DC's Improbable Science

193 responses so far ↓

• 1 coracle // Jul 29, 2007 at 20:00

  Hi David, great to see a nice blog format for improbable science, looking forward to more of the same.

  Oldfart, I think it’s a need to be logged in to comment. I see a comment box on the ‘BBC makes good on MMR’ page, though that might be a recent fix?

• 2 peter horne // Aug 2, 2007 at 11:13

  Much better. This wordpress seems ok.

• 3 Minnies_Dad // Aug 6, 2007 at 10:00

  Hello David…and congratulations on your new look.

  At least something positive has come out of the recent unpleasantness – Improbable though that may have once seemed!

• 4 kazelnio // Aug 9, 2007 at 05:35

  Hello, I found the link to your website in the Lawrence paper. Its a great essay and I have blogged about it on my site at The Other 95%, plus added my perspective on metrics and taxonomy.

  I had a look around and really like what you are doing, will check back often for updates!

• 5 reginald // Aug 15, 2007 at 23:23

  Hello David,
  Having read your amusing Guardian article about homeopathy its good to see that skepticism is alive and well in the British media – what ashame that you didn’t bother to research your article and find out anything about homeopathy, the principles it is based upon or even the fact that it has been used with great success for over 250 years as opposed to 30 as you suggest. Seems that bigotry is also thriving in the media if your writing is anything to go by. Active debate is always useful but it becomes a great stumbling block to evolution when one makes one’s mind up before actually knowing anything about the topic up for discussion. Arguing from blatant ignorance renders any valid points you make a bit laughable you know…

• 6 admin // Aug 16, 2007 at 04:23

  Just one thing. The Guardian piece was not (primarily) about homeopathy, but about something much more important. I think you missed the point Reginald.

  Of course real medicine had hardly begun when homeopathy was invented, and the homeopaths’ solution, to do nothing, could well have been preferable to bloodletting. But homeopaths stayed stuck in 1800 and the rest of us moved on. I wonder if Reginald will opt for a homeopathic general anaesthetic if he needs a hip replacement. Or homeopathic treatment if he is unfortunate enough to get malaria. That would qualify him for a Darwin award. Francis Wheen referred to the Bush-Blair-Khomeini era as a period when mumbo-jumbo came to be mistaken for truth. Homeopathy is just one minor example of that. Being an optimist, it seems to me that the endarkenment is a temporary hiccough which is gradually coming to an end.

• 7 Minnies_Dad // Aug 18, 2007 at 10:52

  David: I see that ‘Reginald’ states that it’s “a shame that you didn’t bother to research your article and find out anything about homeopathy, the principles it is based upon or even the fact that it has been used with great success for over 250 years as opposed to 30 as you suggest.”

  Apart from the fact (since Reginald is rightly concerned about them) that your excellent article doesn’t suggest that homeopathy has only been used for 30 years, his own understanding of homeopathy may well have shed new light on the science behind Samuel Hahnemann’s theory, as it would make the good doctor -who was born in 1755 – no more than two years old at the time.

  In fact, it wasn’t until 1810 that he compiled the results of his cogitations into a treatise called “Organon of rational therapeutics”.

• 8 zathrus // Aug 19, 2007 at 17:23

  Splendid – a much more readable blog – but just as good, contentwise, as before….

  I’ve only just seen here that the Department of Pharmacology is to be “disestablished”. Sad it’s to go – I have many happy memories of the place, from when I did my PhD there. The building had a ramshackle air, totally belying the furious research effort that went on inside. DC’s pipe, the tiniest and smokiest tea room I’ve ever experienced (presided over by the formidable Joyce,), and practical demonstrations that N2O makes medical students behave weirdly are the three abiding memories….oh, and some pharmacology, too….

• 9 Prem_Joshi // Aug 23, 2007 at 15:40

  Hi David, As a college student in India, I was in an area that had a serious “Cobra Problem” And, of course we had a Homeopath who prescribed his pills for cobra bites. Among my friends were some believers in Homeopathy. So one day in jest I asked if they were bitten by a cobra , would they go to this doctor? Without batting an eylid they said yes !! and then as an after thought, added, they will also see a regular doctor. They were all Science , Engineering and Technology students.

• 10 Dr Aust // Sep 5, 2007 at 23:38

  Yes Prem, India is often cited by homeopaths as “a huge population using homeopathy happily”.

  Of course, it is not quite the same as in the European situation as my understanding is that in India you have to pay for medical care, Homeopaths presumably charge far less than conventional doctors, so less well off people consult the homeopath because the fees are affordable.

  In European countries where medical care does not usually have to be paid for it tends to be more a sense of dissatisfaction with “mainstream” medicine, or with a scientific way of looking at the world generally.

  PS Someone bitten by a Cobra taking a homeopathic remedy makes me think “Darwin Award”

  http://www.darwinawards.com/

• 11 Charles Copeland // Sep 6, 2007 at 16:38

  David,

  Great site – you are a past master at putting the boot into pseudoscience!

  But are you sure you are right about the adverse effects of liberal gun control policy in the US? (I’m referring to your posting on the Virginia Tech murder spree). I think the jury is still out on that issue – indeed there have been quite a few studies whose findings suggest that the widespread availability of guns may reduce rather than increase the crime rate (chiefly because felons fear being shot by their putative victims).

  The book to read is John Lott’s ‘More Guns, Less Crime’. You’ll find an interview with Lott here:

  http://www.press.uchicago.edu/Misc/Chicago/493636.html

  Apart from that, you’re perfect.

  Keep up the good work!

• 12 tg2 // Sep 7, 2007 at 18:39

  It is gratifying to see a young Indian, Prem, who realizes homeopaths as quacks. A colleague of mine from India, whose expertise is in statistics, and I had the following conversation recently:

  I: Good to see you. How was your trip?

  (He tells me about his trip to China, about which he had told me earlier. His original plan was to leave his toddler in India with grandparents, and go to China only with his wife. He told me that his child went with them as well.)

  I: I thought you were going to leave the child in India while you went to China. What happened?

  He: Oh, there are all kinds of fevers in the state. So I didn’t want to leave her there.

  I: Yes, I heard chikkungunya is really bad there.

  He: Yes, but we took some homeopathic medicine, so we were fine.

  I: Come on! You are a statistician. You ought to know better! (I am never diplomatic. I am polite, but very direct, which is one reason I am still an honest academic.)

  He: But it worked. We didn’t get sick, whereas my mother-in-law did.

  There was nothing further I could say. I was flabbergasted! Oh, ours is the top-rated and largest program in the US in our branch of engineering. I won’t say which, but you can probably guess if I tell you that a large component of my branch of engineering is statistics. We are supposed to have the strongest statistics program of its kind. I am from India too. As the only other Indian on the faculty, it is rather depressing to see supposedly expert statisticians believe in such quackery.

  Prem, keep it up! India needs more people like you!

• 13 David Colquhoun // Sep 8, 2007 at 21:18

  Charles Copeland. I’m never sure I’m right about anything, and the experiments on gun control have not been done, nor are they likely to be done.

  But you must be as well aware as I am that most guns in the USA are not used on felons, but on family and friends.

  It is, I agree, a bit naive to point out that the USA has a vastly higher homicide rate that any other rich country, as well as vastly more guns. For me it is quite sufficient to say that it is uncivilised to have private citizens carrying lethal weapons, just as state executions are uncivilised. One lives in hopes that now the days of the “Texecutioner” are numbered, the USA may perhaps eventually catch up with Europe in such matters.

• 14 Jack Murphy // Sep 8, 2007 at 22:05

  Sorry…
  Can I ask question?
  Does the problem of gun availability tie anyway to quackery and homeopathy? :)

  However, if you are discussing this question…
  ‘More Guns, Less Crime’ is wrong opinion, certainly. There are many countries where the law prohibits men from carrying arms. Nevertheless, the crime rate in these countries is not more than in USA. Actually, the crime rate and the availability of guns is not tied. A high crime rate is a reflection of an unstable society.

• 15 David Colquhoun // Sep 8, 2007 at 23:26

  Jack -the reference is to the posting about Virginia Tech on my politics page, at http://www.ucl.ac.uk/Pharmacology/dc-bits/corrie.html#vtech

  I think that there is a connection between questions like that and about quackery. They are all about believing things that aren’t true, and about the betrayal of enlightenment values. Originally I had pages on politics and religion as well as about dubious science. Now I agree with Francis Wheen. They are all aspects of the endarkenment.

• 16 Jack Murphy // Sep 9, 2007 at 02:17

  Yes, David, I’ve understood that the talk is about Virginia Tech case.

  You have answered excellently about connection between all these questions. I agree with you that it is different “symptoms” of one and the same “disease” of present civilization – the endarkenment.

  Thereby some idea suggested itself to me. Perhaps I have not enough the right to criticize the form of your blogs. And I don’t try to do it, of course. However, maybe would it be interesting solution to tack two your blogs together? In fact the uppermost subject of conversation in both blogs is one and the same. This subject was designated and defined in your profound article “Science in an Age of Endarkenment”.
  Certainly, the creation of one great combined blog supposes the additional hard work. But I think that future result of it could be very important – new uncommon website (blog) would arise with clear powerful progressive idea. This blog could be divided into different themes according to all aspects of main problem – the crisis in present world and science.
  I could help you in this work, if you would decide to do it. With my pleasure and gladness!

  Well… Perhaps, my enthusiasm ran away with me :) Don’t take to heart…

• 17 DMcILROY // Oct 15, 2007 at 13:36

  I have linked the Lawrence paper as reading for my scientific english students. They have to prepare two role plays connected to this issue; one with a group leader telling a PhD student and post-doc that they have to add two honorary co-authors to their manuscript, and the other a recruitment committee evaluating candidates’ CVs.
  On the theme of CVs and recruitment, I have also linked to the material you obtained on Patrick Holford’s appointment at Teesside. Tomorrow they will be re-enacting the discussion that led to his professorship.

• 18 susanekg // Oct 25, 2007 at 13:37

  Readers of Improbable Science might be interested in reading Snake Oil Salesmen Hit Jackpot in Nevada, an academic blog about the ongoing campaign in that state to promote medical tourism by legalizing medical devices and treatments that are outlawed in other states: http://faculty.uml.edu/sgallagher/NIRB.htm. Thanks for calling attention to the rising power of irrationality in medicine and other sectors of the knowledge industry.

• 19 jdc325 // Oct 25, 2007 at 17:02

  Re Susan’s link – “…placing the supervision of medical research and treatment in the hands of a unique coalition of homeopaths…”, some of whom have “lost their medical licenses in other states”. Remind me not to get sick in Nevada Susan!

  PS – clicking the link brings up a 404 error message. If you copy and paste the link into your browser, the final full stop (or period) needs to be deleted.

• 20 madmedea // Jan 11, 2008 at 14:57

  The names of the “experts” involved should certainly be published alongside the documents which they have made a contribution to. To make a comparison (in case you need to state a precedent) the Quality Assurance Agency for Higher Education produces subject benchmark statements which set our standards expected for undergraduate degrees. All of the published statements include details of who was on the group which created them – experts drawn from the subject area.

  I’ll be interested to see if Skills for Health are covered by the FOI Act – as I can’t see a mention of it on their website. As a similar type of body, QAA are not currently covered.

  P.S. If they come back and say they can’t release the names because of data protection…. that really isn’t true….

• 21 CTurner // Feb 8, 2008 at 14:06

  Hi David, have just stumbled across your site. Very nice indeed… Was impressed to read your robust defence of Martin Walker’s (and Clifford G Miller’s) slanderous accusations about you in the Grauniad’s CiF section (Ben Goldacre – Clinical trials and playing by the rules – http://www.guardian.co.uk/commentisfree/2008/jan/05/1). Keep up the good work.

• 22 Old boy // Apr 10, 2008 at 11:50

  Comment on In-human resources, science and pizza:

  Thanks for that – I LOVED IT. It’s fantastic that the truth of HR (I truly hate that phrase) has been so ruthlessly exposed. Should be part of the School Handbook. Any VC who stripped out all the BS would immediately retain and attract good people and see their productivity soar.

• 23 bigpharma-bigbucks // Apr 10, 2008 at 13:51

  GERD: You don’t have it because it doesn’t exist
  10 April 2008
  If your doctor tells you that you suffer from GERD (gastro-esophageal reflux disease), he’s lying – because the condition doesn’t exist, and was invented by the drugs industry.

  GERD is a serious-sounding name for common-or-garden heartburn, which many of us have from time to time.
  http://www.wddty.com/03363800371954492866/gerd-you-don-t-have-it-because-it-doesn-t-exist.html
  But you don’t need to take a powerful drug indefinitely in order to deal with heartburn – so that’s why drug giant GlaxoSmithKline invented the condition, GERD, in order to market its drug Zantac.

  The same goes for conditions such as ‘overactive bladder’, which was invented by the drug manufacturer Pharmacia in order to market Detrol, and ‘compulsive shopping disorder’, a mental illness devised by Forrest Laboratories and used to promote its antidepressant Celexa.

  This practice is known in the industry as condition branding, a new book, Our Daily Meds, reveals. Doctors usually fall for it because most of their ongoing education after leaving medical school is from the drug company salesmen or company-sponsored conferences.

  (Source: Our Daily Meds, by Melody Petersen, published by Farrar Straus Giroux, 2008).

• 24 bigpharma-bigbucks // Apr 10, 2008 at 13:52

  MMR: Major mumps outbreak proves the vaccine doesn’t work
  10 April 2008
  At a time when health officials are quietly admitting that there could be a link between the MMR (measles-mumps-rubella) vaccine and autism, a new study has also discovered that it doesn’t work.

  Researchers investigating a large outbreak of mumps in 2006, when 6,584 cases were reported among college students, have discovered that virtually every sufferer had been vaccinated twice against the disease.

  The Centers for Disease Control (CDC) reveals that at least 84 per cent of young adults aged between 18 and 24 years had received two-dose vaccines against mumps. And in 2006 – when the outbreak occurred – the national two-dose coverage among adolescents reached 87 per cent, the highest in US history, and just one point below that needed for ‘herd immunity’.
  CDC researchers speculate that the outbreak – primarily among 18- to 24-year-olds – was the result of the ‘wrong type of mumps’. The vaccine is supposed to protect against A-virus mumps, whereas the outbreak in 2006 was caused by the G-virus strain.

  Despite its limitations, the CDC team reckons that all children need a third dose of MMR – even though the two-dose vaccine was introduced following a 1980 mumps outbreak among children who had received a single vaccine dose.

  It may be a measure that will be hard to introduce at a time when health officials are accepting that the MMR vaccine can cause autism among children with a ‘mitochondrial disorder’.

  (Source: New England Journal of Medicine, 2008; 358: 1580-9).

• 25 bigpharma-bigbucks // Apr 10, 2008 at 13:53

  Cancer Drugs: Why ‘wonder’ treatments almost never are
  10 April 2008
  New ‘wonder’ cancer drugs may be nothing of the sort – and could be given miracle status by zealous drug companies anxious to get their new drug on the market before all the proper studies have been carried out.

  In the past 10 years, 25 studies on cancer drugs have been stopped early by the sponsoring drug company because, they have said, results looked ‘promising’.

  Researchers who investigated the pattern discovered that the trials were stopped, on average, after just 30 months, and had been tested on a fraction of patients that were originally enlisted.

  Lead researcher Dr Giovanni Aplone commented: “Data on effectiveness and potential side effects can be missed by stopping a trial early.”

  He said that the true effectiveness and safety of any drug could be established only after years – and not months – of study, and usually among much larger groups than those used for the trials. Most of the studies that were ended prematurely had tested the drug on just 40 per cent of those who had been initially recruited.

  (Source: Annals of Oncology, 2008; March 28: doi: 10.1093/annonc/mdn069).

• 26 bigpharma-bigbucks // Apr 10, 2008 at 14:08

  Just posted 3 sample items which I hope you will not “moderate” David.
  Just wanted to show that Improbable Science might want to consider some of the lies sold to us by big money interests in pharma.

  Makes a change from constantly having a pop at alternative medicine which doesnt result in long term conditions due to over / wrong prescribing, and which results in thousands of deaths every year even when prescribed “correctly”.

  Perhaps you can turn your energies onto the hand that appears to be feeding you?

  …let me start you off with over prescription of Ritalin and the great fluoride deception

• 27 David Colquhoun // Apr 10, 2008 at 14:43

  You really should check before accusing me of taking money from phams. Perhaps you should look at the interchange on that topic with Patrick Holford. Which of us has the vested interest?

  I’d also recommend that you read my blog more carefully. If you did you would see that I criticise pharma almost as much as I criticise the alternative industry (they are both industries – the main difference is that the alternative industry lies all the time to shift the product, whereas pharma lies only some of the time).

