Archive for the ‘ skepticism ’ Category

It’s Not Robots, It’s You!


The above words were said by my not-quite-three-year-old son to his slightly bemused mother this morning.

This exchange followed a conversation I had had with my son earlier while getting him dressed which went something like this:

[a noise outside very much like a car door slamming]

Son: What was that noise?

Me: Sounds like mum putting something in the car.

Son: No.

Me: ok, what do you think it was?

Son: Robots.

Me: ah…… Where did the robots come from?

Son: Outside.  [so much for the imagination of the young...]

Me:  What where the robots doing?

Son:  Something with mum’s car.

Me: ok…. Have you seen any robots?

Son: No.

Me: Have you seen mum?

Son: Yes.

Me: What do you think made the noise outside?

Son: Not robots.

At which point said mum returns from outside and receives the triumphant exclamation which titles this post.

Proud at having determined we were not being invaded by robots my son wanted to share his conclusion with his mum.

What exactly is my point with this? Well, other than an amusing story I thought is was illustrative of something I want to teach my son as well as convey to others. We should think about what we see and hear, as well as examine our own narrative about how the world works.

When faced with new information and new explanations we should consider them carefully and ask questions like: How do new facts/hypotheses fit into our existing knowledge? Is it reasonable to posit new entities/explanations for things when existing ones will do?

Future episodes like this will provide ever more opportunities to help my son examine the world around him and come to thoughtful conclusions – which are themselves open to revision with new information. Lessons which are appropriate no matter what age you learn them.

2013
06/13
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Daily Deals and Altmed Pseudoscience


I’ve been noticing the occasional product on the daily deal site I frequent that is, how to put this delicately, BS.

Today I saw one that I just had to have some fun with and hopefully give people some idea of what the product is really about at the same time.

In this case the product was an “Energy Calcium Activation Cup”. I hadn’t heard of these before but the altmed buzzword combo of “energy” and “activation” got my attention.

The forum moderators tend to be quick to remove questions about products that are overtly critical so I had to play a bit dumb and make sure I didn’t get too much to the point. The outcome was quite amusing:

Grabone Magic Cup

You can see the discussion at:
http://www.grabonestore.co.nz/energy-calcium-activation-cup/discuss (or archived at  http://www.webcitation.org/6GTWgpSot just in case the entire thing gets deleted after this post goes live)

I would like to thank the company liaison Sabina Chadliwa who here was very forthcoming and quite speedy in comparison with other companies I have interacted with in this way. No offense is meant to her – but BS is BS.

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2013
05/09
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Anti-Vaccine Charity, No More


Last year I wrote a series of posts[1] around the Charitable organisation Immunisation Awareness Society and a complaint I had made to the Charities Commission. The Thrust of these posts and the complaint was that the Society does not fulfill the requirements of a charity and should be removed from the register. The effect of this is that they would also be stripped of their tax exempt status.

This indeed was my main goal. There are innumerable groups out there that I don’t agree with but you get that in a wide and varied world. In the case of the IAS though the speech they engage is is effectively publicly subsidised via the tax exemption, this should mean that they are constrained in what they can say. At the very least it should mean that they must present the facts undistorted by ideology.

Yesterday I found out that the Charities Commission agrees with me. In a decision handed down late last month they determined that the IAS does not qualify for charitable status and removed them from the charities register.

So, I guess you could say – I won.

It the words of one of my colleagues it also shows that one person can make a difference. Clichéd but true.

Reading through the Charities Commission decision it seems they focused on two things:

1. The biased nature of the information provided by the IAS and;

2. The political nature of their campaigning for a change in public policy.

This makes sense given the requirements that the Commission need to fulfil to determine whether an organisation meets the requirements to be a charity. Even so I’m a bit disappointed that there was no focus on the factual inaccuracy of and misrepresentation in the materials published by the IAS.

The decision does seem to skirt this line though when stating that  “Overwhelmingly, the information on the website argues that vaccination is ineffective and dangerous” the inference being that is view is incorrect as well as being biased. Even so, none of the language of the report actually states this outright (that I can see).

There was also an additional point touched on that merely providing information does not in and of itself “advance education”. In other words to be an educational charity you actually have to actively educate people, not simply act as a repository of information – otherwise every private citizen with a decent library or informational website could become a charity.

Finally, in my personal 15 minutes of fame, the Commissions decision has been reported in the Dominion Post – complete with a quote from me. Not my most eloquent moment but it’s close enough to the point I wanted to make that I’m fairly happy.

[Edit: Thanks goes to commenter Hemlock for sharing the IAS response to this news]

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1.  And here they are in all their tedious glory:
http://scepticon.wordpress.com/2011/10/11/anti-vaccine-charities-is-there-any-quality-control-on-charities/

http://scepticon.wordpress.com/2011/10/11/ias-complaint-part-1-thimerosal-in-your-vaccine-no/

http://scepticon.wordpress.com/2011/10/12/ias-complaint-part-2-gardasil-horrors-horrific-reasoning/

http://scepticon.wordpress.com/2011/10/13/ias-complaint-part-3-vaccine-ingredients-not-so-bad-really/

http://scepticon.wordpress.com/2011/10/14/ias-complaint-part-4-anti-vaccine-impact-in-new-zealand/

http://scepticon.wordpress.com/2011/10/17/defending-the-term-anti-vaccine/

http://scepticon.wordpress.com/2011/10/18/the-legitimate-risks-of-vaccines/

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2012
11/07
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Energy Mirages and the False Hope of “Water Powered Cars”


This morning while perusing my news feeds I saw this article lamenting the state of scientific ignorance and bald political grandstanding in Pakistan. The specific item that prompted this lambasting of an entire country is the claim by one individual to be able the fuel cars using water – and the near unanimous support of this character within the political and scientific realms – despite the physical impossibility of this feat.

