Pathetic government response to criticisms of homeopathy

The Science and Technology Committee investigation into homeopathy concluded that homeopathic products should not be exempt from requirements of efficacy. Here’s the Government’s response:

37. Homeopathy has a long tradition in Europe and is a recognised and widely used system of medicine across the EU. The Government takes the view that consumers who choose to use homeopathic medicines should be fully informed about their purpose and assured that standards of quality and safety are maintained. If homeopathic medicines were not subject to any kind of regulatory control consumers would not have access to such information or assurances. Conversely, if regulation was applied to homeopathic medicines as understood in the context of conventional pharmaceutical medicines, these products would have to be withdrawn from the market as medicines. This would constrain consumer choice and, more importantly, risk the introduction of unregulated, poor quality and potentially unsafe products on the market to satisfy consumer demand.

Oh well, that’s fine then. It’s obviously more important that people have access to all ‘medicines’ ever dreamt up, than that anyone ensure they work.

An unexpected scrape

Yesterday I woke up with a slight irritation in my eye – it felt like a piece of grit was lodged somewhere, and wouldn’t come out. It was still there this morning, and hurting a bit more, so I figured I’d best get it looked at. I’m away for the next few days, so I needed something pretty quick. Unfortunately my opticians didn’t have anyone around, and a cheeky call to an optician whose computers I fix didn’t help either. So I thought: forget it, I’m sure it’ll go away by itself. But someone suggested I ask at the local Vision Express on the off-chance. So I did.

Optician Chap found a ‘foreign body’ attached to the cornea, and is sending me to the hospital to have it ‘scraped off’. Doesn’t that sound delightful? So I’ll head over there shortly. Apparently it involves anaesthetic, and lots of waiting around. My Dad apparently had the same thing once, and had to wear an eye patch for a few days. I’m rather hoping technology has improved, even though an eye patch would be BRILLIANT.

Quite glad I went. Apparently there’s a danger it could get infected, spread about the cornea, and damage my vision. So I’d best stop blogging and get over there.

Update: All sorted. The eye clinic was closed, so I went to A&E (feeling guilty as it didn’t seem serious, but he had mentioned infection) and they diagnosed it as a ‘corneal abrasion’: essentially, something smacked into my eye and left a crater. I have antibiotics, and it should heal fine. Doctors are amazing, aren’t they? No need for an eye patch, sadly.

Caffeine baby cancer argh run aliens

Do you think someone’s playing a trick on the Daily Mail? Because this reads like one big practical joke:

Women who drink coffee or tea during pregnancy may increase their baby’s odds of developing cancer, doctors believe.

Sounds bad. Details pls.

To establish the link, scientists at Leicester University will scrutinise the caffeine intake of hundreds of pregnant women and compare the results with blood samples from their babies after birth.

Wait. What? To establish the link? That’s a bit backwards. Something’s fishy.

‘Although there’s no evidence at all of a link between caffeine and cancer, we’re putting two and two together and saying: caffeine can induce these changes and it has been shown that these changes are elevated in leukaemia patients,’ added Dr Cooke.

I can’t decide whether it’s more likely the DM is being tricked, or some ‘scientist’ is actually silly enough to say such a sentence out loud, in front of people.

The Mail’s headline on this story? “Coffee may raise child cancer risk: New evidence that caffeine could damage babies’ DNA.” Have I mentioned how much I despise the Daily Mail? Appropriate sarcasm can be found at The Daily Quail. Via NHB.

Itching

Itching. How interesting a medical topic can it be? Turns out, very very:

Now various phenomena became clear. Itch, it turns out, is indeed inseparable from the desire to scratch. It can be triggered chemically (by the saliva injected when a mosquito bites, say) or mechanically (from the mosquito’s legs, even before it bites). The itch-scratch reflex activates higher levels of your brain than the spinal-cord-level reflex that makes you pull your hand away from a flame. Brain scans also show that scratching diminishes activity in brain areas associated with unpleasant sensations.

