking.

I strongly agree with Kerryn Phelps in that individuals taking more responsibility for their health is positive. I support and defend the right of patients to have more choice in managing their health. What I find deeply troubling is that once these two conditions are met, patients and wellness consumers are faced with bogus claims, unnecessary expense and a cornucopia of charlatans. That this is in no small part due to paper tiger regulation reflects that the system itself is broken and failing Australians.

That 19 of Australia’s 39 universities offer courses in scientifically implausible practices is alarming. The role of FSM in highlighting the perils of affording academic credibility to these practices is vital. It can be argued, as Dr. Phelps has previously, that universities will ensure rigid standards are met. Or as now, that FSM should support “an increase in university-based education for practitioners”. Sound reasoning to be sure. Until one considers that these very practices depend upon denial of the scientific method and graduates often emerge highly defensive of an ideology.

There is also an inescapable convolution of practice, integrity and accountability. A belief system associated with one modality may open the way for increasingly absurd practices. The anti-science, anti-medicine, post modernist culture so crucial to new age chiropractic is conducive to opposition, not integration.

This convolution raises the question of where the line is drawn. Few understand what constitute homeopathic principles beyond assuming they provide a “natural” therapy. Yet I would be surprised and disappointed if Dr. Phelps agued it had a role in medicine beyond placebo. Basic chemistry confirms there is no ingredient at all in homeopathic products, beyond expensive sugar. For those who seek to understand more about this “informed choice” there await increasingly bizarre claims most often concluding quantum physics will one day reveal all. This is the same mechanism behind theta healing – even remote theta healing.

For the purposes of this post it’s important to focus primarily on Dr. Phelps’ defence of chiropractic. But what type of chiropractor? John Reggars is past president of the Chiropractors Registration Board of Victoria and present vice president of the Chiropractic and Osteopathic College of Australasia. Focused on science, he is concerned by the rise of “ideological dogma” and the anti-scientific fundamentalist training that FSM have identified as problematic. In a paper by Reggars published in May 2011 he notes that in Australia the 1990s saw a resurgence of “chiropractic philosophy” and with it the belief in VSC, or Vertebral Subluxation Complex.

Reggars is highly critical of such chiropractic pseudoscience, pointing out misuse of diagnostic treatment, schemes to “double your income”, selling the notion of lifelong chiropractic care “to an ignorant public” and locking patients into contract plans. He also writes:

For the true believer, the naive practitioner or undergraduate chiropractic student who accepts in good faith the propaganda and pseudoscience peddled by the VSC teachers, mentors and professional organisations, the result is the same, a sense of belonging and an unshakable and unwavering faith in their ideology.

Belief in the unseen VSC is accompanied by the insistence all disease – including infectious disease – has its origin or cure in the spine. Chiropractic is the invention of 19th century magnetic healer Daniel David Palmer. Perhaps nothing reinforces the value of Friends Of Science In Medicine better than this modern scam of chiropractic. Represented in Australia by the Chiropractor’s Association of Australia [CAA] its aim is:

To achieve a fundamental paradigm shift in healthcare direction where chiropractic is recognised as the most cost efficient and effective health regime of first choice that is readily accessible to all people.

In other words they seek to displace the GP as the primary care physician. It is impossible to broach the many areas of medicine or do the same with the many pseudosciences chiropractic endorses to elaborate on this. Yet from vitamin therapy to homeopathy new age chiropractors have a positive word. Efficacy matters not. The CAA seem to instill fear and confusion about conventional medicine as a key mechanism in their “fundamental paradigm shift in healthcare direction”.

When we understand what seeking to usurp the family doctor entails, we can see that FSM can scarcely be accused of declaring war. The article Recent Controversies in Chiropractic and RMIT courses/clinic provides exceptional insight into the very concerns FSM seek to address with quackery in universities. Palmer argued humans have “a god-given energy flow” which when disrupted leads to illness. Exhuming such nonsense and contending that the doctrine is “evidence-based education and practice”, as suggested by Dr. Ray Myers, head of RMIT University’s School of Health Sciences is shameful.

One area the CAA has chosen to immerse itself in is the anti-vaccine movement. Many graduates emerge convinced that vaccination is a toxic medical trick. As one put it, raging on Meryl Dorey’s anti-vaccine Facebook page; “Of course we don’t support vaccination, it’s the biggest medical sham since bloodletting!”. The reason for his outburst was the article Doctors accuse chiropractors of selling anti-vaccination message.

To better understand why we must travel back over 100 years. In 1909 D.D. Palmer’s son, Bartlett Joshua (or B.J.) Palmer wrote (Ref; 2003), (Ref; 2014):

If we had one hundred cases of small-pox, I can prove to you where, in one, you will find a subluxation and you will find the same conditions in the other ninety-nine. I adjust one and return his functions to normal… . There is no contagious disease… . There is no infection… . ♠

Herein lies a major problem for Dr. Phelps who is under no such illusions about vaccination. As seen above Meryl Dorey has hitched a ride on Dr. Phelps’ reputation. On another email list Dorey simply copied the entire article and sent it off with the opening line, “If only we could get her to look at the vaccination issue as well… <sigh>”.