I think the author of this article is quite correct in his condemnation of this person and those who support him who tout this technology as a solution to the country’s energy woes. That said I think he does his audience a disservice in not breaking down the claims more fully to explain why this “invention” is not all that it seems and why it will not act as a panacea for the dependence on fossil fuels and the deficit of energy that Pakistan endures.*

It is explained that you cannot run a car on water due to the fact that that it would require a reversal of the second law of thermodynamics. A law that is deemed so fundamental to the operation of the universe that it prompted this quote from a distinguished scientist:

“The law that entropy always increases, holds, I think, the supreme position among the laws of Nature. If someone points out to you that your pet theory of the universe is in disagreement with Maxwell’s equations — then so much the worse for Maxwell’s equations. If it is found to be contradicted by observation — well, these experimentalists do bungle things sometimes. But if your theory is found to be against the second law of thermodynamics I can give you no hope; there is nothing for it but to collapse in deepest humiliation. ”

–Sir Arthur Stanley Eddington, The Nature of the Physical World (1927)

But this is not the end of the story. For while the “inventor” and his supporters use the word “fuel” to refer to the water, it is a misnomer as we normally understand the word. A fuel is something that supplies energy, it stores energy that is created by one of any number of processes and enables it to be used to do work seconds, hours or millennia after the energy was first produced.

This is what fossil fuels are – the condensed energy of biological processes that occurred millions of years ago. We tap this energy and use it to run our cars, and depending on where you live, the entire rest of our lives.

So what’s this to do with water?

Well, simply put water is the end product of energy use. It is not a storage medium it is a waste product. It would be like saying you’ll run your furnace on ash. You would be laughed out of the human race. But say you’ll use the magical liquid of life – water – and for some reason people think there’s something to this idea.

Now, what is the proclaimed inventor claiming? When you get right down to it he knows the water isn’t a fuel. He is in effect using the water as a convenient hydrogen source. It is the hydrogen that runs the car, and presumably the “water-kit” enables the car to process this hydrogen as it would petrol. The kit also contains an electrolysis component that splits the water into hydrogen and oxygen. I am unaware as to whether the oxygen released is retained to react with the hydrogen or whether atmospheric oxygen is used for this.

In any case the energy for running the car comes not from the water, but the batteries used to extract the hydrogen. The hydrogen then becomes the interim energy storage medium and the “fuel” for the car.

What we have then is the energy generation being pushed back a step, instead of being done at the car via petrol, it will be handled by the country’s power plants.

I can well imagine that there are benefits to converting cars to this set-up. It effectively turns your automobile into one of this new fangled electric cars without the downside of looking like a self-righteous dick*. There are benefits to using electric cars even if the ultimate power generation comes from fossil fuel consuming power plants (which by my calculation more than half of Pakistan’s electricity comes from) such as local air quality improvements. The ability to deal with emissions at centralised locations and the possibility of sequestering that pesky CO2 at the source.

I suspect however that in the rush to embrace the technology at issue here these peripheral concerns are not really being considered. And for a country that already has too little electricity for the population it has (40% of the country has no access to electricity, and demand is ever increasing for those that do) this does not sound like such a great idea and won’t result in everyone having unlimited fuel for their cars. It can only add to the pressure on the already over-taxed electrical grid.

In addition it is being implied (if not outright stated) that water could be used to run generators. This is where you could justifiably call fraud. While there are conceivable reasons why you might convert a car to “run” on water those reason evaporate when you try to argue that the same can be done for a generator. I’m sure you can see why. You end up just inserting an extra step in the energy generation process, well more like a loop. You have to provide energy to the water to extract the hydrogen and then burn the hydrogen back to water to get the energy. Thanks to that second law thingy you will never get more energy out of that reaction than you out in.

Not only do you insert a completely useless extra step, in doing so you guarantee that the whole process is less efficient. You literally get less combustion for your buck.

I hope that no government official is seriously considering funding a project to replace generators with water powered devices, though I gather millions may be spent investigating the possibility of employing this technology in Pakistan. I don’t know where that money (assuming people don’t wake up by then) is intended to go.

This is the concern whenever fringe theories and technologies are held up as the solution to our problems, that money will be wasted on these rather than put toward more worthy projects.

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* A more thorough treatment is here, by former chairman of the Pakistani – Higher Education Commission  Dr Attaur Rehman.

** Just kidding. For what it’s worth I think electric cars are really cool and if I could spare the dosh would love to have one. But I gather there is something of a stigma and well it’s a joke – lets not analyse it too much eh?

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2012
08/06
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Guess what Percentage of the World Thinks it Will End In Their lifetime?


The optimist in me (no sniggers please it’s not polite) would liked to have thought that this percentage is quite low. You know, in the barely worth mentioning category. Alas, according to a poll conducted by Ipsos the world average is about 14%.

One in seven.

Think about that for a second.

One seventh of the world thinks they will see the end of civilisation as we know it.

One prediction has only a few weeks to go before hitting the cold light of reality, it won’t be the last. Why? I don’t know – You tell me.

I’ve given up, people are crazy.

2012
05/07
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TCM and You: Cupping


I have noticed that Chinese massage seems to be becoming popular, and seemingly with it Traditional Chinese Medicine (TCM1). At least browsing through two of the larger shopping centres in Hamilton (bring on the hick jokes) I saw massage centres offering these services. In particular cupping was advertised. But what exactly is cupping2?

As with many modalities in TCM Cupping appears to be based on pre-scientific notions of blood stagnation and energy blockages3. Applying cups with a slight vacuum to the skin is meant to draw out the “toxins” which then results in improved health, somehow.

The active part of cupping essentially boils down to a pressure difference. The pressure is lower on the inside of the cup and greater on the outside, this difference causes the skin to be forced up into the cup4. This process in turn causes blood to gather in the region and may cause minor damage to the area resulting in bruising.

Presumably the fact that the skin appears to be drawn up into the cup gives the impression that there is a general pulling action at work here and that toxins and other “bad stuff” are pulled out of the body in this fashion.

The trouble with this is that pressure difference is a fairly crude physical process and with regard to this biological system lacks what we in the science biz call “Specificity”5. What this means is that there is no way for the cup to restrict the “pulling action” to only harmful chemicals (the “toxins”, say) and allow everything else to be unaffected, i.e. it is not “specific” to toxins. Everything will be drawn up in the same way.

