A few weeks ago we noticed a claim in GEO, a German magazine, stating that only 40% of medicine were evidence-based. Since the article contained lots of errors (we blogged about its flaws) and no real source was given (apart from the allegation this was a quote from a former president of State Chambers of Physicians), we were inclined to dismiss the contention without further consideration.
But then we pondered the question and started digging. We found an official document on Evidence-Based Medicine and we discovered a website of the British Medical Journal dedicated to evidence based medicine supporting the claim.
The BMJ Site displays a nice diagram showing that 51% of medicine were of unknown effectiveness! 51%. And another 15 percent were harmful/likely ineffective. We were flabbergasted. According to these figures, medicine(about 40% proven efficiacy) was not much better than alternative medicine(about 0% proven efficiacy).
A rate of unknown effectiveness of as much as 51% for medicine? Wow. We were stunned and decided to ask Professor Edzard Ernst about the BMJ page.
You probably know the following page: http://clinicalevidence.bmj.com/ceweb/about/knowledge.jsp
This overview isn’t exactly much to write home about. What is your opinion on this?
Isn’t it unfair to look down upon alternative methods when there is still so much unknown in medicine?
- Firstly, the low percentage of proven treatments is partly due to the fact that this figure includes alternative medicine.
- Secondly, the figure relates to all treatments even those that are very rarely used. If you look at the percentage of effective treatments that are actually in daily use, you arrive at figures around 80%.
- Thirdly the process of applying science to medicine is relatively young – so we are looking at work in progress.
- Fourthly, if one area is not optimal, this is no reason to allow another one to be even worse.
Alternative medicine is included in those figures? Well, ok, that explains a lot.
“By definition”, I begin
“Alternative Medicine”, I continue
“Has either not been proved to work,
Or been proved not to work.
You know what they call “alternative medicine”
That’s been proved to work?
(Storm by Tim Minchin)
When we contacted Edzard Ernst about the disgraceful interview in the Telegraph, we were presented with the opportunity to do a full interview. It was very interesting and a bit alarming…
As you may know, Edzard Ernst is the first Professor of Complementary Medicine, and more or less retired, two years prior to the official age of retirement. To understand the reasons for his early retirement and some of our questions, we need to look back a few years:
Edzard Ernst became professor for Complementary Medicine in 1993 and has built quite a reputation as a man of science and as a researcher. But in 2005, things took a rather strange turn. Economist Christopher Smallwood, personally commissioned by Prince Charles, claimed a lot of money could be saved applying CAM treatments. Unfortunately, this position was not supported by evidence. Not in the least! Edzard Ernst called it “complete, misleading rubbish.”. To cut a long story short, Prince Charles’ private secretary complained about Edzard Ernst who became “persona non grata” at his university.
Mr Ernst had been promised further funding, but all fundraising died down at that time. (This is actually quite an obvious development, since most CAM institutions apparently do not want real science to have a look at their methods) He had been promised the university would match initial funding of his unit, but this did not materialize. The unit was not able to keep all employees. He was informed the unit would be entirely dismantled after his retirement.
And so he negotiated. The deal: Immediate retirement and getting re-hired part-time for a year to help find a successor. The unit was not to be shut down.
Professor Edzard Ernst officially retired in May. We did not like that kind of horse-trade, but if Professor Ernst is fine with it, it is fine with us, too. The world is complicated, and so be it. The only part of the bargain we truly liked was that Professor Ernst may choose his successor. Well, at least this is what we assumed when we started asking…
But let’s get started with the interview:
Professor Ernst, when you started examining these methods scientifically, did you expect to meet such massive opposition or did that come as a surprise?
Lots of things were very surprising to me: that alternative medicine practitioners in the UK are often anti-scientific untrained non-medics, that so many of our results turned out to be negative, that there was so much public interest in my work, that alternative medicine enjoys royal protection in Britain etc, etc. The fact that I soon came under increasingly bitter criticism from the enthusiasts was, of course, a result of all this.
Most “alternative professors” practice Cargo-Cult-Science. Why does critical approach seem to be so unusual?
Yes, most if not all of my colleagues use science as a drunken man uses a lamppost – for support and not for illumination. I have come to the conclusion that this is due to them being primarily advocates of alternative medicine and true scientific scrutiny comes at a far remote second or third place.
In which way could this be improved?