As well?! Dr. Phelps opined in The Australian about the “us and them” attitude. Yet these two words reflect just how rusted on and integral to many who entertain alternatives to medicine the “us and them” mindset is.

Some months back Dorey was also using Phelps’ prior role as AMA president, in the AVN attack on all conventional medicine. I wondered if Dr. Phelps knew of her unofficial patronage.

Past president of the CAA, Simon Floreani, has promoted homeoprophylaxis, showcasing Isaac Golden. Anti-vaccine activist and “paediatric chiropractor” Warren Sipser went as far as testifying in the family court against the immunisation of a five year old girl. Sipser informed reporters at the time “there is credible evidence they [vaccines] may do more harm than good”. Nimrod Weiner of Newtown Chiropractic ran anti-vaccine workshops using information garnered from the same AVN to whom Dr. Phelps is “diametrically opposed”.

Weiner informed pregnant mothers at a public talk that homeopathic immunisation (water) was superior to regular immunisation. That Andrew Wakefield’s fraudulent paper attempting to causally link MMR to autism was “scientifically good”. Last July Dr. Phelps tweeted:

WIN News Wollongong recently aired a comment from Meryl Dorey claiming that “all vaccines” are linked to autism in the medical literature. This is complete opportunistic nonsense and is now quite properly the subject of a complaint to ACMA. As Jonathon Holmes observed on Media Watch “there’s evidence and there’s bulldust” and that “Dorey’s claim about the medical literature linking vaccination and autism is pure, unadulterated baloney.”

Quite right. Which raises my point on convolution again. Where do we draw the line? Of the 222 listed professional members of Dorey’s anti-vaccine group over 60%, or 135 are chiropractors. The next largest is homeopaths with 16 members, or a comparatively small 7%. Naturopaths number 15 members. Then kinesiologists, then acupuncturists with 5 and 4 members respectively. Aside from one physiotherapist and one occupational therapist, all “professional members” sell alternatives to medicine of some description.

A US study published in Vaccine showed that parents who deny their children vaccination are four times more likely to see a chiropractor as the primary care physician. When Floreani was CAA president his chiropractor wife wrote of their newborn son’s pertussis. Including [bold hers]:

We performed chiropractic checks on our baby daily and utilised a whooping cough homeopathic. I dosed myself with an array of vitamins to boost his immunity via breast milk and kept him hydrated with constant breastfeeding. Whooping cough is often slow to develop and may respond well to conservative management, including chiropractic, osteopathy, homeopathy, herbs, acupuncture or acupressure.

Magically, it resolved within two weeks. Which means it wasn’t pertussis but a self limiting infection and all that woo did nothing but correlate to the illness. But I am sure Dr. Phelps would be the first to agree herbs, acupressure, homeopathy and so on would do nothing to manage pertussis. It is very dangerous misinformation with potentially fatal consequences.

So not only are unvaccinated children more likely to see a chiropractor and be subject to such abuse, but by not seeing a GP they are unlikely to become a recorded notification. Officially whilst only 5% of 0-4 year olds in Australia are not fully vaccinated for pertussis they make up 27% of cases. Thus, this figure may well be conservative. Dr. Phelps must ask herself; If vaccine deniers will choose chiropractors, might chiropractors influence parents to reject vaccination? The above rubbish is by Dr Jennifer Barham-Floreani – B.App.Clin.Sci, B.Chiropractic after all.

Australian Doctor wrote in part about the study in Vaccine:

Are naturopathic and complementary healthcare providers reinforcing parental concerns and ‘anti-vaccine’ opinions or promoting exemptions, or are they providing healthcare without emphasizing vaccinations?

I hope Dr. Phelps is asking herself that question also. As I stress above I’m sure Dr. Phelps and her colleagues are above reproach. But that’s not the point. The larger message being advanced here is that alternatives to medicine not only complement but “integrate” with conventional medicine. Not only does available evidence show this is not true but to generalise is to lend credence to dangerous charlatans.

This post has focused primarily on chiropractors, because they not only serve as a hub for health focused pseudosciences, but also seek to replace the family GP. I will contend that my point on convoluted overlap is valid. Once a patient is referred to one pseudoscience how does the referring GP control for pollution as it were? More material on the dubious ethics of new age chiropractic, including catastrophic neck injury and paediatric “improvement” by parental proxy can be found here.