In which case you get a lovely bruise and feel like you’ve done something but that’s about it.

Ok, that’s fine for just thinking about it. What about evidence, we’re always going on about evidence here.

I attempted to find a Cochrane review on cupping but while one was listed for pain relief there did not seem to be a completed review for perusal. I did come across this review that found equivocal results for the effectiveness of cupping for pain.

The review comments on the putative mechanism of cupping:

“Assuming that cupping was beneficial for the management of pain conditions, its mechanisms of action may be of interest. The postulated modes of actions include the interruption of blood circulation and congestion as well as stopping the inflammatory extravasations (escaping of bodily fluids such as blood) from the tissues. Others have postulated that cupping could affect the autonomic nervous system and help to reduce pain . None of these theories are, however, currently established in a scientific sense.” [Emphasis added, citations removed]

The discussion of the reviews limitations is especially worth noting:

“Our review has a number of important limitations. Although strong efforts were made to retrieve all RCTs on the subject, we cannot be absolutely certain that we succeeded. Moreover, selective publishing and reporting are other major causes for bias, which have to be considered. It is conceivable that several negative RCTs remained unpublished and thus distorted the overall picture. Most of the included RCTs that reported positive results come from China, a country which has been shown to produce no negative results. Further limitations include the paucity and the often suboptimal methodological quality of the primary data. One should note, however, that design features such as placebo or blinding are difficult to incorporate in studies of cupping and that research funds are scarce. These are factors that influence both the quality and the quantity of research. In total, these factors limit the conclusiveness of this systematic review.

In conclusion, the results of our systematic review provide some suggestive evidence for the effectiveness of cupping in the management of pain conditions. However, the total number of RCTs included in the analysis and the methodological quality were too low to draw firm conclusions. Future RCTs seem warranted but must overcome the methodological shortcomings of the existing evidence.”

In conclusion then, you may see a placebo effect from this treatment – though I suspect this is over rated as a therapeutic outcome6. You may also find yourself covered in bruises (though I hear they are painless – think of them as CAM hickies). So… Dubious premise with dubious benefit, same thing – different day.

Here are a couple of images for you to keep in mind…

Mmmmm, cupping goodness.

[UPDATE 30/5/12: Islam appears to support cupping, check out this completely unbiased arabic wikipedia article]

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Footnotes:

1. Can’t get away from TLAs

2. So many jokes spring to mind, I mean come on – “cupping”?

3. See this link for some scary science illiteracy around cupping. And here’s good old Wikipedia. And “blood stagnation” really? isn’t that gangrene or septicaemia or something?

4. Keeping in mind that a vacuum does not suck, high pressure pushes.  If I may geek out a bit here; hence one of my favourite exchanges from ST:TNG:

“You were right. Somebody blew out the hatch. They were all sucked out into space.“
“Correction, sir, that’s blown out.“
“Thank you, Data.“
“A common mistake, sir.“

- Riker and Data get precise about the physics of rapid decompression into the vacuum of space

5. Yeah, I know, it sounds made up.

6. See here, here and here.

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2012
04/04
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Monday Afternoon Movies: From Daleks to Vectron


I was collecting up videos to drip feed when I got around to it, but figured I may as well post them all at once to liven up a Monday afternoon.

Enjoy.

The Great and Powerful Tyson…

Dan Dennett on “Deepities”…

“Vectron” from the amazingly funny Mitchell and Webb….

Levitation, I have to admit while watching this I was grinning like and idiot..it’s awesome….

Richard Wiseman amazes and astounds….

Daleks: Hitchhiker’s Guide style…

2012
04/02
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Amber Teething Beads: A Follow-Up


Over the week or so I expect the page views for my amber teething necklace post to top 20,000 over the two blogs. Interest in the article has just kept increasing over the last year or so of it being up, as opposed to the majority of my posts which slip into internet obscurity within days. In anticipation of the occasion I thought I’d cover some of the comments that this post has gathered over the last few months.

Many of the comments are along the lines of “It worked for me” and “Try it yourself”.

To the first, I don’t really have much to say. I can’t peer inside the inner workings of your child and determine what is going on. But at the same time a bunch of individuals making claims of efficacy without adequate control for bias, natural history and various other contingencies is not a compelling argument to me. Plenty of others swear by practices that have no hope of working*, why should this one get more credibility based on personal experience?

As to the second, three words for you: Anecdote and Confirmation bias. I know enough to realise that I am not immune to the wiles of confirmation bias, which would make my trial just another anecdote – something I don’t accept from others so what would make my own experience any more valid? I also realise that for most people this sort of reasoning is at best foreign and at worst incomprehensible. The general thinking appears to go something like “If I try something and it seems to work, then it works – QED”.

No.

Related to this point are appeals to the “Placebo Effect”, the idea being that simply trying something helps, somehow. This may be true. But I’ll expand on the faulty reasoning behind this assertion.

The placebo effect as this seems now to be the “go-to” explanation for all things unexplained so it might be a good idea to dwell on this concept on it’s own for a bit. First off with regard to talking about the placebo effect, it depends on what you mean. The placebo effect started off being simply the improvement seen in the control group for clinical studies. It was the group that was given everything except the active treatment. Therefore by definition the placebo response is what happens when people aren’t treated. It was the catch all for everything that could affect the outcome that wasn’t due to the treatment itself: poor method design, confirmation bias, reporting bias, observer effect on the patients, regression to the mean, natural history of the disease, etc, etc.

Recently there has been some work done to see if there is a real change in people that is due to thinking they are getting an active treatment, the so called “Placebo response/effect”, this has been mixed. It is true that people will report less pain and their brain will show less activation in pain related areas. But people are susceptible to what they are told, it turns out if you tell people a cheap wine is expensive they will enjoy it more. Is there a placebo wine effect? possibly, but the wine didn’t change and neither did any underlying physiology in relation to placebo medical treatments.

In fact recent studies in asthma showed that while people reported feeling better while taking placebo their ability to perform on objective measures remained the same, while those on active medications improved. If you feel better while still having a life threatening condition are you better? I don’t think so.