  I can’t answer your question about the halting of cancer trials because I don’t know what stopping rule they uses -there are perfectly good statistical ways to deal with that dilemma. I’m willing to bet that you haven’t read the originals either, but are merely repeating the headlines.

• 28 Dr Aust // Apr 10, 2008 at 15:43

  Hear hear, DC.

  One of the hallmarks of the AltMed / Nutri-Balls / Natural Therapy lot is that:

  (i) they never met a “natural” therapy they didn’t like;
  (ii) they never met an “allopathic” remedy they did.

  In contrast, conventional science and medicine generally, and the BadSci lobby, will call time on bullshit, or bad science to be less Anglo-Saxon, wherever it can be found… for instance, see Ben Goldacre’s discussion of fluoride. And you can find extensive discussion of Pharma’s disease-mongering over GERD, or ritalin, or SSRIs, in the mainstream medical literature as well as on the BadSci forums.

  And now a question:

  When did you EVER see a complementary therapist, or natural therapy advocate, discussing the possibility that compelmentary theraies are ineffective or over-sold?

  Anyone?

  Thought not.

  When the Complementary Therapy crew stop pushing bullshit, and develop any meaningful level of self-critique, they might get less of a flaying. Until then, as John Wayne would say, ” not hardly”.

• 29 bigpharma-bigbucks // Apr 14, 2008 at 08:47

  Well Dr Aust (I guess you feel the need to include the magic letters DR in your username to add to your credibility), you seem to think that the “AltMed / Nutri-Balls / Natural Therapy lot” are something different to your superior “allopathic crew”.
  You may want to find out how many of your Dr, physiotherapist, Nurse, Midwife, Oncologist, etc etc colleagues are ALSO part of the “Altmed Lot”. Why is it that mainstream health practitioners are increasingly incorporating CAM into their practice, maybe its because they have found that many of them WORK!
  Example is Nutritional therapy. It is easy for “educated ” professionals like yourself to scoff at treating many conditions with nutrition, however I would ask how many hours of nutritional input do doctors have in their training?
  As is often said, the medical establishment serves as the retail arm of the pharma industry and the core of medic training is to dispense patented medicines.
  As Im sure you will know, the OTHER part of the Hippocratic oath is “Let your food be your medicine and your medicine be your food”.

  How many times do doctors apply this strategy rather than writing a prescription?

• 30 David Colquhoun // Apr 14, 2008 at 10:18

  It is, sadly, true,that there are a few corrupt clinicians who act as mouthpieces for big pharma (but not many pharmacologists). My guess that is nothing like the number of alternative people who act as salespeople for the truly enormous alternative industry. That is specially true in the peddling of unnecessary “supplements” by nutritional gurus who often qute blatantly have strong financial interests in the recommendations that they make.

• 31 Dr Aust // Apr 14, 2008 at 12:08

  *sigh*

  bigpharma-bigbucks, if you check on my blog you will see I am a PhD type working in a medical school. I use the alias “Dr Aust” because I picked it after about 20 seconds thought two years ago and I can’t be arsed changing it.

  I am not a clinician and have no direct vested interest in selling you pills. I do not work for a PharmaCo, and have never had a single penny of money off them either.

  One thing I do know a bit about is what medical students are taught, since I do the teaching. They are taught about nutrition throughout their courses. And from my wife – who is a doctor – and my GP friends I know that doctors DO dispense basic nutritional advice – the simple stuff that is actually known to be soundly based, like “eat more complex carbohydrates” “eat less saturated fat”, “eat more fruit and veg”, and “oily fish is good for you”. They also do “lifestyle advice”, like taking exercise, and do various kinds of “counselling”-type talk.

  The line about “doctors exist to push pills for PharmaCos” is a tired piece of nonsense. Apart from anything else, it is cheaper for the NHS if doctors DON’T put people on expensive drugs. Most doctors are far more interested in NOT medicating patients unnecessarily than in dosing them full of pharmaceuticals. The demand for “pills for ills” increasingly comes from the patients, fuelled by a societal trend towards demanding quick-fix solutions. The complex supplement regimes peddled by tossers like Patrick Holford are just another example of this rather unhelpful Zeitgeist.

• 32 superburger // Apr 14, 2008 at 16:02

  also interesting to compare the attitude of the GMC towards a GP involved in recommending nutritional supplements (in which they have a direct financial interest) to a patient with that of the BANT (whose code of ethics seemingly permits people to take payment from pill companies for pills they give to customers)

• 33 jdc325 // Apr 14, 2008 at 16:45

  I’m not sure this is the right question: “how many hours of nutritional input do doctors have in their training?”

  Presumably, MDs receive sufficient training to give basic advice and are able to refer patients to Registered Dietitians if necessary.

  RDs must have a BSc in Nutrition / Dietetics. There are no requirements whatsoever for Nutritionists to receive any training.

• 34 dvd20 // Apr 15, 2008 at 11:38

  Just to say I thought your article was great on HR gobbledegook and I now work in HR! Actually, I have a perfect view of both science and HR as I am a senior research scientist whose funding ran out and now manage a new University programme for training (yes, training!) principal investigators! It actually makes sense to give PIs all the information they need to manage groups rather than trying to get competitors to help them out, so I have been designing an appropriate Programme for them see http://www.admin.cam.ac.uk/offices/personnel/staffdev/pi/. It is early days yet but people seem to find it helpful.
  In the HR world where verbosity currently rules and management-speak dominates, it may be possible to change this balance in HE and create an efficient, leaner and less grotesque HR function if you actually encourage more academics and scientists in! HR is a very wide remit and presents a short circuit into HE management. In my view, only by encouraging academics to leap across the divide and join in – can that divide begin to close.

  Dr Denise V. Dear,
  Academic Development Consultant – PI programme,
  University Teaching Associate,
  Staff Development,
  University of Cambridge,
  25, Trumpington Street,
  Cambridge.
  CB2 1QA
  01223 765786
  dvd20@admin.cam.ac.uk

• 35 bigpharma-bigbucks // Apr 17, 2008 at 13:48

  More big pharma fuelled rubbish:

  ‘Killer’ Vitamins: It’s bad science, but everyone believes it
  17 April 2008
  So are you about to die if you take an antioxidant vitamin supplement, such as A, C and E? A study that has been pounced on by the world’s media suggests you may. It says that not only do the vitamins not make you healthier or help you live longer, they may even shorten your life.

  The study looked at 67 medical trials, involving 232,550 people, most of whom were taking a high-dose antioxidant because they had a health problem, such as heart disease, gastrointestinal ailments or neurological complaints.
  Overall, 13.1 per cent of participants who were taking an antioxidant died, compared with 10.5 per cent of deaths among those who were either taking a placebo or no nutritional.

  As a result, say the researchers, vitamins must be more carefully controlled, and their use restricted.

  This is just the news that opponents of the booming nutritionals industry wanted to hear, and at a time when worldwide bans and restrictions are being considered by the EU and others.

  Better yet, the study is from the prestigious Cochrane Collaboration, which styles itself as the independent and scientific evaluator of medicine and therapies.

  But there’s a story behind the headlines, and it’s one that nobody is getting to read. Dr Robert Verkerk, scientific director of the Alliance for Natural Health, which is fighting to keep high-dose vitamins on the healthshop shelves, has found a range of faults with the Cochrane review.

  * The ‘new’ study isn’t new at all. It was first published in the Journal of the American Medical Association (JAMA) in February last year. The only difference is that the ‘new’ Cochrane review includes one less study. So the anti-nutritional lobby has had strong press coverage twice from the same data.
  * Despite its claims to be an independent review, the Cochrane study excluded 405 studies into vitamins because there were no deaths, and another 69 because they weren’t ‘randomised’ trials. As it is, the review looked only at studies that involved sick people, taking very high-dose synthetic vitamins, and which had participants dying. This does not replicate average use, and does not give the researchers the authority to claim that supplements shouldn’t be taken by healthy people.
  * The studies look only at synthetic vitamins, and did not include those that are sourced from plants, such as flavonoids, anthocyanins, and sulforaphanes, which are included in leading-edge supplements, usually produced by small independent companies.
  * The review flies in the face of many other studies that have established that high-dose vitamins are effective in reducing the risk of lethal diseases, such as cancer and heart disease.

  (Source: Cochrane Database of Systematic Reviews, 2008, 2: No. CD007176; Alliance for Natural Health)

• 36 David Colquhoun // Apr 17, 2008 at 14:38

  I see that bigpharma-bigbucks is again on the side of the enormous nutritional supplement industry, much if which is, of course, owned by the industry that he loves to deride. What a gift for them! By recommending their pills for diseases, but describing them as “supplements”, not drugs, they are able to get away from all that tedious stuff about producing evidence for the truth of their claims. That is how Boots get away (so far) with their ludicrous claims that CoQ10 peps you up.

• 37 Dr Aust // Apr 17, 2008 at 15:38

  bp-bb, your conspiracy mania is playing up again.

  For those that haven’t actually looked up the Cochrane review, the authors are Danish academics (not “Pharma shills”) and have precisely no “big Pharma” funding, or connections.

  Celebrity vitamin peddler-in-chief Patrick Holford was even forced to admit on R4 that his viewpoint on supplements was “less independent” that that of Professor Gluud, one of the study authors.

  Quite contrary to our resident conspiracist’s ravings, the Cochrane study was in fact funded by this Danish Foundation for (objective) Research into Complementary Therapies. Strange but true.

• 38 Dr Aust // Apr 17, 2008 at 15:45

  PS Sarah Boseley over at the Guardian has just penned one of her best ever pieces detailing just exactly why Bp-bb and Co. are frantically trying to rubbish and smear the Cochrane review. Solid gold stuff.

• 39 David Colquhoun // Apr 17, 2008 at 19:08

  bigpharma-bigbucks has sent two more comments, one immensely long, but simply repeating points that have already been made at length. The most striking thing to be is the alarming similarity of the tricks used by both the regular pharmaceutical industry and the alternative industry. The difference is that at least some of the products of the former do some good. I wonder if you will opt for a herbal general anaesthetic if you need a hip replacement. Or homeopathic treatment if you are unfortunate enough to get malaria.

• 40 bigpharma-bigbucks // Apr 18, 2008 at 09:32

  Ah I see you are now acting as spokesman for me now David. Not necessary, as I am quite able to put forward my own view without your censorship. oh sorry, its “moderation” isnt it….

  You and I both know that my posts were most definitely not repeating things, and even if they were, this is allegedly a forum for discussion isnt it? Or just a shop window for your own belief system and biased rantings?

  Strange how those who are allegedly seeking truth have to suppress the views of others who may be as eloquent as themselves in expressing a different view.

  I guess looking at other views is not part of your agenda and easy targets are the best you can do, so my challenge will remain unanswered for now.

  What is funny is that you felt the need to comment on my 2 posts anyway, as if that in some way justified your censorship, and avoided me directly accusing you of ignoring them, and thus compromising your own self image as a “truth seeker”.
  And bravo for the tired cheap shot at the end, knowing full well that you wouldnt print my response anyway. For the record, you should understand the difference between surgery and practice of medicine for non urgent disease. I also would not want my NHS GP to perform surgery on me. (incidentally hypnosis was used extensively AND successfully for anesthetic purposes as far back as the 19th century), and I would certainly not be getting ANY vaccinations for malaria having seen what is in them, though its unlikely I would need this in this part of England.

  Perhaps I will just forward my comments to others on this forum direct as you have not afforded me the courtesy to do so.

• 41 Dr Aust // Apr 18, 2008 at 17:39

  You are safe, BP-bb. There are NO vaccines available for malaria. If there were, perhaps we could save some of the millions round the world, notably in Africa, who suffer and die from the disease.

  If you go on a trekking holiday to a malarial part of Thailand, we Pharma-Shills would recommend prophylactic antimalarial DRUGS (see threads passim). That’s what I take for trips to malarial regions, anyway.

  If you want to take a useless homeopathic remedy instead, I hope you are lucky and do not get bitten by a malarial mosquito. I also hope you don’t come home to clog up our local tropical diseases unit with an eminently preventable disease brought on by stupidity.

• 42 bigpharma-bigbucks // Apr 19, 2008 at 00:50

  New malaria vaccine raises high hopes

  Prospects for a malaria vaccine have been boosted by “tantalising” results from a trial in 2000 children in Mozambique. Although the vaccine reduced the risk of infection by only 30% compared with a control vaccine – this is far better than any previous result.

  “With 300 million people in Africa with malaria, a 30% reduction in infection is pretty substantial,” says Ripley Ballou, vice president of clinical development at GlaxoSmithKline (GSK), the company co-developing and testing the vaccine.

  Even more impressive, say the investigators, is that the vaccine reduced the risk that the children – aged one to four – would develop the most severe and lethal form of malaria by 57%.

  Better still, the risk of severe disease in recipients aged less than two saw a 77% reduction. The investigators are delighted by this because, ultimately, they want to give the vaccine to infants in their first year of life to maximise early protection.
  Orders of magnitude

  “We’ve found these results to be quite tantalising,” says Pedro Alonso of the Hospital Clinic of the University of Barcelona, and head of the team. “This is clearly the best result we’ve seen with a candidate malaria vaccine,” he said in a press briefing, organised by the international Malaria Vaccine Initiative, GSK and the Bill & Melinda Gates Foundation.

  The vaccine attacks Plasmodium falciparum – the parasite which causes malaria – at the early infection stage, when it has just been injected into human blood by the bite of a carrier mosquito.

  The vaccine, named RTS,S/AS02A carries two short proteins, called RTS and S, mimicking a key surface component of the sporozoite usually recognised by the immune system.

  Incorporated into the empty shell of a hepatitis B vaccine, the new vaccine is thought to trigger production of antibodies and white blood cells that recognise and neutralise the sporozoites.
  Manifestation decreased

  “It works by preventing the parasite from emerging from the liver, or at least diminishing the load of parasites emerging,” says Joe Cohen, inventor of the vaccine at GSK.

  “The next parasitic stages are controlled and manifestation of the disease is greatly decreased,” he adds.

  The development partners hope to begin larger, phase III trials as soon as possible, working steadily towards the goal of a vaccine for infants. “One million children under five die each year from malaria,” says Melinda Moree of the Malaria Vaccine Initiative.

  Journal reference: The Lancet (vol 364, p 1411)

  So with the greatest of respect “DA” …fuck you!

• 43 Dr Aust // Apr 19, 2008 at 12:25

  Very erudite sign-off, Bp-bb.

  And I’m surprised and delighted to see you approving of the efforts of BigPharma, in the form of the GSK vaccine development operation.

  Yes, there is an experimental vaccine in development. (“Experimental” is the key word missing from the headline of the story you cut and pasted – lazy journalism.) That is not what I call a vaccine, in its normal sense of “something non-experimental, widely available, and which offers a reasonably high degree of protection against the disease”.

  When (if?) the experimental vaccine is actually finished trials, and licenced for mass production, it will be “a vaccine”.

  There have been many attempts over the years to develop a malaria vaccine, sadly all unsuccessful. This is the latest try.

  If it actually does make it through Phase III trials (not a certainty) it will be a big improvement on “no vaccine” for people in malaria-endemic areas, though only a stage on the road given the very partial protection it appears to provide.

  The wider point is that I actually understand the difference between “an experimental treatment in the research stage” and “a fully tested and validated treatment ready to be rolled out”. Your statements on this and other threads make it very clear that you do not.

  Incidentally, for people from malaria-free countries like the UK travelling to malaria-endemic areas, a vaccine like this is quite clearly NOT going to replace malaria prophylaxis with drugs even if it is gets to the market.

• 44 David Colquhoun // Apr 19, 2008 at 16:07

  I guess I should have referred to homeopathic, or acupuncture general anaesthesia, not herbal. Nevertheless, I expect that Bp-bb would opt for something like halothane rather than opium and henbane.

  I don’t think anyone disputes that herbal things can be effective, and there is evidence that a few actually are effective. But not many. Herbal medicine is, in my view, just pharmacology circa 1900, from the time before it was realised how to do proper clinical trials, and the time before it was realised how important it was for the patient to standardise potency.

• 45 Anna // Apr 24, 2008 at 11:23

  Nice post

• 46 bigpharma-bigbucks // May 2, 2008 at 11:13

  Typical response I would expect. unfortunately your poor attempts at mind reading of myself are most unscientific. If you had read one of my (uncensored by yourself) posts you would see I wrote
  QUOTE: I also would not want my NHS GP to perform surgery on me. (incidentally hypnosis was used extensively AND successfully for anesthetic purposes as far back as the 19th century), END QUOTE.

  Rather than sarcasm about herbal remedies many of which are very effective, how about looking at killers like aspartame, which only got FDA approval because Donald Rumsfeld was Searle Chairman.