St. John’s Wort seems to be trotted out in almost every article claiming alternatives to medicine have an evidence base. What is forgotten is that hyperforin, the antidepressant extract of St. John’s Wort, and other extracts are both inducers and inhibitors of P450 cytochrome enzymes. These liver cytochromes are involved in the metabolism of over 50% of marketed medication.

In the case of opioid pain relief studies have demonstrated a decrease of blood plasma levels of oxycodone of up to 50% and reduced half life of 27%. In the case of alprazolzm (a benzodiazapine), prescribed for anxiety and panic attacks a doubling of clearance rate has been documented.

Chronic pain is associated with depression and depression with anxiety. Opioids and benzodiazapines are causally linked to respiratory depression overdose death. Hence the clinical significance of any “integration” of serious pain management with a herbal choice for the depression it may cause is likely to be anything but “complementary” for the patient. Many patients choose not to inform their GP of herbal supplements.

Proper diagnosis following treatment with medication will be hampered by St. John’s Wort. Excessive doses of actual medication may be prescribed. Should a patient cease St. John’s Wort whilst on opioid, benzodiazapine or both medication regimes a spike in blood plasma of the active metabolites will ensue. More likely, as St. John’s Wort is improperly regulated and dose concentration varies widely a patient may unwittingly expose themselves to respiratory depression and possibly death with no change in their daily medication/St. John’s Wort routine.

In short whilst the concentration (dose) of actual medication is stable, the drug interaction outcome due to St. John’s Wort mimics an unstable medication dose. Patients may easily find themselves unsuitable to drive, work, operate machinery, bathe or sleep without potential for disaster. Consequently many medication regimes may be deleteriously effected by St. John’s Wort.

Thus the wider picture of evidence pertaining to St. John’s Wort is not quite the basis for “integration” proponents of alternatives to medicine would have us believe.

My response to the ongoing insistence that placebo effects derived from acupuncture constitute evidence is likely to be here in Acupuncture: essential facts about a major scam. Over and again it emerges that subjects who think they are receiving acupuncture, whether they are or not, demonstrate a response.

Findings aside, how would Dr. Phelps explain meridians, invisible forces, chakra or vital energies? It is too easy to point to apparently positive findings when the mechanism by which they arise is implausible, unknown or assumed to be related to endorphin release. The technology to manufacture acupuncture needles did not exist until the 1600s and the only nation to seriously try to ban acupuncture was China under the Chinese Nationalist Government. Western marketing has done much for this “traditional” Chinese medicine.

What of naturopaths who insist on Black Salve [2]? Or who use herbal balls from China with high levels of elemental mercury, arsenic and lead? What of poor hygiene and bacterial infection from acupuncturists or masseurs? The astonishing story of Monika Milka and non-sterile syringes used in biomesotherapy, leaving her patients seriously infected with mycobacterium chelonae?

Tragic cases like Penelope Dingle and Isabella Denley indicate that the notion of integration or proper supervision is seriously flawed. One point raised repeatedly by FSM is that whilst ill patients waste time being exploited by pseudoscience acting as a health choice, the chance of genuine care, full recovery or even survival is lost.

These are the real issues Dr. Phelps could constructively help Aussies understand before raging at FSM. How is it that so many various practices have come to exist that are beholden to ideology, not evidence? How is it they can convince parents to withhold treatment from their children and in doing so undermine the health of our entire community?

FSM exists to address an unacceptable situation in our educational institutions. They have taken a stand because those in a position to defend academia seemingly chose to act unethically. When it comes to “informed choice” there is an excess of non evidence based, expensive pseudoscience. It is pervaded by a combative, arrogant anti-science and anti-medicine mindset. It is amply equipped with scams.

This madness must stop and Dr. Kerryn Phelps is most welcome to clearly state just what aspects of non conventional medicine are high risk ideology and what is safe, effective and backed by evidence. Real evidence that can be trusted alone.

Presently, there appears to be a scarcity.

♠ This quote has been attributed to D.D. Palmer. However in 2013 the Journal of the Canadian Chiropractic Association, cited the author as B.J. Palmer.

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 it’s 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 it’s 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. It’s 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.

Floreani, Golden and the myth of homeopathic immunisation

For a mob that officially professes “no position” on vaccination the Chiroprctors’ Association of Australia disseminate ample false, misleading and quite dangerous antivaccination hanky panky.

Take CAA NSW branch vice president, Nimrod Weiner. The Weiner from Newtown Community Chiropractic whose Nimroddery was pegged as a “rant on vaccines” by The Australian. Although he feverishly ran for cover after outraging real doctors, not-a-real-doctor Weiner’s “rant” bibliography can be found here. A hodge podge of dusty conspiracy twaddle and outright lies, much from the Australian Vaccination Network it alone refutes Weiner’s claim:

I’m good at knowing how to read a research aritcle, and knowing whether it’s viable or not. I’m also good at collecting a lot of research. This vaccine topic I update every single week. So what we’re looking at is new as of yesterday morning.