So in appealing to the placebo effect you have to concede that 1. the beads don’t have any active ingredient, and 2. don’t make any difference to the underlying condition.
i.e. They do nothing.
Now notice in my original piece this is not what I say, I merely point out there is no good reason to think they are doing anything, not that they definitely aren’t. A subtle distinction I admit.

In essence the argument becomes: “If you think it works then it does”, well I would counter with why don’t you use something that we know does work and then you can capitalise on both effects: You will think it works and it will actually work too. Double goodness.

One poster asserted that amber necklaces were registered with the Therapeutic Goods Administration in Australia as a Medical Device. Arguing that this must mean they have therapeutic properties.

This one was my favourite as it was almost laughably easy to dismantle. After only a few minutes I found that this was completely untrue (you can search the TGA resister here). Not only that but there were suppliers admitting** that they couldn’t claim therapeutic benefits because they were not on the register:

“Amber Teething Necklace Information – TGA Australia

Due to regulations of the Therapeutic Goods ACT, policed by the Therapeutic Goods Administration (TGA), whose register does not recognise the claimed healing and theraputic[sic] properties of Amber we are unable to offer any detailed information on Amber Teething necklaces or Amber in general in a theraputic[sic] advisory capacity.

Therapeutic goods are defined in the Act to include goods that are represented in any way to be for therapeutic use. Therapeutic use is defined to include use in or in connection with influencing, inhibiting, or modifying a physiological process in persons.

In all amber related cases that we have seen, the TGA Panel note “that the advertisement appeared likely to breach section 42DL(1)(g) of the Act, which prohibits the publication of advertisements for therapeutic goods that are not included in the Register“” [Emphasis added]

A complaint was made against a supplier for making claims for the product and this was upheld in part because the necklaces are not on the register.

“The Panel noted, without making any formal finding, that the advertisement appeared likely to breach section 42DL(1)(g) of the Act, which  prohibits the publication of advertisements for therapeutic goods that are not included in the Register.“

The website involved changed their wording to get around the regulations, spot the difference:

OLD: “natural pain relief provided by Amber works by placing the necklace on your body, this allows your skin to warm the amber beads, releasing healing oils which are then absorbed into the blood stream.“

NEW: “Amber is believed to soothe naturally, when Amber is worn next to the skin it is warm and it is reputed to release natural oils that can care for the skin.”

What a difference a few words make.

At the time the comment was made alleging the necklaces were on the register I suspected that intended therapeutic benefits would be enough to fulfil the therapeutic benefits category.

This is supported both in the declaration of the supplier above and from the wording from the complaint, just prior to the excerpt above it states:

“Therapeutic goods are defined in the Act to include goods that are represented in any way to be for therapeutic use. Therapeutic use is defined to include use in or in connection with influencing, inhibiting, or modifying a physiological process in persons.

In representing the advertised products to have an “active ingredient”, to release “healing oils which are then absorbed into the blood stream”, and to relieve teething in infants, the advertisement clearly constituted an advertisement for therapeutic goods.” [Emphasis added]

Lets say though that the product had been registered with the TGA or will sometime in the near future, I would note that unless the administration was in possession of studies that are not published elsewhere there is no way that they could be sure that an actual benefit is occurring. Bringing us right back where we are now.

As an extra note on the activities of the Australian government on this topic I found it amusing to see that the Australian Competition and Consumer Commission issued a safety warning about Amber teething beads end of September last year (see here and here and here).

I say amusing because, while it’s not impossible, I do find it unlikely that one branch of the government is condoning their use while another warns against them. Luckily this is not actually the case.

Finally, this post is not intended to address every conceivable objection to my arguments, merely a survey of what has been proffered so far. I am not really convinced by anything I have yet seen but I remain open to changing my mind so long as the evidence is of good quality. It doesn’t have to be much, a good start would be something that suggests succinic acid has the analgesic properties attributed to it. Then we could address whether succinic acid is released from the beads at ambient/skin temperature. Finally we would need to tackle whether the succinic acid is absorbed topically in any significant dose (decent dose response curves could be obtained at stage one of this theoretical research programme).

All three of these items would need to be looked at in order to state that amber beads have good plausibility for what they are marketed for.

[Update 29/4/13: Apparently there is a chain email circulating blaming amber beads for a case of SIDS. This seemed implausible to me and a very brief check seems to back up my gut feeling. There is no reason to think that amber beads contribute to SIDS at all. For a more thorough break-down go here: http://www.hoax-slayer.com/amber-teething-necklace-sids.shtml . I am not one who feels we need to latch onto any reason to vilify our intellectual opponents and spreading misinformation (especially easily debunked misinformation) is a big no-no in my book.]

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*Not that I think this product has “no hope” of working, it could as far as I know. We just can’t make that determination on the basis of anecdote and there are no trials that I’m aware of.

** Argh, this site seems to have removed any trace of of this page. Should have archived it. It has essentially been replaced with this (archive):

In keeping with Australian Fair Trading guidelines no therapeutic claims are made and no medical advice is offered. The material provided on allaboutamber.com.au is for information and educational purposes only and is not a substitute for medical treatment or diagnosis. We assume no responsibility for treatment or cure of any illness or disease. If you have a health problem we recommend seeking medical advice from your qualified natural/health professional. This information is strictly a source of general information and is not intended for use as a tool for self-diagnosis. All About Amber provides this information for you to make your own decisions, if you want to use them on your own family, we believe they work for us and please read the reviews to gather many other peoples opinions.

Which seems to me to be saying “We can’t claim the beads have any healing powers directly, but they really do.”

They haven’t yet learned this lesson for Hazelwood jewellery (archive)though:

How does hazelwood jewellery work?