  And Im guessing these clinical trials are the same ones that allow around 40,000 Britons each year to die from reactions to prescription drugs? And the 150,000 which are disabled or need hospital treatment after taking a drug?
  And lets not get into thalidomide, or pemoline (took 23 years to realise liver toxicity), ketoconazole (took 15 years to realise it caused heart complications). The list goes on…
  And how many clinical trials take into account combinations of drugs?

  For a site which claims to look at bad science, all Ive seen is smugness and unflinching belief that science has all the answers.
  Which it doesnt…

• 47 David Colquhoun // May 2, 2008 at 11:29

  The one thing that is blindingly obvious is that science has not got all the answers,

  The difference is that scientists, unlike bigpharma-bigbucks, don’t feel free to invent the answer when there is none.

  The irony is that BB resembles rather closely the marketing people in the pharmaceutical industry that he loathes so much. They too feel free to invent evidence if there isn’t any, and to misrepresent what evidence there is.

• 48 bigpharma-bigbucks // May 2, 2008 at 18:23

  {Another long post cut down, because it is getting so repetitive DC]

  And you still havent provided any evidence that alternative treatments dont work as requested in my censored post.

• 49 David Colquhoun // May 2, 2008 at 20:49

  I just had to post the final sentence of BB’s last long submission, because nothing shows more clearly his/her lack of comprehension about how one goes about separating truth from fiction,

• 50 drsquared2b // Sep 28, 2008 at 15:38

  Have we (UCL) been infiltrated? UCLU now has a new complementary medicine society (although the UCLU website seems unsure whether their medicine is complimentary or complementary…). Their events include regular case discussions with students/staff from Westminster. See
  http://www.freewebs.com/uclucomplementarymedicine/index.htm
  I’m appalled. Why has UCLU accepted their affiliation?

• 51 David Colquhoun // Sep 29, 2008 at 22:32

  drsquared2b. Yes I had a horrified mail from an undergraduate a while back when she discovered this society, but nothing can be done about it. It makes one worry about the selection process a bit though. I just hope their medicine is better than their spelling. I called in on their stand at the Freshers’ Fayre [sic] and may get invited to speak there. If so please come and bring your friends. I may need allies.

• 52 notawitchdoctor // Nov 11, 2008 at 23:28

  Funny seeing a ‘colleague’ being so angry on this thread. I’m not sure what that is about. We are all here to be in dialogue with each other. Herbalists are a funny bunch, and many of them make me question my profession. However, be assured that not all of us are as angry as bp-bb. I’m not angry at all. Just curious as to how we can bring plant medicines into the 21st century.

  I would like to say this: Medicine should be first and foremost about compassion. I don’t care about anything but human beings getting first-class health-care. The NHS does not have the resources to care for everyone. I worked in the busiest surgical ward in my local hospital for 3 years and saw the short-comings of the system: Old people not being fed or given something to drink, medicines being badly prescribed by junior doctors, pharmaceutical toxicity, problems with surgery, psychological problems not being dealt with…. etc etc, ad infinitum.

  I came home from my job on many days and cried at the sheer frustration of not being able to help the people I wanted to help. For the ‘anti-woo’ set: there are SO many shortcomings in modern orthodox medicine. These need to be addressed properly.

  I have a dream that one day people will be given the care they deserve, in private rooms, with proper consultations by specialists who have time to talk to them and doctors and nurses who can support this work. For all of the skeptics: in the meantime, some of us do really care what happens to people when they are ill and we are investigating every way we can make their suffering a little less. If I can help one of my patients feel better, I consider what I do a success.

  Perhaps academic discussions about evidence are moot when you consider the scope of human suffering? I find this a very difficult subject. Dr. Colquhoun?

• 53 Alan Henness // Dec 13, 2008 at 00:41

  Any progress in getting invited to talk to the complementary medicine society? Maria and I would love to come to support you!

• 54 David Colquhoun // Dec 14, 2008 at 07:04

  Well I offered but so far they have had only George Lewith and a Christmas visit to the RLHH, so I’m not holding my breath.

• 55 Dr Aust // Dec 14, 2008 at 10:34

  I suppose George L is the sort of acceptable academic face of homeopathic apologism. Personally I lost any respect for him when he started making noises about how double-blinded placebo trials were not an adequate way to assess CAM interventions.

  Perhaps he combined the talk with one of his visits to his Harley Street alternative clinic?

• 56 JNB // Jan 20, 2009 at 22:00

  Hi DC,

  Thought your readers might chortlee at the following The Daily Mash (http://www.thedailymash.co.uk/news/health/complementary-therapists-to-be-regulated-by-witch-doctor-200901201522/):

  COMPLEMENTARY THERAPISTS TO BE REGULATED BY WITCH DOCTOR

  STRICT standards must be applied to alternative medicine, according to the voodoo priest who will run the UK’s complimentary therapy watchdog.

  Haitian born Papa Limba said his first task as chairman of the Complementary and Natural Healthcare Council would be to identify which therapists were righteous shamans and which had the bad juju.

  But the witch doctor stressed the therapists would be judged not on the effectiveness of their treatments but on the strength of their mogambo.

  Limba said: “There are many frauds and not everyone has as strong a connection to the serpent god Demballa as they like to make out.

  “I place my hands on their head and if their spirit vibrates to the rhythm of the ocean I give them a sticker to put in the window. If not I rub them with the mashed root of the banyan tree and we never hear of them again.”

  He added: “Once a year I shall visit them and cast my chicken bones on their consulting room floor. If they are still there a week later I report them to health and safety.”

  A CNHC official said all applicants would be judged on the four key elements: earth, fire, water and the age of the magazines in their waiting room.

  Homeopaths will be able to apply for accreditiation by visualising the application form and then beaming their thoughts down the nearest ley line.

• 57 Pilocarp // Jan 25, 2009 at 08:48

  How very sad to hear of the trials and tribulations of poor UC Pharmacology. I was so sad to hear of the departure of the mechanical genius from the basement, whose father had also worked with previous generations of UC physiology “greats”. Another irreplaceable resource lost.

• 58 steve reid // Feb 24, 2009 at 21:08

  David I stand corrected: irascible is much preferable to jaudiced. I look forward to Bonnie Prince Charlie’s revelations.

  HeadtoHead (BMJ)
  [DC comment. This refers to the HeadtoHead blog]

• 59 oldboy // Mar 17, 2009 at 11:15

  Eager to support EPSRC’s new “Three strikes and you’re out” policy (http://www.epsrc.ac.uk/ResearchFunding/HowToApply/Exclusions.htm), I have the following suggestion:

  “Blueprint of events for an EPSRC bootcamp”

  1. Crossing the critical path: an example from aeronautics

  This pod will comprise two minutes of dart throwing at an image of a well-known scientific leader to be chosen following “cess-pit” discussions within the group. Three bulls and you’re out will apply only to the boot-camp delegate, the scientific leader being immune to all challenges.

  2. Interdisciplinary chanting

  Going forward from the aeronautics challenge, this pod will build on the team-working skills developed in Pod 1 by enabling delegates to bark collectively into the wind until either (a) they, as a unit, see the error of their non-pan-industrial ways or (b) there is a change of government, whichever is the longer.

  3. The lab. diary room
  When the previous two pods have been successfully passed, each delegate will have the opportunity for personal reflection and immersion in the lab. diary room. There will be ample opportunity for one-way discussions with a leading policy maker, who, drawing on CIA seige strategy, will sing “you’re not laughing over there” for a period not less than fifteen minutes.

  4. The signature
  In a final act of contrition, each delegate will sign the creed of re-alignment with best industrial practice and be immediately re-deployed as a Business Development Executive.

• 60 Arsenicum // Apr 10, 2009 at 14:53

  Hi Just registered, wow what can I say, I have a place to post my blogs now. I love the fact there are still people who believe the fact that because you cannot understand the science behind it, it cannot work.
  You must all be anti-depressant swallowing junkies, and thank god we now have evidence based science behind homeopathy. I am a student of Homeopathy and a qualified Nutritional Therapist who is currently doing a MSc in Nutritional Therapy. Accept the fact that not everything should be medicalised, if a baby has colic give the mother a tea to help, instead of the sugar laden chemical cocktail found in the chemist.
  Remember our bodies are not designed to metabolize the ongoing ingestion of chemicals and suppressants the medical profession churn out willy nilly.
  Look forward to your comments, oh yeah Ben goldacre if you read this please respond, Im in the mood for a good arguement.

• 61 andrew // Apr 10, 2009 at 19:43

  Hi Arsenicum. You say “thank god we now have evidence based science behind homeopathy.” Could you let us know the details of the evidence please ? Thank you.

• 62 David Colquhoun // Apr 10, 2009 at 19:49

  OK Arsenicum, here are a few things for you to think about.

  (1) If you knew anything at all about pharmacology, you would realise it is quite common for the mechanism of action of drugs not to be known.  What matters is that they are tested properly.  Most of the things that you sell are either not tested or have failed tests.

  (2) If you had read anything that I (or Goldacre) writes, you’d have known that we absolutely oppose the tendency to medicalise everyday life.

  (3) The tendency to medicalise everyday life has been encouraged by some big pharmaceutical companies.  But the worst offenders by far is the alternative medicine industry,  and in particular, nutritional therapists.  They specialise in giving people tests, often fraudulent, on the basis of which they sell you a lot of expensive supplements that you don’t need and won’t help you,

  (4) The extreme wing of the nutritional therapy business kills people.  It is estimated that AIDS denialism, encouraged by Matthias Rath’s efforts in treating AIDS patients with vitamins, has cost 300 000 lives.  You can read all about it here. That isn’t medicine, It is homicide. 

  I wonder how many of these things you learned on your course? Not much, I’ll bet,  If hope your course wasn’t anything like this one at Westminster University, or this one at Thames Valley University, because they have become a bit of a laughing stock since it was revealed what they actually teach (watch this space for more).

  Perhaps you should consider suing your college for misleading you about the what’s true and what isn’t.

• 63 John Hooper // Apr 14, 2009 at 18:06

  At least Arsenicum got the first four letters of his/her alias correct and rather neatly summarised his/her contribution.

  If a baby has colic what is the point of giving the mother a cup of tea ?

  And if our “”"bodies are not designed to metabolize the ongoing ingestion of chemicals”"” what are we supposed to do for food ? These quacks seem to constantly ignore the fact that food is made out of chemicals.

• 64 Mojo // Apr 14, 2009 at 20:31

  “If a baby has colic what is the point of giving the mother a cup of tea?”

  It’s probably something to do with “quantum entanglement”, or something. To quote Lionel Milgrom:

  “If that is the case, then perhaps you have to consider the owner and the animal as an entangled entity. Ergo if you gave the remedy to the owner, would it have the same effect? I was giving a talk down in the South West recently and apparently there is a vet down there who works in that way, which I find absolutely fascinating.”

• 65 andrew // May 15, 2009 at 17:58

  congratulations on succesful move to new server!

• 66 carlos // May 28, 2009 at 12:32

  Hello all,

  I have just read all the comments, and this is all nonsense…

  Science is a library of all the things there are to known…
  Its all a question of what books have you be reading in that library.

  Homeopathy is not a question or discussion between believers and non-believers, Its a question and discussion between knower’s and non-knower`s.

  Start reading the Scientific literature, first, and then come and discuss Homeopathy.

  Homeopathy, was already proven (Scientifically) more than once.
  In 2003 the Physica A (for who who don`t know- is the best Scientific journal, where all the new scientific discovers are published) published an article that finally proves the Scientific evidence of Homeopathy, and how homeopathy works above the Avogrado`s number.
  The Memory of water by Louis Rey (he also didn´t believed in Homeopathy, and was a major critic of Homeopathy)

  This article is on internet, you can all look for it and read something Scientific.

  As a MD it is sad to see so much ignorance and personal persecution for Homeopathy…

  Maybe there are many interests to defend, or afraid of something to happen in a near future…

• 67 Dr Aust // May 28, 2009 at 15:04

  Dr Rey’s work did not in any way prove homeopathy. Indeed, it didn’t claim to. It simply purported to show, using one particular thermoluminscence technique, that there appeared to be a difference between water and a homeopathic remedy. This has been widely and inaccurately touted by homeopaths as demonstrating that the memory of water is a fact, and that therefore (they infer) the rest of their mumbo-jumbo must be true too.

  Rey’s work was not (technically speaking) a particularly well-controlled experiment, and the method he used (which essentially depends on freezing the sample, then irradiating it, and finally rewarming it and examining thermoluminescent emissions) offers many possible sources of artifacts and/or explanations. One of the most notable is that the method relies on thermolumininescent emissions generated at “irregularities” in the crystal structure of the frozen sample. If lots and lots of shaking causes gas micro-bubbles, which is quite plausible, then a “more shaken” sample might be expected to produce different results in a thermomluminescence experiment. This would not, note, show that the sample had a “memory of dissolved solutes”. Just that it had been shaken harder.

  As ever, homeopaths will believe what they want to believe. That is how faith-based positions work.

• 68 physicsmum // Jun 6, 2009 at 14:30

  The link between mother and baby is not so mysterious, especially if the baby is being breast-fed! Not sure about the tea, but when my baby had colic I was told to eliminate dairy products from my diet, by the conventional medical establishment. Hard cheese, as they say!! Funny thing about cause and effect, though, the day I was going to cut out my beloved cheese, the colic suddenly vanished on its own. One day earlier and I would been convinced it was dairy, and suffered without for months! Oh, and I do drink lots of tea……

• 69 bigpharma-bigbucks // Jul 16, 2009 at 13:24

  Ah Mr Colhoun
  I see that you have finally seen the light and decided to join the alternative medicine crowd by becoming a committee member of the Complementary and Natural Healthcare Council http://www.cnhc.org.uk/pages/index.cfm?page_id=98

  Well done for seeing sense at last!
  Or as CNHC is so closely associated with FIH, are we just after a knighthood perhaps?

  I wonder if your colleagues are aware and if this comment will be censored like many others?

• 70 David Colquhoun // Jul 16, 2009 at 14:35

  Oh yes, everyone knows. I announced it on the blog. I gather that I was appointed to the Conduct and Competence committee because I have some experience in assessing evidence. It is proving to be a quite fascinating job.

• 71 Chris // Jul 21, 2009 at 16:38

  “EU inquiry pours doubt on benefit of health foods – EFSA has done good job on nutriquacks”.

  To see a list of the reports (in a couple of cases they did find that the evidence submitted supported the claim), go to the EFSA website at http://www.efsa.europa.eu/EFSA/efsa_locale-1178620753812_ScientificDocuments.htm
  and in the box labelled “search for term” type:

  1924

  (This is the number of the European Regulation under which the reports are made).

• 72 Lindy // Jul 24, 2009 at 18:36

  I find the piece in the Independent ( miniblog) about the resignation of City’s VC, Malcolm Gillies, is quite shocking and I feel it has wider implications for universities everywhere in the UK. Says it all: money first, education and truth afterwards.

  The university’s website already has the name of the new acting VC, but I shall be sending an e-mail to vicechancellorsoffice@city.ac.uk

  but I will address the comments therein to Malcolm Gillies expressing support for him and his approach etc.. If several people do this it will at least be a bit embarassing.

• 73 harradine // Jul 26, 2009 at 23:38

• 74 epigenetics // Oct 15, 2009 at 22:47

  just an update. If that ex chiro student from NZCC is Jonathan mann, perhaps you should check out the NZ Sunday Times website for fake physio clip. he as a student of NZCC but was booted out for false academic records. He then enrolled at Osteopathy school at Unitec and kicked out of there as well. Finally set up as a unqualified and unregistered physio at a auck clinic. Thats one pathological liar, and I’m sure David slowly worked out that one out and hence why you cant find the article. It kind of sums up the depth and integrity of Davids Dr Who article is the NZMJ. keep up the good work

• 75 David Colquhoun // Oct 16, 2009 at 08:23

  @epigenetics
  Very interesting, but it wasn’t Jonathan Mann

• 76 epigenetics // Oct 20, 2009 at 06:17

  hey blogs, google the following case. It came about when the AMA tried to push the quackery committee. A bit like the tone of Singh, but no, its all about Singh’s freedom of speech of course bla bla..the Singhs to David Colquhoun’s of this planet just need a perspective change, its not the title Dr,lack of evidence and all that rubbish. Chiropractic is everywhere, you prove it wrong with your evidence based shoes, and whilst you trip and stumble around, individual results will tell a different story, like the Wilk trial

  Wilk v. American Medical Association, 895 F.2d 352 (7th Cir. 1990), was a federal antitrust suit brought against the American Medical Association (AMA) and 10 co-defendants by chiropractor Chester A. Wilk, DC, and four co-plaintiffs. It resulted in a ruling against the AMA.

