LOB-vs
Download Lectures on Biostatistics (1971).
Corrected and searchable version of Google books edition

Download review of Lectures on Biostatistics (THES, 1973).

Latest Tweets
Categories
Archives

Jump to follow-up

I don’t know about you, but I’m bored stiff with homeopathy. There are a lot more important things. Nevertheless, it remains a gross insult to reason, and there has been such enormous success in combating it over the last five years so, this is not the moment to stop.

Hats off to the Merseyside Skeptics Society. I admit that when I first heard about the 10:23 campaign, it seemed to be a bit of a gimmick, but in fact it turned out to be an enormous success., not just in the UK but also in Canada, Australia and New Zealand

10:23 Leeds

The campaign was focussed on Boots, the UK’s biggest pharmacy chain, In particular the fact that Boots sell homeopathic pills. and regularly gives appallingly bad advice about all forms of quackery that they stock.

I’ve been criticising Boots for years now, starting with Mis-education at Boots the Chemist in May 2006. was largely about homeopathy, but Boots’ quackery is not restricted to homeopathy, In November 2007, Don’t Trust Boots described Boots’ promotion of vitamin pills that were
advertised by Boots to increase your energy, and also the appallingly bad advice given by shop staff on this product.

In March 2008, Boots did it again, with a big promotion written up as Boots reaches new level of dishonesty with CoQ10 promotion. The strategy seems clear by now. Launch an enormous publicity effort, and rely on journalists to parrot the press release. Put mendacious advertisements in every newspaper. Eventually the advertisements are found to be inaccurate by the Advertising Standards Authority. Boots are told to stop using the advertisement, but suffer no penalty at all.  By that time the advertising campaign is over anyway, and they can rely now on inaccurate advice from "Boots expert team"; face to face in the store, to continue the promotion in a way that evades all regulation.

Boots is deeply involved too in the great ‘detox’ scam, as recounted, for example, in “Detox”: nonsense for the gullible, along with the Prince of Wales.  And, most recently, Lactium: more rubbish from Boots the Chemists. And a more serious problem.

The nauseating hypocrisy of Boots’ Corporate Social Responsibility statement beggars belief. The same stuff is repeated on the current Alliance Boots site.

“Trust – The essence of the way we do business. We are trusted because we deliver on our promises.”

You must be joking.

Who owns Boots?

Boots started in 1849 as a single shop in Nottingham. Within my lifetime, they were rather ethical pharmacies (my recollection is that they didn’t sell homeopathic pills). They were also an ethical pharmaceutical company.  They developed ibuprofen, which was launched in 1969.   But since then the company was involved in a complicated series of acquisitions. Now it is a supranational conglomerate with presence in 20 countries, and almost beyond the reach of the law. Boots’ executive chairman is Stefano Pessina, who, with private equity firm Kohlberg Kravis Roberts in a £11.1 billion deal last year, took the firm private in 2007.   In 2008 they announced a 20% increase in profits, to £771 million In 2008 they moved their headquarters out of the UK, to Geneva, partly, it seems, so they can be closer to other giants of Big Pharma, and partly, no doubt, to put pressure on the UK government not to tax them too much,   On the other hand, tax may not be a big consideration because, according to The Times, the ultimate owners of Boots are based in Gibralter

The disgraced head of HBOS, Andy Hornby, was appointed as chief executive of Alliance Boots in June 2009. Before playing his part in ruining the UK economy he used to work for grocery chain, Asda. I’d guess that he has limited interest in pharmacology.

The economics of such organisations are beyond most people. a bit like the two cow economics joke perhaps.

"VENTURE CAPITALISM – AN ICELANDIC CORPORATION

You have two cows.

You sell three of them to your publicly listed company, using letters of credit opened by your brother-in-law at the bank, then execute a debt/equity swap with an associated general offer so that you get all four cows back, with a tax exemption for five cows. The milk rights of the six cows are transferred via an intermediary to a Cayman Island Company secretly owned by the majority shareholder who sells the rights to all seven cows back to your listed company. The annual report says the company owns eight cows, with an option on one more. You sell one cow to buy a new president of the United States, leaving you with nine cows. No balance sheet provided with the release. The public then buys your bull."

