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The Institute of Science in Society purports to be about promoting a socially responsible approach to science. It combines some reasonable stuff about global warming with a lot of utter rubbish about homeopathy (mainly written by the Institute’s director, Dr Mae-Wan Ho).

(This item has been transferred from the old IMPROBABLE SCIENCE page.)

I just stumbled across this organisation. At first sight, its theme of “science, society and sustainability” sounded right up my street. It seems to be predominantly an anti-GM, pro-organic farming, organisation. Although some of their contributors seem to be somewhat paranoid, there is much that I can agree with in what they say about that.

But they completely ruin their case by including quite barmy homilies about homeopathy (and here), water structure and traditional chinese medicine. There is also an amazing piece of sheer pseudo-scientific nonsense, “Homeopathic Medicine is Nanopharmacology” by Dana Ullman (though elsewhere on the site, nanotechnology gets a bad press).

Most of the nutty content seems to be written by the director of the Institute herself. Dr Mae-Wan Ho, who is listed as “Reader in Biology at the Open University” (that’s odd -no trace of her on the Open University web site). In fact some doubts have been cast on her biography. Wikipedia says “She is former head of the Bio-Electrodynamics laboratory at the Open University in Milton Keynes after either having been fired for incompetence or resigning because of personal reasons.” Whatever the truth in that may be, she clearly doesn’t understand homeopathy.

The board of directors of the Institute includes Zac Goldsmith (editor of The Ecologist) and it is advised by some apparently respectable scientists.

It is sad that an organisation with a respectable sounding title like the Institute of Science in Society is being used to propagate some pure pseudo-scientific gobblydegook. Is it any wonder that journalists and the general public get confused?

George Lewith, who is an advocate of CAM research, appears to have rather different standards in his private clinic.

Some interesting emails have come into my possession recently. They concern the Centre for Complementary and Integrated Medicine, which gives its address as Harley House, Brunswick Place (Formerly Upper Harley St.), London NW1 4PR (don’t you just love “formerly Upper Harley Street”?).

This centre lists its doctors as Dr Nick Avery, Dr Mike Clark and Professor George Lewith.

Their web site claims “There are several approaches that we use in complementary medicine that may be of help to people with fibromyalgia. There is at least one positive clinical trial that indicates that homeopathy can help this condition.”

An enquiry was sent to the clinic, as follows.

My GP diagnosed my pain as fibromyalgia almost 2 years ago, but I have not had much relief from the treatment I’ve had so far. I have never tried alternative treatments, but I have looked at your web site and I see that you say “There is at least one positive clinical trial that indicates that homeopathy can help this condition”.

I wonder if you could give me some more details about that before I commit myself to trying it?

After some delay, a polite response came from Dr Avery.

We treat an enormous number of patients with fibromyalgia and there are many things that can help. In practise [sic] we tend to use combinations of diet, nutrition, homeopathy and acupuncture.In my experience fibromyalgia patients are almost all suffering from magnesium deficiency which, once corrected, can have an enormous impact on symptoms. If this is not corrected, then conventional treatment cannot help.

Homeopathy seems to be a fundamental part of treating the (whole person) and it is the combination that seems to be so helpful.If you would like to come and see me then please ring my receptionists

But no mention there of a trial. A second enquiry gave a fascinating
result.

I am forwarding you the information you requested about the clinical trial for homeopathy used in helping with Fibromyalgia. I will pass Dr. Lewith’s reply to Dr. Avery who will be able to write to you with more detail when he’s at the clinic this Thursday.

Best wishes

Catherine (Reception)


—– Original Message —–

From: “Lewith G.” < gl3@soton.ac.uk>

To: “CCIM” < harley@complemed.co.uk >; < nickavery@tiscali.co.uk>

Sent: Friday, May 26, 2006 10:50 PM

Subject: RE: Message from Dr Avery

Its a BMJ paper in the late 1980’s by Peter Fisher. He used Rhus Tox 6C and it was a small positive trial.He will have it.

