VKendology: Vodka fuelled "research"

Guess what! Scientists have found the equation for the Perfect Night Out. Some really clever boffins have done loads of really hard work and figured out that: PNO = (A+Sp)* (N + V + T + TFT) * (E)

How great is that? Well, the Yorkshire Evening Post seem to think so, according to an article they wrote in October.

The background to all of this is that a Leeds University student recently won a competition advertised on facebook by VK, producers of a vodka based alco-pop. The aim of the competition was to find a science or maths student to spend a summer working for them researching what made a perfect night out. To make it sound all sciencey it had to lead to a mathematical equation, which they could then based PR activity on.

VK certainly aren't the first company to use such an approach. Increasingly companies are using “science” as part of their PR activity to get free advertising. Why pay for an advert when a journalist would be quite happy to print your corporate client's name in a news article for free? All you need is a hook and this can be provided by claiming that scientists have “found the equation for...”. Ben Goldacre has covered this issue on a few occasions, and a good overview of this can be found in this Guardian article.


Back to the VK equation though. VK, though a PR company called Brahm, made quite a big thing about how serious this research was going to be, as can be seen in the first press release relating to their search for a scientist. It was going to be scrutinised by the “Best Brains in Britain” and the equation had to be supported by an in-depth thesis. I therefore contacted Brahm and asked them to send me a copy of the thesis. To say it's poor would be a massive understatement.

Petra Boynton (a social psychologist) and Steve Anderson (a programmer with an interest in science and maths) have both reviewed the thesis and equation, from different perspectives, and their opinions can be seen at www.drpetra.co.uk/blog/ and www.twindx.co.uk. In summary, the key problems with this work are:

1) The maths is terrible. I mean, really shockingly bad, which is worrying given it was put together by a science student and apparently reviewed by the “Best Brains in Britain”. As Steve point out in his blog there are circumstances in which you end up dividing by zero, meaning for example that it's possible to have an infinitely good night out by going out alone.

2) The social research done is very poor, with the student clearly not understanding basic concepts within social research. For example, she doesn't seem to know the difference between a semi-structured interview and a survey.

3) Nobody seems to consider or take responsibility for ethical issues, which given the research involves interviewing presumably drunk people in a night club is quite a big problem. There are issues around the safety of the researchers and whether respondents are in a position to actually give consent to being interviewed.

I decided to put a series of questions to the team at Brahm, including:

- On what basis was Ms Toon selected to undertake this research?
- Was this research and subsequent PR activity endorsed by the University of Leeds?
- How were the ethics of conducting this research considered?
- Who reviewed this research to ensure it's findings were accurate?

Brahm provided the following response:

“Vkendology by VK Vodka Kick is a fun study into what criteria we need to have the most fun nights out, and therefore we hope taken in the spirit in which it is intended. Phillippa Toon was one of over 50 respondents who applied to undertake the research and develop the formula following a cheeky VK Vodka Kick Facebook campaign to find a talented maths or science student who enjoyed nights out. She developed the formula, which we are assured is correct, in her own time following some very entertaining evenings out spent researching and interviewing partygoers. More than 2,000 responses were gathered in total and we’d like to thank her for her hard work and for being a great sport. The formula is her own work and is not connected at all with her studies at the University of Leeds. The guide to the formula is available at http://www.vktv.co.uk/vkendologist.asp for you to view. Thank you for your interest in story and we hope it helps you to have lots more fun in the future.”

This essentially tells us nothing. Nothing about the ethics, which as Petra outlines on her blog are significant issues. Nothing about the review process, apart from them having been assured that the equation is correct.

I decided to follow up the issue of the reviewers, asking who they were and what their thoughts on the work was. I was told that

“We asked other individuals to check Phillippa’s report but they became involved on the understanding that they wouldn’t be named“

When probed further and asked simply for the backgrounds and credentials of the reviewers, rather than their names, I was told that the PR company was no longer able to help. I have a suspicion that the reviewers either didn't exist, or were certainly far from being the “Best Brains in Britain”. Any decent academic would have been able to flag up the massive problems with the report.

Now, some people may shrug all of this off, saying that's it's obvious from the start that this is just a PR exercise, maybe even “a bit of fun”. I disagree, as I see this as part of a wider problem of science being undermined and trivialised by such PR exercises. If a company wants to get free press by publishing “science” they should at least have the decency to do it properly and try to add something of some value to knowledge. If they don't want to do that then they should pay for their advertising space just like everyone else.

Perhaps one of the most depressing aspects of this is that people who really should know better are actively participating in this undermining of science.

Someone who should know better is Professor Anne Glover, Scotland’s chief scientific adviser, who has commented that:

“By and large most scientists would be pleased to see equations being used, and giving prominence to science. There will be some purists who look at it, realise it doesn’t work, and say it’s shocking and you shouldn’t be doing that. But it is interesting to raise the profile around science.”

There's a lot wrong with this statement. First of all, I doubt it's only “purists” who would say there's something wrong with a campaign such as VK's. What she also gets wrong is the idea that somehow this raises the profile of science, and that using equations somehow makes something more “sciencey”. Surely a chief scientific adviser should know that the key problem with the public understanding of science is that people simply don't know what science is, and by promoting bogus stories such as this they are reinforcing the idea that it's all just about equations.

Of course, the other key problem is that by attempting to promote science with nonsense like this you risk also promoting the public misconception that scientists spend all day researching pointless things and not actually doing much to benefit society.

Someone else who should know better is the student who conducted this research, who's potentially jeapordising the prospect of having a serious career in science. It would be interesting to know what her academic supervisors at Leeds University think of her research work, which she seems to take seriously. Whilst VK and Brahm seem to be now telling us it's all just a bit of fun, Phillippa Toon is standing by her research, seemingly thinking it's a robust piece of work. She has been quoted in the press as saying:

“It does stand up to scientific scrutiny. I wanted to prove that scientists weren’t all geeks. We can have a good time too.”

It's really worrying that a final year science student can really think this work stands up to scientific scrutiny. As we've seen from what Petra Boyton and Steve Anderson have to say, this work if full of holes. However, what really annoys me about this comment is her wanting to prove that scientists aren't all geeks, and that they can have a good time. Well, I'm sure there are many scientists out there who would resent the implication that you can only have fun by pretending to be a scientist and getting pissed on what to me tastes like sugary flavoured meths!