But some basic features of itch remained unexplained—features that make itch a uniquely revealing case study. On the one hand, our bodies are studded with receptors for itch, as they are with receptors for touch, pain, and other sensations; this provides an alarm system for harm and allows us to safely navigate the world. But why does a feather brushed across the skin sometimes itch and at other times tickle? (Tickling has a social component: you can make yourself itch, but only another person can tickle you.) And, even more puzzling, how is it that you can make yourself itchy just by thinking about it?

The article describes cases of chronic itching that weren’t solved by cutting the nerve endings. Neuroscientists studying this phenomenon have linked it to phantom limb disorders and various issues often classified as psychiatric. This has lead to radical theories on our brain’s use of external stimuli. Atul Gawande, the author, compares it to a car: a sensor reports a problem, so you fiddle in the engine. Nothing fixes it so eventually you treat the driver, when it’s actually the sensor itself that’s broken.

How do you treat this? I won’t spoil it, but the research does have some practical applications. Highly recommended, and very well written – I’ve just ordered a cheap copy of the author’s first book.

Warning one: it’s a little gruesome, and I’ll be impressed if you don’t get any wide-eyed pauses, with an optional ‘oh my god’.

Warning two: Metafilter commenters report this article causing massive itching. I got a very mild outbreak, but some have it much worse…

Friday bits and pieces

Still going with the cold and needing aspirin to get through the day, but I no longer care as it could be much, much worse.

I’ve been working on a writing project for the last couple of days, and made a breakthrough late this evening. I’ve no idea why I find it so much easier to work after 2200, but I’ve done as much work in two hours as I have the rest of the day. Hopefully I’ll finish tomorrow, and it’ll be an enormous guilt-ridden weight off my mind. Then I’d best start working on an essay due into uni on the 14th. Have left that waaaay too late, but such is the way of things sometimes.

I finally bought the £40 Student version of Office 2007, as it was becoming far too much of a hassle to deal with uni stuff in .doc format. Having used the new UI for a few weeks, it’s really quite the thing1. Everything’s just there, in the expected place, and it practically forces you to use proper styles, rather than individually formatting headings etc.. A massive improvement, imho.

I would like to register my distress at Kevin dying in Eastenders, as he was one of the few characters I actually liked.

I’m aware I link to almost everything Ben Goldacre does, but that’s because he rocks and I’m not sorry at all. He’s released a podcast of a lecture he gave on:

how attractive we all find it, as a society, to dodge important social, political and personal problems by reducing them to mechanical and sciencey-sounding explanations involving serotonin or fish oils

He finds this more of a danger than homeopathy / the usual band of other actively anti-science treatments, as it encourages the classification of the ‘deserving sick’ by making us believe people can solve their health problems if only they looked after themselves properly. I hadn’t thought of it that way before. Definitely worth a listen.

The blog is now de-Christmas-ified, which makes me sad. I’ve fixed up a few things that needed doing, like updated the blogroll to come straight from Google Reader, finally fixed the Grazr link etc.. I’d like to work on a new design. I’d also like a pet monkey. It’s on the list, anyway.

Via Damian, a Guardian columnist’s experience of tagging along with various paparazzi following, amongst others, Amy Winehouse:

She darts into a shop. I stop and catch my breath. And then, all of a sudden, a great wave of revulsion crashes over me. I’m stalking Amy Winehouse. What am I doing? This is weird. And what if she sees me? It’s so cold that I’ve worn a furry Russian hat. She saw me earlier in the newsagent’s, so she’s bound to recognise my stupid big hat. I am mortified, and desperate for Hammond to get here so that I can hide. I could stop and turn around – only by now I really like him and don’t want to let him down.

And then it dawns that what I’m experiencing is precisely the same emotional spectrum every pap describes: predatory adrenaline rush, horrified shame, professional dissociation.

It’s fascinating, and not nice.