G

This paper must be the one that I was asked to check by the producer of a television programme (QED), (Fisher, P., Greenwood, A., Huskisson, E. C., Turner, P., & Belon, P. (1989). Effect of homoeopathic treatment on fibrositis (primary fibromyalgia) British Medical Journal 299, 365-366.).

But surely some mistake here? The problems with this paper have already been here. Fisher et al. had made a naive mistake in their statistical analysis, and in fact the homeopathic treatment had no demonstrable effect whatsoever, a result that was published soon after in the Lancet: Colquhoun, D. (1990), Reanalysis of a clinical trial of a homoeopathic treatment of fibrositis. Lancet 336, 441-442.). [Get the pdf]

So why does Professor Lewith cite the Fisher paper without mentioning that it provides no evidence at all? Professor Lewith says that he was unaware of this history. That does seem odd for someone who is devoted to assessment of CAM (all you have to do is search for ‘fibromyalgia and homeopathy’ in Medline). Very baffling.

Despite these puzzles, when I showed a draft for this site to Prof Lewith he said “Nick [Avery] and I have thought very carefully about the responses and we are very happy with them”.

There are now more papers on the treatment of fibromyalgia, as Prof Lewith has pointed out to me. They are all from the University of Arizona, and all appear to refer to the same set of patients. One of these suggests that homeopathic treatment is effective (Bell IR; Lewis DA; Brooks AJ; Schwartz GE; Lewis SE; Walsh BT; Baldwin CM, Improved clinical status in fibromyalgia patients treated with individualized homeopathic remedies versus placebo. Rheumatology. 2004; 43: 77-582).

But a second paper about the same patients seems much less sure. The trial was organised as an ‘optional crossover trial’, and there was no significant difference between the proportion of patients who opted to swap treatments between those who were initially on placebo and those who were initially on homeopathy. Evidently they couldn’t tell the difference! (Bell et al., 2004, J. Alt Comp Med, 10, 269 383).


Both of these papers, incidentally, have as a co-author the famous (or perhaps infamous) Gary Schwartz, of the “Centre for Frontier Medicine in Biofield Science”, which is, believe it or not, part of the University of Arizona, and which, even more incredibly, gets NIH funding. He “photographs” non-existent “energy fields” and claims to be able to communicate with the dead (critique here).Well I guess the immortality is an even better seller than homeopathy. The picture on the right is what the “Biofield science” centre uses on its web site.

The AMI test and the Vega test

Dr Avery also sent “our information leaflet on Fibromyalgia”. This document was rather interesting.

We find that a lot of patients with this condition suffer from food intolerance, which can be identified and treated. . . .Other measurements using the “AMI” which measures imbalances in the body can also indicate the whereabouts of the most significant internal dysfunction.Dietary and nutritional approaches can be enhanced by using acupuncture, classical and, in particular, complex homeopathy. Remedies can be identified using the Vega test, which measures energetic imbalances in the body, helping the practitioner to target the most appropriate areas in each individual patient.




The Vega test and the AMI machine

What are these tests? The Vega test is one of the older con tricks. Dr Avery seems to be misinformed. The Vega test does not measure “energetic imbalances” (whatever that means), it measures skin conductance. So it resembles the infamous lie detector (perhaps it should be tried on its advocates). It has been the subject of several legal actions (listed here, by the Quackwatch site). Here are three of many examples.

  • In 1985, the FDA notified a distributor that Vegatest devices could not be marketed as a medical devices without FDA approval (which they do not have).
  • In 1990, the New Zealand Medical Journal described how a homeopathic physician had used a Vega device to diagnose allergies in three infants. In each case, the device was applied to the mother with the child on the mother’s lap or roaming about the examining room. The doctor also diagnosed “miasms,” which, if not removed, would prove fatal later in life. The Medical Practitioners Disciplinary Committee ordered that he be censured, pay a penalty of NZ$900 plus NZ$25,000 for costs and expenses, and follow certain standards of care for three years
  • In 2002, the British Advertising Standards Agency concluded that a leaflet offering Vega testing as a “complete test for hidden problems” was misleading and advised the advertiser to withdraw it .

In 2003, the BBC did its own investigation.

“We sent Inside Out’s Chris Packham to three Holland and Barrett stores across the South to find out more.