The sooner PR companies start leaving science alone, the sooner we can actually make some progress on meaningful promotion of science.

Nelsons - Can they be trusted not to misrepresent research... again?

I recently noticed a job advert for a Research Associate at the University of Westminster to work on a collaborative research project with Nelsons Ltd, purveyors of natural and quack medicines. It appears Nelsons needs “expert endorsement” from a university to enhance their “scientific credentials”. A bit of digging around shows us that Nelsons have previously misrepresented scientific research to suit their marketing objectives. Might they be about to do the same thing again?

Before we look at the detail, let’s start with a little background.

Westminster are well known for their rather gullible approach to quackery, and indeed have a whole department dedicated to “Chinese Medicine and Complementary Therapies”.

Nelsons are one of the UK’s largest providers of “natural medicine”, with a turnover of £28.9m in 2007 (latest figures available) and profits of £7.6m. They sell, amongst other things, homeopathic remedies and Bach flower remedies. In 2006 they were featured on Newsnight when they tried to sell an undercover reporter a homeopathic alternative to anti-malarial drugs, stating that:

“They make it so your energy doesn’t have a malaria-shaped hole in it so the malarial mosquitos won’t come along and fill that in.”

This is a company with a record of being more interested in PR and promoting products than accurate research. Last year they were involved in developing a PR toolkit for homeopaths to “reach local people in order to grow your client base, keep in touch effectively with your clients and make use of local or regional newspapers to print positive stories about homeopathy”. This was covered by the excellent Gimpy.

Nelsons are also involved in nutritional supplements and sell Spatone, “a 100% natural liquid iron supplement” through a sister company, Spatone Ltd.

The research project they have set up, which focuses on Spatone, is done through a subsidised (in this case by £74,928) government scheme called Knowledge Transfer Partnerships (KTP). The idea behind KTP is that companies and Universities can pool their commercial and academic expertise to run a commercially focused research project to their mutual benefit, as well as to the benefit of the UK economy. Each KTP project recruits a recent graduate to conduct the bulk of the research, and this is the job I saw advertised.

This research project will focus on identifying the active compounds in Spatone and comparing these to competitor products. Now, there’s nothing wrong with that, but from looking at the job description it seems that the results of the project, before it has even taken place, have been pre-determined:

“The results will help establish Nelsons products as unique product, with significant points of difference verses other supplements in the market”

But how can they already be claiming what the results of studies on their existing products will show?

The job description also indicates that the research Nelsons have conducted into their products has been focussed on quality control, rather than effectiveness:

“Nelson’s facilities have been so far mainly limited to quality control”

For a company with a turnover of nearly £30m and profits of nearly £8m you’d think they could afford to do a little more research into the efficacy of their products before releasing them!

It seems to me that the key reason that Nelsons/Spatone are conducting this study is to make their product sound all “sciencey” for marketing and PR purposes. Their “five pillars” to support growth of the company specifically include “expert endorsement” and the outcome of the project is identified by the company as being to:

“give the brand the scientific credentials necessary for such a development…”

If I was the lead academic or the research assistant working on this project I would be concerned that rigorous scientific analysis is not what the company may be looking for. One thing that is clear is that Nelsons/Spatone can’t be trusted to accurately report research into their products. They make a very big thing on their website about the fact that Spatone has been backed up by a range of scientific studies, however reading the original research papers gives a very different picture.

I contacted Nelsons to discuss this with them, initially speaking to Chris Oldham, their R&D Manager. However, following this I was referred to a member of their communications team. They claim that the requirement for “expert endorsement” is to meet regulatory requirements when selling into new territories. I’m not convinced that this is the only reason for wanting this endorsement, as the way they have misrepresented their previous research for marketing purposes leads me to think this is as much about marketing and PR as it is about meeting regulations.

“Bod”, a blogger and contributor to the forum at Badscience, has a background in biochemistry. He examined the claims made on the Spatone website and compared these with the original research. The Spatone website was then edited on the 6th August, after I contacted them. The claims we are investigating below appear as they were originally. Here’s what Bod found:

Claim: "Spatone is effective against iron deficiency in pregnancy"

The research (1) involved a sample of only 24 anaemic pregnant and 21 non-pregnant, non-anaemic women, and therefore has little statistical power. The groups allocated to different regimes were of different sizes. The research was partially funded by Spatone. It showed Spatone to be about as effective as other forms of ferrous sulphate. Why wouldn't it be?

Claim: "Spatone does not cause the side-effects usually associated with conventional iron supplements"

The study did not prove side effects to be lower for Spatone, but rather assumed it to be the case. No-one reported the side-effects, but there is no evidence they were asked about side effects.

Claim: “Spatone has an absorption rate of iron which is up to 40% - an absorption rate unmatched by iron intake from food sources or conventional iron supplements"

The small study showed 5-40% absorption of the Spatone’s iron by anaemic pregnant women. It did not compare this with conventional supplements, but instead compared it with literature values, measured under different circumstances with different subjects. As pregnant women are known to have a far higher absorption of iron than non-pregnant women, and people with low iron stores have a far higher absorption of iron than people with high stores, all the study has done is demonstrate these two points. Comparing the results obtained with those for non-pregnant non-anaemic people is invalid.

Claim: "Spatone Iron-Plus (previous trade name of Spatone) does not cause these side-effects"

This seemingly better-designed trial (2) with 102 subjects randomised and supposedly double-blinded (hopefully the placebo was as coloured and flavoured as iron containing water would be) did not show this at all. "Dyspepsia scores did not differ between the two groups" is what it said. Once again, the researchers explain why Spatone should have a lower incidence of GI side effects without actually demonstrating it in their experiment.

It does claim that compliance scores were different between the two groups, but fails to note the lack of statistical significance of the result meant that it was probably down to chance. The conclusion was that a randomised controlled trial would probably be worthwhile. No note is made of who funded the study in the paper, but we would guess Spatone played a part.

When asked to comment about this, Nelsons stated that the dyspepsia scores did not differ between the Spatone and placebo groups and that it is on this basis that the claim of no side effects is made. However, this doesn’t tell us anything about how Spatone compares to alternative products, and the trial didn’t examine this. If Nelsons wish to show that their ferrous sulphate differs in some way from the standard kind, they needed to do an experiment to show this directly, rather than playing games with the known facts by doing half-experiments.