• 77 patientscomefirst // Nov 22, 2009 at 10:19

  Mr Colquhoun… I can’t see your response to ‘Notawitchdoctor’. Would you be so kind as to post your response…many thanks

• 78 David Colquhoun // Nov 23, 2009 at 07:11

  @patientscomefirst
  One reason for not having replied to NAWD is because I have been a patient myself, and I’m still recovering: http://www.dcscience.net/?page_id=1621#neph1 That experience has been quite helpful in formulating an answer.

  NAWD says “I would like to say this: Medicine should be first and foremost about compassion.”. I simply disagree. Medicine is first and foremost is about getting people better who would otherwise be ill. It turned out that I had an early stage renal cancer. In all probability I owe my life to the smart people who first spotted it during imaging, and the smart surgeons who got it out before it had time to do much harm.

  As it happens, both physicians and surgeons were compassionate too, As I have said, the attitude of everyone at the Royal Marsden was wonderful. They know how to make you feel better when you are a bit down. That is wonderful, and greatly appreciated, but it is no substitute for knowing your stuff.

  If I had gone to the most compassionate herbalist in the world, I’d probably have died quite soon of metastatic renal cancer. If that had happened it would be a result of people saying things like “Medicine should be first and foremost about compassion.”

• 79 daijiyobu // Dec 10, 2009 at 04:05

  Great. Sounds like education standards are higher in the UK than here in the US, where alt.med. universities can sell completely nonscientific belief systems as “science” degrees with complete impunity and complete accreditation. With help from State and Federal Dept.s of Education, I might add.

• 80 toots // Dec 23, 2009 at 19:38

  Medicine should be first and foremost about compassion?

  No. Compassion may or may not be an effective “medicine” for what is essentially or primarily emotional pain, but for strictly physical medical conditions, first and foremost what is required is a physical solution. Compassion in these cases is a sad second best.

• 81 oblio421 // Dec 30, 2009 at 21:38

  People die everyday because of charlatans and their magic potions. People must be aware of that.

• 82 mortaucons // Jan 9, 2010 at 07:33

  Dear Pr. Colquhoun.
  As a homeopath physician, I’d like to say here how much I agree with you. We share certainly the same love for science and strictness. I’m very interested to read the comments left on your blog.

  For example, when you write « Medicine should be first and foremost about compassion. I simply disagree. Medicine is first and foremost is about getting people better who would otherwise be ill », you’re almost quoting Hahnemann himself. He writes in §1 of the Organon :

  « The physician’s high and only mission is to restore the sick to health, to cure, as it is termed». I hope nobody here disagrees?

  Talking of compassion is sweet, but in no way medical. Of course compassion should be there within the physician, otherwise we become nothing else but technicians, but first we have to learn to have a neutral attitude.

  I’m fighting everyday against the intrusion in the field of medicine of “doux rêveurs” as we say in French. Certainly some of them are loaded with good intentions but I’m afraid that consulting people longing for compassion in a comfortable study, is somewhat different from the reality of suffering people, the hospitals, the emergencies.

  Ready to believe anything, most of these people lack of discernment, not unlike people taking cannabis. Prone to syncretism, they mix up many theories: the “astral influences”, “graphology”, so-called interpretation of the brain scanners, magic thinking, and so on.

  Here I can’t resist quoting Hahnemann again, in his note to §1 about the physician’s duty:

  “His mission is not, however, to construct so-called systems, by interweaving empty speculations and hypotheses concerning the internal essential nature of the vital processes and the mode in which diseases originate in the interior of the organism, (whereon so many physicians have hitherto ambitiously wasted their talents and their time); nor is it to attempt to give countless explanations regarding the phenomena in diseases and their proximate cause (which must ever remain concealed), wrapped in unintelligible words and an inflated abstract mode of expression, which should sound very learned in order to astonish the ignorant – whilst sick humanity sighs in vain for aid. Of such learned reveries (to which the name of theoretic medicine is given, and for which special professorships are instituted) we have had quite enough, and it is now high time that all who call themselves physicians should at length cease to deceive suffering mankind with mere talk, and begin now, instead, for once to act, that is, really to help and to cure”

  If junkies start dealing with mechanics, can they do anything but junk-mechanics? Do we have then to attack and destroy mechanics? I suggest to be careful not to throw the baby out with the bath water.

  If time allows, it’ll be a pleasure to write here again, if my clumsy English is not too repulsive :-)

  I wish you a speedy recovery.

• 83 Chester Acupuncture Clinic // Feb 20, 2010 at 12:17

  It seems unlikely that given the logevity of acupuncture and its widespread and regular use that it can be explained away by pure science

• 84 David Colquhoun // Feb 20, 2010 at 16:08

  Normally I would delete an obvious advertisement like that from Chester Acupuncture Clinic. But the comment is so garbled that I can’t resist leaving it.

  I presume though, that it is intended to mean that it has been around a long time, so it must be true. Well, christianity and islam have been around for a long time too, and they aren’t both true.

  In addition to that, acupuncture in its present from has not been around for a long time. It is essentially a post-war invention used by Mao Tse-Tung as a means of promoting Chinese nationalism (though he is reported to have preferred more effective medicine himself).

• 85 Lindy // Mar 12, 2010 at 09:13

  Reading the miniblog ‘Ghastly report from WHO’, I am wondering whether I’ve been in a time warp and that it is April 1st already!

  It reads like a total micky-take, with stuff about gratitude to Lombardy for hosting the meeting and then all the serious sounding nonsense. What a con! How can we have faith in WHO’s workings when they produce this stuff?

• 86 toots // Mar 16, 2010 at 21:30

  Re 84/85
  The preface to the appalling WHO document “Safety issues in the preparation of homeopathic medicines ” contains the following:

  ‘The resolution on traditional medicine adopted by the World Health Assembly
  (WHA) in May 2009 (WHA62.13),1 urges Member States to “formulate national policies, regulations and standards, as part of comprehensive national health systems, to promote appropriate, safe and effective use of traditional medicine.”‘

  The appalling author of the said document is Dr Xiaorui Zhang, anointed and appointed by the WHO, so it would seem, to extend the posthumous writ of Chairman Mao around the globe by seeking to integrate anti-scientific traditional gobbledegook with scientific medicine.

  This is the person responsible for producing a WHO report on acupuncture which even the Medical Director of the British Medical Acupuncture Society condemned as being “highly biased” saying “this unsystematic review cannot be used to support the contention that acupuncture is efficacious”.
  http://beta.medicinescomplete.com/journals/fact/current/fact0803a02t02.htm

• 87 toots // Mar 17, 2010 at 21:37

  I should clarify that Zhang was author of the preface to the WHO homeopathic document.

  The World Health Assembly resolution WHA62.13 follows on from the Beijing Declaration 2008
  http://www.un.org.cn/cms/p/news/27/868/content.html

  A relevant European regional WHO document here is EUR/RC59/6:
  “Several EU countries are supporting WHO’s traditional medicines programme, and there are a number of WHO collaborating centres in the European Region.
  Research and development programmes in Europe also address the effectiveness and safety of TM, and this could be further expanded within the global strategy on public health, innovation and intellectual property.”
  http://euro.who.int/document/rc59/rc59_edoc06.pdf

• 88 altest // Apr 7, 2010 at 09:45

  Test comment

• 89 isobelmat // Apr 13, 2010 at 14:43

  I have just joined this site and, I must say I have really enjoyed reading such a range and variety of entries. I have an MSc in Social Science Research and am a qualified paediatric nurse and Health Visitor. I am also a qualified acupuncturist. So, I am reading about many things that not only interest me but also relate to my work. Until I have read more though, I shall reserve comment, except to say that whatever the background or discipline the truth of medical practice is, surely, first do the patient no harm? I have seen immense (and I mean dreadful) harm done in 32 years of NHS practice: I have seen the most spectacular results, too, from brave practitioners who defied science and did all they could to save a life. Amazing stuff. I have also worked with CAM therapists that I would not let look after a rice pudding, let alone an illness, as well as therapists who are smart, on the ball and getting good results. I have nursed very sick children who did not survive the most robust treatment, and children who should have died and didn’t. I have, as an acupuncturist, seen patients recover from stuff that has had me scratching my head and patients not respond to the most rudimentary intervention. I don’t know what the answer is. Hiding from the clinical gaze is not good but, neither is taking the moral/intellectual high ground. On either ‘side’, even though I don’t consider myself to be on any ‘side’. However, I am looking forward to some engaging and informative times on this site. Thanks.

• 90 David Colquhoun // Apr 13, 2010 at 20:40

  @isobelmet

  I’m delighted that an acupuncturist finds something of interest here. I’m not against acupuncture or any other sort of alternative medicine, just against treatments that don’t work. That includes some conventional treatments too.

  Your observations are interesting, but sadly simple observations are not sufficient to tell whether or not a treatment works, because so many conditions get better without any treatment at all.

  As you say, it is important to do no harm, but that is a very minimal criterion. The aim must be to do positive good, whenevr that is possible (sadly not always).

• 91 isobelmat // Apr 14, 2010 at 10:06

  I am interested in your challenge to universities issuing degrees in various therapies. When I did my acupuncture training I did not want a degree – I already had two – but that was what was available. As a former senior lecturer I had concerns about the academic process and standards, which is not to say that the underlying Chinese philosophy did not have rigour. Rather, trying to make very different paradigms ‘fit’ each other is not necessarily a good thing. As a social scientist I am used to the conflicts around this issue (sociology is not scientific, say the chemists, for example) and to a certain extent I have come to agree to differ. However, you are right to bring questions to the table. Maybe with not quite as much hostility, perhaps, but I note an equal amount of hostility from CAM people, too. Doing positive good is a worthy ideal but, as a practitioner of some years standing, I realise what I believe is good for the patient is not always shared by the patient. Nobody can dispute the advantages of breastfeeding, or of not smoking, but somehow or other neither of these messages have got home to patients (including health professionals as patients), or policy makers. The human condition is not easily encapsulated, but seemingly easily manipulated. As I said before, I don’t know. And I often tell my patients that, too. Accusations that CAM practitioners are all liars is a little inflammatory! Yes, often things will get better on their own, many conditions are self limiting. Both camps, if you like, are guilty of generating business. As an acupuncturist I work a lot with people having IVF and am dismayed at the level of intervention ordered for people who are being made to feel inadequate and lacking. As a HV I spent far too many hours with parents who cared nothing for their children yet my ‘performance’ was judged on the amount of time I wasted on them. The point I am trying to make is that scientific evidence is all well and good but, translating it into meaningful, effective practice is hard, wherever you come from. Allopathic medicine needs to accept there IS a placebo effect, there IS some kind of therapeutic interaction between the practitioner(s) and patient, and that patients individual experiences are part of the healthcare continuum. I am not saying it’s easy, though!

• 92 David Colquhoun // Apr 14, 2010 at 12:10

  @isobelmat

  I have never accused all CAM practitioners of being liars. Many I have met are obviously quite sincere in their beliefs. Oddly enough, I get the imprssion that the dafter the belief the more sincere the believer. Homeopaths and crysral enthusiasts seem quite sincere. At the other extreme, nutritional supplement salesman seem often to be in the business just for the money. There is an interesting chapter in Robert Park’s Voodoo Science on this topic: the road from delusion to fraud.

  I see that you use acupuncture with IVF. Does it not worry you that the latest analysis shows it to be ineffective?
  http://www3.interscience.wiley.com/journal/120847906/abstract

• 93 isobelmat // Apr 14, 2010 at 18:26

  Thanks for the reference. There are conflicting reports about the efficacy of improving conception with acupuncture and IVF. Southampton Uni’s meta analysis felt is was a worthwhile intervention (cf. BMJ Aug 2008). However, acupuncture, as in sticking needles in, is only a part of the cannon of Chinese medicine. I will freely admit that I give the same advice re: lifestyle changes, treatment co-operation, sex activity, as I did as an HV. No contest there. But, many women find their periods become regular or sleep improves or stress responses drop when I combine it with sticking pins in, and that didn’t happen to the same extent when I didn’t stick pins in. I’m not claiming anything special. I frequently treat for free, as I am aware of the very high expense people go to with IVF. Does it not worry you that the NHS spends millions a year on an intervention that is, at best, only 35% effective and shows only minimal improvement year on year? I can’t think of any other service offered at public expense with such poor results. Cardiac units with better rates have been shut on the grounds that they are not worth the cost, and my specialist area as a nurse (neonatal intensive care) has frequently been responsible for increasing the degree and incidence of chronic neurological/developmental problems without closer scrutiny of the interventions used. Health care the world over is complex and becoming increasingly sophisticated in the messages given to practitioners and users alike. As a researcher, I spent many hours on literature searches and was astonished at the amount of unmitigated b****cks published in learned journals, all in the game of research. I also saw work that was ‘edited’ to suit the prof or funders or to get someones membership passed. I was not popular. If any acupuncturist claimed they could cure it all, or that it was the best, I would give them a wide berth, and advise others to do the same. There is room for intelligent debate (not rude defence) but, where widely different paradigms exist, there is also room for misunderstanding and arrogance – a claim to know the absolute truth. Nobody has the right to do that on behalf of anyone, let alone vulnerable, confused or frightened patients. BTW, there are far weirder things than homeopathy or crystal healing out there. Trust me. I’m an acupuncturist. Namaste.

• 94 Felix // Apr 18, 2010 at 22:51

  Just had an idea for a website based upon your excellent work:

  “So you want to be a Quack?”

  Which could list all the educational institutions in the UK teaching altmed bollocks.

  If a wiki format was used then the workload could be crowd sourced.

  And the site could be a ‘Wikileaks’ for educational material from these courses.

  What do you think?

  VinylTiger

• 95 Michael Kingsford Gray // May 9, 2010 at 09:37

  @isobelmat:
  I have a bridge for sale.
  No, honestly!
  I am a Nutritionist, would I lie to you?
  In fact, this bridge is rather special, as it generates ~AU$32,500 per day in tolls.
  I have to go to Nigeria to cure AIDS patients with acupuncture, and due to strict tax rules, I need to ‘park’ it in someone else’s ownership for 3 years or more. You can keep the revenue. All I ask is that you deposit AU$500,000 into my bank account as a refundable deposit. You seem like the kind of intellect that can spot a great opportunity such as this.
  What do you say?

• 96 isobelmat // May 9, 2010 at 11:25

  Thank you, Michael. I came to this site so I could access some of the sharp thinking associated with great minds of science. I wanted to add to my knowledge as well as engage in honest, open debate. I had been led to believe this is what clever people do, so I sought out clever people (given that I am, clearly, not one of Them). And so I remain Not One of Them, as your comments might indicate that I was mistaken in my beliefs. Who knows what else we can be mistaken about? Isn’t life exciting….

• 97 Teige // May 9, 2010 at 14:44

  isobelmat,

  When deciding whether acupuncture is worthwhile for IVF, which is more important: your recall of your own experiences, or a ctritical look at the quality of all trials and the validity of their conclusions?

  Perhaps you could keep detailed records for all your patients, with objective outcome measures and avoiding the liability of patients telling you what you want to hear and the bias of only recording notable examples.
  That might help you with your decision-making. But you must accept that your judgement alone is fallible and has its place.

• 98 isobelmat // May 9, 2010 at 18:28

  Yes, I agree clinical audit is a vital part of generating evidence. However, the clinic I previously worked in felt it was a waste of my salary to give me time to design and run proper audit tools (a common complaint from those who do not know what they are talking about). I intend to do it in my own practice, which is just getting going in a different location. Naturally, if I can enlist the support of a range of IVF clinics, this will be a much better exercise than just my caseload. Any suggestions on how I can convince them it might be worthwhile joining forces? It’s because I know (not merely ‘accept’) that my judgement alone is not a basis for disseminating good practice that I feel this must be done.

• 99 isobelmat // May 9, 2010 at 22:19

  Michael. I note your blog spot and have tried to access it so we could maybe discuss one or two things off this site (as an non-theistic person who recognises god). However, it seems to be impossible to access your blog. I have tried many times, and have been sent lotsa passwords and codes and things and STILL and I can’t get to speak to you. Spooky, eh? Or is it a way of keeping us heretics out? Anyway, how can I contact you to engage in, hopefully, meanigful dialogue.

• 100 isobelmat // May 9, 2010 at 22:20

  Sorry. Meaningful. Bit too much communion wine.

• 101 Avoided Cranium // May 9, 2010 at 23:31

  @Teige
  You are quite right to question subjective impressions of the efficacy of some unproven intervention, and look to proper research and systematic reviews as a way of eliminating bias or even self-delusion.

  However, taking notes of outcomes in a single-handed private practice is not going to help much. Audit is about modifying existing clinical protocols to refine and improve practice. It applies in areas where there is already a broadly agreed approach which produces positive results, but identifies changes in the protocol that are likely to improve outcome.