Chris took the Vega test in Newbury, Chichester and Farnborough, only to discover that his allergy results differed from store to store.

In total, Chris was sensitive to over 33 different foods, including staples like wheat, potatoes, milk, tomatoes, tea and coffee. But out of the 33 products, there was only two that all three testers agreed on – cheese and chocolate.

Chris was also advised by Holland and Barrett staff to take a total of 20 different vitamins and minerals. But again, the testers can’t seem to agree and all three testers advised different supplements.

It seems your allergies may not be determined by food alone, but also your location.

Professor Lewith told me, when I asked about the Vega test,

“I use it to help with homeopathic diagnoses, your next question of course is why on earth would you want to make an irrational diagnosis about a completely irrational subject.”

Yes, indeed it is! But that question has not been answered.

To make matters still odder, Professor Lewith has himself published a paper showing that the Vega test does not work. Why, then, does he use it in his private clinic? The paper in question is in British Medical Journal, 2001;322:131-4. It concludes “Electrodermal testing cannot be used to diagnose environmental allergies.”
Despite his own conclusion in the BMJ, the homeopathy page of the Rosedale Clinic concludes

The Vega offers one of the most exciting advances in modern medicine to appear in recent years, an accurate method of non-invasive deep physiological investigation

I would like to dedicate this section to Dr’s LEWITH, KENYON and SCHIMMEL for their tuition and helpful guidance with the Vega technique.

Wow!

The AMI machine is much less well-known. It presumably refers to “Apparatus for Measuring the Functions Of the Meridians and Corresponding Internal Organ”. Again it is said the the mysterious and undefined “imbalances”. The most likely interpretation seems to be that it just another galvanometer.

For a sane description of bizarre ‘allergy tests’, look here.

This letter was sent to the chief executives of 476 NHS Trusts (acute and primary care trusts). It was the main headline in The Times, and the lead item on the BBC’s Today Programme.

From Professor Michael Baum and others 19th May 2006


Dear

Re Use of ‘alternative’ medicine in the NHS


We are a group of physicians and scientists who are concerned about ways in which nproven or disproved treatments are being encouraged for general use in the NHS. We would ask you to review practices in your own trust, and to join us in representing our concerns to the Department of Health because we want patients to benefit from the best treatments available.


There are two particular developments to which we would like to draw your attention. First, there is now overt promotion of homeopathy in parts of the NHS (including the NHS Direct website). It is an implausible treatment for which over a dozen systematic reviews have failed to produce convincing evidence of effectiveness. Despite this, a recently-published patient guide, promoting use of homeopathy without making the lack of proven efficacy clear to patients, is being made available through government funding. Further suggestions about benefits of homeopathy in the treatment of asthma have been made in the ‘Smallwood Report’ and in another publication by the Department of Health designed to give primary care groups “a basic source of reference on complementary and alternative therapies.” A Cochrane review of all relevant studies, however, failed to confirm any benefits for asthma treatment.


Secondly, as you may know, there has been a concerted campaign to promote complementary and alternative medicine as a component of healthcare provision. Treatments covered by this definition include some which have not been tested as pharmaceutical products, but which are known to cause adverse effects, and others that have no demonstrable benefits. While medical practice must remain open to new discoveries for which there is convincing evidence, including any branded as ‘alternative’, it would be highly irresponsible to embrace any medicine as though it were a matter of principle.


At a time when the NHS is under intense pressure, patients, the public and the NHS are best served by using the available funds for treatments that are based on solid evidence. Furthermore, as someone in a position of accountability for resource distribution, you will be familiar with just how publicly emotive the decisions concerning which therapies to provide under the NHS can be; our ability to explain and justify to patients the selection of treatments, and to account for expenditure on them more widely, is compromised if we abandon our reference to evidence. We are sensitive to the needs of patients for complementary care to enhance well-being and for spiritual support to deal with the fear of death at a time of critical illness, all of which can be supported through services already available within the NHS without resorting to false claims.


These are not trivial matters. We urge you to take an early opportunity to review practice in your own trust with a view to ensuring that patients do not receive misleading information about the effectiveness of alternative medicines. We would also ask you to write to the Department of Health requesting evidence-based information for trusts and for patients with respect to alternative medicine.