They compare absorption of the product by pregnant anaemic women with literature values for those who we should already know will absorb less iron, instead of comparing Spatone and standard product. They compare a low dose of Spatone with placebo, then make a false comparison with a higher dose of conventional product. If they want to know whether their product has magic powers, they need to compare the same dose of Spatone and standard product, at the same dose and concentration.

Claim: "It has... been shown that spatone has an absorption of iron of up to 40%"

This study (3) only had 13 subjects initially, of whom one was eliminated as they might have had a history of iron malabsorbtion. This already causes a problem as it is bad practice to pick and choose your subjects when your sample size is so small. The study tells us that Spatone's active ingredient is ferrous sulphate, just like the standard iron tablets. The study does NOT claim that Spatone differs in any way from any other dilute solution of ferrous sulphate. The study tells us that up to 40 % of the iron in ferrous sulphate can be absorbed under certain special conditions. The study thanks Spatone for their financial contribution.

In summary, this is poor quality research on statistically insignificant, unrepresentative and in one case cherry-picked groups which give explanations for effects not shown by the research. They are funded in at least two of the three cases by Spatone Ltd.

What this research doesn’t do is show us how Spatone differs from any of their competitor’s products. Perhaps what is needed is a clinical trial of Spatone against Irn-bru, which is also a dilute solution of iron salts. Irn-bru has around 3.5mg/l of iron as ammonium ferric citrate, a very well tolerated iron salt. Using Nelson’s level of scientific robustness we can therefore conclude that one dose of Spatone is therefore slightly inferior to one litre of Irn-bru (probably the daily consumption for some in Scotland!). One would also predict slightly better scores for GI side effects. Of course Barr's are not claiming that their product is a neutraceutical. I don't think they are even allowed to claim it is made in Scotland from girders any more.

Derek Renshaw, the KTP's lead academic at Westminster was contacted about these issues and said he would have to discuss with colleagues whether and how to respond. I have heard nothing from him since.

Previous poor quality research was spun with weasel words into what look to be claims that Spatone differs from conventional supplementation. Given the stated aims of this current research project, can we really expect anything different from them this time? Is it really an appropriate use of public money to support a multi-million profit making company’s PR and marketing work?


References:

(1) G. HALKSWORTH, L. MOSELEY, K. CARTER, M. WORWOOD (2003) Iron absorption from Spatone (a natural mineral water) for prevention of iron deficiency in pregnancy, Clinical and Laboratory Haematology, 25, 227–231


(2) D. MCKENNA, D. SPENCE, S.E. HAGGAN, E. MCCRUM, J.C. DORNAN,T.R. LAPPIN (2003) A randomized trial investigating an iron-rich natural mineral water as a prophylaxis against iron deficiency in pregnancy, Clinical and Laboratory Haematology, 25, 99–103

(3) M.WORWOOD, W.D.EVAN, R.J.VILLIS, A.K.BURNETT (1996) Iron absorption from a natural mineral water (Spatone Iron+), Clinical and Laboratory Haematology, 18, 23-27

I'd like to thank "Bod" for his help in putting this together and analysing the previous research conducted on Spatone.

Science: So What? - Recruiting a Dialogue Manager

Nothing really to add to this, other than what Science: So What? have sent out. Anyone out there interested in this role?

Dear Bloggy People,

Having recognized some of the shortcomings of SSW online to date, and in an attempt to listen to the feedback we’ve received and act appropriately, we’re hoping you might help in publicising the opportunity below.

Time is shorter than we’d like so we’re trying to publicise this in the science blog space in the hope of attracting the right kind of applicants quickly. We’ve taken recommendations from bloggers and other stakeholders and are going to try and whittle down to a shortlist for interview in the next week or so. Whilst we recognise this is not ideal, we’re hoping you’ll understand why.

Any help you might give us in publicising this would be very much appreciated – if you want any more info on the campaign please mail us at the very catchy sciencesowhatcommunicator at googlemail dot com

Science: So What? is a Department of Business Innovation and Skills campaign to encourage wider public engagement in science at all levels – from casual interest to education and employment opportunities – as well as promoting greater understanding of why science is important to the UK.

As part of refreshing the campaign we are now looking for a science communicator to find, create and edit online content and manage dialogue across the web and social media.

We’re looking for people that have a track record as a science writer, the ability to write for diverse audiences (including young people) and excellent working knowledge of online science content, social media etiquette, and the principles of good science communication.

We imagine this to be a part-time role in the first instance, but we are open-minded as to how the role will develop and would hope that you would want to be a part of that ongoing development.

If you would like more information please contact us with your name and contact details and a brief paragraph describing your experience at email address: sciencesowhatcommunicator at googlemail dot com
Update
The projected monthly payment is £500-£750 per month, depending on hours, responsibilities and subject to discussion.

Simon Singh to appeal - Sign up now to keep the libel laws out of science!

Just a quick one tonight... Simon Singh has decided to appeal the recent pre-trial judgement against him in the libel case brought against him by the BCA.

This is excellent news, as is the fact that his campaign is gathering momentum, with support from a huge range of people. As well as overwhelming support of the scientific community, the campaign also has support from journalists, politicians, actors, comedians and of course an active blogging community.

Sense About Science have launched a petition in support of Singh, and also to make the wider point that libel laws have no place in scientific debate. You can sign the petition at the Sense About Science website.

I'm rather chuffed that one of my old physics profs. (Jim Al-Khalili) is near the top of the list of supporters.

Bassett Chiropractic refuse to engage with critics

You'll remember I got a positive response from Jeremy Spanton at Victoria Chiropractic following my complaint regarding their use of the term "Dr" and claims made that would not be allowed by the Advertising Standards Agency.

Over at JDC325's blog we see a very different response from Bassett Chiropractic Clinic, St Albans. JDC's complaint to Bassett was in some ways similar to mine, though the conditions they claim to treat differ. Bassett claimed to be able to treat whiplash injuries and headaches.

JDC spent a while looking at the evidence base for these treatments and found it to be significantly lacking. He then pointed out to them that making claims which the ASA would not allow is against the General Chiropractic Council's code of conduct. Their response to this point differs significantly to the one I got from Jeremy Spanton.

Bassett Chiropractic responded by saying that the ASA guidelines don't apply to them because they're making the claims on their website, and not in print advertising, which is the ASA's remit. They make no attempt to justify their claims, resorting to what is essentially a childish response along the lines of "naa naa, you can't get me, naa naa, you can't get me". Pretty pathetic really.