One would need to make sure that critical scientists are appointed, for instance, by looking closely what any candidate has previously published. If it is mostly poor science or promotional pseudo-science, the person should be disqualified.
Do you agree with the way your results are being communicated?
I am often misquoted from both sides of the divide. The Telegraph article, for instance, claimed that I am against all alternative medicine. This is not true; I am against all ineffective or unsafe treatments, and that is very different.
You are compelled to a state of “retirement” now, as a result of the éclat with “Prince Charles”. (Smallwood report)
Was there any reaction by the Prince (or someone from his environment) after you called him a ‘snake-oil salesman’?
I offered to go in order to save the unit. My med school is now looking for a successor. Previously I was told that they will close the unit on my retirement. When I called Charles “snake oil salesman” there was no reaction from him or his entourage at all. I did not expect a reaction.
So, you are looking for a successor; do you believe he will have an easier life? Or do you think Prince Charles and his ilk will also try to throw a spanner in his works?
It depends what he/she will do. It would be easy to have it easy in that position; either one does very little or one does only stuff that upsets no one [such as surveys] or one does some basic research that is not so relevant to the public or one avoids all publicity – there are many ways.
The reaction of Charles and other enthusiasts of bogus medicine will depend on the work of my successor and the public image it receives.
Are there promising candidates for the position yet?
I have not yet heard of any.
How much freedom do you have in choosing a candidate? Can you choose/decide freely?
Sadly, I was only involved in drafting the job description. Everything else is out of my hands. I offered my further assistance but the offer was so far not accepted.
ERRM. Half a second. Wait.
What the …??? We understood the deal Professor Ernst made to save his unit, but so far we were under the impression that he will choose his successor!
We winced and mourned the loss when Professor Ernst retired (even when, in an interview, he said he was over the moon with that solution; that he feels exhausted, feels the scars from the many battles). We felt the loss. And now once more, we feel very strongly about the issue at hand!
Dear University of Exeter, to whomever it may concern, do not forget you (probably) have the only real chair of alternative medicine in the entire world (the entire world!), the only position respected by the scientific community and not just by quacks and royal half-quacks. Please, pretty please, do not gamble with your reputation.
Professor Ernst, can the public assist you in any way? Is it possible for us ordinary citizens to help your unit in any way to continue work same as before the éclat?
Public support will be a crucial element whenever controversies arise. I had lots of it – despite all the flack.
This answer is too diplomatic for our liking!
We know there are lots of supporters of Mr Ernst and his fantastic work out there, fighting an eternal battle against the overwhelming degree of lunacy in the world; therefore we would like to encourage all of you to join this fight, too. You may think it is premature, the university of Exeter should be given a chance. Certainly, but once they have taken a decision, it will be too late. We have to take a stance now and proactively defend this chair.
Let’s tell the university that we, the public, will not accept a quack or mediocre scientist in that position. While he/she will not be able to fill the gap, he/she has to be a true scientist! We will accept nothing less!
Bitte beachten, dieser Artikel existiert auch auf Deutsch: http://blog.psiram.com/?p=3908
When we noticed a recent interview in the “Telegraph” with Edzard Ernst, we were enthused, since we are huge fans of Mr Ernst.
We are certain most of our readers have already heard about Edzard Ernst, and probably read “Trick or Treatment”, a book on alternative medicine he wrote together with Simon Singh. Despite his being known here already, we would like to give our readers a short introduction;
Mr Ernst is the first Professor of Complementary Medicine in the world at the University of Exeter, England. He is the world’s leading expert on alternative medicine and a stalwart defender of scientific methodology. His position is probably best expressed in his own words (from an interview with Mr Ernst and Simon Singh):
For us, there is no such thing as alternative medicine. There is either medicine that is effective or not, medicine that is safe or not. So-called alternative therapies need to be assessed and then classified as good medicines or bogus medicines. Hopefully, in the future, the good medicines will be embraced within conventional medicine and the bogus medicines will be abandoned.
His work has earned him a lot of respect by scientists all over the world.
Back to the topic at hand. The article published in the Telegraph turned out to be – errrm, well. Let’s put it like this, it had a particular touch. We had expected something different, something more sound, with more style.
Taken aback, we decided to ask Professor Ernst about the article:
What annoyed you most about the “Telegraph” article?
In my view, the most irritating thing was the attitude of the journalist. She seemed to belittle science and promote non-science. This is what one might expect from a cheap women’s magazine but not from the most-read UK broadsheet.