Hazelwood products are believed to help to create an alkaline environment in your body, which may help, precent[sic] and appease many of the symptoms caused by being to acidic. Hazelwood, being an alkaline wood, has the natural property of absorbing and neutralizing the body’s acidity through contact with the skin. By doing so, the necklaces can also help with digestion, constipation, eczema, migraines, acid reflux, heart burn, nausea, arthritis, skin problems, etc. If you suffer from one of these issues, it is highly probable that you are suffering from an acidity imbalance, and hazelwood may be able to help you alleviate these symptoms in a natural way.  Most people who suffer from an unbalanced pH are unbalanced towards the acidic. This condition forces the body to borrow minerals—including calcium, sodium, potassium and magnesium—from vital organs and bones to buffer (neutralize) the acid and safely remove it from the body.

Hhhhm, perhaps another post is in order. And a complaint.

As a brief aside, as it seems there are quite a few parents out there hungry for this information if you know of a good parenting or early childhood publication that would be willing to print the original article (probably in an altered form) then let me know.

And I’ll stop there before the footnotes become longer than the post.

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04/02
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Future History: Apocalypse Then


End of the world predictions and scenarios abound, we have always been fascinated with our own demise it seems. Last year I covered the predictions of Harold Camping and the relatively small following he had in his advertising the apocalypse campaign.

This year we have the Mayans to blame and it’s rather more wide spread than a few eccentric Camping followers. In my previous post I essentially put together and End of the World retrospective, surveying a small number of past predictions that failed. This time showcase the many predictions that still lie in our future.

Behold the Future History of the Apocalypse!

[Edit] I tested the Vodpod code on the Sciblogs platform and it didn’t work but the syndicated version does. If you still have trouble viewing then go Here  or Here to see the timeline.

NB. Where I couldn’t find or couldn’t be bothered looking for exact dates 1-January was substituted. Click the individual events to find the person who predicted it, move the sliders at the bottom to zoom in and out of timeframes.

Timeline Key:

Sources are given by letters, links below or can be copied from the timeline with a right click.

ABHOTA , AV  , MB , CoB , RT , L , WZ

Sources are of varying veracity and humour.

What I found interesting was the fact that the dates are mostly clustered in the period covering the next 40 years or so. Further, about 40% (9 events) occur within the next 10 years. This matches with data showing that a significant number of Christians (in America at least) believe that the second coming will occur in their own lifetime.

It’s a point I made in the previous post, but it is not a little disturbing that many people who ridicule putting a date on the “End Times” don’t do so because they think it’s not going to happen but because they think it’s a “mystery”. An interesting research project might be whether this propensity to feel the end of the world is nigh is a general human condition or a feature of religious individuals in particular. Presumably there is some innate propensity there that religious traditions use.

Anyway, plenty of opportunities for End of the World parties ahead! YAY!

[EDIT 3/05/12: I have just learned of another End of the World Event (a EWE if you will), this will be a combo of nuclear war and second coming of Jesus. Quite economical really. If I may indulge myself, a quote from the page:

"When I began writing posts for this site, I initially envisioned the possible need of writing more often, primarily due to our preparing for the possibility of “great tribulation” beginning at the very start of this final three and one-half year period. However, great physical tribulation did not begin at that time, and it thankfully has not yet begun. So the need to write more often in order to help people deal with tribulation that could have begun early on has not been needed. But rather, in the midst of horrifying prophecies for this end-time, God has revealed in a most powerful manner one of His greatest attributes toward His creation—toward mankind. It is the awesome quality of “mercy”!"

I'm not sure why this guy has put mercy in scare quotes but it is coincidental that God's "mercy" looks exactly like nothing happening at all. Looks to me like a built in excuse when the end of the world fizzles. More economy, handy that. Via UnreasonableFaith]

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03/29
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First, Do No Harm


Primum non nocere

A while ago I was accused of advocating that doctors should break the Hippocratic oath. That the cardinal rule of “First, do no harm” should be ignored. Setting aside that this phrase does not appear in the Hippocratic oath, what do we mean by harm in the context of medicine?

I was reminded of this by a post on Science Based Medicine by David Gorski in which he muses over the measure of patient satisfaction as a proxy for how well hospitals meet their obligations with regard to patient care. To kick it off the good doctor notes that many interventions used by modern medicine cause harm, often direct harm.

Does this mean that doctors are throwing out their obligation not to harm patients? No, because we recognise that the concept of harm in this case includes those harms that would occur were we to withhold treatment as well as recognising that the total harm is reliant on the amount of benefit obtained by the patient.

The accusation against me was in the context of my arguing against the claims of anti-vaccinationists that vaccines do more harm than good. I don’t want to rehash that argument here but I do want to dwell a bit on our concept of harm and how it applies in the medical arena.

One of the themes that return to over and over again on this blog is that of risk vs benefit. The amount of harm or risk can only be appropriately assessed in light of the benefit accrued. As pointed out by doctor Gorski there are many procedures that hurt, they hurt a lot. Should a doctor refuse to perform them then? Even if they could save a patient’s life?

Of course not.

It is plainly ridiculous to assert that short term harm out weighs long term benefit, it might but that calculation has to be made in each case. In many cases the benefit will be clear, in others less so. If a patient undergoes a painful procedure that is relatively short lived and then makes a full recovery then the choice is fairly simple. If the recovery is likely to be only partial and the patient’s quality of life is ever after severely reduced then we may weigh up the benefits of that treatment differently.

What then of treatments that are good for most but may harm a few? These are the tricky cases and it depends on a few variables. One is can we identify the persons that will be harmed,  second, how much harm are they likely to suffer and what percentage of the treatment population do they make up? Finally what total benefit will accrue to the population if treatment is green lit?

I listed these variables in the order of importance I estimate they have. If we can identify prospectively harmed persons then they may be removed from the treatment group, harm avoided. If this information is unavailable then we may move to the next criterion: how much harm will they suffer? If this is likely to be relatively mild then all to the good. If the harm is considerably more serious then we may stop the treatment altogether in order to avoid these instances. The last two variables may switch in order depending on the situation or individual values.

Should a vital treatment be withheld from the general population if a very small percentage with be greatly harmed by it? Frankly I don’t know. Help – is there a Medical Ethicist in the house?