On further probing by JDC, Bassett respond with:

You have my response, and I am not prepared to engage in further
correspondence with you on this matter

.

This now provides a good opportunity to see what the GCC will actually do about chiropractors breaching their code of conduct. Will they, like the Society of Homeopaths, attempt to find loopholes to avoid having to do anything, or will they actually do what they are there to do - regulate the profession?

JDC has submitted a complaint to the GCC, so hopefully we should soon get an answer to that question.

A success with Victoria Chiropractic, a chap called Lanigan, and a paradigmatically relevant hypothesis...

Hurrah, time to chalk one up for the good guys! Following my complaint to Victoria Chiropractic Clinic in Woking I have finally had a response from Jeremy Spanton. As you may remember, I complained about his misleading use of the "Dr" title as well as his claims to be able to treat childhood illnesses such as colic.

He emailed me today to confirm that he had been

"in touch with my association, and on their recommendation... I have altered my name to Jeremy Spanton, Doctor of Chiropractic, and have removed mention of the specific childhood ailments for which Chiropractic can be helpful"

Sure enough, a quick visit to his site confirms that he now correctly identifies himself as a "Doctor of Chiropractic" and whilst he still refers to treating children he has removed references to colic, ADHD, IBS etc. The tone of this page has also been changed somewhat. I'm still not comfortable with his equating spinal exams with dental and hearing tests, but it's a big improvement.

Now, his reference to being in contact with his association interested me. Was he talking about the GCC (the industry regulator) or BCA? As you may know, the BCA are currently suing Simon Singh for claiming that treatments for conditions such as colic are "bogus". It struck me that if the BCA was now advising its members to remove references to such conditions then it might have some bearing on the case.

It turns out Spanton was referring to neither. He was in fact refering to the United Chiropractics Association (UCA), an organisation I had never heard of before.

I looked the UCA up, and what an odd bunch they are! The first thing that struck me was how unprofessional their website looked - kind of worrying for a "professional association". It looks like something straight out of the '90s.

It seems the UCA was set up in 2001 by a bunch of disgruntled chiropractors who were concerned that existing organisations just weren't wacky enough didn't adequately represent "the subluxation based wellness view of chiropractic". These are the people who won't only claim to help you with your sore lower back, posture etc. These are the ones that will claim to help with all sorts of conditions, for which there is no evidence chiropractic can help.

Their "Mission" page shows how bizarre they get. It's full of mumbo-jumbo cod philosophy that would make even a stoned sociology undergraduate blush. They base their mission around a "Philosophical Construct" that states:

Vitalism: We ascribe to the idea that all living organisms are sustained by an innate intelligence, which is both different from and greater than physical and chemical forces. Further we believe innate intelligence is an expression of universal intelligence.

Holism: The whole is greater than the sum of the parts.

Neural supremacy: We ascribe to the concept that the nervous system is the major co-ordinator and regulator of all bodily systems.

Conservative ethic: Our belief in the body's ability to heal itself logically implies that the best care is the least invasive care.

Humanism: We ascribe to the belief that individuals have immutable rights.

Indeed.

Looking further down the page we have the following gems:

In Relation To The Science Of Chiropractic

- Science should seek to answer paradigmatically relevant hypothesis, which by necessity, are borne out of our philosophical constructs
- Science itself is based on a metaphysical belief system built on a priori assumptions not amenable to proof.

This is classic "woo", and a clear attempt to change the rules of the game. Essentially, they're saying "science is what we say it is". That makes it nice and easy to later say that "science" says this stuff works. I call that bullshit.

The UCA currently have 250, 350 or 450 members, depending on which page you look at. Jeremy Spanton is one of them. I dare say the websites of a fair few others contain a few unjutifiable claims.

This isn't the end of the story though. What this demonstrates to me is that chiropractors don't really know what they are. The internal politics of the profession seem quite interesting, and mirrors some of the disputes between other alternative medicine groups such as that between the Alliance of Registered Homeopaths and the Society of Homeopaths:

SoH has sent out inaccurate and defamatory information to ARH members to coincide with ARH membership renewals. This communication has been accompanied by information and registering documents inviting ARH registered members to join SoH. This at the very least, constitutes unethical behaviour.

[T]he SoH’s recent actions suggest that they are more concerned about preserving their own position of power within the profession, than representing the actual needs of practising homeopaths.

I was made aware of the internal politics of chiropractic when a Richard Lanigan copied and entire earlier post of mine on his blog.

It seems Lanigan hopes that complaints from skeptics such as myself will bankrupt the GCC. Lanigan can't call himself a chiropractor, because he isn't one. He resigned from the GCC last year. Though he does offer chiropractic treatment at his clinic. in Kingston-upon-Thames. He is good enough to tell us on his website that:

This may affect your ability to claim from an insurance provider for chiropractic treatment from Richard

Buyer beware!

Not being a member of the GCC does have its benefits though. It means he is presumably not bound by their code of conduct and can therefore make whatever claims he likes on his website.

There's more to say on Lanigan, the BCA and the GCC, but I'll leave it there for now.

Make what you will of all of this. Perhaps you could even make a "paradigmatically relevant hypothesis"!

Neal's Yard - who thought this would be a good idea?

The Guardian have a regular "You ask, they answer" column as part of their "Ethical Living" blog.

Today, the "they" in question is Neal's Yard, the well known spelling mistake and woo-remedy store. I can see the team meeting at Neal's Yard HQ, with everyone sat on bean bags drinking organic herbal tea (coffee and boardroom tables being too corporate!). Desperate to spread the message of holistic organic goodness, someone comes up with the idea of getting a piece into The Guardian. After all, surely only mung bean eating, sandal wearing beardy hippies read The Guardian.... don't they?

It obviously didn't occur to them that a fair few skeptics also read The Guardian, and regularly frequent thier Comment is Free website.

So far, around 25 questions have been asked. I don't think Neal's Yard will enjoy answering them. Here are a choice few:

Benulek : How do you validate the medical efficacy of your 'remedies'?

Saltycdogg : Do you see no problem with trying to be 'ethical' while at the same time selling snake oil for a living?

puzzlebobble : you sell a multitude of products for a wide variety of medical conditions, some of which are serious or life threatening.

Please could you explain what level of evidence of efficacy you require before stocking any product?

