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Thanks To CBC Marketplace’s Erica Johnson

January 18, 2011 Leave a comment

A few days ago, I wrote a post about the CBC Marketplace episode on Homeopathy called “Cure or Con?”

I was quite pleased with the episode, and made that known. I also decided I would send my appreciation to the host of the show, Erica Johnson via Twitter.

I didn’t expect a response, but to my surprise she was kind enough to this nerdy little internet blogger a message back.

There certainly is a lot of animosity towards her and the episode from homeopaths, mainly because they are running out of options on how to defend their practice. The evidence is quite clear that homeopathy is nothing but a placebo, and homeopaths are bilking honest consumers out of their money.

Perhaps more importantly, they are putting people at a huge health risk if they choose homeopathic remedies rather than real medicine.

Just know that you have lots of supporters Erica, and don’t let the Homeopaths nonsense get to you!

Yet Another Acupuncture Experiment Overblown

November 30, 2010 4 comments

Acupuncture being performed. From Wikipedia

A presentation is being given today at the 96th Scientific Assembly and Annual Meeting of the Radiological Society of North America.

A couple of media outlets have jumped on this presentation, titled “Influence of Acupuncture on Pain Modulation during Electrical Stimulation: An fMRI Study“.

The headline in the Telegraph reads: Acupuncture’s effect ‘isn’t just psychological’

In the Daily Mail it reads: Acupuncture is no placebo and does relieve pain, say scientists

The Telegraph headline is misleading, and the Daily Mail headline is just plain wrong. And, as I’ll point out, both are overstating the findings of the study, as are the scientists who performed it.

So first off, fMRI stands for Functional Magnetic Resonance Imaging. It is a type of MRI scan which can determine which parts of the brain become “activated” by measuring the amount of blood flow to each part of the brain.

It is a fascinating field of study, and in a future post I will explain the physics of MRI, but for now lets just say that fMRI is (somewhat) able to tell which parts of the brain “turn on” when you do certain tasks.

So what happened in this particular study is this: the authors got 18 healthy volunteers and shocked their ankle with an electric shock to induce pain. At the same time, they imaged their brain using fMRI.

Next, they took the same 18 people, performed acupuncture on them, and then shocked their ankle again and took another fMRI of their brain.

They compare the two images, before and after the acupuncture, to see which parts of the brain light up (or don’t) to see if they could see any differences in how the brain reacts to pain stimuli with and without acupuncture.

And wouldn’t you know it? They did see a difference. Their conclusion:

Activation of brain areas involved in pain modulation was significantly reduced or modulated under acupuncture and the majority of the detected areas were not influenced by the analyzed covariate. However, left anterior insular cortex and orbitofrontal / superior frontal gyrus activation was modulated by stimulus intensity. We hypothesize that insula activation seems to be correlated to the stimulus and pain intensity while the importance of frontal activation increases during acupuncture and may be an acupuncture specific effect.

Essentially, they found that after the acupuncture, parts of the brain which control pain were not activated as strongly. Not only that, but the affective response to pain (the frontal cortex) was changed after the acupuncture as well. Pretty convincing right?

No. It’s not . First off, a similar response has been shown by Wager et al. in 2004 that placebos induce the same effect.

Second, it has also been shown that expecting pain can alter one’s response to pain. This study had the volunteers get their ankle shocked first, then they got acupuncture and had to be shocked again. They were expecting the pain, so this may have affected the results.

Third, there was no control group. A proper study should have had a placebo type of acupuncture, such as pricking the skin with toothpicks (which has been done before) or placing the needles at non-acupuncture points. Or they should have tried some other type of pain relief, like massage or relaxation prior to the second shock, to see if there was any difference.

Fourth, the study only had 18 volunteers. To make a claim that acupuncture works based on such a small group is irresponsible.

Fifth (geez, five points?!) fMRI is not easy to gather accurate conclusions from. The workings of the brain are affected by many things and brain responses can be non-localized.