Clearly there is not the slightest chance of an organisation like this will have any sort of conscience about selling useless pills, The only way that they can be influenced is by public mockery of their outrageous behaviour. If the publicity harms their image enough they may decide to cut their losses, because it pays, not because it is right.

10:23 a great success

The campaign was a success because it got good coverage in the newspapers, radio and TV. Boots, rather like vice-chancellors, seems to be uninterested in reason or morals, but will certainly be sensitive about its public image, There is a partial list of coverage at the 10.23 site.

Laura Donnelly had a good account in the Telegraph, "Homeopathy: medicine that’s hard to swallow?".  And Hadley Freeman in the Guardian showed that fashion journalists can spot nonsense too, in "Me and my homeopathic overdose. How I knocked back a bottle of homeopathic ‘medicine’ and lived to tell the tale"

The spoof published on the NewsArse site (despite the name, it is excellent) hit the nail on the head, because it uses exactly the naive sort of post ho ergo propter hoc argument that homoeopaths love.,

Homeopathy proven to work after overdosing protesters eventually fall asleep

Homeopathic practitioners are today claiming victory for the efficacy of their remedies, after a protest by the 10:23 group who overdosed on homeopathic sleeping pills, left each participant asleep within just 36 hours of taking the remedy.

Funniest of all though, was the bleating by homeopaths themselves. Try, for example, Homeopathy Heals. Like all the others it alleges a conspiracy by big Pharma: “it seems to be driven by those working for Pharma behind the scenes”. It seems to have escaped the attention of these conspiritorialists that the demonstration was aimed at Boots and Boots IS Big Pharma. The two are inextricably linked and both use the same tactics to increase sales.

My small contribution

Apart form contributing to Laura Donnelly’s piece in the Telegraph, "Homeopathy: medicine that’s hard to swallow?"., I had a few more calls.

Mary English, homeopath and astrologer

The most interesting was a talk show on Radio 5 live, where I was was pitted against a homeopath, Mary English [play the mp3 file, 4.4
Mb]. Having come across Mary English before, I was well-prepared to talk about her record not only in homeopathy, but also in astrology. The presenter didn’t give me time to raise these points but he did a pretty good job himself in asking her the relevant questions.

Mary English’s website is a delight. "Homeopathy and Astrology can heal you".

" If you eat a whole bottle of them it wouldn’t make any difference because it’s the dose that you have, not the quantity of the tablets"

"It’s the frequency of dose . . .because it’s vibrational medicine"

The host asked "what’s vibrational medicine?"

"it works with your bodies systems as opposed to against it"

No doubt Mary English is quite sincere, She just, like so many homeopaths, seems to be quite unaware that these words don’t mean anything at all. Just pure gobbeldygook.

Some of her claims are bizarre, even by the standards of homeopaths.  She has researched the birth charts of Indigo Children, and written a book, "How to survive a Pisces"  Her claim to homeopathic fame is that she has done "provings" of "remedies" including thunderstorm, and shipwreck  and Stanton Drew Stone Circle, and Old Wardour Castle. Ahem, suddenly Arnica 30C sounds quite sane.

Less excusably, Mary English went on to claim that there is good evidence that homeopathy works. She just hasn’t read, or hasn’t understood the evidence. But since she earns her living as a homeopath
and astrologer, she hasn’t got much incentive to read the evidence. if she did, her income would dry up.

The presenter put directly to Mary English the recommendation of homeopathy for malaria prevention. "You wouldn’t condone that would you?". Quite disgracefully that question was avoided. She
changed the subject without answering the question.  The quackometer’s classic post on The Gentle Art of Homeopathic Killing came to mind (see also here for links to full text)

Some herbal stuff

Herbal medicine rather than homeopathy was the topic of the other two weekend gigs. That arose from the Pittilo proposals for statutory regulation of herbalists and Chinese medicine.