Finally, I’m making an effort to learn more words. If I’m honest, this is more due to admiration of Russell Brand’s lexicon than anything else. Here are a few I’ve looked up today:

  • operculum: A lid or flap covering an aperture, such as the gill cover in some fishes or the horny shell cover in snails or other mollusks.
  • hermeneutic: serving to explain
  • esoteric: intended for or understood by only a particular group / not publicly disclosed (no idea why my brain is incapable of remembering this one – I’ve looked it up so many times)
  1. especially when you turn on the black theme 🙂 []

Rampant Homeophobia

I thought ‘homeophobia’ might catch on – there’s a Guardian piece today with the word in its headline. First thing to point out is the author:

 Rustum Roy is Evan Pugh professor of the solid state, and research professor of materials at Arizona State University

Research professor of materials. Got it. He spends a couple of paragraphs going on about closed-minded scientists who don’t think water has a ‘memory’, and then comes this:

As it happens, there is agreement among all those who have studied liquid water that it is, in fact, the critics, who are totally wrong. Proof? Diamond is the planet’s hardest material; graphite one of the softest. They are absolutely identical in composition, and they can be interconverted in a millisecond with zero change of composition.

I think this paragraph should win some kind of award. The whole thing is a complete non sequitur, for starters: how do carbon compositions translate to ‘proof’ that water has a memory? Not that the diamond thing makes sense. Graphite and diamond are not, as far as I’m aware, ‘absolutely identical in composition’, or my pencil pot would be worth a fortune. They sure as hell can’t be ‘interconverted in a millisecond’, or de Beers would be out of business, not to mention how it’s apparently possible to convert something with zero change of composition. This is from a ‘research professor of materials’?

It’s not like the next paragraph continues this argument – that’s it. I find it difficult to take the guy seriously after this. But here’s some more:

But the main thrust of Goldacre’s argument is the role of the “placebo effect”. Yes, this works. And, yes, it is without doubt present in every homeopathic intervention; but it is far more powerfully present in orthodox medical pills because they are advertised so widely in billion-dollar campaigns.

Afaik the placebo effect is much more subtle than he’s suggesting. It’s not just about public awareness, it’s about time spent with the patient, the type/colour/dose of ‘medicine’ and plenty of other factors – placebos are complex. But even if he’s right, so what? Is he suggesting that ‘orthodox’ medicine is all placebo effect?

Goldacre is accurate in pointing out the high rates of positive v negative outcomes in many of the homeopathy studies. But there are enormous discrepancies in any set of randomised controlled trials on the same orthodox pills.

Only if you include all the crappy trials. Once you remove the poor methodologies you tend to find a convergence of outcomes, and there’s plenty of statistical analysis to help figure it out. What’s this meant to prove, anyway? That trials aren’t indicative of anything? Why does he think homeopathy works, then?

Ben Goldacre must be doing a good job – the homeopathy proponents are increasingly desperate, and increasingly rubbish.

Defending homeopathy against evil nasty bigoted scientists

The Guardian has an article defending homeopathy, which includes a moment of genius. Most of it is the usual:

I am sure that there is a placebo effect in homeopathy, but it is a fact that many of the people who end up visiting a homeopath do so as a last resort, when nothing else is working. That such people often see an improvement suggests that the remedies themselves are contributing to the wellness of the individual.

Bit of a non sequitur, there. Then there’s:

Homeopathy seeks to understand everything we are, everything we do, as a web of relatedness. The reason why I have a recurring sore throat will not be the reason why you have one, and what helps me may not help you.

This seems to be partly why tests used for conventional medicines fail when used to test homeopathy.

If only there were some kind of testing system based on, oh, I don’t know, efficacy? Ah, right – the reason your homeopathic remedy doesn’t work for me is that it’s designed for someone else! Now I get it.

I take New Scientist every week [I am not sure this is wise – Andrew] and I am continually amazed at how the seemingly well-known physical world of ours is beginning to show itself as stranger than anyone imagined.

You see? New things are being discovered, therefore my made-up-crap is true. This is the logical fallacy of Completely Missing The Point.

And finally, if you’re particularly masochistic:

Objections to homeopathy begin with what are viewed as the impossible dilutions of the remedies, so that only nano amounts of the original active substance remain, and in some cases are only an imprint, or memory. Yet our recent discoveries in the world of the very small point to a whole new set of rules for the behaviour of nano-quantities. Thundering around in our Gulliver world, we were first shocked to find that splitting the atom allowed inconceivable amounts of energy to be released. Now, we are discovering that the properties of materials change as their size reaches the nano-scale. Bulk material should have constant physical properties, regardless of its size, but at the nano-scale this is not the case. In a solvent, such as water, nano particles can remain suspended, neither floating nor sinking, but permeating the solution. Such particles are also able to pass through cell walls, and they can cause biochemical change.