I am not refuting the results of the study, only the conclusions drawn by the authors and the media. The data itself is not surprising. In fact, it is exactly what you would expect since placebos have shown similar results. But to draw the conclusion that this is an acupuncture specific effect from this data is fallacious.

Pseudoscience for Christmas Anyone?

November 22, 2010 Leave a comment

I don’t fly very much. And when I do, I am usually so engrossed in my headphones that I don’t bother looking at the crap they have for sale in that catalog sitting in the pouch in front of me.

SkyMall apparently does good business selling products to weary travellers. I never really knew what kind of stuff they had in there, until I read this article in the L.A. Times about some of the alt-med nonsense that evidently graces its pages.

The one product that simultaneously had me chuckling and my blood boiling was the Aculife Therapist Deluxe, a do-it-youself acupuncture tool. Acupuncture is an ancient Chinese medicine which has become popular in North America because, well…the Chinese must know what they are doing right?

Putting aside the fact that acupuncture has never consistently shown any effect greater than a placebo, let’s look more closely at this product which was developed in Ireland (wait…what?).

Aculife Therapist Deluxe. From SkyMall Website

Aculife claims to work by using magnetic pulses instead of needles to stimulate acupuncture points in the hand. Even though traditional acupuncture uses points all over the body, this product claims to do the same thing, but using only your hand. Their evidence?

Otzi, a 5,000 year old mummy found in the Alps during 1991, has spurred a whole new vigor into modern research of the Ancient Chinese medical practice of acupuncture. Recent examinations of the mummy found that Otzi has a number of tattoos that coincide with acupuncture points that would be used to treat various ailments from which he was suffering.

While it is true that Otzi had some tattoos which show some similarity to acupuncture points, it could just be a coincidence as there are a large number of acupuncture points. Also, Otzi had no tattoos on his hand, but Aculife makes no mention of that.

Map of relevant points in the hand, according to Aculife.

Combining magnets with acupuncture is like mating Bigfoot with the Loch Ness Monster. Two pseudosciences for the price of one. But by using the “latest ancient technology” (wait… what?) Aculife claims to be able to treat (from their ad on Amazon):

hypertension, insomnia, fatigue, asthma, ulcers, hemorrhoids, high-blood pressure, rheumatism and muscle pain. You can even have a simple ailments treated like stiff backs, muscles and neck from constant travel or strenuous workouts.

One of the keys to having a product sell well is to have a large demographic to sell to. And you would be hard-pressed to find someone who doesn’t suffer from at least one of the aforementioned ailments.

So does it work? One of the customer reviews on the SkyMall website claims that he used the product for a toothache. The results?

the pain was still there but more bearable.

My favourite review came from Robert Strohmeyer of PCWorld:

I did spend a little more than an hour zapping myself while following the dubious included “Acupoints” chart. The result? It’s probably not as uncomfortable as a dog-training collar, but likely just as effective for most maladies.

Basically this is yet another alt-med product using pseudoscience, anecdotal evidence and the placebo effect to make a profit. And at a $200 price tag ($250 at Amazon!) it is making quite a profit indeed.

On a related note, likeminded folks at Skeptic North are planning a field trip to the Whole Life Expo next Sunday in Toronto, “Canada’s largest showcase of natural health and green living”. It is usually a great place to find all kinds of wacky “health” products, so if you are in the area you should check it out.

“Natural” Does Not Mean “Better”

November 18, 2010 10 comments

At least, not always.

But that’s what purveyors of Natural Health Products (NHPs) say. Synthetic is bad. Natural is good.

Unfortunately, things are not that simple. Some things that occur naturally on Earth are very good for you. But some of them are very bad.

Some things that are synthetic are very good for you. But some of them are very bad.

And some things, natural and synthetic, do nothing at all.