The BBC TV interview, together with a herbalist, Rhona Edmonds, is now in YouTube. A Welsh member of the European parliament, Jill Evans (Plaid Cymru) , has been backing herbalists on the grounds that they are a “well-respected profession”. Oh yes?  The Prince of Wales has also had support from another MEP. Mike Nattrass (UKIP).  It seems that our fringe parties have even more trouble with science than the Labour and Conservative parties (and, tragically, that includes the Green party too).

There was also an early morning talk show interview on Sunday 31 January, against the same herbalist [play mp3 file] She claims "we treat all sorts of conditions",. Yes indeed, that’s the problem. "If we were recognised it would give the public even more confidence". And that is the problem too. They don’t deserve that confidence.

The analogy between alternative medicine and religion is often striking. Both involve blind faith, and both are characterised by tendency to split into sects that war with each other even more viciously than they war with unbelievers. All the discussions of herbalism ignore the fact that an enormous number of herbalists (2536 as of 4th February) have signed a petition opposing the idea of statutory regulation, even in the ineffective form that is being proposed.

The Prince of Wales declares war on . . . the Enlightenment

That was the headline of an article in The Times (February 4th, 2010).  There can be no more high profile propagandist for every form of magic medicine than the Prince of Wales. Nothing seems to stretch his credulity.  But even I was taken aback by his latest pronouncement.  It seems he’s been called an enemy of the enlightenment (yes, by me among many others).

“I was accused once of being the enemy of the Enlightenment,” “I felt proud of that.”

“We cannot go on like this, just imagining that the principles of the Enlightenment still apply now. I don’t believe they do. But if you challenge people who hold the Enlightenment as the ultimate answer to everything, you do really upset them.”

So it seems he wants to return medicine not just to 1800, but to 1500, the dark ages. Can he really think that life in 1500 was some sort of utopia?  Of course one suspects that his disapproval of the enlightenment is restricted to medical matters.  He hasn’t been seen to reject other products of the enlightenment, like cars, aircraft, telephones, radio, TV and the internet.

I suspect that the Prince of Wales needs a history lesson.

Follow-up

Thanks to a colleague for pointing out an excellent sketch from the Newsjack show on BBC Radio 7, broadcast on 4th February 2009. [play mp3 file, 2.4 Mb]. I quote.

“Last weekend, people up and down rhe country engaged in a mass anti-homeopathy protest, swallowing whole bottles of remedies outside Boots.”

“It’s very easy to sneer at homeopathy but we at Newsjack believe it’s important to listen to both sides of the debate. So to put the case for homeopathy we have invited on a ridiculous charlatan who extorts money from innocent people while providing no services of any actual value.”

“Will you please welcome His Royal Highness, the Prince of Wales”

Print Friendly, PDF & Email

15 Responses to Mass placebocide attempt. The 10:23 campaign

  • Excellent post David.

    Regarding Mary English & treatment of Croup.

    She claims in the audio clip that conventional medicine has no treatment for croup. Simply not true. As someone who has had to rush kids to Hospital with croup, treatment is either a salbutamol nebuliser or an oral dose of steroids. Which, in my experience, works very quickly.

    Shame there wasn’t time in the interview to take her to task!

  • No, it’s if everyone else read the evidence that Mary English’s income would dry up, David. Mary can read it contently knowing there’s no chance of her income drying up as long as people believe there’s something in it. The 10.23 campaign has a lot of work to do.

    Great post, anyway.

  • Careful now.

    Mary English once wrote to me saying you have “24 hours to remove all mention, links, comments, writings and/or articles about me or my sites or I will be instructing them to sue for libel”

    If I remember, my response was roughly along the lines of the Private Eye classic,

    “We would therefore be grateful if you could inform us what [your] attitude to damages would be, were [you] to learn that the nature of our reply is as follows: fuck off”

  • @skepticat
    That rather depends on how honest the person in question is. I’m inclined to think that most homeopaths are quite honest, in the sense that they really believe all that weird stuff. So if they ever were persuaded to take notice of evidence, they’d have to stop selling it. I suspect that if you are willing to lie consciously to make money, it might be more profitable to go into something like selling “nutritional supplements”.

    Of course if you are doing things that are actually dangerous, as many homeopaths do, the fact that you honestly believe it is not a sufficient excuse.