If, as I suspect, the level of evidence of efficacy is poor then will you tell us what, if any, studies are done to look for harmful side-effects? How are these studies conducted? Furthermore please show us the power calculations for these studies.

Surely you don't view it as ethical to sell products which are of unproven benefit and which you don't even know are safe?

takearisk : Your website states:

The correct homoeopathic remedy will stimulate a sick person's vitality to send healing energy where it is needed, thus rectifying mental, emotional and physical imbalances.

Could you please explain how the 'correct homoeopathic remedy' is decided on and describe the qualifications of the people who make these decisions?

I'd also be grateful for a biological definition of 'healing energy' and an indication of where I can find the scientific evidence for its existence.

I can't wait for the answers.

Complaint to Victoria Chiropractic submitted

Following my last post, I've now officially complained to Victoria Chiropractic, Woking, to give them an opportunity to get their website in order before a complaint to the GCC. Here's the complaint:

Dear Sir/Madam,

Following my previous emails I would now like to make a complaint about Victoria Chiropractic Clinic, which unless adequately resolved I will be forwarding on to the General Chiropractic Council.

I have two complaints to make, as I believe in each case you are breaching GCC regulations.

My first complaint relates to the use of the title "Dr" to describe Jeremy Spanton on your website. I believe the use of this term is misleading, as members of the public may be led to believe that Jeremy Spanton is a medical doctor. Whilst Nichola Worril states that she has a PhD, there is no such explanation of Jeremy Spanton's use of the title. I have searched the General Medical Council's register and find no Dr Spanton, and therefore assume he is not a registered medical practitioner.

I would like to refer you to GCC regulations which state that members:

"must not use any title or qualification in such a way that the public may be misled as to its meaning or significance. In particular, chiropractors who use the title of ‘doctor’ and who are not registered medical practitioners must ensure that they make it clear that they are registered chiropractors and not registered medical practitioners"

My second complaint relates to you page entitles "What we treat". On this page you claim that chiropractic is beneficial for children suffering from colic, amongst other conditions. However, you provide no evidence to back up these claims. I would like to refer you to a recent Advertising Standards Authority adjudication against a chiropractor named Carl Irwin, which stated that:

"We considered that, whilst some of the studies indicated that further research was worth pursuing, in particular in relation to the chiropractic relief of colic, we had not seen robust clinical evidence to support the claim that chiropractic could treat IBS, colic and learning difficulties."

The adjudication also instructed Irwin: " not to refer to the treatment of IBS, colic and learning difficulties in future."


I should remind you that GCC regulations state that members:

"may publicise their practices or permit another person to do so consistent with the law and the guidance issued by the Advertising Standards Authority."

Your claims are clearly not consistent with ASA guidance, and therefore are not permitted by the GCC.

I therefore request that you clarify Jeremy Spanton's qualifications on your website and remove any claims for which robust evidence is not available. I would also like you to acknowledge this complaint and confirm your intent to resolve these issues as soon as possible. Should I recieve no response, or not be satisfied with your response I will be submitting a complaint to the GCC and may also complain to Trading Standard.

Yours sincerely

Victoria Chiropractic Clinic, Woking, may break GCC rules

As shown before, the BCA's libel action against Simon Singh is causing a significant Streisand effect, drawing attention to dodgy claims made by chiropractors and their representative organisations in the UK.

It didn't take much googling to find a relatively local chiropractor making dodgy claims, and I now present to you... Victoria Chiropractic Clinic, Woking, Surrey, run by "Dr" Jeremy Spanton and Dr (PhD only) Nichola Worril.

So, what are the claims they are making, and how to they breach General Chiropractic Council regulations?

Use of the "Dr" title

It should be made clear that in the UK "Dr" is not a protected title. Anyone can call themselves a doctor if they wish, however certain organisations take a dim view of doing so misleadingly, including the GCC and the Advertising Standards Agency.

GCC guidelines, to which Spanton and Worril, as members, are bound, state that chiropractors:

must not use any title or qualification in such a way that the public may be misled as to its meaning or significance. In particular, chiropractors who use the title of ‘doctor’ and who are not registered medical practitioners must ensure that they make it clear that they are registered chiropractors and not registered medical practitioners

Whilst their website does indicate that Worril has a PhD (though it's not clear in what), there is no such explanation of Jeremy Spanton's title. Searching the General Medical Council's register brings up no results for a Dr Spanton. It is therefore likely that Spanton is using the term misleadingly. An email asking the clinic to confirm his qualifications has not been replied to in three days. The GCC will therefore be recieving a complaint about this claim.

Claims that chiropractic can help with conditions with no supporting evidence

Victoria Clinic's website has a page about what they can treat. Rather disturbingly they recommend chiropractic checks of children along the same lines as dental, hearing, eyesight checks etc. They seem to play the guilt card somewhat by claiming that:

Without Chiropractic care some children will live in continued sickness, condemned to a life of taking medicines and perhaps even surgery.

Whilst this is distasteful, the key part of this page which breaks GCC guidelines is the following:

Chiropractic care has been beneficial in a wide range of child-hood ailments, including:

ADHD, Asthma, Bedwetting, Colic, Poor posture, Allergies

The claim about Colic is one that cannot be justified. Again, I have emailed the clinic asking for evidence for this claim, but with no response. Victoria Chiropractic is not the only clinic to make such claims. In fact, a chiropractor named Carl Irwin recently made similar claims, which were investigated by the ASA. The full adjudication is available here, and the relevant extract quoted below:

We considered that, whilst some of the studies indicated that further research was worth pursuing, in particular in relation to the chiropractic relief of colic, we had not seen robust clinical evidence to support the claim that chiropractic could treat IBS, colic and learning difficulties.

This is important for all chiropractors, as the GCC require that chiropractors:

may publicise their practices or permit another person to do so consistent with the law and the guidance issued by the Advertising Standards Authority.

By claiming that chiropractic is beneficial for colic Victoria Chiropractic is not being consistent with ASA regulations and guidance, and as such may be breaking GCC guidelines.

A complaint will be made to the GCC about Victoria Chiropractic, who rather disappointingly have not responded to my concerns put to them by email.

Victoria Chiropractic certainly aren't the first to be making such claims. There are many more out there, and I, along with other bloggers, will be investigating these and making further complaints to the GCC until they start cleaning up their act and taking their own guidelines more seriously.