We do not know whether this has a bearing on homeopathic dilutions, but it may well be that nanoparticles offer a clue.

I don’t know where to start. I expect it was a bit of a shock when somebody first accidentally split an atom, though. Thus far, the article is nothing particularly interesting, but then I saw this:

This homeophobia is[…]

Homeophobia. Genius. Google turns up a few previous references, but I’d never seen it before. I can see that term spreading. Article via Bad Science.

The benefits of statistic-based medical diagnoses

A recent eSkeptic reviewed ‘How Doctors Think’ and, amongst some fairly strong criticisms of the book, mentions ‘decision aids’ – algorithm-based methods of diagnosis:

Most doctors do not like decision aids. They rob them of much of their power and prestige. Why go through medical school and accrue a six-figure debt if you’re simply going to use a computer to make diagnoses? One study famously showed that a successful predictive instrument for acute ischemic heart disease (which reduced the false positive rate from 71% to 0) was, after its use in randomized trials, all but discarded by doctors (only 2.8% of the sample continued to use it).5 It is no secret many doctors despise evidence-based medicine. It is impersonal “cookbook medicine.” It is “dehumanizing,” treating people like statistics. Patients do not like it either. They think less of doctors’ abilities who rely on such aids.6

The problem is that it is usually in patients’ best interest to be treated like a “statistic.” Doctors cannot outperform mechanical diagnoses because their own diagnoses are inconsistent. An algorithm guarantees the same input results in the same output, and whether one likes this or not, this maximizes accuracy. If the exact same information results in variable and individual output, error will increase. However, the psychological baggage associated with the use of statistics in medicine (doctors’ pride and patients’ insistence on “certainty”) makes this a difficult issue to overcome.

I can see how that would suck, from a doctor’s perspective. But that’s quite the statistic on the heart disease prediction. Maybe this is the way of the future: statistical techniques that apply to the majority, with human oversight to spot the minority cases.

Having said that, I was hearing this evening how current advances in the understanding of disease at the genetic level are going to lead to much more personalised medicine in the next 10-20 years. Which is cool. It was Francis Collins who said it, mind, and his reasoning skills elsewhere in the interview were somewhat suspect, but he nevertheless knows more about it than me 🙂

Two Extremes of Medicine

Wonderful medicine:

Two men have been cured of cancer, after being told they had 3-6 months to live. This was done by altering the body’s defence mechanisms so that they attacked cancerous cells:

Dr Stephen Rosenberg and his team isolated T cells from the cancer patients and multiplied them in the lab.

Next they used a virus to carry receptor genes into the T cells. These receptors are what enable the modified T cell to recognise specific cancers – in this case malignant melanoma.

When the modified T cells were transfused into the patients they began to attack the tumour cells.

15 other patients in the trial were not so lucky, but this is apparently a very promising procedure.

Disastrous medicine:

Previously, homeopathic ‘remedies’ were required to say “Homeopathic medicinal product without approved therapeutic indications” on the label. From today, however, the labels can instead claim to ‘treat’ medical conditions. According to Bad Science:

All you need is evidence of manufacturing quality and safety, and “bibliographic evidence that the product has been used in the indications sought”.

What you don’t need, of course, is any evidence that your tablets treat the thing you’re selling them as treating.

Homeopathy is theoretical and demonstrable nonsense. There is no rational argument to the contrary, and it’s unbelievable that this regulatory change has been made. The government body who made the decision to market magic as medicine describe themselves as follows (my emphasis):

[The Medicines and Healthcare products Regulatory Agency] is the government agency that is responsible for ensuring that medicines and medical devices work, and are acceptably safe. We keep watch over medicines and devices, and we take any necessary action to protect the public promptly if there is a problem. No product is risk-free. Underpinning all our work lie robust and fact-based judgements to ensure that the benefits to patients and the public justify the risks.

That’s clearly untrue.