    @lecanardnoir. I hope that response is sufficient to prevent me from having to use your defence (hehe I love it). Also love the post that presumably gave rise to it, at http://www.quackometer.net/blog/2007/07/what-our-nhs-money-is-being-spent-on.html

  • I agree with you DC. It sounded a bit daft at first but the publicity it got was great! Of course it won’t change the mind of a single homeopath, but it might make a few of their customers think twice. What’s next?

  • I’m with DC and Mike Eslea. One of the things the 10;23 Campaign and the Merseyside Skeptic Society (and others) have shown is that you can generate excellent coverage of these issues with a grass-roots campaign. Given the amount of credulous PR puffing the Alt.Reality crew get in newspapers in particular, this is important.

    Oh – and I got to be in one of the videos!

  • I left U.S. naturopathy school because of my aversion towards homeopathy stupidity.

    Lovin’ it.

    -r.c.

  • DC wrote;
    Less excusably, Mary English went on to claim that there is good evidence that homeopathy works. She just hasn’t read, or hasn’t understood the evidence. But since she earns her living as a homeopath
    and astrologer, she hasn’t got much incentive to read the evidence. if she did, her income would dry up

    So what’s your knowledge of evidence-based medicine? When I’ve raised the NNTs and NNH of conventional medicines the only thing I’ve heard is the sound of one hand clapping.

  • @Dangerous

    Always livens things up to get some sniping from you, though I’m not quite sure what your point is this time.

    I suspect you should be asking Mary English, rather than me, about her understanding of Number Needed to Treat (NNT) and Number Needed to Harm (NNH). They are pretty standard terms these days, though I don’t think they were around at the time I wrote my textbook on statistics.

    They do involve an assumption of causality of course, and for some reason that baffles me alt. med enthusiasts seem to have a particularly weak grasp of that. Hence their disdain for RCTs

  • You can have RCTs which don’t look at primary end point data and focus on surrogate markers, which many studies do. They are not the be all and end all.

    Would I take homeopathy,no. Would I take simvastatin 40mg with an NNT of 22 in very high risk individuals? Nah, I’ll stick with the sardines.And this is a drug with gold standard primary end point data. I wonder what would happen if they took 84 simvastatin tablets in one go. I hope they’re not lactose intolerant.

  • @Dangerous
    It seems we agree about homeopathy so your post is entirely off topic,

    But since you raised it, I deplore as much as you the commercial pressures to overprescribe statins. There is a good review by NICE. I have fairly low risk of CVD despite my age so I wouldn’t take them. I should pont out that the evidence for sardines being useful is hardly strong either.

  • Not entirely off topic. Homeopathy costs the NHS about £12 million a year while conventional prescribing costs £12 billion a year (excluding secondary care costs due to adverse reactions). I’m no accountant but if I was looking to save money I know where I would look first.
    The NICE guidance on statins is one of their better efforts but this needs to be balanced against their awful guidance on COX-2 inhibitors.

  • @Dangerous

    I know too, I would take the 12million from homeopathy and put it into genetic research into what alleles cause adverse reactions to what substances so that patients can be screened before prescribing. But hold on, such work is already being done, funded as is proper, by the likes of the MRC. The NHS does fund some research but you don’t seem to realise that research is not its primary purpose and the system in this country is that the right people should do the research, which is what happens.

    The results are coming in, for eg knowing your cytochrome p450 profile determines the dose of a number of anti cancer drugs like cisplatin. If you metabolise the drug quickly you need a higher or more frequent dose, if you metabolise it slowly you need a smaller dose. This means everyone gets the same dose in the tissue where it is required.

    This work was funded iirc by CRUK. I was not involved, I just worked in the dept where it was done here in Dundee.

    The work is ongoing as the genome is large and not only p450s are involved and there are a lot of drugs but pharmacogenetics is a growth area. So your criticism is premature. Also criticising a doctor for prescribing something that helps the large majority when she has no way of telling in advance who are the minority it will harm is more than harsh. You try that job for a while and see how you like it.

Leave a Reply