  Clinical audit of IVF and acupuncture won’t tell you if acupuncture works for IVF or not. In fact until you know that there is a proven method of using acupuncture to improve IVF outcome, then it doesn’t make sense to engage in the audit cycle. It’s like trying to redecorate a house that hasn’t been built yet.

  Isobelmat’s phrase of “disseminating good practice” is a nonsense. The premise of that phrase is that the technique is already reasonably efficacious. That is completely unproven. So you end up with trying to say what is a “better” way to produce the same null result.
  It would seem that despite all her self-proclaimed qualifications, this nurse doesn’t seem to understand the difference between research and clinical audit: demonstrating a lack of intellectual rigour that so often accompanies a lack of discernment in matters of clinical evidence.

• 102 isobelmat // May 13, 2010 at 20:57

  On the contrary, I do know the difference. Frequently, though, a reasonable clinical audit provides some start points for research, which in turn leads to more accurate audit. It seems that a decent start point for research in acupuncture and IVF eludes us, so a crude assessment might, at least, give us a direction. Please note I said CA is “a vital part in generating evidence”. Not the only way. My qualifications are not self proclaimed. They exist.

• 103 Mark Cannell // Aug 9, 2010 at 05:47

  Much to my dismay the GRASP trial is about to be published and the conclusion is stated to be:
  “The pragmatic GRASP trial showed that Chinese acupuncture is an effective alternative to conventional standard therapy in chronic shoulder pain. Fifteen Chinese acupuncture treatments over 6 weeks are more effective than conventional standard therapy with NSAIDs and physiotherapy. After the end of treatment, the therapeutic effect of acupuncture lasts for 3 months. The pragmatic trial shows that verum acupuncture is more effective than sham acupuncture at non-verum points located far away from the verum acupuncture points.”
  German Randomized Acupuncture Trial for chronic shoulder pain (GRASP) – A pragmatic, controlled, patient-blinded, multi-centre trial in an outpatient care environment. Albrecht F. Molsbergera, Thomas Schneiderb, Hermann Gotthardtc, Attyla Drabikde 2010 Pain in press.

  This will no doubt open the flood gates for acupuncturists who will claim that it proves that acupuncture is better than conventional therapy (or doing nothing). The trial was (of course) flawed by not controlling for patient and practitioner expectation and lack of practitioner blinding. Can good science ever hope to prevail?

• 104 Dudeistan // Aug 9, 2010 at 08:04

  @Mark Cannell
  Interesting report. I share your concerns about potential trial flaws.

  I do find it frustrating though when non-verum points in acupuncture (i.e. non-Traditional Chinese points) are referred to as ‘sham’.

  Counter-irritation using sharp objects such as acupuncture needles can have a modest analgesic effect.

  It’s not really an argument whether acupuncture can provide pain relief (it can). It is more a question of whether is is any more effective than paracetamol.

  The so called verum points issue is a red herring.

• 105 skepto_troll // Aug 20, 2010 at 00:01

  @ Dudeistan

  “Counter-irritation using sharp objects such as acupuncture needles can have a modest analgesic effect.”

  Just to be clear that we understand you fully here, Dud, are you saying that, in pain control at least, there’s a principle that “like cures like”?

• 106 Dudeistan // Aug 20, 2010 at 17:36

  @skepto_troll

  No, not Dud (even if you think I am a dud). It’s Dude. That, or Duder. His Dudeness. Or El Duderino, if you know, you’re not into the whole brevity thing.

  Like cures like? I don’t know.

  However stimulating mylenated sensory nerves can trigger a natural release of opiates across the blood brain barrier.

  But then is sensory stimulation for pain relief any more effective than taking paracetamol for your pain?

  Probably yes, given that paracetamol doesn’t have any theatrical ‘aura’ to it.

• 107 skepto_troll // Aug 20, 2010 at 21:24

  http://www.dcscience.net/

  @Dudeistanissimo

  Du, du bist keine Blindgänger, schon verstimt! (excuse my poor German)

  Natural release of endorphins, eh?
  Natural medicine! Great! Give me some of that!

  Probably kinder on the liver than big doses of paracetamol, too.
  But hey, what about morphine? Pharmed version of natural herbal medicine, so no unwanted effects there either, eh? 8-)

  On that principle, I suppose one might use heat shock, too, or just bayonet some one.
  That would make that root canal treatment so much more interesting!
  But primum non nocere, I suppose.

  Another effect is that each time you needle someone, it lowers their blood pressure a point or two. The Chinese may be more tolerant of this, but lower your bp enough & you’re out of it.
  That’s effective, too.

  And there’s the observed effect that people who use acu or mesmeric (let’s not get confused with hypnotics) methods seem to recover better, with fewer undesirable sequelae. (Forgive me if I’m not going to quote paper on this.)

  So far as a clean experimental design is concerned, there are other things to be considered, like nerve blocking, referred pain, neurasthenias, parasthenias, suggestibility (in the mesmeric sense), and induced meditative states.

  So, yes, what exactly is one showing if one does a trial like this?

  It does really seem to highlight the inadequacies of the specific-single-diagnosis/ single-intervention / narrow-outcome dbpc trial system. (SSD/SI/NO-DBPCT?)

  Of course,
  > Cannel
  is being faintly ridiculous when he can’t accept a trial result because his belief system doesn’t admit the result. He should be careful lest he ends up with chronic shoulder pain from shifting all those goal posts.

  The thought has just struck me that one might use blind acupucturists….
  Blind patients? Too specific a group.
  Blinded scientists, maybe…

  If one is to do a genuine trial of this kind, maybe one has to take a deep breath and step into the field a little.

  A truly sceptical evidence seeker is going to have to question ‘established medical knowledge’ (Wot’s Overwhelmingly Obvious – WOO) and accept that a result might not be as they would like it to be.

  Sham points (whatever they might be) simply will not do, for reasons I’ve outlined. It’s silly.
  It’s the infantile thought of some one who can see no further than the needle-sticking (eurrgh?), and can’t begin to imagine what those funny oriental gentlemen might be about apart from that.
  That the oriental gentlemen may have put a few thousand years into refining their ideas is completely beyond such people.
  Missing the point, sort of.

  But, Hey, buddy, if it’s connected to my sensory nervous system, you’ better know what you’re doing, or use a sham needle, or else!

  But some acu points are not in sensitive places. It’s generally bad form to go for the nerves, I understand. Or the arteries. Unless you’re a sham scientist, that is.

  So one ends up maybe having to a genuine honest test using a ‘whole alternative system’ approach instead of a specific misundertood part of it.
  And a broad outcome study.
  All very inconvenient.

  Worshippers of the SSD/SI/NO-DBPCT are not going to like that. Not at all.

• 108 Dudeistan // Aug 21, 2010 at 00:14

  Ich fürchte, ich verstehe nicht, worauf Sie hinauswollen.

• 109 skepto_troll // Aug 21, 2010 at 01:22

  Ich bin auch manchmal sehr Angst vor spitze Sachen?

  Ich habe kein Google-Deutsch,
  Ich habe nur Babel-Deutsch E:-D

  Very amusing example of how interpretations can differ, but has strayed somewhat from the point, I think.

  The exercise is to design a meaningful trial
  for a discipline which is incompatible with one’s accustomed mode of thought, like a dolphin-translator.
  Perhaps dolphins do not converse. But perhaps they discuss cosmology & fish. And the weather.

  Answers on a blog, please..

• 110 Dudeistan // Aug 21, 2010 at 08:57

  @skepto_troll

  “Ich bin auch manchmal sehr Angst vor spitze Sachen?”

  I was being ironic. Please don’t reply.

• 111 skepto_troll // Aug 21, 2010 at 15:32

  Ah, irony.
  I mistook it for something else.
  Dud after all. Never mind.

  To move on.

  @everybody:

  The question remains, how to design a meaningful trial for a discipline which is incompatible with one’s accustomed mode of thought.

  Come on, it’s not difficult.

• 112 Eric the half // Aug 21, 2010 at 19:48

  “a meaningful trial for a discipline which is incompatible with one’s accustomed mode of thought”

  Hmmm…
  You want to meaningfully assess a “discipline” that is incompatible with the way meaning means things.

  Bit of cheek terming it a discipline, under the circumstances, wouldn’t you agree?

• 113 skepto_troll // Aug 21, 2010 at 22:04

  Cheek ? Not really. Inquiry.
  Circumstances? You mean the conclusions of the GRASP trial (whatever)?

  How would you define a discipline,
  Eric 1/2 ?

  (You can say what you mean by “mean”, too, if you like :-D )

  No, I want you to ‘assess’, not by merely insulting it, a ‘discipline’ with which you are unfamiliar, and which you suspect is incompatible with your own deeply revered superstitions.

  Your word, “assess”; I was a little more precise, and fitted to the audience. If I can be more clear:

  Please attempt to design a trial (of some overlapping part of the mutual experience), which will either make the average pseudo-sceptic sit bolt upright and say to himself, “My God , I was wrong, there really is something in this, after all” (Well, probably not “My God”, but whatever a pseudo-sceptic takes in vain at these moments),

  or, by contrast, will make the average practitioner or beneficiary(?) of said ‘discipline’ in his or her own way, say to themselves, “Yes, I see your point, I shall now give this up for ever!”.

  Of course, one has to allow a little room for evidence that is at first superficially attractive, but on consideration is faulted.
  That can be forgiven.

  There are a numerous things that are more difficult to forgive, such as continuing to pick fault even when your stipulations have been fulfilled, fixing the trial or results in your own favour, or the prior determination that one will only be convinced when Hell freezes over (or whatever a pseudo-skepo freezes over on the these occasions).

  Come on, it can’t be that difficult.

• 114 David Colquhoun // Aug 22, 2010 at 00:11

  @skepto_troll

  The answer to your question is very easy, The way to test homeopathy properly can be found in the newspapers (A kind of magic?, by Ben Goldacre, Guardian, 2007).

  If a large trial done by that method were to give a strongly positive result, and that result could be replicated in a couple of other places, than I’d change my mind about homeopathy entirely.

  The fact that this has not happened, and that most homeopaths are unwilling to do it, suggests to me that they know, in their heart of hearts, that the test would be failed. The big homeopathic companies have plenty of money to do proper tests, and so end the arguments, and make even more money than they already do. Have you neve asked yourself why the big business people in homeopathy (Boiron, Weleda etc) are so reluctant to test what they sell?

• 115 phayes // Aug 22, 2010 at 08:20

  “If a large trial done by that method were to give a strongly positive result, and that result could be replicated in a couple of other places, than I’d change my mind about homeopathy entirely.”

  I’m shocked! I certainly wouldn’t. Even if such miraculous results from a set of ostensibly well-controlled large trials of some one supposed ‘homeopathic remedy’ were ever obtained, I’d still assume there to be a true explanation other than the absurd homeopathic one.

• 116 skepto_troll // Aug 22, 2010 at 13:32

  @DC
  May I first thank you, David, and other moderators here, for allowing me a voice in this oasis of rational thought.
  It is not so in all blogs of this faction, sad to say.
  I have already felt like a spectre at the feast, disturbing the peaceful calm of those who come to relax and swap anecdotes in the company of like-minded friends.
  I suppose we who are sceptical of the conventional knowledge of the age will come and go, but I hope we may pass the time in fruitful discussion, and perhaps advance a little in some way.

  Yes, I have on occasion asked manufacturers why, given that they must presumably be in profit, they cannot produce some acceptable ‘proof’ for us, why sometimes they are making claims that don’t stack up. From time to time I have proposed suggestions about what might be better. It would be to the benefit of all.

  Often they continue to plead poverty. Very often the CAM sector has small, insecure outfits, without the backing of huge moolah available to the competition.

  Of course, on a rational basis, Welada, with its’ nicely eccentric outlook, and Boiron, with its thriving market in ducks, have little to gain from taking any such business risk, lest they have to turn to selling jewellery instead. The shareholders would not be pleased.

  That would be like over-reacting to reports of the odd few deaths from the cox-1 component of a cox-2 ACE inhibitor, or psychoses induced by a chinchona extract analogue designed to combat P. falciparum, all before the coffers are filled and it’s your only source of income. (There’s that natural medicine again!)

  And I am constantly disappointed by the existence of enthusiastic reports of the latest miracle product in what are really marketing zines.

  But that would be to ignore a swathe of reasonably well-conducted research in the more respectable CAM journals (yes, we might disagree on that one).

  One could make similar observations about the conventional sector, if one could be bothered, especially prior to the Lancet decision to force registration of tests.
  (I wonder where the loopholes are in that? I can think of a way..) How carefully do they quantise undesirable effects in a population, for example.

  More on the subject of credible proof, as the Americans say, momentarily.

• 117 skepto_troll // Aug 22, 2010 at 14:24

  Yes, as I said, it’s not difficult, it just requires some clarity about exactly what one is showing with a demonstration, and the pitfalls of missing alternative hypotheses.

  I was following the comments on acupuncture, of course, but since your thoughts have strayed to homeopathy, I am happy to pick that up as well.
  We can cover the other points later.

  Thank you, I have just read Ben Goldacre’s article, and the article which apparently gave rise to it: In defence of homeopathy by Jeanette Winterson http://www.guardian.co.uk/science/2007/nov/16/sciencenews.g2
  (“a temperature of 102, spots on my throat, delirium …. remedy called Lachesis, ….. Four hours later I have no symptoms whatsoever.”)

  Yes, there certainly is some sloppy thinking there, and Ms. Winterson’s article has some problems with it, too.
  I shall try not to criticise BenGoldacre to too deeply in his absense (?), but I counted a number of Aunts Sally – or perhaps just the one straw man of multiple personality – and the odd exaggerated claim, maybe a couple of idées fixes (I’m being imprecise, here) in his extended monologue. But he does try hard.

  Going out on a limb here, and I don’t mean to insult your integrity on the matter, but I’m going to suggest that even if his trial design, enacted a few times, showed sparkling results in favour of homeopathic effect (unlikely, implausible though it may seem), that you and others might well still be looking for the fundamental flaw in it for some time to come..
  Conversely, well, not everyone has faith in the gold standard.

  And I’m already out on a limb in following your enthusiasm for SSD/SI/NO-DBPCTs rather than more rounded outcome studies in a clinical setting.

  Leaving aside for the moment the question, “would this get past an ethics committee?”,
  what exactly is Ben’s hypothesis, there, do you think? Is it a startlingly worthwhile piece of science for funding?
  Is this a real test of homeopathy as a therapy?
  Are we looking at self-limiting, treatable, (or undergoing treatment), curable, incurable or delusional cases? (And why does that matter?)
  Would it prove or disprove the homeopaths’ extraordinary claim that, even in this day, homeopathy, not ‘allopathy’ is the superior medical system?
  Could we define ‘outcome’ a little better than ‘does just as well’? Perhaps follow up a bit better.
  And perhaps at least carefully define the placebo?
  And be precise about protocols, the environment, contamination.

  What would be the effect on the sample of knowing placebos were involved?

  On a darker point, how might one obviate fraud? There’s certainly a faction who are angrily adamant that H~thy is a fraud anyway, so it’s fair game to disrupt a trial. Are there any holes for the underhanded financial giants of homeopathic pharmacy to exploit?

  I might observe that his kind of trial goes on constantly, in any case.
  Of every 200 individuals that purchase some little pills from an established homeopathic pharmacy, the half that I see may well be taking an effective remedy (sadly, not always necessarily the most appropriate remedy according to the doctrine) and are going to get better, the other 100 that you see are just taking an imaginary “IllPlease”, and are going to die.

  Naturally, most of them are there because they distrust the proof offered for conventional medicine, or else doctors have told them they are “‘incurable’”, or they are suffering from persistent undesired effects from a piece of EBM they’ve been given earlier. Or they’re just imagining it.

• 118 Dudeistan // Aug 22, 2010 at 17:23

  @phayes
  If well controlled repeatable RCTs demonstrated consistently good clinical effect for homeopathy then that would imply there is clinical value to homeopathy. Such tests would not establish why it works, simply that it does.

  Of course, to date studies do not show a convincing clinical effect.

  However, in theory, in the unlikely event that homeopathy passed clinical scrutiny it would be the job of scientists to establish a reason for its clinical efficacy.

  Clearly there is not point in them bothering to do that if we agree that homeopathy has no clinical value as seems to the case.

• 119 phayes // Aug 22, 2010 at 18:42

  @Dudeistan

  “If well controlled repeatable RCTs demonstrated consistently good clinical effect for homeopathy then that would imply there is clinical value to homeopathy. Such tests would not establish why it works, simply that it does.”