For more blogs on chiropractic claims, visit:
http://www.layscience.net
http://gimpyblog.wordpress.com/
http://www.quackometer.net
http://skepticat.wordpress.com/
http://jdc325.wordpress.com/

Chiropractors - a shot in the foot?

Have chiropractors shot themselves in the foot? Possibly. Following an article in the Guardian by Simon Singh, the scientist and co-author of Trick or Treatment?: Alternative Medicine on Trial, in which he was critical of chiropractors, the British Chiropractic Association (BCA) has decided to sue for libel.

Many people have already written about this case and rather than re-hash what has already been written I would recommend you peruse the following blogs to keep up to date here and here.

The reason I believe the BCA may have shot itself in the foot is because of the attention they have drawn to themselves and the glaring holes in the evidence base for chiropractic. This isn’t only attention from bloggers. A recent meeting in support for Simon Singh was attended by journalists, an MP, and various comedians. Interestingly, Dave Gorman spoke at this event, indicating that before this whole debacle he’d always assumed chiropractic was part of mainstream medicine. I wonder how many people out there thought the same thing.

Bloggers have already started taking on chiropractors and their dodgy claims, with the persistent Gimpy already chalking up one success following an Advertising Standards Agency ruling. Gimpy complained about “Dr” Carl Irwin’s use of the title (implying he’s a medical doctor) and his claims to be able to treat a range of conditions such as IBS, Colic, and Learning Difficulties.

Others are also starting to look out for claims made by other chiropractors. I have found a local chiropractor making similar claims to those of Carl Irwin. The chiropractor in question has been email, and I look forward to another blog post soon with details… and hopefully a response from them.

Watch this space.

Duchy Originals: Told off by MHRA

Just a quick update to my post earlier today. The MHRA have had a go at Duchy Originals for misleading advertising of their tinctures.

Here's what they had to say:

A member of the public complained to the MHRA about the advertising of Duchy Herbals Echina-Relief Tincture and Duchy Herbals Hyperi-Lift Tincture which appeared on the Duchy Originals website from 24 January 2009. The complainant alleged that the advertising suggested that the products had been assessed for efficacy and was therefore misleading.

The MHRA upheld the complaint. Nelsons, the registration holder, on behalf of Duchy Originals agreed that they would amend their advertising and remove claims of efficacy from their website and all future advertising. Following delays in implementing the changes, Nelsons provided additional training to Duchy Originals staff on the legislative requirements.

MHRA advice
These two products have been registered under the Traditional Herbal Medicines Registration Scheme as required by Directive 2004/24/EC on Traditional Herbal Medicinal Products. The MHRA, as UK regulator, is required to assess applications for traditional herbal medicinal products for safety, quality and evidence of traditional use. Efficacy of the product based on scientific data is not assessed, although the MHRA is required to refuse registration if efficacy on the basis of long established traditional use is not plausible.


Date case raised: 26 January 2009
Date action agreed: 30 January 2009
Date of publication: 20 March 2009

Hats off to the complainant!

Duchy Originals Tinctures: Never described as a cure, treatment or remedy. Oh really?

Back in January I posted about Duchy Original’s new range of herbal tinctures and the claims they were making for them.

The story was picked up in the mainstream press when Prof. Edzard Ernst, the UK’s first Professor of Complementary Medicine, accused Prince Charles and his advisors of deliberately ignoring science and promoting quackery, claiming they “financially exploits a gullible public in a time of financial hardship."

The main criticism, not only from me but also from other bloggers (such as Rob Hinkley at semiskimmed.net) was that Duchy Originals were claiming that the tinctures had been tested for efficacy, and were basing this claim on MHRA approval of the product. The MHRA specifically state that they do not test medicines for efficacy and that they are only tested for safety and quality.

Since then, Duchy Originals have changed their product descriptions of their site to reflect that. For example, their Hyperi-Lift Tincture is now described as:

“A traditional herbal medicinal product used to relieve the symptoms of slightly low mood and mild anxiety, based on traditional use only. “

(my emphasis)

This is to be welcomed. What is less welcome is the fact that Duchy are still trying to claim they never did anything wrong. In a recent article in the Daily Telegraph , a Duchy Originals spokesman made the following statement about their Detox Tincture:

“It is not – and has never been described as – a medicine, remedy or cure for any disease.”

It’s interesting that he chose to talk about their Detox Tincture, since they had made medical claims about other tinctures. Indeed, they had even stated:

“Each of our tinctures provides an alternative and natural way of treating common ailments such as colds and flu.”

The Detox tincture is the only one that didn’t’ need MHRA approval as it’s being sold as a food supplement.

It’s somewhat disingenuous of them to imply that they hadn’t therefore made claims about their products efficacy.

Duchy Originals have also felt the need, given the bad publicity this has caused, to put the following statement up on their blog:

Following recent press articles regarding our Duchy Herbals range, we are aware that some of our customers may be seeking reassurance about the range. Our CEO, Andrew Baker, says: 'Together with our partners, Nelsons - leaders in the field of natural medicine, we spent many years researching and developing our first range of herbal tinctures. It is a range that we are truly proud of. Our Duchy Herbals Echina-Relief Tincture and Duchy Herbals Hyperi-lift Tincture have both been approved and licensed as traditional herbal medicines by the UK regulatory authorities, the Medicines and Healthcare Products Regulatory Agency (MHRA). Our Duchy Herbals Detox Tincture, which is traded as a food supplement, has been produced to the highest quality standards and within the regulatory framework of both UK and European food law. I do hope, therefore, that you are able to share our confidence in the compliance of the Duchy Herbals range to the very highest regulatory standards.' We'd love to hear what you think, click on comments below and send us your thoughts.

As you can see, they’d “love to hear what you think”, so why don’t you tell them?

Lots of people have been telling them, but for some reason their posts are still “awaiting moderation”, mine included. I wonder if they’ll ever get published?

Here’s a selection of comments that a range of people across teh interwebz have left, which are still awaiting moderation, starting with my own. It could be a long wait:

What you fail to mention, again, is that MHRA approval does not give any indications as to effectiveness. The MHRA never make any claims as to a products efficacy, just that it is safe to use and has been well manufactured. This is not in doubt.

What is in doubt is whether or not these tinctures have any effect. Nothing you have said removes any of that doubt.

Where is your evidence that these tinctures work?