Yours sincerely


Text Box: Professor Michael Baum   Emeritus Professor of Surgery, University College London  and Professor Frances Ashcroft FRS
University Laboratory of Physiology, Oxford

Professor Sir Colin Berry
Emeritus Professor of Pathology, Queen Mary, London

Professor Gustav Born FRS
Emeritus Professor of Pharmacology, Kings College London

Professor Sir James Black FRS
Kings College London

Professor David Colquhoun FRS
University College London

Professor Peter Dawson
Clinical Director of Imaging, University College London

Professor Edzard Ernst
Peninsula Medical School , Exeter

Professor John Garrow
Emeritus Professor of Human Nutrition, London

Professor Sir Keith Peters FRS
President, The Academy of Medical Sciences

Mr Leslie Rose
Consultant Clinical Scientist

Professor Raymond Tallis
Emeritus Professor of Geriatric Medicine, University of Manchester

Professor Lewis Wolpert CBE FRS
University College London


As soon as this appeared the phone started ringing.

Michael Baum did an excellent job on the Today Programme, and on BBC Birmingham, BBC55, BBC world service, ITN news (interviewed for 20 minutes outdoor in the rain), Sky News live, and as well as all that he saw patients, and missed lunch while in the operating theatre. Michael comments ” How was your day your Royal Highness? “.


Leslie Rose did BBC Breakfast TV interview and various radio stations.


I did interviews for BBC News24, BBC1 News, Chanel 5 News, Sky news, the Jeremy Vine Show (radio 2), BBC Radio Solent, and wrote something for the Scotsman. Today it’s Radio London at 10.35 pm and tomorrow, Radio Foyle (Derry).

Listen to the Today Programme 08.10 interview


John Humphrys, on the Today Programme, interviews Michael Baum (lead signatory on the letter), and Peter Fisher of the Royal London Homeopathic Hospital (For more on Peter Fisher, see here, and here, and here). Listen to the interview [mp3 file, 4.4 Mb]

Leslie Rose interviewed on BBC
Breakfast
TV. Watch the interview (Realplayer file).

Interview for Sky News.

The Jeremy Vine show interview (Radio 2)

The Late Show on BBC Radio London (24 May), host Stephen
Rhodes, DC versus Gary Trainer: click to listen

Radio Foyle (N. Irelend) Talk show with Mark Patterson. The local health
food shop manager told me that ‘arthritis is a build up of toxins in the body’,
and that glucosamine and chondroitin are herbal! Click to listen


Michael Baum’s 2004 Open letter. “An open letter to the Prince of Wales: with respect, your highness, you’ve got it wrong”. Download pdf file.

Coverage in The Times, 23 May 2006. The front page headline.

New International has forced me to remove the pictures of the front page, but the front page headline was

NHS told to abandon alternative medicine

Top doctors say money should go to conventional treatment

Here is Mark Henderson’s article.

NHS told to abandon alternative medicine

By Mark Henderson, Science Editor

Top doctors say money should go to conventional treatment

A GROUP of Britain’s leading doctors has urged every NHS trust to stop paying for alternative medicine and to use the money for conventional treatments.

Their appeal is a direct challenge to the Prince of Wales’s outspoken campaign to widen access to complementary therapies.

Public funding of “unproven or disproved treatments” such as homoeopathy and reflexology, which are promoted by the Prince, is unacceptable while huge NHS deficits are forcing trusts to sack nurses and limit access to life-saving drugs, the doctors say.

The 13 scientists, who include some of the most eminent names in British medicine, have written to the chief executives of all 476 acute and primary care trusts to demand that only evidence-based therapies are provided free to patients.

Their letter, seen by The Times, has been sent as the Prince today steps up his crusade for increased provision of alternative treatments with a controversial speech to the World Health Organisation assembly in Geneva.

The Prince, who was yesterday given a lesson in crystal therapy while touring a complementary health unit in Merthyr Tydfil, will ask the WHO to embrace alternative therapies in the fight against serious disease. His views have outraged clinicians and researchers, who claim that many of the therapies that he advocates have been shown to be ineffective in trials or have never been properly tested.