Often I’ll find that the people who oppose modern medicine will emphasise the risks of medicine while over-hyping the benefits of alternative medicine. The claims that iatrogenic (caused by medical treatment) harms are enormous abound. This point of view seems completely ignore the benefits received by individuals and society by medicine in it’s current form*.

This seems perverse to me, the idea appears to be that any risk is unacceptable – a completely untenable position to my mind – every action carries risk. I take my life in my hands every time I drive to work, but the risks a relatively low and the benefits are more important to me – and the majority of other drivers I suspect. To argue that we should abstain from automotive transport until it is completely safe misses the point entirely. As does decrying the risks of the majority of medical science in the face of the undoubted benefit received.

To conclude this ramble, harm or risk is part of the human condition. Arguably the complete removal of risk is not only impossible but not even desirable**. We have to live with risk and harm, the key is to ensure we balance these against the good that comes from acting in the world to oppose even greater harms.

—————————————————————————————-

*This is quite an extreme view and I would hasten to add that I don’t think the majority of alternative medicine users (however you may break that group down) would subscribe to it, but it exists.

** Depending on how this might be achieved. Possibly we could make ourselves impervious to harm rather than removing everything that might harm us.

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The Role of Experiments in Science


In an attempt to widen my horizons I have been listening to the Philosophy Now podcast out of the UK. A recent episode concerned philosophy of science (ep 29) and the host asked an interesting question: “Why do we have to have experiments when sometimes we can get away with observations?”.

The point he was trying to make was that when we think about science in an abstract way we also have the idea that experiments are at the core of the scientific method. This clashed somewhat with the person the host was talking with at the time who was emphasising observation as the way we confirm hypotheses in science.

The implication here is that we have two things, observations on the one hand and experiments on the other.

This appears to be a fairly common view, I have seen arguments accusing cosmology (specifically the big bang theory) of not being science because you can’t perform an experiment to create a new universe. Similar arguments have been made for evolution.

I don’t know how widely held this view is in the general population (as opposed to those who are set against certain findings of science) but the question of the podcast host implies that it’s wide enough.

The problem with this view however is that there really aren’t two things here that are different in kind. Rather, one is a sub-set of the other; experiments are a special kind of observation.

The whole point of an experiment is to interrogate nature in a specific kind of way. While we can passively observe an event and gain valuable information (say, watching the development of an embryo) we can also create an experiment that constrains the conditions in a particular way in order for us to draw more conclusive conclusions about the situation of interest (perhaps we knock out a gene and watch that embryo follow a different developmental path).

By using experiments we aren’t doing anything fundamentally different, we are still observing what nature has to tell us about the world we inhabit, but we are trying to set up conditions that are meant to clarify what nature is saying. In this view experiments are nature’s interpreter.*

Experiments also allow us to get access to things that we might not normally be able to see. For example high energy physics requires elaborate experiments in order to allow us to in some way visualise particles that are mind bogglingly small. We aren’t creating the physics we observe we are simply delving into realms that would normally be hidden from us.

This was brought home to me a few years back when the attempts to listen for extraterrestrial signals by SETI were referred to as experiments. In this case we aren’t setting up the conditions by which we control whether an ET sends us a signal, we are determining the conditions by which we would receive such a signal. At it’s heart this activity is an observation, no different in it’s intent from viewing a microbe under a microscope.

So it is that the ability to do or not do a experiment does not determine science from non-science (termed the demarcation problem and certainly not definitively settled). Experiments may have come to be thought of as the defining feature of science but they are really just a special case of something we all do every day – observe the world around us.

—————————

*If that’s too narrow for you, how about experiments as nature’s speech therapist?

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03/20
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The Freedom of Ignorance: Health Freedom, What is it and Do We Want it?


When policy around how herbal remedies, alternative medicines, supplements and all sorts of other practices outside the mainstream of medical practice is discussed the concept of “Health Freedom” inevitably comes up. It’s not always couched in that term but the idea is that people should be free to choose whatever method of healthcare that they wish.

Sounds good right? Who wants to impinge in someone’s freedom to make their own decisions? Isn’t that what living in a free country is all about? Personal autonomy, the right to take action unfettered by how someone else thinks I should run my life. That’s how I want to live, why should I want to take that away from others?

Well, I don’t. But the notion of freedom has always come with a caveat (several actually), that is – it is inherently restricted by ignorance. Is someone who is uninformed about the actual state of affairs truly free?

That’s what those who speak out about alternative medicine are actually trying to achieve. We aren’t attempting to “defend our turf” or “squelch the competition” we are attempting to inform the public about the true underpinnings of these therapies and point out they they are either unsupported by science or have in fact been disproved.

As has been noted before, a majority of New Zealanders are unaware that Homeopathic medicines do not contain any active ingredient and yet many people think they are scientifically proven.

Education was also the intent of the co-ordinated Sciblogs rebuttal to the poorly conceived and executed series on alternative therapies printed by the Herald earlier this year. (see here, here, here and here)

Policies that are aimed at restricting access to herbal or alternative medicine usually are doing so from the aspect of quality control. Does the remedy or practice have good evidence of efficacy, is it safe? These are the questions that we should be asking about every medical practice, not just those in the “alternative” (or complementary, or integrative, pick your marketing phrase of choice) camp.

Unfortunately is is not in the interests of those pushing alternative modalities to undergo strict evidence based testing so the issue is re-packaged from a quality control issue to a “freedom” issue.

Similar tactics are seen in arenas outside the medical realm. In biology the evolution vs creationism/intelligent design “debate” is framed as “Academic Freedom” as is the debate around climate change. This is not a coincidence. Whether or not these decisions are made consciously or not there has been convergence on the “Freedom” aspect of these cases for a reason, people respond to it. We are jealous of our freedom, and rightly so, freedom forms the basis of our society.

But as I alluded above, freedom is not an absolute and unalloyed good under all circumstances. It comes up against restrictions in all sorts of ways, some epistemological (as in the case of whether a choice is really free if the person is not aware of all the factors affecting that choice) and some are practical (as in should we allow freedom to include the freedom to sell harmful products?).