“Beermonkey” from the Badscience.net forums left the following:

While I don't doubt that the tinctures are produced to a high standard, is there any actual evidence that they work? As far as I'm aware, that isn't covered by the 'regulatory framework' you mention; you simply have to demonstrate that they've been taken for a long time, which isn't the same thing at all.

If you're going to sell a mixture claiming to alter your digestion, your immune response or especially your brain chemistry, it seems reasonable to ask you to back up your sales patter with some real evidence. If these tinctures work, they could have some major effects that need investigating; if not, selling them is a waste of everyone's time, however traditional they may be.

“Alan H” over at Thinkhumanism.com:

Yes, yes. You've provided evidence that your 'tinctures' are safe and of a certain quality, but they still don't work. And that's what's different between your products and proper medicines: they have to provide proper evidence that they work. Dodgy Originals don't have to bother with such minor details!

Yet, you make claims that will fool customers into thinking they need it and that your product actually has some effect. You sell it like a medicine, with careful use of language. You take great pride that your products are 'regulated', just like proper medicines, but you don't fool everyone.

“Stvb2170”, again from Badscience.net wrote:

Customers seeking reassurance are probably not concerned whether the products are of high quality (I'm not entirely sure what that means) or that they are produced within legal regulatory frameworks (the minimum you would expect). What customers would probably like reassurance on is that these products are of any benefit as this is the reason that they have been fairly criticised in the media.

Is there any evidence that each of these products is beneficial and hence worthy of the price tag?

I’m sure there are many more out there also awaiting moderation. If you posted something that hasn’t shown up yet, why don’t you post it below for the record?

I will be pleasantly surprised if Duchy Originals do finally allow these messages on their site!

Thanks to Dr*T over at Thinking is Dangerous, who has also written about this

A breath of fresh air from Big Pharma's GSK

Big Pharma regularly comes in for a lot of critiscism from all sides. At the extreme we have some CAM practitioners and followers, as well as conspiracy theorists and anti-vaccine campaigners accusing them of killing hundreds of thousands with their "allopathic" approach to medicine. More reasonable critics accept that, whilst their drugs play a crucial part in keeping us healthy and alive, they follow dubious business practices, focus too much on "me too" drugs and are less that open with their research. A low point for the industry was surely their attempt to take the South African government to court in 2001 to block their imports of cheap generic HIV drugs.

A lot of this may be about to change following proposals put forward by GlaxoSmithKline's new CEO, Andrew Witty. The Guardian today focussed on reports that GSK is to:

- reduce the cost of drugs to the 50 least developed countries in the world, charging no more than 25% of the price charged in the UK

- plough 20% of it's (vast!) profits back into developing countries to help develop their healthcare services, hospitals etc.

- develop a "patent pool" of IP on processes and chemicals it has patents on, to be made available to NGOs and scientists from other companies in order to support the development of new drugs for a range of diseases.

However, other proposals that reflect a significant change in the ethos of GSK's business practices are likely to attract less attention from the mainstream. These further changes will bring about a new sense of openness from the company, which it is hoped other companies will follow. The first of this is greater transparency in GSK's payments to doctors. This is to be welcomed and will hopefully put a stop to the constant whinging claims from CAM practioners and their supporters that anyone criticising them is in the pay of Big Pharma.

The second of these proposals is a commitment to publishing data and results from all of GSK's research, regardless of whether the outcome is positive or negative. This is something that is likely to please Ben Goldacre, who has been calling for an international register of clinical trials for some time.

Whilst it's clear that these proposals are to be welcomed because they are the right thing to do, it's worth bearing in mind that at least some of these proposals make good business sense for GSK. For example, reducing the cost of drugs in the developing world will allow them to compete more effectively with the cheap generic drugs industry that has grown in China and India.

There are also areas where more work could be done. For example, Witty hasn't said a great deal about how GSK could provide more support in the fight against AIDS. In fact, his "patent pools" idea excludes the development of HIV drugs. This is something that has attracted critiscism from Michelle Childs, Director of Policy at Medecins Sans Frontieres, who stated:

"He is saying there is no need for a patent pool for HIV. Our position is that there is an urgent need for a patent pool for HIV because of the rising prices of new first and second line drugs for patients who develop resistance."

Whilst there is more that could be done, this is certainly a very bold a positive step for Witty and GSK. What remains to be seen is the reaction from the rest of the industry. With any luck they will follow where GSK leads.

ETA: James over at JDC325 discusses what some big pharma companies actually are doing in relation to providing free or cheap AIDS drugs to the developing world here.

Virgos need not apply - Hiring through horoscope

I've checked the date, and we're still a good few weeks away from 1st April. But how else can you explain an Austrian insurance company selecting employees based on their star signs?

The Salzburg insurance company has performed a statistical analysis of its employees' star signs and have determined that those who are Capricorn, Taurus, Aquarius, Aries and Leo are their best workers. They therefore want to make sure that Sales & Management recruits for 20 new roles also have said star signs.

Now, I haven't been able to find any details of this statistical analysis, and if anyone else has come across it I'd love to see it.

Perhaps the most worrying thing about this is that it doesn't seem to be illegal. In fact, the Salzburg employees council have said:

'When an employer considers star signs and says: "I want to only hire Pisces, for an example, it must be assumed that within this group of people born under the sign of Pisces there are old and young people, women and women etc. It does appear like a certain limitation, but it is not discrimination.'

It'll be interesting to see how astrologers react to this. On the one hand I can see them being happy that a mainstream business is buying into the whole astrology idea, but at the same time I doubt they'd be happy at it being used to discriminate.

The mind boggles!

There DEFINITELY is a god, claims number 23 bus

A campaign was launched last year on the Guardian's Comment is Free site, raising funds to place a few adverts on London buses explaining that god doesn't exist. The campaign was launched by Ariane Sherine as an attempt to counter the increasing numbers of religious adverts found on the tube and buses. With an initial plan to raise £5,500 from online donations, the campaign eventually raised over £150,000 allowing a much larger advertising push than anticipated. The campaign first went national and has now gone global.

A lot was said about the wording of the advert, which read:

"There probably is no god. Now stop worrying and enjoy your life"

Many thought the wording was too weak, questioning the need for the word "probably". Surely if it was an atheist advert it shouldn't need that word?

Many thought the "probably" implied agnosticism rather than atheism, though I see no problem. A read around the different forms of atheism shows how you can be a de-facto atheist whilst still enternaining a very very very small possibility that you are wrong. After all, I might also be wrong about the celestial teapot.