Along with the Green revolution came the Natural Health revolution. We’ve begun to hear more and more about how many chemicals permeate through our food chain, how many pills we take and how many food additives we eat.

As a corollary, we have begun to see Natural Health and Food stores cropping up on street corners. Supermarkets have "all organic" sections. Pharmacies have a whole aisle dedicated to herbal supplements.

Whole Foods Market in Redwood, California. Via Wikipedia

Companies respond to customer demand. Customers have begun demanding natural and "organic" foods. So companies have committed resources acknowledging this demand.

But are these products as good as the companies say? Do the hippies down at the natural food store know, without a doubt, that taking certain supplements will boost your immune system, or help prevent cancer, or increase your energy level? Or are they simply reading the label and regurgitating it to their customers?

It is a question that has gotten some international attention recently. Most notably perhaps, is the company POM Wonderful, which has

…been banned from endorsing any product without competent and reliable scientific information to back up the claim. [The Globe and Mail]

POM Wonderful has shown up in the news a couple of times this year. In March, POM was one of 17 companies given a warning letter from the Food and Drug Administration for making misleading statements about their POM Juice and POMx pills.

In the case of POM pomegranate juice, the agency said that the company’s Web site, which is listed on its bottles, carried misleading claims that the juice could prevent or cure diseases like hypertension, diabetes and cancer.Such claims are not allowed on food products and would require that the juice be treated, in regulatory terms, as a drug, according to the letter sent to the company. [The New York Times]

In September of 2010, the Federal Trade Commission released a statement concerning the advertisements of POM. David Vladeck, Director of the FTC’s Bureau of Consumer Protection said

When a company touts scientific research in its advertising, the research must squarely support the claims made.  Contrary to POM Wonderful’s advertising, the available scientific information does not prove that POM Juice or POMx effectively treats or prevents these illnesses.

POM disputes the FTC’s claims, and has filed suit against them. This battle will go on for a while.

But this situation raises a big question: how are NHPs regulated? How are the health benefits they claim to provide substantiated? Let’s investigate…

Perhaps unsurprisingly, NHPs are not regulated in the same way as drugs. Up until the 1990’s, Canada did not have a non-drug supplement regulation framework in place. Products were either drugs or they were food products.

After several years in development, the Natural Health Product Regulations (NHPR) were put into effect on January 1, 2004. So what products fall under these regulations?

Products that fall within these Regulations include herbal remedies, homeopathic medicines, vitamins, minerals, traditional medicines, probiotics, amino acids and essential fatty acids. In addition, many everyday consumer products, such as certain toothpastes, antiperspirants, shampoos, facial products and mouthwashes are also classified as NHPs in Canada because of their medicinal ingredients and intended uses. [Health Canada Website] (emphasis mine)

I emphasize ‘homeopathic medicines’ because I am not a big fan of homeopathy and I am thoroughly disgusted that Canada allows such products to be sold.

So the NHPR does require that these products meet certain standards of safety and efficacy. Unfortunately, these standards are set extremely low.

In the case of homeopathic medicines, for example, Health Canada will accept references to the Homeopathic Pharmacopeia or Homeopathic Materia Medica. These documents are essentially a collection of anecdotal evidence, and have no scientific basis.

For other NHPs, Health Canada will accept "references to a traditional use". This means that if a product has been used for over 50 years to treat a certain ailment, it is deemed "effective" by Health Canada standards. No scientific evidence or medical studies are necessary in this case. If sufficient documentation is not available to prove that a product has been used for 50 years, the word of "three or more herbalists or aboriginal elders may serve as the source of information".

What pops into my mind in this case is bloodletting, which was used for well over 50 years and, by these standards, it would have sufficient evidence to prove its efficacy.

The topic of efficacy becomes the primary issue here. I would never take a prescription medication, or even an over-the-counter medication, without knowing that it has been sufficiently tested. Why then, do we take NHPs without demanding the same high standards of testing?