Conclusion

The natural/alternative remedies debate is not, at it’s heart, about freedom at all. Rather it is about education and quality control. We should subject all medical practices to the same rigorous examination regarding safety and efficacy. Long term “after market” monitoring should also factor into this equation to catch those practices that looked good in the necessarily limited testing that they are subjected to prior to being rolled out to the general public but may still have safety problems.

In this way we should be able to serve the public’s health interests and avoid false choices about freedom.

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Chiropractic for the 21st Century


Every week I get a number of email alerts about various online medical journals. Each email represents the opportunity for blogging material though many are deathly dull.

Several of the journals I receive alerts from are in the AltMed domain and I sometimes wonder why I bother looking through them at all. The mix is usually some proportion of “Survey of x population using y alternative modality” often merely chronicling the depressing rise of AltMed/CAM in general use (either actual or claimed depending on your definition of CAM).

The rest are often boringly conventional in their attempt to be scientific having titles like “Effects of vitamin E suplementation on renal non-enzymatic antioxidants in young rats submitted to exhaustive exercise stress“. These I don’t bother with. I just don’t have the expertise to parse them with any reliability.

Then there are the odd gems, either for comedic value or because they offer an alternative perspective on alternative medicine.

Recently one of the later came down the intertubes and into my in-box. Published in BioMed Central’s journal “Chiropractic & Manual Therapies”, the article is entitled “The Five Eras of Chiropractic & the future of chiropractic as seen through the eyes of a participant observer”.

The paper starts with a potted history of Chiropractic and the environment that it was founded and grew up in to the present. The early days could be seen as Chiropractic’s first opportunity to start down the science based path. In 1910 the “Flexner Report” on medical education was published and with it’s acceptance by the medical educational community came legitimation to those who abided by it’s recommendations. As well as:

“…generous funding via the Rockefeller Foundation while schools that did not assent, simply ceased operation due to lack of funding. The result was that, by 1930, only 76 of the 168 medical schools remained.“

The impact on Chiropractic is characterised thusly:

“In part because of the rejection of science by a significant element within the chiropractic profession, and in part because the Flexner Report dismissed the chiropractors as “unconscionable quacks who should be dealt with by the public prosecutor and the grand jury”, the chiropractic profession bypassed the era of educational reform.“

The early twentieth century therefore saw a great deal of animosity towards the nascent Chiropractic practice and the emerging scientific medicine of the time. Indeed the author argues that this conflict essentially shaped Chiropractic as we know it today. In order to defend Chiropractic from the legal attacks being made on it it was necessary to develop a definition of Chiropractic that would insulate it from charges of practising medicine without a licence, charges that were common against Chiropractors of the time.

This is related as involving four simple concepts:

“1. Chiropractic is not medicine; chiropractic has a “separate and distinct philosophy and practice”.
2. Chiropractors do not diagnose, but analyze the spine for the  cause of dis-ease.
3. Chiropractors do not “treat,” but adjust the spine for the cause of dis-ease.
4. The Chiropractic profession has been built upon success in cases where medical doctors failed.“

Putting aside the obvious sophistry in these concepts (how might we define the difference between diagnosis and “analyz[ing] … for the  cause of dis-ease” or between treatment and “adjust[ing] the spine for the cause of dis-ease“?) it is argued then that the very fact of opposition by the medical establishment helped to solidify the tenets and practice of Chiropractic:

“During this journey, the chiropractic community developed and embraced a distinct lexicon and rationale toward health and its maintenance in order to emphasise the difference between medicine and chiropractic. Thus the “philosophy of chiropractic” became “an unyielding dogma”.“

With this legal history at it’s back Chiropractic moved into the next period of it’s history where it was the focus of a co-ordinated and sustained attack by the medical establishment in the form of the AMA.

Carrying out the opposition to Chiropractic was the “Committee on Quackery”:

“The Committee on Quackery was well funded, and operated a highly successful campaign that was centred on three main strategies:
1. An ethics based boycott, which deemed it unethical for AMA members to have professional dealings with chiropractors;
2. Convincing other organizations to adopt or adapt the AMA’s anti-chiropractic policy; and
3. Instituting a comprehensive political campaign to thwart chiropractic progress on several fronts, including but not limited to education, research and insurance funding.“

This campaign was put to an end in 1987 thanks to a permanent injunction ordered against the AMA, after a lawsuit was levelled against it by a number of Chiropractors. At this point it’s difficult not to see the Chiropractic as a beleaguered philosophy deserving of empathy on behalf of it’s persecuted adherents.

Emerging from this legal victory Chiropractic has been slowly edging it’s way into mainstream acceptance with the development of Chiropractic based courses in universities and a surge in chiropractic research. Unfortunately the steadfast refusal of many Chiropractors to relinquish the unscientific concepts of old has meant that as a profession they are still looked upon with disdain:

“Chiropractic’s problem is that subluxation based chiropractors are not only deluding themselves, they are indoctrinating patients into believing in a purportedly dangerous mythical entity, and that without regular adjustments, patients will not only fail to reach their full potential, they will likely suffer serious health problems.

Some authors have suggested that this may be a threat to public health . And this, at a time when the profession has just entered The Era of Chiropractic Opportunity.”

The opportunity discussed is that of the ever growing need for specialists in musculoskeletal care. As the worlds population ages the demand for providers who are proficient in the treatment of pack pain/musculoskeletal disorders will only increase.

It is into this world that the Chiropractic profession must be re-born as the evidence based providers of musculoskeletal care that are needed. The problem is that if Chiropractic insists on holding onto the non-scientific notions of DD Palmer then it voluntarily relegates itself to the back waters of medical practice.

This then is the proper focus of the article: where Chiropractic will go from here.

Least attractive to the author is the prospect that the practice will stay on it’s current trajectory, keeping the outdated concepts that it was founded upon and denying the very science that would confer upon them the legitimacy they crave.

Two options are given as alternatives to this “Status Quo” approach: one is to definitively split the profession into those that follow the traditional method of chiropractic practice, so-called “Straight Chiropractic”, and those who are willing to discard tradition and step into the light of science and evidence based practice.