Well, we cannot agree more, the article sounded very condescending to us. The journalist’s attitude is probably most aptly described with “So what, I couldn’t care less”.
Unfortunately, the worst is yet to come. We asked Professor Ernst about the quality of the article and possible mistakes. He was so kind as to provide a few examples:
There were too many factual mistakes and inaccuracies to mention. For instance, there is no such thing as “recuperative medicine”. I told her that I had the chair of rehabilitation medicine in Vienna. Similarly, I never said that at the peak my unit was doing 20 research projects; I told her that once we were 20 researchers. At that stage, we ran many more than 20 projects and even now we conduct about 20. These may look like trivialities but they are, in fact, the result of poor journalism.
Well, our German readers probably agree this is nowhere near what GEO or Die Welt published, but it is bad enough. Shouldn’t a journalist strive to get the facts straight? We are not certain which is worse: The blatant mistakes easily detected in our German newspapers or the negligent, lackadaisical mistakes in the Telegraph?
“Only two things are infinite, the universe and human stupidity, and I’m not sure about the former.”
– Albert Einstein
Well, in the days of the internet, this famous quote by Einstein is proven true every day. On some occasions, however, real gems will appear. Not out of nowhere, no, they grow from seeds of idiocy to fully grown mammoth trees of stupidity. We “proudly” present such a gem today:
The impact of the finding that many vaccines are derived from aborted fetal cell lines is potentially enormous, given the great number of people who define themselves as Pro Life. For someone who is Pro Life to discover that a vaccine contains the DNA from aborted fetuses is like a Muslim finding out that a vaccine is derived from pork.
A recent study by the Environmental Protection Agency (EPA) has led to a question of whether there is a correlation between the abrupt rise in American autism rates with the introduction of fetal cells for use in vaccines (1988). This correlation has prompted researchers to ask the question about how aborted fetal DNA could be causing, or contributing to, the development of autism disorders in children.
The author of these lines actually claims that vaccines were not only created from aborted fetuses, no, they were also causing autism because of that. But wait, it gets even better:
The Vatican states it’s your “grave responsibility” to use alternative vaccines when available, i.e., vaccines not derived from aborted human fetuses.
Wow, even the Vatican agrees with him… (Well, actually, the Vatican does not, but who cares? Truth and proof are just guidelines, right?)
The Stupidity, It Burns!
Well, you may probably think we made this up. Sorry, too much credit to our creativity. We could never make THAT up…
Joseph Mercola is a real “hero” of alternative medicine. He promotes Germanic New Medicine of racist Ryke Geerd Hamer as a “new view of cancer” on his website. What he does not mention is that the total number of victims of Hamer’s method in and outside of Germany exceeds 140 (as of 2007).
He also promotes the Sodium Bicarbonate Therapy according to Tullio Simoncini which must be considered one of the most ineffective and absurd methods claiming to cure cancer patients: Cancer was a fungus and can be cured with baking soda. (The stupidity, It Burns!)
Mercola also claims that HIV was not the cause of AIDS, that sunscreen increased the likelihood of skin cancer, that prescription drugs were harmful and that medicine killed more people than it saved. Notable is a series of articles titled Death by Medicine. Among the authors of this series are dubious writers like Gary Null (dubious credentials and products) and Carolyn Dean (had her registration certificate revoked because of “disgraceful, dishonourable and unprofessional conduct” in 1995).
But, it is unfair to give him the full credit for this story, he has certainly grown the mammoth tree (of stupidity) from a seed, but the seed was planted by one Helen Ratajczak (the inventor of the idea) and one Sharyl Attkisson, a CBS reporter who made an article out of it.
Regardless of other flaws, the core logic behind the Ms Ratajczak’s claim is simple: “Nobody has shown that DNA does not cause autism, so it must be true.”
Sure. Nobody has shown that Pluto is not made of cake, so it must be true.
Alas, even if they are so stupid that it burns, we should also look at the claims themselves and not dismiss them just because Mercola made them. We really should, but the pain, the pain…
So, instead of doing this here, we want to refer you to other sites which have already accomplished this tremendous feat. First and foremost to the blog Respectful Insolence and secondly to the Skeptic’s dictionary. Both are worth bookmarking, two beacons of reason in the craziness of the internet.
You will find lots of details about the entire story there, also discussing aspects we didn’t cover.