  I strongly disagree, and it’s got nothing to do with failure to discover exactly how it ‘works’, but rather more fundamentally with whether it is remotely reasonable to believe it could work at all. A clinical trial of some homeopathic ‘remedy’ is implicitly also a grossly inappropriately clumsy experiment presuming to be able to establish the existence of a substantial difference between magic homeopathic water and ordinary water. But that is something it simply cannot do. As Alan Sokal puts it:

  “In short, all the millions of experiments confirming modern physics and chemistry also constitute powerful evidence against homeopathy. For this reason, the flaw in the justification of homeopathy is not merely the lack of statistical evidence showing the efficacy of homeopathic remedies over placebo at the 95% or 99% confidence level. Even an experiment at the 99.9% confidence level would not begin to compete with all the evidence in favor of modern physics and chemistry.”

  Homeopathy clinical trials are futile and unethical pathological science. The poor deluded homeopaths would need to show us how to easily and reliably distinguish a drop of water with ‘no’ molecules of X from a drop with ‘no’ molecules of Y (or a control) in the lab. before they could even begin to hope for their maximally absurd, ugly and stupid fantasy medicine/science to be taken seriously.

• 120 phayes // Aug 22, 2010 at 19:41

  See also this very good article:

  http://www.sciencebasedmedicine.org/?p=42

  It doesn’t go so far as to contemplate how (I believe) one should interpret the hypothetical situation being discussed here – the (replicated) strong positive result from a large trial of some homeopathic ‘medicine’ – but it should give you some idea of why I’m honestly not joking when I say that I’d consider it more likely to have been due to a prank by extraterrestrial medical students (veterinary students?) than due to the effect of the homeopathic pills.

• 121 phayes // Aug 22, 2010 at 19:46

  Uh… That should’ve been “due to the effect of homeopathic pills” rather than “due to the effect of the homeopathic pills”, obviously.

• 122 Dudeistan // Aug 23, 2010 at 10:51

  @phayes
  I did stress “well controlled repeatable RCTs [that] demonstrate consistently good clinical effect”, not ad hoc half-baked biased trials.

  However I agree with your argument that to set out to test something that clearly makes no scientific sense could be seen as futile.

  Bu then it isn’t futile, as how else would we persuade gullible consumers and politicians that its all hokum?

• 123 phayes // Aug 23, 2010 at 12:26

  @dudeistan

  “I did stress “well controlled repeatable RCTs [that] demonstrate consistently good clinical effect””

  Yes, and I tried to explain why it doesn’t matter. A clinical trial simply cannot be large and well-controlled enough to be able to demonstrate the truth of a claim contradicting a vast body of intrinsically much more powerful evidence.

  “how else would we persuade gullible consumers and politicians that its all hokum?”

  I don’t see how anyone could possibly remain unpersuaded by the rock-solid evidence of a couple of centuries of genuine science – much of which they should’ve already learnt in school – together with knowledge of the “chain of implausibility”¹ involved in the ludicrous homeopathic delusion. Unless they are as barking as a homeopath themselves, of course.

  I can’t stress enough: a homeopathy clinical trial is a futile and unethical cart-before-the-horse exercise in pathological science, and pretending otherwise, perhaps just because we don’t want to be too mean to the poor quacks and deny them credibility and hope, is unethical too if it encourages them to continue to carry out such trials. Their bizarre delusions don’t really even merit testing in the laboratory but they sure as hell don’t belong anywhere near a clinical trial setting.

  ¹ http://www.theness.com/neurologicablog/?p=40

• 124 Dudeistan // Aug 23, 2010 at 16:40

  @phayes
  I understand your argument as it is logical and scientifically sound as a pound

  I suppose I am looking at the issue from a purely pragmatic point of view.

• 125 skepto_troll // Aug 24, 2010 at 13:11

  @ Brothers Grimm

  Oh, I’m sooo glad I came!

  Have you seen the man in the motor car?

  Look Behind You!!!

  My memory of these things is a bit vague.
  Are you going to do the one where Dick decides to give up economics, but encounters a band of Maoist thought-reformers, and is persuaded to return to make his fortune in pharmaceuticals? Something to do with socks, I think.

  OH, no is isn’t!

  Oh, yes it is!

  Yes, the man on the motor car.
  He’s driving this big, powerful machine, you see, protected from the outside environment by all that shiny plastic & steel,
  trying to get down the road just a bit faster than the next guy.
  The shell has a strange effect on the psychology, makes him feel invulnerable.
  Like the Zeitgeist thing (Google German).

  What gets in his way just makes him mad. Mad. maaaad m ad maa….

  d.

  And there’s that pedestrian.
  Absurd thing.
  In my way.
  Heee’s innn myy waaaay!

  How can he expect to get about like that, he hasn’t even got wheels!

  Baaarp, baaarp!

  Oops, blind spot, Your Honour.

  I’ll be back, I’m getting through some enjoyable reading.

  Who’s playing the Dame?

• 126 andrew // Aug 24, 2010 at 20:42

  “There is nothing like a dame. Nothing in the world. There is nothing you can name that is anything like a dame”

  Ben Goldacre told the Commons Committee/enquiry into homeopathy that there were a little over two hundred RCT showing nothing positive for homeopathy beyond placaebo. Get RCting.

• 127 andrew // Aug 24, 2010 at 20:46

  PS When driving plase note “Objects behind you may be closer than you think.”

• 128 skepto_troll // Aug 25, 2010 at 01:39

  Remind me, andrew, how many of the committee were persuaded by Ben’s argument?

  Have you read any of those trials?
  How many were of ‘ultra dilutions’, ‘vigorously shaken’?
  (Homeopaths don’t do that, you see, they have this idea that they produce ‘potencies’ by a rather precise ritual – lets call it a correct protocol. So, they aren’t going to be impressed much.)

  I won’t go on too much about this just now, but if you are going to test a hypothesis, it’s as well to test that hypothesis, rather than a prejudiced interpretation of it. If you want to make an honest scientist, that is.

  Any outcome studies there, by the way?

  But thanks for introducing nothing, much, into the discussion 0:-)

• 129 Dudeistan // Aug 25, 2010 at 08:56

  @phayes
  I am sure you have spotted the latest link on the Home Page; George Lundberg (there is no alternative medicine).

  His states his three criteria for assessing treatments:

  1. You have a test or treatment that has itself been tested and found to be safe and effective. Use it; pay for it.

  2. You have a test or treatment that has been found to be unsafe or ineffective. Don’t use it; don’t pay for it.

  3. You have a test or treatment that is SCIENTIFICALLY PLAUSIBLE, meaning not preposterous. Test it AND then put it into one of the other two piles.

  This neatly supports your argument.

• 130 andrew // Aug 25, 2010 at 16:18

  The report is here : http://www.parliament.uk/business/committees/committees-archive/science-technology/s-t-homeopathy-inquiry/

  The were 14 people on the committee, but I don’t know how many were persuaded by Ben’s arguement.

  However big the majority, conclusion 11 page44 states “In our view, the systematic reviews and meta-analyses conclusively demonstrate that
  homeopathic products perform no better than placebos. (Paragraph 70)”.

  That is the key point surely ?
  I have n’t read the trials and I don’t know how many of ‘ultra dilutions’ or ‘vigorously shaken’.

  I agree with you about hypothesis testing though.

• 131 skepto_troll // Aug 25, 2010 at 22:47

  @ Brothers Grimm

  Oh, aren’t the responses to that simply wonderful!

  Re: DC Ref “There is no Alternative Medicine” Geo Lundbergtroll
  medpagetoday.com/Columns/21819

  How can so many errors seep into any rational person’s thought?

  If I allowed to quote:
  “All the studies found exactly the same thing: if the original dodgy fact fits with your prejudices, a correction only reinforces these even more. If your goal is to move opinion, then this depressing finding suggests that smears work, and what’s more, corrections don’t challenge them much: because for people who already agree with you, it only make them agree even more.”

  Ben Goldacre, The Guardian, Saturday 1 May 2010
  http://www.badscience.net/2010/05/evidence-based-smear-campaigns/

• 132 skepto_troll // Aug 26, 2010 at 00:05

  @andrew
  You know the Ctrl+C, Ctrl+V Copy/Paste thing?
  Have you tried Ctrl+C, Ctrl+W?

  A biased view of largely biased investigations doesn’t really count for much, IMNSHO
  (But perhaps I’m being unfair.)

  I found this:
  //avilian.co.uk/2010/02/homeopathy-british-justice-or-british-bullying/

  But that would be ‘not to understand’ the steaming pile of importance of EBM, of course.

  Thank you for the agreement on the actual good science bit, however.
  It’s encouraging.
  Keep it up.

  That is the key point surely ?
  (C & P’d, ibid)

• 133 skepto_troll // Aug 26, 2010 at 03:01

  @andrew
  I located this for you:

  //www.homeopathyeurope.org/news-and-press/news/ech-rebuffs-uk-parliamentary-committee-report

  which reports a vote of
  3 in favour, 1 dissenter out of the 14,
  and reports that “One of its three signatories has stridently campaigned against homeopathy …”.
  No prejudice there, then.

• 134 phayes // Aug 26, 2010 at 17:27

  @Dudeistan

  Yes – I watched it. But I don’t think it’s support for my argument: Lundberg doesn’t say exactly *why* one shouldn’t test a highly implausible treatment but I’d guess his reasons would more likely be of the usual EBM-motivated pragmatic and ethical kind than the recognition that such a test would not in fact be a test at all (except under appropriately highly implausible conditions!).

  Anyway, due to the content of some of the comments here ;-) I thought a sanity-restoring Feynman chaser might be appreciated:

  mmst://Mv-helix1.cwru.edu/a/physics/kavli_cerca_weinberg_lecture.wmv

  (Just for a change it’s actually Weinberg not Feynman this time).

• 135 skepto_troll // Aug 27, 2010 at 02:32

  @skepto-troll

  No, not that Dick; it was the other one with the cat.
  Cat in a box, it was, only you have to open the box to see if it’s smiling or not. Years ago, can’t be certain.

  Put the back out a bit, hanging on the eves.
  It’ a Troll thing.
  Does anyone know a good chiropractor?
  I heard there’s this Sikh fellow, wonderful with backs. Got a nerve, trapped? Pain in the neck? Colic? No trouble at all. He’s just the man you want. Just harangues the vertebrae until they all get into line, I’m told. Safe as can be, as safe as going to any other doc. in a white coat.

  Is he still around, anyone know? Or did he move on to that other outfit? Keep Fundamental Laws out of Physics, I think it was,
  ( He_hit_me.back.com ? I just get server not found.)

  I think he must have some troll genes in there, somewhere.

• 136 skepto_troll // Aug 27, 2010 at 02:49

  Sorely missed, that Dick. Feynman. Fell into bad company, magicians & the like. Bad influences. But it’s only right that he should have enjoyed himself at the end.
  If you’d asked him how someone had fixed an experiment to ensure it failed, he’d have got it. If you’d set him the problem, that is. Rara avis.

  Perhaps he’s smiling down at us all, right now. Or working at his next chapter on the memory of water.

  I was in the WHSmug’s the other day. The 7th it must have been. When my attention strayed off the top shelf to a copy of New Scientist, and this wonderful contention that the latest incarnation of the Standard Model isn’t really broken at all, it’s just a trick of the light, a bad run of the dice. Something about things being counter-intuitive, & inference throwing up wobbly advice. Andrew Pontzen & Hiranya Peiris, it was. Couldn’t make the names up, really. (Excuse me, Troll humour.)

  Have you seen what they’re doing up at Cosmo recently? It seems they’ve lost the plot; well, three-quarters of it, anyway, and people have been demanding an explanation. Up to negative energy, dark radiation, all sorts of woo, to see if they can find it again.
  Inference, massively important there.
  Negative energy can really mess up your life, I’m told. No matter.

  Or was it the one where the Emperor is trying to explain the Altogether? It’s all such a long time ago, it seems like the beginning of time.
  Something about the very fabric of existence being so fine you can’t see it.

  Makes you wonder about whether you really know what you think you know about what you actually know you know.
  At least I do know, if I’ve seen something actually work, over and over, that it does work. Well, from this side, it does.
  And all those other people who’ve seen it work as well, they know it works, too.
  Nay-sayers can come up with all sorts of fancy, contrived explanations of why you just imagined a method works,
  but why would the Creator come up with so many conjurors?

  I’m talking about methodical DBPCTs, of course. God-given.

• 137 phayes // Aug 27, 2010 at 07:15

  @skepto_troll

  “Up to negative energy, dark radiation, all sorts of woo,”

  If I told you that I’m well aware that my much-more-likely-than-homeopathy extraterrestrial medical students would almost certainly need just that kind of ‘woo’ to be able to get here in the first place, would it make *you* “wonder about whether you really know what you think you know…”?

  http://en.wikipedia.org/wiki/Alcubierre_drive#Difficulties

  The crackpots’ and quacks’ incessant whining about “closed-minded ignorance” is extremely ironic.

• 138 pberry // Aug 27, 2010 at 12:58

  @skepto_troll (re:http://www.dcscience.net/?cpage=3#comment-7387)

  Maybe I shouldn’t feed the troll but I’m surprise no-one has picked you up on your pleading that someone should be able to design a fair way of testing a “discipline they do not respect/understand”.

  There are a number of things as fault with the way this question has even been asked, most significantly the use of the potentially loaded term “respect”. You seem to be of the opinion that only those versed in a discipline are best placed to assess it, which is patently wrong, and suggests you want a special treatment for certain disciplines. This is tantamount to stating that certain “belief systems” are outside the realm of science which, again, is simply a prima facie incorrect assertion.

  Moreover, attempts made to understand a closed-book system are in fact best made by those outside of it. They are likely to be able to be more objective about it since they have no vested interest in propping up something they don’t currently subscribe to. Any failure to gain a true understanding does strongly suggest the subject under test lacks any verifiable, repeatable, demonstrable effectiveness. And so it does, indeed, remain “outside of science”. Some call this realm magic; I call it bullshit.

  Every statement along the lines of “CAM practice X cannot be tested as scientists don’t understand the realm in which it operates” just serves to paint the whole business into a corner of logical absurdity.

  We are each entitled to our own opinions but not our own facts, and the evidence base, such as it is, for CAM practices, makes for a pretty thin reading.

  If you can’t see that there is no point attempting to explore this topic any further.

• 139 skepto_troll // Aug 27, 2010 at 13:37

  :-@phayes
  Hoorah! First mention of “closed-minded ignorance” here!
  And “crackpot” too!
  Ventral prefrontal cortex problem? I don’t know, just visiting.

  E:-0 You have extra-terrestrial students?? Are they humanoid?

  Actually, yes, it does make me wonder too. Still learning.

  Yes I know the design. All very yin/yang, but how to set it up?
  Pass the di- Lithium crystals!
  Or just the plain old Lithium Carbonate, maybe. Trace elements in food, all sorts of disproportionate effects.

  ~~~~~~~~~~~~~~~~~~~~~~~~~~~
  A little light entertainment to calm the spirits;
  after the old Oscar Brand ditty & sometime rugby song
  (vide Youtube.com/watch?v=ls_nPA8o71A)
  To the tune of “Johnny’s So Long at the Fair”:

  “Oh, Dear, where can the matter be?
  locked in thought from Monday to Saturday,
  Teasing out alternate realities,
  Nobody knew they were there!”

  “Wish I had been a Professor of Chemistry!
  Nothing at all to appear as a mystery,
  All anecdote I’d consign into History,
  No-one would know it was there!”

  (Repeats chorus)
  ~~~~~~~~~~~~~~~~~~~~~~~~~~~

  I’m only here to take the epistemiology, of course.

• 140 Dudeistan // Aug 27, 2010 at 13:47

  @pberry
  It’s not just altmed advocates that seem to want to be treated in a special way. I sometimes wonder whether quantum physicists also behave like this – but then I am in danger now of going off topic.

  @skepto_troll
  Are you a bit piddled when you write your entires?

• 141 andrew // Aug 27, 2010 at 17:22

  @skepto_troll

  Thanks for the links @ #132 & 133. However mind stretching and enthralling I find your blogs, nothing changed my mind. Still all #129 Lundgerg category 2 stuff.

• 142 skepto_troll // Aug 28, 2010 at 13:33

  Went to see Avatar at the Imax with an old friend.
  Quite engaging. I think you’d hate it.
  I could possibly identify with any central character known as Scaum; after watching the film for a bit, you might prefer Parker or Colonel Quaritch.

  I couldn’t help but test my cognition with the 3d specs reversed.
  Fascinating; as expected, my brain automatically corrected for human images, but had more trouble with the contextual backgrounds.

  It goes to show that you can design instruments to see what you want to see, misapply them, and still see what you’d thought you’d see in the first place.

  Cognitive dissonance. Now, there’s a thought.