The second and preferred option is to move forward with a united front, ditching along the way those parts of Chiropractic that are unsound and unproven. This is also recognised as the most difficult route for the profession, requiring near superhuman commitment from the individuals and organisations that make up the world’s Chiropractic profession:

“Escaping from the dogma house will require extraordinary cooperation amongst all aspects of the profession. Organizations such as the World Federation of Chiropractic and all major chiropractic associations will need to agree upon and adopt a position statement identifying the chiropractic subluxation as an historical construct that remains a hypothesis, which cannot form the basis for patient care until and unless there is a body of scientific evidence to support it.“

“If the profession is to gain the trust of the consuming public it must, of necessity, become truly self-policing.

Only in this way will chiropractic generate the cultural authority required for recognition as a group worthy of the title “Profession”.

No longer can we cast a blind eye. By our silence we are giving consent.“

Should Chiropractic refuse to move properly into the 21st Century then the consequences for it as a whole may be dire, leaving it’s future as a force in medical practice in doubt.

“The chiropractic profession can choose to be illiterate, but it will do so at its peril. It is realized that thinking is hard and that those who are unaccustomed to thinking may even find it unpleasant. On the other hand, thinkers have always found it rather fun and there are no confirmed reports of anyone dying or being seriously injured by thinking. Thinking may necessitate changing our minds – which may not be a bad thing. At the very least the profession owes it to its patients.“

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NZ (Nearly) Tops Skeptics Chart


Just in my RSS feed is this post on the SkepticBlog site talking about the number of page views of the blog ranked by country. The stats are adjusted and represent page views per million of the country’s population.

New Zealand follows Canada in the #1 spot relegating the US to #3. HA.

What’s the deal? Why are we so over represented?

I’d like to say it’s because our population is just highly educated and naturally receptive to the sceptical mind set.

Any suggestions?

Page Views of "Skepticblog" per million Ranked by Country

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Thai Yoga Massage: Herald, Wherefore Art Thou Sense?


So here I am, again latching onto the brilliance of others and writing my own counterpoint to the nonsense that is currently being run in the NZ Herald under the “Alternative Therapies” summer fluff.

Previously Alison kicked us off by looking at the use of medicinal leeches, as did  Siouxsie, and Michael took on Ayurvedic Medicine.

The latest round concerns something called Thai Yoga Massage or Nuad (Nuat) Boran. Essentially the practice consists of the massaged party adopting a series of yoga positions while the massager applies pressure to the body’s “Sen” lines. Those familiar with acupuncture’s “Meridians” can replace Miridian with Sen and get the general idea.

From an article describing the practice:

“The theoretical basis for traditional Thai healing is rooted in the belief  that all forms of life are sustained by a vital force (lom) that is carried  along invisible energy pathways (sen) running through our bodies.  This energy force is extracted from air, water, and food, and it is  believed that disease and dysfunction come about when energy  becomes blocked along these pathways. Accordingly, Thai massage’s  intent is to free this trapped energy, stimulate the natural flow of life  force, and maintain a general balance of wellness.”

Thus Nuad Boran is a system of energy medicine based on pre-scientific notions of “Vital Force” or “Life Energy”, blockages in which are the cause of disease (though exactly what disease seems to be harder to pin down). It is also claimed to be based partly on Ayurvedic medicine.

So what exactly does this “Alternative Therapy” treat? From the same article quoted above:

“The result of a full-body Thai session is often an exciting and powerful mind/body experience, bringing both the recipient and the practitioner to greater states of physical and mental well-being.”

But that’s kind of vague, what else?

Like many alternative treatments and especially the ones covered by the Herald this week the actual claims for Thai Massage seem to centre around improved blood flow. At least that’s the impression I got from looking at the listed clinical research on this page.

But apparently in the medical literature Thai Massage is mainly focused on pain relief, though there is this one hopeful study trying to use it as a treatment for Autism (the current trendy target for alternative therapies where nothing is too insane to try including chemical castration). Though a brief look at the abstract implies to me that they took one implausible treatment added a second implausible treatment and decided that Implausible2 = Success.

Pain is a good candidate for effective use of Thai Massage; the end point is subjective and massage involves close contact which humans generally find inherently soothing. Hopefully any successes in the pain arena will not be parlayed into evidence that the treatment “works” for any other condition.

The main issue I have with all the literature I’ve been able to dig up so far is that only Thai Massage was included in the studys. The specific reason for using Thai Massage (at least traditionally) is the claims regarding redirecting and unblocking life energy. Remove that unscientific aspect and why wouldn’t any massage work just as well?

I’m perfectly sanguine about the possibility that Thai Massage may be beneficial for perception of pain and reliving stress for the reasons given above. Should we be saddled with the extra hypothesis about life force, with the implication that there is something mystical and magical going on; giving the added justification that the therapy could be of use beyond pain and stress (and whatever else massage is good for)?

I don’t think so.

As Michael pointed out in his post, even the Herald reporters aren’t approaching these “therapies” as medical treatments but more as a relaxing massage/spa  session (except for the leeches, but perhaps there are those out there who would consider this relaxing).

Frankly, after the above it should be “’nuff said”. But how does the Herald approach this wellspring of traditional medical wisdom?

Well, possibly this article is the most honest so far, explicitly calling the technique a “relaxation therapy”. The life force concept is only briefly and obliquely referenced and the main emphasis is that this is simply a massage.

Even so, there are vague hints that the procedure is beneficial to your health is way that go beyond simple massage.

Passages like:

“…the yoga-like stretches help to stimulate and move air through the body.

“Every vital part of the human body, from the heart to the lungs, needs good air flow to function well, and Thai massage is aimed at stimulating these air vessels in the body,” said Nucharee Weerawan”

Do subtly imply that the massage will not only relax you but will help your body to “function well” whatever that might mean in this context. Which in turn may lead people to be more open to the idea that the massage could be used to treat more serious ailments. Or maybe the population will actually think things through for themselves and see through more extravagant claims.

I’m hoping for the later.

Though reading further into the description of the massage given, it doesn’t sound especially pleasant. Despite the attempt at a positive spin in the last line.

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