The letter criticises two of his flagship initiatives on complementary medicine: a government-funded patient guide prepared by his Foundation for Integrated Medicine, and the Smallwood report last year, which he commissioned to make a financial case for increasing NHS provision.

Both documents, it is claimed, give misleading information about scientific support for therapies such as homoeo-pathy, described as “an implausible treatment for which over a dozen systematic reviews have failed to produce convincing evidence of effectiveness”.

The letter’s signatories include Sir James Black, who won the Nobel Prize for Medicine in 1988, and Sir Keith Peters, president of the Academy of Medical Science, which represents Britain’s leading clinical researchers.

It was organised by Michael Baum, Emeritus Professor of Surgery at University College London, and other supporters include six Fellows of the Royal Society, Britain’s national academy of science, and Professor Edzard Ernst, of the Peninsula Medical School in Exeter, who holds the UK’s first chair in complementary medicine.

The doctors ask trust chief executives to review their policies so that patients are given accurate information, and not to waste scarce resources on therapies that have not been shown to work by rigorous clinical trials.

They conclude: “At a time when the NHS is under intense pressure, patients, the public and the NHS are best served by using the available funds for treatments that are based on solid evidence.”

Professor Baum, a cancer specialist, said that he had organised the letter because of his “utter despair” at growing NHS acceptance of alternative treatments while drugs of proven effectiveness are being withheld. “At a time when we are struggling to gain access for our patients to Herceptin, which is absolutely proven to extend survival in breast cancer, I find it appalling that the NHS should be funding a therapy like homoeopathy that is utterly bogus,” he said.

He said that he was happy for the NHS to offer the treatments once research has proven them effective, such as acupuncture for pain relief, but that very few had reached the required standards.

“If people want to spend their own money on it, fine, but it shouldn’t be NHS money.”

The Department of Health does not keep figures on the total NHS spending on alternative medicine, but Britain’s total market is estimated at £1.6 billion.

There’s no remedy for the Prince of Quacks

This is the title of a piece by Francis Wheen in the London Evening Standard, 16 May 2006. Francis Wheen is the author of the Top ten delusions.

“Prince Charles travels to Geneva next week to deliver the keynote speech at the annual assembly of the World Health Organisation. Some mistake, surely?”

“The WHO describes Charles as the president of the Prince’s Foundation for Integrated Health and “patron of a number of health charities”. It omits to add that his views on medicine are barmy – and pernicious. ”

“WHO delegates from 192 nations have plenty to discuss during their five-day meeting – HIV/Aids, sickle-cell anaemia, preparations for a flu pandemic, the eradication of polio and smallpox. Why waste precious time listening to the heir to the British throne, who has spent more than 20 years displaying his ignorance of medical science?”

“The prince has never met a snake oil vendor he didn’t like. A couple of years ago he urged doctors to prescribe coffee enemas to cancer patients, a suggestion which provoked this rebuke from Professor Michael Baum of University College London: “The power of my authority comes with a knowledge built on 40 years of study and 25 years of active involvement in cancer research. Your power and authority rest on an accident of birth.” ”

The Prince’s Foundation for Integrated Health publishes Complementary healthcare: a guide for patients which is full of wishful thinking. For example, it tells the unfortunate patient that

“Homeopathy is most often used to treat chronic conditions such as asthma; eczema; arthritis; fatigue disorders like ME; headache and migraine; menstrual and menopausal problems; irritable bowel syndrome; Crohn’s disease; allergies; repeated ear, nose, throat and chest infections or urine infections; depression and anxiety.”

but says nothing at all about whether or not they work. That is just irresponsible.  And to describe pills that contain no trace of the substance on the label as ”very diluted” is plain dishonest .

This item was transferred from the old IMPROBABLE SCIENCE page.

Several of the people who contributed to, and/or appeared in, the BBC2 series on alternative medicine, have complained that they were treated “like marionettes”, and that the programme was sensationalised and uncritical,

Read full entry on the original IMPROBABLE SCIENCE page.