• 143 skepto_troll // Aug 28, 2010 at 13:35

  Reverse order:

  @andrew
  Yes, the S&T subject-poaching starts to look less impressive after that.
  Yes, nothing has a way of doing that.
  Lundgurg, trite. Consider HepC.
  There are better strategies for risk-based medical decision taking, but they are probably inaccessible to the average victim. Patient.

  @Dudeistan
  Entires? Piddled?

  @pberry
  I spent some time re-reading, searching right through for \discip\ \respect\ & \underst\ to identify what I am supposed to have said.

  Then I just thought, intellectual equivalent of birdsong.

• 144 skepto_troll // Aug 28, 2010 at 13:37

  @pberry
  Sorry, I just couldn’t get past that for a while, it seemed like a convolution of the original exercise #109.

  “Respect”? No, I didn’t use any of that, even in my poor German.

  And respect is very much what is lacking from the pseudo-skep side of the discussion. (#138 & ..)

  “Pleading”? No, it was intended as a not-particularly-special intellectual exercise.
  But you are correct, only DC has tried to answer, albeit in a desultory way, #114 (thank you, David), but I suppose that’s why he’s Professor.

  My lengthy response #116 #117, specifically the last two para.

  ” … versed in a discipline are best placed …. patently wrong ….”?
  No, but touché.

  Then, I’m sorry, it’s the birdsong again.

• 145 Dudeistan // Aug 28, 2010 at 15:23

  A bit of light relief from all this heavy vibes: http://www.youtube.com/watch?v=HMGIbOGu8q0

• 146 skepto_troll // Aug 30, 2010 at 00:46

  Nah, seen it Repeats, repeats.
  Does that make it ‘evidence’ of something, I wonder?

  I rather regret the demise of humour in the ’70s, in favour of insult & sarcasm (which used to be called the lowest form of wit).
  Fry could do better, but he’s another of the vicariously angry. Perhaps he could do with a visit to the RLHH to see what really goes on.

  Dull here.

  Thought someone else might come up with a verse, but no.

  I have one, but it seems wrong to intrude on private grief after the

  http://www.dailymail.co.uk/news/article-1307095/Family-win-18-year-fight-MMR-damage-son–90-000-payout-concerns-vaccine-surfaced.html

  Paltry compensation, though. They must be expecting a flood.
  I won’t say more, I think one of the main players is appealing an earlier incorrect decision. Ought to keep that kind of thing out of the research arena, really.

  Pleased also for singer Sheryl Crow, much better now, following some weeks in ICU after her (EBM) anti-malarials failed to protect her. Nice of her to make the point. Lucky she didn’t get psychosis, I suppose.

• 147 physicsteacher // Aug 31, 2010 at 13:17

  skepto_troll: are you an ELIZA program? Reading your posts is rather like interacting with the “doctor” function on my EMACS text editor!

  (No rudeness intended!)

• 148 David Colquhoun // Aug 31, 2010 at 20:51

  @physicsteacher
  You have pointed out by dilemma. I don’t censor comments just because I disagree with them (unlike most alt med people). But skepto-troll verges on rambling incomprehensibility. Is that grounds for censoring?

• 149 Dudeistan // Aug 31, 2010 at 21:20

  @DC
  A dilemma. If you censure discursive pro-altmed advocates you may be in danger of edging towards Nazi book burning (OK, a bit extreme, but valid nevertheless).

  Then if you do not censor, you run the risk of allowing pro-altmed mavericks to be savaged by an anti-altmed posse.

  My view would be to draw the line against discursive ramblings, whether pro-altmed or anti-altmed (that’s me out then).

• 150 phayes // Sep 1, 2010 at 20:13

  @physicsteacher

  Text editor?!!! ;-)

  I’ve been using Emacs for nearly a decade and yet even now I’ll occasionally find myself sitting back and staring at it with a big grin on my face thinking “Wow… just wow!”. :D

• 151 toots // Sep 1, 2010 at 21:09

  @ Mark Canell 103, Dudeistan 104

  The GRASP results are surprising considering that the other GERAC trials for migraine, tension headache, chronic low back pain and knee osteoarthritis showed little difference between the effectiveness of verum and sham acupuncture.

  GRASP shows a yawning gap!

  I wonder why?

• 152 andrew // Sep 3, 2010 at 08:41

  I understood about seven things,more or less, from skepto_troll’s entries.

  Much prefir the more logical style.

• 153 andrew // Sep 3, 2010 at 10:33

  That should have been \prefer the more logical style.\
  I think a majority opinion is that most people can understand most of the logical threads and know how to look in to the remainder, but with Skepto_trolls one looks for ever and ever.

• 154 skepto_troll // Sep 8, 2010 at 00:10

  Am I allowed to comment, or is this a private thread?

  @physicsteacher
  Why are you interested in whether or not I am an ELIZA program?

  @David
  “rambling incomprehensibility”? All in the mind of the beholder, dear boy.

  I couldn’t speak for ‘most alt-med people’
  but two other Skep sites had severe sense-of-humour failure and modded my job application out, before I found welcome here.

  I get the strong impression that ‘most alt-med people’ are regularly attacked by the trolling ps-skeptic crowd, often in capital letters, and with very little use of the cerebellum. I imagine they get pretty fed up with it.

  @andrew: Is that a compliment? Thank you, anyway.

  @Dude: I have great distaste for censors, even when it comes to the deranged rantings of the anti-alt-med crowd.

  I see that the RLHH is about to change its name, which will no doubt lead to a huge bill for new stationery & another round of vitiative hate-speech and crowing from the anti-choice factions.
  Doesn’t seem to be reciprocated, that need to abolish the competition.

  What has happened to that witless bunch at 10:23? I see their Alexa ratings are down quite a way. Perhaps a good many of them felt a lot better for their single dose of homeopathic remedy, came to their senses & went home.
  Why 10:23 anyway?
  I’d understand if they had called it “1811: 1666e-24=0″ (Missing the point entirely, that it’s only an expectation anyway. In molecular chemistry, which homeopathy isn’t.)
  Or 22:50×6, maybe.
  They’d still be wrong.

  Perhaps they’ll be holding an anti- Healing-Crystal Night?

  0ooops

  (I’ll
  be
  back.)

• 155 Eric the half // Sep 8, 2010 at 09:26

  \and with very little use of the cerebellum\

  …resulting in a lack of balance, no doubt.

• 156 Dudeistan // Sep 8, 2010 at 14:05

  @Eric the Half

  Parkinson’s?

  @skepto-troll
  I agree.

• 157 Eric the half // Sep 8, 2010 at 14:44

  @Dude

  No, not particularly. Just struck by the level of basic Biology involved.

• 158 Dudeistan // Sep 8, 2010 at 16:26

  @Eric the Half
  I was agreeing with you.

• 159 kimsanders01 // Sep 30, 2010 at 02:48

  Thanks for the very informative article. I have a great reading. I check out for its website review.

• 160 Mark Cannell // Nov 17, 2010 at 14:00

  @Skepto
  To do a blind acupuncture trial should be straightforward I think. Since the tested assumption is that it is only needle insertion that is important, you give an untrained (in acupuncture) needle inserter a map of where to put the needles, some maps are ‘correct’ some false. To correct for patient expectation you give them a questionnaire. To blind the patient you erect a screen so they can’t see if a needle has been inserted (you tap the skin to make them unsure if the needle was inserted). I suggest that it just takes a bit of thought on how to do a reasonable blind experiment (which in the case of the above trial seems to be lacking). Even if the researchers were incapable of thinking about these issues, shame on the reviewers for not pointing the problems out.

• 161 David Colquhoun // Nov 17, 2010 at 19:17

  Mark
  That has been done often. See, for example, Barker Bausell’s book, Snake Oil Science. he result is, virtually always to show no difference between “real” acupuncture and sham (there sham is retractable needles in the “right” position or real needles in the wrong position (or even toothpicks). One of the few clear results in alt med is that meridians and Qi are figments of the imagination.

• 162 Dr Aust // Nov 17, 2010 at 23:34

  Acupuncture is now so deeply embedded in the medical mainstream that even the repeated demonstrations that it is a (fancy) placebo aren’t going to winkle it out, I think. It is popular with the punters, and gives lots of of physios and GPs something else to offer both their heartsink and their “frequent flyer”-worried-well patients, complete with lots of ritual and theatre.

  Given its popularity, Govts and health authorities are unlikely to opt explicitly to dump it unless it can be shown clearly to lose/waste money.

  Anyway, I hope I’m wrong, but I predict the approach of (e.g.) the UK Govt to acupuncture will be the one they have used with homeopathy, as in: washing their hands while muttering about:

  “Choice”

  and;

  “There are some people arguing it works”

• 163 Teige // Mar 13, 2011 at 02:11

  Thanks for linking to Yudkowsky’s Bayes page DC! I’m a biology student who likes probability & stats, and it was a useful and interesting find.

  DCscience.net is a good resource and long may you continue to have the time and interest to update it.

• 164 David Colquhoun // Mar 13, 2011 at 09:15

  @Teige
  Thanks very much, To clarify, your comment refers to my comment left at a blog about Bayesian statistics, http://www.evidencesoup.com/canopener/2011/03/yudkowskys-bayesian-evidence.html

  Yudkowsky’s account is indeed lovely, but I don’t think it is really touches on the contentious bit of Bayesian statistics at all. It can all be done with standard conditional probabilities, interpreted in the usual frequentist way. There is barely any need to introduce Bayes at all.

  Bayes becomes problematic when you have no real numerical knowledge of the prior probabilities and when you you are forced to drop the interpretation of probabilities as long-run frequencies. These problems didn’t arise in the examples chosen by Yudkowsky.

  More on this in the diary section.

• 165 Teige // Mar 13, 2011 at 15:31

  @DC
  If you wouldn’t mind, what kind of scenario would this be? Does it relate to your work on ion channels?
  In the examples Yudkowsky gives there’s no problem inferring the prior probs and n is large, so it doesn’t lead to your comment well without some kind of example.
  What alternative can there be to simply gathering a lot of data, many repeats, to make n large enough if you want to find an accurrate probability?

• 166 David Colquhoun // Mar 14, 2011 at 00:37

  @Teige
  In our case, what we are trying to estimate is the values of the rate constants for specified mechanisms that we hope will describe with reasonable accuracy the physical events that occur when an agonist binds to an ion channel. In order to compare rival mechanisms we need to find the best estimates of the transition rates for each postulated mechanism.

  In order to use Bayes’ theorem, we would have to postulate a prior distribution for the value of each rate constant. We have no idea before we fit what these values will be. We may sometimes hope that particular values will emerge in order to test some idea that we have, but to use such hopes as a prior would be merely to influence the outcome of the experiment by feeding in our prejudices. That would, in my view, be wrong. Consequently we use only the uncontentious right hand side of Bayes’ theorem, the likelihood, and choose values that maximise the likelihood. That way each experiment stands alone.

  Our sort of problem is typical in lab work. It is only in cases like the screening problem, and a handful of similar ones, that you can actually know about the prior probabilities.
  .
  My worry about Bayesian methods for any sort of experiment where you off with no real knowledge of the outcome is that either (a) you feed your own biases into the result by specifying a prior or (b) you use a prior that doesn’t influence the result, in which case you might as well use maximum likelihood. Either way, Bayes is not helpful.

• 167 r1chy // Jul 28, 2011 at 20:49

  I read your rant about the charity YesToLife at the end of which you claim. “The information supplied by YesToLife is more likely to kill you than to cure you.” As at the top of your page you claim this site is about Truth, falsehood and evidence. I ask where is your evidence to collaborate this poisonous, spiteful statement. I also looked at the alternative treatments you attacked and they appear to provide only links to people offering these treatments all over the world. The Vitimin C treatment you scoffed at at expensive may well be so. However statements like “what? Vitamin C is very cheap indeed.” belittle a 5 day, 3 week course of intravenous administration.
  You go onto attack some of the people involved including Charlotte Grobien merely because she is part of a fund raising organisation that has supported Yes To Life, how ridiculous. Lastly your closing statement of “The next time you see somebody collecting for a “cancer charity” be very careful before you give them money”. Well I will leave others to make of this statement what they will, at best its poorly phrased at worst well, like I said let others decide. Are you honestly a Professor? Where is your evidence for the personally motivated attack.

• 168 David Colquhoun // Jul 28, 2011 at 23:10

  @richy

  You are referring to A thoroughly dangerous charity: YesToLife promotes nonsense cancer treatments. It’s a pity you didn’t post your comment on the right page.

  I’d make two comments.

  First, if if anyone proposes a treatment for any condition, it is their responsibility to provide some evidence to back up their claims. It is not the responsibility of other people to ‘disprove’ their claims. That’s especially true of treatments for dangerous conditions like cancer. As i pointed out, some of the things offered by YesToLife are utterly bizarre things like Gerson therapy that have been around for many years without any decent evidence ever being produced.

  Second,I certainly stick to my advice never to give money to YesToLife collectors. When people see the word ‘cancer’, they tent to give some money. I don’t think it would be at all obvious from the placards that the money would be spent largely on crackpot and ineffective treatments.

  I actually give quite a lot of money to charities, but I never give it to street collectors. I wait until I get home and check on what the charity spends its money on. It’s quite surprising how many of them are little more than confidence tricks. There are several very respectable cancer charities who would spend the money properly.

  I do hope that if you are unfortunate enough to get cancer, you don’t rely on Vitamin C infusions. If you were persuaded to that by a charity like YesToLife, they would be responsible for your death.

• 169 cub // Sep 20, 2011 at 19:41

  Just thought you might be interested to see an example of what passes for journalism these days:
  (from the website ‘healthylifeessex.co.uk’ – my capitalisation added):

  “I was delighted when Gavin King, an experienced martial arts instructor and Shiatsu practitioner, offered me a Shiatsu massage but did not really know what to expect. I DON’T HAVE ANY HEALTH ISSUES so it is always difficult for me to gauge the success of a treatment. But my massage was a pleasant and interesting experience AND GAVIN CERTAINLY EXPOSED LEVELS OF TENSION AND STRESS THAT NEEDED TO BE DEALT WITH. I left feeling a strange awareness that I found very difficult to articulate.

• 170 David Colquhoun // Sep 20, 2011 at 19:58

  @cub
  That looks like yet another pappy advertorial.

  Presumably Essex politicians have employed a “wellbeing manager” who is hard up for ways to fill his/her time. This stuff isn’t restricted to local councils though. Harvard does it and so does UCL.

  If you haven’t already seen it, you might be interested in “The A to Z of the wellbeing industry“.

  Stuff like this certainly suggests some savings that could be made in local government and in universities.

• 171 TonyBav // Oct 28, 2011 at 10:45

  Mr Colquhon

  I was reading your blog and in older posts I found comments on “The Woman’s Health institute Study” on HRT treatment (Rossouw et al, 2002) which you seem to regard as a good example of randomised testing.

  I presume you failed to give the study sufficient consideration. The study was a bench mark in how not to do statistical studies. Here are some of the issues which are not addressed in the paper.

  1. The study was ended early after a perceived increase in certain health risks. No where does the paper consider this might have been a spike in results which if the test had continued would have regressed to the mean. Rule 1 of a statistical study is you cannot stop just because you get an interesting result.
  2. If we then look at the apparent randomness of the study:
  a) The participants where selected and contacted by mail shot and some then volunteered to take part. No mention is made of take up rate but I would expect it would be very low. There is no discussion about the fact those involved in the trial where all volunteers. Using volunteers is a self selection process. Who has time to take part in such a long term study where you will be taking medicines daily. This is a very select group. The paper ignores this and gives little information on the background on the volunteers. Reading the study my first question (knowing this was a US study and most women who have to pay for HRT drugs) where how many of the volunteers where women who where already taking HRT and joined the study because they would be given the drugs free.
  b) Much is made of the fact that volunteers where selected randomly to receive either a placebo or the relevant drugs. A proper paper would recognise that HRT is a powerful drug with side effects. While the initial selection was random most involved in the study would quickly be aware of whether they where taking the placebo or HRT. If as I suggest above many volunteers where those who where already taking HRT then they would quickly realise if they where getting the placebo and drop out from the study. Can I suggest you look at the drop out rates and this is a possible explanation for the high level of initial drop out from those getting the placebo.

  The study was far from randomised and ignored any consideration of the back ground of volunteers or that most volunteers would quickly realise if they where receiving the placebo or HRT. It then stopped when it got an interesting result.

  These gaps mean the conclusions of the study, which show only minor increases in some health risks, has no validity.

  Subsequent studies have highlighted the problems with a similar UK study with all the same problems again being stopped but highlighting completely different alleged health risks.

  It is almost impossible to do any long term randomised medical studies on people add in testing a powerful drug and it is impossible.