A complaint was made to the Advertising Standards Agency about the advert by professional loon Stephen Green of Christian Voice. The complaint was rejected, and the inclusion of the word "probably" may have helped. The ASA judged that:

the ad was an expression of the advertiser’s opinion and that the claims in it were not capable of objective substantiation.

Since then, Christian groups have decided to go ahead with their own campaign. One of the key differences between their adverts and the Atheist one is their certainty. One advert reads:

There definitely is a God. So join the Christian Party and enjoy your life

I'm sure somebody at some stage will submit a complaint to the ASA, though I'm not sure how far that will get. It seems from their guidelines that first of all a complainant would have to show that the existence or otherwise of god is capable of objective substantiation, and then that the conclusion that god exists is false. I would love to be a fly on the wall at the ASA meeting to decide this. The prospect of the ASA having to decide on the existence of god is quite interesting but it would never get that far.

I'm on two minds as to whether to submit my own complaint or not. Do I really want to lower myself to the level of Christian Voice?

What is most interesting however is how the religious seem unable to contemplate even the remotest prospect that they are wrong. The word "probably" is so threatening to them that you won't find it in their adverts.

MMR: Wakefield hearing uncovers research falsification

Dr Andrew Wakefield is nearing the end of his GMC hearing on charges of conducting research unethically. This relates to the Lancet paper that sparked the media "controversy" over the MMR vaccine in 1998, apparently linking it to bowel disease and Autism. We all know what happened next... ill informed journalists and columnists demanding the withdrawal of the vaccine, the Blairs refusing to confirm or deny whether Leo had been vaccinated, a massive drop in immunisation, and now finally a return to Measles being endemic in the UK.

A lot has been written about who was to blame for this. Whilst it may have been tempting to pin it all on Wakefield I think it's fair to say the press should take a massive share of the blame.

What is only properly coming to light now however is how flawed Wakefield's research was. An article in today's Sunday Times by Brian Deer look at some of the evidence that has been uncovered through the GMC hearing.

We had been told that the Lancet paper showed evidence of 12 previously normal children contracting from bowel disease and behavioural problems indicative of Autism only a short time after receiving MMR. Nobody has ever been able to replicate these findings, and no other evidence linking MMR to Autism has ever been found. Still, Wakefield stood by his research.

The previously unreleased papers show a pattern of falsification, misreporting and selective reporting of the evidence that led to Wakefield's conclusion. These include:

- children showing indications of behavioural problems before the MMR jab
- children showing similar problems several months following MMR, when Wakefield had claimed it was two weeks later
- pathology records showing that Wakefield's bowel disease diagnoses were inaccurate and misleading

Sometimes people get things wrong, which is why scientists regularly review and reproduce each others work. Could Wakefield simply have been mistaken, made errors, and just not been very good at his job? Or is these something else that can account for the poor quality of his research and conclusions?

What has also been uncovered through this hearing is that before his research Wakefield will have had a vested interest in the outcome. Wakefield had already been working with a lawyer, representing the anti-vaccine lobby group JABS in order to seek compensation for families who claimed MMR had damaged their child.

Wakefield had sought funding from the Legal Aid Board, claiming to have found a "new syndrome" (remember, this is before the research). This funding was to "seek evidence which will be acceptable in a court of law" to establish a link between MMR and Autism. So far Wakefield has earned over £430,000 from families seeking compensation.

The last word should perhaps go to Wakefield, who, at the press conference announcing the Lancet paper (itself an unusual event) said:

“It’s a moral issue for me. I can’t support the continued use of these three vaccines, given in combination, until this issue has been resolved.”

Moral. Indeed.

Tim Minchin's "Storm" - So F**cking Rock

Tim Minchin has finally put up a decent quality version of Storm on Youtube, after somebody leaked a poor quality version in December.

This 9 minute beat poem is awesome. I'm sure some readers of this blog (if I have any!) will appreciate the situation in this poem. I'd love to think I could one day respond to Woo's as wittily and eloquently as Tim.

Enjoy!

Prince Charles: Nice biscuits, shame about the woo!

You may, or may not have heard of Duchy Originals, the company Prince Charles set up in 1990 to produce and promote organic food. Say what you like about organic farming, I personally think it's expensive nonsense (more on that another time!), but his biscuits are bloody nice!



It seems Charlie is diversifying. We've always known he's prone to a bit of woolly thinking and like's his alternative therapies, but it now seems he's started selling them. He's just launched a range of herbal tinctures , encouraging us to try them if we're "suffering from the sniffles".



What's most interesting about this is that he's claiming the Medicines and Healthcare Products Regulatory Agency (MHRA) have assessed them and approved them for "safety, quality and efficacy" (my emphasis).



What's interesting about this is that they claim that this was done under the Traditional Herbal Medicinal Product Directive. A little digging by Rob Hinkley at semiskimmed.net found that this directive doesn't guarantee that remedies are assessed for efficacy, and more importantly that the specific licensing decisions for Charlie's tinctures:

"is based exclusively upon evidence of traditional use as herbal medicine [and] There is no requirement under the Traditional Herbal Registration scheme to prove scientifically that the product works."

It seems therefore that Duchy's originals have been telling (presumably organic!) porkie pies.

Their error has of course been pointed out to them on their blog, though the comment is still "awaiting moderation".

What is this blog about?

I've finally decided to start a blog, having wanted to do so for a while and having admired the work of other bloggers such as Gimpy, David Colquhoun, Le Canard Noir, JDC, Holfordwatch, DrT, and of course Ben Goldacre

You'll notice something that these blogs all have in common. They're aimed at examing and taking apart the false claims of quacks and cranks around the world, from alternative therapists, through nutritionists to religious nuts... the generally hard of thinking.

This blog will be along similar lines, perhaps picking up the odd story the others don't and adding a different perspective to them.

Oh, and why the name "Cargo Cult Science"? Well, if you haven't come across that term before it comes from one of my scientific heroes - the physicist Richard Feynman. He coined the term at his commencement speech at Caltech in 1974:

There is one feature I notice that is generally missing in "cargo cult science"... It's a kind of scientific integrity, a principle of scientific thought that corresponds to a kind of utter honesty — a kind of leaning over backwards... For example, if you're doing an experiment, you should report everything that you think might make it invalid — not only what you think is right about it... Details that could throw doubt on your interpretation must be given, if you know them.