It seems as though we should. Looking at Health Canada’s Advisories, Warnings and Recalls for the Public – 2009, we see that more than half of the warnings were issued for NHPs.

Natural, it seems, does not mean better.

It is a very polarizing issue. A post written by Barry Green on Ottawa Skeptics a couple of years ago summarizes the position of the two sides extremely well.

When skeptics look at NHPs, they see a broad spectrum of products ranging from those proven effective under certain circumstances (vitamins) to those with possible pharmacological properties yet unproven (naturopathy) to those which are the very essence of quackery (homeopathy).  Skeptics see efficacy regulations as necessary to prevent wasting healthcare spending on nonsense and to protect the public from fraud and the dangerous distraction of ineffective treatments.

When CAM advocates look at NHPs, they see a rich pharmacopoeia of natural remedies whose curative powers, tapped through ancient wisdom, can be experienced firsthand without the need for scientific sanction, the dangers of "allopathic" medicine or the enrichment of "Big Pharma."  NHP supporters see efficacy regulations as unethical restriction and unnecessary expense.

My personal opinion is that NHPs should be required to undergo a higher standard of efficacy and safety testing. I don’t think all NHPs are bad. However I do feel that any product which is intended to alter the function of your body, even if the intent is to improve function, should be rigorously tested.

This will not go over well. It was announced recently in the European Union that all herbal supplements must be classified as either food or drugs by April 2011. This puts the supplements under the same guidelines of testing as pharmaceutical drugs. However, many NHP proponents see this as a big problem, since many small-time manufacturers of NHPs will not be able to afford to get the regulatory approval and be driven out of business.

This seems a bit hypocritical to me. If you are so concerned about the health of people, don’t you want to guarantee that what you are selling them is not only safe, but also that it truly is making them healthier?

Another big problem is that the current system of regulation makes it far too easy for peddlers of pseudoscience and quackery to make a profit off the general public, whose choices about products and treatments for maintaining a healthy lifestyle have gotten much more complicated in recent years. The recent acai berry scam comes to mind, not to mention the large number of sham diet drugs on the market today. All of these products were able to flourish because of the lack of strong regulation on NHPs.

So sometimes "natural" is better. Sometimes it’s not. But in order to be sure the products need to be tested. We can’t take tradition, word of mouth, or anecdotes as evidence anymore. We need something more concrete. Because after all, we are all trying to be healthy. So let’s do the legwork and find the best way to make that happen.

Homeopathy “Tricks You” Into Feeling Better? *Facepalm*

November 17, 2010 1 comment

Homeopathy is a form of Complementary and Alternative Medicine which has been largely discredited by the medical community. At its core, it is the belief that by diluting a substance to extremely small amounts, often until none of the active ingredient remains in the final product, makes the remedy more potent.

It makes no sense, and it doesn’t work. Yet because of tradition and some unfortunate legislation in 1938 in the United States, Homeopathy is still around.

A study was published earlier this week in the journal Rheumatology. Some news outlets are saying that the outcome shows that homeopathy “tricks you” into feeling better. This made me feel like poor Captain Picard here.

The study examined 5 groups of patients suffering from Rheumatoid arthritis. It split these participants into 5 groups:

  1. Those that received consultation and individualized treatment from a Homeopath
  2. Those that received consultation and complex treatment from a Homeopath (complex treatment is giving the patient a group of standard homeopathic remedies which are not tailored specifically to the patient).
  3. Those that received consultation from a Homeopath but given a placebo.
  4. Those that received no consolation and given complex treatment.
  5. Those that received no consolation and given a placebo.

The groups were blinded as to whether they received a placebo or a real treatment, but obviously you couldn’t blind them to whether or not they received a consultation.

I won’t go into all the data analysis or statistics, but the results eventually state that there was no difference between the placebo treatment and homeopathic treatment, which is not surprising.

However, the authors go on to assert that there was a significant difference between those that received a consultation and those that didn’t, and that this is evidence for the efficacy of homeopathy.