He didn’t write that, but announced this to attendees of his seminar Vaccinations: An informed choice, in what can quite justifiably be called a lie. There’s more on the entire debacle along with a Radio National segment here. At times we’ve met other crackpots from the CAA. Jason Parkes and Rob Hutchings, both of whom approach their profession like a religious fundamentalist approaches taking up arms. Warren Sipser who believes vaccines cause harm yet chiropractic “repairs DNA”. Genevieve Keating is another pleasant sounding predator who specialises in convincing parents chiropractic builds super human kids. They lean toward the weird beliefs of founder Daniel David Palmer and his views on “God given energy flows”.

Sipser was the subject of an article in The Australian headed The Chiro Kids which brought home just how ludicrous (and scurrilous) the new brand of Mystical Chiropractors really are. Thanks to Dr. Rachael Dunlop we can read the CAA’s Media Release warning CAA members of that article. It’s disturbing stuff given these quacks are subsidised by our government (Medicare foots the bill for five sessions per year) and health insurers. Written by CAA national president Simon Floreani, it is a straight out attempt at damage control, obfuscation and dodging questions.

Floreani himself has run antivaccination clinics and is a member of the Australian Vaccination Network. He describes Dorey’s little fraudulent scheme as a valuable resource for patients. Simon is married to Jennifer Floreani, famous for writing an article supposedly describing (Update – as noted below the bogus article has been removed but can be found here pp. 348-349) her newborn’s battle with pertussis, picked up from an older sibling. Given the outcome and treatment the article is almost certainly fraudulent, but if perchance the diagnosis is correct then at best it is reckless neglect and at worst simple child abuse.
She writes (bold hers):

This experience did indeed test our resolve and we were forced to draw on our support network of healthcare providers. We performed chiropractic checks on our baby daily and utilised a whooping cough homeopathic. I dosed myself with an array of vitamins to boost his immunity via breast milk and kept him hydrated with constant breastfeeding.

Whooping cough is often slow to develop and may respond well to conservative management, including chiropractic, osteopathy, homeopathy, herbs, acupuncture or acupressure. Within two days, the severity of our baby’s symptoms cleared and within a two week period, each of our boys had a complete resolution of their symptoms.

Fortunately for the Floreani’s this little tale is just that – a tale and a comical one too. Every type of “conservative management” is absolutely non efficacious. Babies with pertussis gag, choke and may have profound difficulty breathing making this nonsense of super fortified breast milk as a realistic option seem laughable. More so, there’s no evidence an increase of maternal vitamin intake when breastfeeding will do anything but produce expensive maternal urine. Even more farcical is the notion of “boosting immunity” with vitamins. Either way, if their baby did have pertussis there’d be no magic recovery after two days but admission to intensive care many days later as the insanity of their hokery pokery gradually sank in. Yet, that’s not really the point.

The dangerous, deluded and unconscionable message pushed on parents here is that using your breasts, vitamins and witch doctor spells, you can clear up a potentially fatal disease within two days. It’s outrageous and a bald faced lie that I cannot even begin to comprehend the motivation for. What’s infuriating is that chiropractors exploit the confirmation bias in parents and the Floreani’s are prime examples.

Parents who believe these nonsense manipulations cure everything report that yes treatment keeps children healthy. They also report inaccurately that lapses in treatment lead to poor health. Knowing this, chiropractors are famous for setting treatment frequencies, with some even insisting on treatment contracts. That the locus lies with parental bias has been shown splendidly in trials on colic.

As we know, chiropractors claim they can “successfully treat” colic or – in their lingo – Irritable Baby Syndrome. Trials show that if parents believed their baby received chiropractic care, whether they did or did not, they reported improvement. If they believed that no chiropractic care was applied – even when it was – they reported a worsening of colic. You can catch up with Simon Floreani admitting no proper trials exist here on Lateline back in July 2009.

He’s caught out claiming injuries from neck manipulation are one in 5.85 million cases when in fact they are gauged at 1.3-5 per 100,000 manipulations, by insurer Kaiser Permanente, who refuse to cover the practice. In short Floreani is claiming instance of vertebral injury is 60 – 300 times less than it is.

On August 21st this year, a video entitled “Homeopathy evidence and research” filmed by Simon Floreani and featuring homeopath and fraud Isaac Golden, appeared on YouTube. The video below looks initially at the rise of the Mystical Chiropractors and then picks through Golden’s claims of Cuban “homeopathic immunisation” and his own so-called PhD on “homeopathic immunisation”.

When used to defend against a complaint to the TGA about homeoprophylaxis, Golden’s PhD actually helped uphold the CRP decision of misleading claims by fellow crook, Fran Sheffield. This is because even Golden admits in his thesis text that his sample was flawed in size and there was no chance of contracting infection. In short he showed nothing.

Enjoy…