• 172 coz1979 // Feb 6, 2012 at 12:46

  Hi I am a student currently studying complementary therapies. I am a mature student and had previously studied chemistry, so i am always skeptical of everything and like to see scientific evidence for many things, but i do believe in CAM. I think you, in the nicest possible way, have started a campaign and have been a little blind sighted with it. I think universities should teach CAM but because of your campaign a lot have stopped which is very sad as now people who are not being taught to a high standard or level or even learning anatomy etc are doing day or weekend courses and calling themselves CAM therapists (i am completely against this), you wouldn’t want someone going to a weekend course and then calling themselves a GP. CAM does not in anyway replace modern medicine but is complementary to it. Don’t you think if they work in harmony with each other it would be better? CAM couldn’t treat a burst appendix now could it? No obviously not. Perhaps if you campaigned to get the weekend courses stopped and get people fully trained to degree level then i can understand. I would love to do research vigorous research into my treatments as i would love to have scientific evidence to help back it up, but if universities stop teaching where can i get my teaching job so i can do research into CAM. I am anything but blind sighted to CAM and know it has limitations, but i also know modern medicine has its limitations as well. Why not look at it from that point of view. We live in a world/country where people have choices you are trying to stop those choices. Work with the fully trained CAM therapist and see if CAM and modern medicine can work together and not be one against the other?
  Thanks

• 173 David Colquhoun // Feb 7, 2012 at 20:32

  @coz1979

  You say

  “Don’t you think if they work in harmony with each other it would be better?”

  It would be better if the CAM component were effective. Otherwise it would be a waste of time and money.

  If you look through this blog you’ll find many examples of the absurd, delusional, and sometimes outright dangerous, things that are taught to students on three year full time Bachelor of Science degrees. The degrees are not proper training. On the whole they are mis-education. They teach students superstitious and untrue things, and then let the students loose on sick people.

  Perhaps the course that you are doing is better than those that I’ve uncovered. That possibility is easily tested. I’d be very happy if you sent me your powerpoints and handouts from your own course. Let the reader decide.

• 174 coz1979 // Feb 23, 2012 at 10:35

  Yes i do think that certain people make absurd claims, but i also feel that some claims are completely just. I get very annoyed when i hear people training to only HNC or worse a weekend course then go out and practice, they do not have the proper training perhaps compulsory regulation would be the way forward rather than getting universities to stop teaching? A beautician is not a reflexologist but calls themselves one, they can do serious harm. Also i feel that not having compulsory registration is bringing all manner of things into CAM rather than just the therapy with those doing short courses, ie new age, psychics etc… instead of focusing in on the healthcare side

  Research has to be carried out but with CAM it is very difficult as what may make one person better might not with the next. Each treatment is done on an individual basis, which does not fit with the “scientific” model. But like i said before CAM does not replace conventional medicine but should be used along side it. Healthcare should not be about winning or loosing but about what is best for the patient in the long run.
  Also might i add, having seen a GP recently they are not getting the best of training and just seem to sit looking up a computer for symptoms, maybe that should be investigated. Anatomy and pathology is the same across the board so i wouldnt have expected a GP too have to look something very basic up?

• 175 David Colquhoun // Feb 25, 2012 at 19:04

  @coz1979
  You say

  “Research has to be carried out but with CAM it is very difficult as what may make one person better might not with the next”

  Precisely the same is true for any treatment, CAM or not. There is no difference.

  A long course is better than a short one only if the long course teaches students things that are true. This blog has endless examples of full time BSc courses that teach utter nonsense. That is not in the interests of patients.

  Regulation sounds like a good idea in principle, but in practice it doesn’t work. Recent experience with the CNHC and with the GCC has shown that very clearly. If a subject is mystical nonsense in the first place, there is no way that regulation can make it anything other than mystical nonsense.

  I can’t comment on your GP because I have no idea what he/she was looking up.

• 176 005 basher // Apr 3, 2013 at 19:19

  *However, in theory, in the unlikely event that homeopathy passed
  clinical scrutiny it would be the job of scientists to establish a
  reason for its clinical efficacy.

    <a href=”http:www.facebook.com/”>facebook</a>

• 177 keynes // Jun 22, 2013 at 13:55

  **However, in theory, in the unlikely event that homeopathy passed

  clinical scrutiny it would be the job of scientists to establish a
  reason for its clinical efficacy. I agree this comment…

• 178 flymail // Jul 16, 2013 at 08:11

  @DC’s comment:

  `In order to use Bayes’ theorem, we would have to postulate a prior
  distribution for the value of each rate constant. We have no idea before we fit what these values will be. We may sometimes hope that particular values will emerge in order to test some idea that we have,
  but to use such hopes as a prior would be merely to influence the outcome of the experiment by feeding in our prejudices. That would, in my view, be wrong. Consequently we use only the uncontentious right hand side of Bayes’ theorem, the likelihood, and choose values that maximise the likelihood. That way each experiment stands alone.’

  I have no desire for the thread to degenerate to a frequentist vs Bayesian argument, but it is disheartening to to see so-esteemed and numerate a scientist as DC to make such statements in a public forum. While in the past such conceptions may have reasonable, they nowadays seem just out-of-date following recent developments in probability and information theory. Nowadays it’s trivial to assign naive (i.e. non-informative) priors to most (though not quite all) parameters of probability distributions and they are _not_ based on prejudice but easily justified by their mathematical properties (e.g. using MaxEnt, invariance under reparameterisation, conjugation – although I concede conjugation is more `convenient’ than `correct’).

  Using likelihoods is just equivalent to shrugging one’s shoulders and assuming a flat prior in willful ignorance of the known properties of parameters (e.g. -inf<mean<+inf cf. 0 < S.D < +inf). This is as arbitrary an assumption as plucking a prior at random. It doesn’t necessarily make it wrong, just inefficient. No wonder the physical scientists are light years ahead in solving inferential problems in comparison to their biological colleagues. It is reminiscent of the exchanges between Ronald Fisher and Harold Jeffreys. I imagine it’s no coincidence that Ronald Fisher was a biologist whereas Harold Jeffreys was a physicist.

  Is strongly advise DC to read Edwin Jaynes’ book `Probability Theory: The Logic of Science’. Then I suggest DC reconsiders his position in the light of recent developments. If DC wishes to remain unsympathetic to Bayesian approaches then that’s fine (and DC would by no means be alone!), but I would hope at least DC would be enlightened to see how priors are based  on the numerical properties of the relevant parameters and not on prejudice as dismissively contested above.

• 179 David Colquhoun // Jul 18, 2013 at 14:18

  @flymail

  Oh dear, it seems a pity to let this discussion degenerate into anonymous abuse.

  The procedure that you describe merely constrains parameter estimates to lie within a physically-plausible range. If you had bothered to check our methods before firing off, you would have known that we have done this for years. Such constraints have no necessary connection with Bayes’ theorem at all, so I think you argument is a red herring. For example, we fit log(rates) so that all estimates are constrained to be positive. That’s much simpler than invoking Bayes. We also set a physical upper limit for association rate constants, usually to below $ 10^{10} M^{-1}s^{-1}$. Since we use Simplex optimisation rather than a gradient method, this is very easily achieved by resetting the parameter to the limit if it goes past the limit.

  Presumably these procedures give us the same estimates as the Bayesian formulation, but in a much simpler way. That being the case, remarks like “No wonder the physical scientists are light years ahead in solving inferential problems in comparison to their biological colleagues” seem to be not only arrogant and condescending, but also wrong.

• 180 flymail // Jul 18, 2013 at 14:52

  DC:  Oh dear, it seems a pity to let this discussion degenerate into anonymous abuse.

  My apologies. Abuse was not intended.

  DC: The procedure that you describe merely constrains parameter estimates to lie within a physically-plausible range. If you had bothered to check our methods before firing off, you would have known that we have done this for years.

  What you call constraints are merely the limits of a flat prior. But because you clearly do not understand Bayesian methods, your criticism is misdirected. I was _not_ referring merely to boundary conditions but referring to how to derive parametric transformations that afford efficient fitting (you provide an example below). The difference with Bayesian approaches is that this transformation is not ad hoc.

  DC: Such constraints have no necessary connection with Bayes’ theorem at all, so I think you argument is a red herring. For example, we fit log(rates) so that all estimates are constrained to be positive. That’s much simpler than invoking Bayes.

  It would appear you are unwittingly invoking Bayes by fitting log(+ve only parameters) according to Jeffreys rule for standard deviations. The prior prob(parameters)= constant/parameter is effectively the same as fitting log(parameters). Since non-informative priors can be assigned objectively to derive the ideal parameter transformation for parameters of most (though not all) probability density functions, probabilities turn out to be much simpler than likelihoods because you get the same result every time rather than resorting to arbitrarily chosen ad-hoc transformations that `get the right answer’.

  DC: Presumably these procedures give us the same estimates as the Bayesian formulation, but in a much simpler way.

  I’m glad you used the word `presumably’ because the Bayesian formulation is usually simpler for solving _really_ complex problems because it’s much easier to deal with probabilities than their un-normalised counterparts (i.e. likelihoods) that demand i.i.d. data.

  DC: That being the case, remarks like “No wonder the physical scientists are
  light years ahead in solving inferential problems in comparison to their biological colleagues” seem to be not only arrogant and condescending, but also wrong.

  I apologise. However I suspect you’re as guilty of prejudice against Bayesian methods as much as you suspect Bayesian methods are guilty of prejudice. In order to allay the latter, I strongly urge you to read Edwin Jaynes’ book (at least on how to assign non-informative priors) before you resume bashing Bayesian methods on the basis of prejudice. At least that way your bashing would be informed!

• 181 David Colquhoun // Jul 18, 2013 at 19:55

  I’m quite aware that it’s possible to formulate the constraints as a uniform Bayesian prior.  It merely seems like an unnecessarily complicated way of formulating very simple physical ideas, like rate constants can’t be negative.  The reasons for the constraints come from physics, not statistics. It’s nothing to do with Jeffery’s rule. 

  I don’t think I am prejudiced against Bayes’ methods in cases for which you have a real (observed) prior distribution.  That does not include problems like mine.

• 182 flymail // Jul 18, 2013 at 22:05

  DC: I don’t think I am prejudiced against Bayes’ methods in cases for which you have a real (observed) prior distribution.  That does not include problems like mine.

  I think you’ll find your comments on this site (and others) are at odds with this the first sentence.

  DC: I’m quite aware that it’s possible to formulate the constraints as a uniform Bayesian prior.  It merely seems like an unnecessarily complicated way of formulating very simple physical ideas, like rate
  constants can’t be negative.  The reasons for the constraints come from physics, not statistics. It’s nothing to do with Jeffery’s rule. 

  I’m afraid it’s clear to me (or any other fluent probabilistic modeller) that you still don’t understand. Please read the book (and no I don’t have shares!): if you’re pushed for time, focus on Chapter 12. If you’re still not convinced then that’s fine, but I really don’t think you’re in a position to fairly criticise Bayesian methods until you do.

• 183 David Colquhoun // Jul 18, 2013 at 23:33

  @Flymail

  Since you are anonymous, I have no idea what field you are in, so I can’t judge your claims.  In my field, Bayesian methods will give the same answer as I get without them. So I don’t understand why you are getting so excited.  It isn’t religion (or is it?).

• 184 flymail // Jul 19, 2013 at 08:47

  DC: Since you are anonymous, I have no idea what field you are in, so I can’t judge your claims.  

  Knowing my area of expertise will be of no help to you, suffice to say that scientists from chemical/physical or engineering backgrounds would not have the difficulties you appear to have in understanding what I am saying. My intent was purely to point out your issue against Bayesian priors prejudicing data analysis is really a non-issue because any serious probabilistic modellist would employ a non-informative prior which can be assigned objectively.

  DC: In my field, Bayesian methods will give the same answer as I get without them.

  That tells me three things:

  a) You only use flat priors: that’s the _only_ way you can obtain exactly identical same answers (including confidence limits). If your posterior is directly proportional to the likelihood of course you’ll get the same  answer. Have you ever considered that a flat prior doesn’t necessarily represent the greatest state of ignorance concerning a specific  parameter? In most cases, it doesn’t.
  b) You don’t know Jeffrey’s rule and why it’s useful.
  c) In your field, your problems appear to be sufficiently simple to be solved using likelihood methods alone. In complex systems where you have to create sophisticated models to make inferences based on data sets that aren’t necessarily i.i.d., you cannot use likelihoods because it’s only valid to combine likelihoods if all your data are independent and identically distributed – this is not a requirement of probabilities.

  DC: So I don’t understand why you are getting so excited.

  I’m afraid it’s not excitement, but merely expressing a groan upon reading your uninformed comments. To those who actually perform probabilistic modelling, your accusations of Bayesian analysis imposing one’s prejudices read as naive (no offence intended) or out-of-date at the very least. Do you really think probabilistic modellers would waste their time performing complex analysis (used in industry as well as academia) if there was any chance of being able to reduce it to ridicule by the effects of one’s prejudices?

  DC: It isn’t religion (or is it?).

  I will overlook your religious slur, except to answer `use what works’ whether it’s likelihood or probabilities. You will notice I’m not zealously criticising likelihoods, but only highlighting their limitations. You on the other hand are critical of Bayesian approaches on the basis of priors, that you think cannot be assigned objectively.

  My intent was draw your intention to non-informative priors (with a helpful and very readable reference) that readily overcomes your objections in nearly all (and I have already conceded not _all_) cases. I intended to enlighten rather than convince. I failed; so I will now withdraw and move on. Life’s too short.

• 185 David Colquhoun // Jul 19, 2013 at 15:07

  I said right at the outset that flat priors are the only thing that’s appropriate when estimating rate constants in a chemical reaction scheme.  If you think otherwise, please make a suggestion.  The mathematics of calculating the likelihood with exact allowance for missed events is far from simple.  The inference problem is quite straightforward once you’ve done it.

  I find your condescending attitude quite astonishing. You keep saying that I’m wrong and/or naive without providing any examples to show why.

  It’s tempting to quote the eminent statistician, Stephen Senn, who tweeted yesterday

  @david_colquhoun This must be same Bayesian physicist troll who worships Jaynes (a physicist) despite the objections .http://t.co/hEC8EtmnWo

  — Stephen John Senn (@stephensenn) July 19, 2013

• 186 phayes // Aug 9, 2013 at 13:06

  :-(

  I really hope the [Frequentist] statistician trolls who hate Jaynes (not a Bayesian) despite the objections and the Jaynes worshippers from hell don’t continue this for another 250 years. 

• 187 Jochen Lueg // Aug 10, 2013 at 10:10

  Hello David

  Apart from agreeing with nearly everything you say, I just wanted to point out that nthe links at the top of your page to ‘archives’ and ‘about’ don’t seem to work (on this machine anyway).

  All the best from Northern |Ireland

  Jochen Lueg

• 188 David Colquhoun // Aug 11, 2013 at 13:45

  Thanks -I know they don’t work, but haven’t found a way to get rid of them. The front page is “about” and “archives” is at the bottom of the left side bar (though I have never found it to be useful).

• 189 Jochen Lueg // Aug 12, 2013 at 17:08

  Hello again David

  I loaded the source of your front page into Kompozer, and it seems to me that if you remove lines 134 and 135 and save and up-load the document the two lines should be gone.

  Unless I am missing something.

  All the best

  Jochen

• 190 Gary // Sep 23, 2013 at 23:03

  Dear David,

  Lovely site. Sorry for posting on the mainboard, but Twitter etc…, is beyond me!

  My prior experience of hospital work in the NHS has been completely alternative-medicine free and so it’s quite worrying to see how much has crept in since.

  Just a quick suggestion about the site (which I guess have already been made). How about having more than one thread (e.g. one for homoeopathy, one for political argy-bargy, and one for statistics which seems to a bee in the bonnet for some)? I realise there may be some overlap, but it’s quite intimidating to have to read a very long stream before being brave enough to post in case you missed something.

  Gary.

• 191 David Colquhoun // Sep 24, 2013 at 11:07

  Thanks Gary

  I don’t know how you could split the blog into separate threads, but I’m
  not sure that it’s desirable anyway. Medicine, politics and statistics
  are all aspects of evidence and it’s not really possible to separate
  them.

  The best way to find things that are too old to appear under “recent posts” is to use the search box.

• 192 Gary // Sep 30, 2013 at 22:08

  Thanks David, I see your point. I guess you don’t view too many webpages on a mobile phone!

• 193 David Colquhoun // Sep 30, 2013 at 22:36

  Actually I use the mobile more and more.  I have a plug in that removes the sidebars, but the search is still available (top right) in both the Android default browser and in Chrome for Android.  The menu button (top left) brings up the list of pages (as opposed to posts).  But there is no way to see anything else.  For other things you have to swap to desktop view which shows all three columns as on a desktop. In that view you have to expand the bit you want to see if it’s on a phone.

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