From the Telegraph:

Dr Sarah Brien, the study’s lead author, said that while previous research had suggested homeopathy could help patients with rheumatoid arthritis, the study provided the first scientific evidence to show such benefits were “specifically due to its unique consultation process”.

There are a few problems with this. The first is that the study is fairly small, therefore the power of their results is not high enough to make any broad stroke conclusions about the efficacy of homeopathy.

Second, the group which received a consultation was not adequately compared to anything. Comparing a homeopathic consultation to no consultation, and then claiming that homeopathy made these people feel better is not a sound conclusion. The authors should have compared the group receiving a homeopathic consultation to a group which received some other form of personal consultation or experience, like speaking with a medical doctor or hell, even a motivational speaker!

Steven Novella gives a good explanation on Science-Based Medicine about the Hawthorne effect which can have a significant impact on a study. Having the personal experience of speakin to a person may make for a better patient outcome, but it certainly does not prove any efficacy of homeopathy itself.

My 100th Post!

September 25, 2010 2 comments

I realize that if we humans had evolved 8 or 12 fingers instead of 10, then perhaps this particular post wouldn’t hold as much meaning. But since we do live in a base-10 world, happy 100th post!

Its been only a few short months since I started this blog, and I am quite proud of how it has progressed. I can only hope that you have enjoyed reading it as much as I have enjoyed writing it.

I got the idea of starting a blog when I moved from Ontario to Alberta after finishing my M.Sc. degree. I got a “real” job out here in oil country, but found that I was missing some of the intellectual stimulation of being in school and doing research.

That being said, I was not about to head back to the lab just yet. Instead, I thought it would be a good idea to branch out and start exploring new topics; topics that were currently making it into the news.

Unfortunately, what I found in the news was not always “science”. Alternative medicine, UFOs, psychics, and *emphatic groan* anti-vaccinationists were what I kept reading about.

And so I discovered the skeptical movement. A large collection of scientists and bloggers (often both) who shared my viewpoint on “science” in the media. We all decided that we wanted to do something to change it, and this new thing called the “interweb” has given us the ability to do so.

So what does the future hold for ‘A Quantum of Knowledge’?

Well I will be trying to do more blogging on current research papers and making them accessible to the general reader. What I’ve also found is that some of my most popular posts are when I explain the “Physics Of” everyday things, as well things you hear about in the news (like solar cells, Vuvuzelas, or that girl getting hit with the watermelon). So expect to see a whole bunch of posts explaining the physics of everything from hair dryers (why DO they always trip the circuit breakers?) to the new James Webb Telescope.

You can also expect me to start writing a bit more about myself and what I actually do out here in good ol’ Calgary. Some of the most interesting posts from the blogs I read are those about the author’s everyday lives, so expect to see more of that here.

Finally, I’d like to say thanks to you, my readers! I’ve gotten a great deal of satisfaction from watching my readership grow and reading all of your comments. Keep reading, keep commenting, and if you really like a particular post,  maybe you could help me promote it by using the ‘Share’ buttons down at the bottom of the page.

You can also follow me on Twitter, where I send out my thoughts and interesting science links as they happen.

P.S. If you have any ideas or physics related questions you’d like to have answered, please feel free to email them to aquantumofknowledge@gmail.com . I’m always looking for topics to write about so I’d love to hear from you guys!

Why Homeopathy is Stupid and Dangerous

July 13, 2010 2 comments

There are a lot of quacks out there. People will do, say or sell anything for a buck. And unfortunately, the field of “medical therapies” has long been victim to such quackery.

Homeopathy is one of the more prolific of these pseudosciences. It operates on a principle that by diluting a remedy in water, you can make it more effective. In fact, homeopaths claim that the remedy gets more effective in smaller concentrations. This is what homeopaths call the “Law of Infinitesmals”.

Now common sense should already be telling you that this is bogus. But lets do some history, and then science will blast apart homeopathy.

From xkcd

In the late 1700s a German physician named Samuel Hahnemann (1755-1843) developed the underlying theories of homeopathy. He believed that symptoms of disease could be cured by administering small amounts of substances that would cause the same symptoms in healthy people. This is called the “Law of Similars”. He further believed that chronic diseases were caused by the presence of evil miasmas or spirits in the body.

Samuel Hahnemann (1755-1843)

So, homeopaths have a text called the Homeopathic Pharmacopeia. Within, you will find over a thousand homeopathic “remedies”. Which remedy, and in what concentration, to use on a certain patient is evidently at the discretion of the practitioner. Basically this means you could see two different homeopaths and receive two different treatments for the same illness. Hmmm…..

To show you how dumb this stuff is, consider the following:

A “remedy” called Oscillococcinum is prepared by diluting freeze dried duck heart and liver. The dilution is supposed to be what homeopaths call 200C, which means the concentration is 1 part in 100200

For the non-scientific, this number is a 1 followed by 400 zeros. That this small concentration could have any effect at all is mind boggling.

In fact, the laws of chemistry state that there is a limit to how far one can dilute a solution (about 1 part in 10012, which is far greater than that of Oscillococcinum). Hahnenmann was aware of this, but proposed that by vigorously shaking the solution the water will retain a kind of “memory” or “essence” of the active ingredient. Thus, even if none of the active ingredient remains in the water, the water will somehow “remember” it was there and give the same effect.

Homeopathy has never been shown to do anything greater than a placebo effect. There are many studies and reviews looking at the scientific evidence. One such review noted that:

Homeopathy has been the subject of at least 12 scientific reviews, including meta-analytic studies, published since the mid-1980s….[And] the findings are remarkably consistent:….homeopathic “remedies” are not effective.

In addition, at a meeting of the British Medical Association’s junior doctors in May 2010, Dr. Tom Dolphin, deputy chairman, said:

Homeopathy is witchcraft. It is a disgrace that nestling between the National Hospital for Neurology and Great Ormond Street there is a National Hospital for Homeopathy which is paid for by the [National Health Service]. (emphasis mine)

In should be noted that there has been a small smattering of studies suggesting a statistically significant effect of homeopathy over a placebo. However, these studies have never been shown to be reproducible and are heavily criticized for their poor scientific methodologies. Homeopathy proponents will tout these studies proudly; but a simple bit of research, or even just reading the papers will show the weaknesses in any of these studies.

So why do people continue to believe in this stuff? Well there are a couple of reasons.

The first is that when Hahnemann began developing homeopathy, treatments such as bloodletting were ubiquitous. Bloodletting, if you didn’t already know, is extremely dangerous and ineffective as a medical treatment.

So when someone arrived on the scene offering medical “remedies” which don’t involve opening people’s veins, and sometimes even make the patient feel better (the placebo effect) it garnered a lot of attention.

Secondly, the placebo effect can be significant. And word of mouth is a powerful force. So when one person says they feel better after seeing a homeopath, people start to listen. In fact, studies have shown that people are more likely to listen to a friend than read the scientific evidence.

This is dangerous.

Touting the placebo effect as a medical treatment is wrong and terrible. It causes people to choose pseudoscientific treatments over science-based medical treatment, which can lead to disastrous results and even death.

Furthermore, it leads to unscientific thinking. Once we start believing in homeopathy, whats next? Faith healing? Aliens listening to our thoughts? Its a very slippery slope and it needs to be stopped.

Thirdly, some insurance companies cover homeopathic treatments and some governments cover it in their public health plan. So we are all footing the bill in our insurance premiums or taxes for a therapy that simply does not work.

So my final words? Homeopathy sucks. It doesn’t work. It steals money from sick people who believe they are being treated for their illness. It takes advantage on the hopes of sick people to make a profit, and it is disgusting.