The original version of Holford's CV stated that he had graduated in 1976. 1976 left a respectable period during which Holford might have pursued further studies or apprenticed himself to figures whom he lionised before feeling that he was fully prepared to start work in 1980 as a fully independent nutritional therapist, specialising in the field of mental health.

However, as Goldacre points out, there was no such period of grace during which Holford could have worked or studied under supervision while he acquired the requisite knowledge and experience before 1980.

[The CV states that Holford] was at York studying experimental psychology [until] 1976 before studying in America under two researchers in mental health and nutrition (Carl Pfeiffer and Abram Hoffer), and then returning to the UK in 1980 to treat 'mental health patients with nutritional medicine'. In fact...Holford actually [graduated in] 1979, and after getting a 2:2 degree he began his first job, working as a salesman for the supplement-pill company Higher Nature. So he was treating mental health patients in 1980, one year out of this undergraduate degree. [pp. 173-4, Bad Science. Emphasis added.]

Holford has a standard story of his epiphany concerning mental health and nutrition that appears in various publications. Sometimes the details vary a little, but most of them contain some form of the claim that soon after the revelation in the final year of his degree, "Within months I was on a plane to America". From around the 90s, this detail is typically associated with the disclosure that he studied with Drs Pfeiffer and Hoffer.^[i]

Dr Aust offers some interesting background on Holford's mentors and inspirations, including Drs Pfeiffer and Hoffer. One consistently gnawing issue is why Holford directs attention to his period of 'study' with Pfeiffer and Hoffer when neither of them was working in a recognised academic institution at the time^[ii] and would therefore have been unable to offer academic credits or qualifications for whatever length of time Holford spent with them in between graduating, working for Higher Nature and then setting up as a nutritional therapist. One might question whether study is the appropriate word for what may have been a simple visit of what must have been a brief duration.

One might already have some misgivings about how much supervised study Holford was able to cram in, post-graduation and before starting to work as a vitamin-pill salesman, before he started 'treating mental health patients' in 1980, all while researching and writing the Whole Health Manual (originally published in 1981^[iii]) so must have been in preparation during this interesting and somewhat hectic period. Any unease is amplified when one recalls that the Brain Bio Centre information pack (thoughtfully annotated by Holford Myths claims that Holford has been treating patients since the 1970s).

The story becomes even more tangled when one consults Holford's juvenilia in search of enlightenment. It had seemed reasonable to assume that any biographical details written by Holford so soon after his graduation would be more accurate and reliable but biographical inaccuracy seems to have set in at an early age. Browsing through the biographical notes in Holford's 1985 classic, Vitamin Vitality, we learned:

PATRICK HOLFORD started his academic career in the field of psychology. While completing his BSc in Experimental Psychology at the University of York he researched into the effects of nutrition and vitamins on mental illness and was astounded by some of the results, which were often more effective than commonly recommended drug treatments or psychotherapy.

After university, Patrick Holford started to study nutrition and visited all the major nutritional research centres in the United States. He has carried out extensive research into the effects of vitamins and diet on various allergies, athletic performance and premenstrual tension. In 1981 Parick Holford established a nutrition consultancy called Whole Health Programmes. [Emphasis added.]

One wonders what counts as "extensive research" by Holford's standards for the above to be true although some of the research reported in Vitamin Vitality provides some clues). However, in subsequent accounts, Holford claims to have studied mental health and nutrition straight after university so it is conspicuous by its absence from this account of his post-university activities.

Beyond that, however, when did he have the time or resources to visit "all the major nutritional research centres in the United States"? How many centres did he visit? Was he just visiting and observing or working there? How long and frequent were these trips and how did he manage to explain his activities to the Immigration Officers? What did he do at all of these research centres to justify the boundless confidence in his expertise and competence to feel adequately prepared to 'treat mental health patients with nutritional medicine' with no more than a 2:2 in Psychology and some experience as a vitamin-pill salesman for Higher Nature to underpin his knowledge?

Notes

[i] This is easily falsifiable so we pledge that the next time that we are near a national library, we shall plough through a number of the earlier works to check for the first mentions of the time spent studying with Pfeiffer and Hoffer.

[ii] We should clarify that Pfeiffer was working in his own centre in Skillman, New Jersey, not Princeton University, despite the implied designation that Holford uses in several places of 'Princeton Brain Bio Center' or just Princeton.

[iii] The Whole Health Manual was published by Holford's Whole Health Programmes in 1981; it was later reprinted by Thorsons in 1983.

BPSDB

I was sound in off about Water Metering on 22 November 2006:

I see that there are proposals to force us all to have water meters, supposedly to conserve water. I concede that there is a valid argument to be had that we should all pay for the actual amount of water we use, rather than an amount based on the size of the property we live in but come on, this will not reduce usage by much.

If the Government is serious about water conservation, why don't they force the water companies to repair their leaky pipes? Somebody leaving the tap running while brushing their teeth might waste a bucket of water per week but the leaky mains lose Olympic swimming poolsful of water per day.

If we must have metering, there should also be meters on the resevoirs to measure the volume of water going into the system. Totalling the domestic and industrial meter readings would tell us how much was actually being used by consumers. It would then be a simple matter to calculate how much is leaking from the system.The water companies should then be fined in proportion to the measured leakage. If this hits share-holders in their pockets then tough!

This subject was discussed on the Bad Science forums (fora?) during the summer. I really recommend this site; it can be found at www.badscience.net/forums

The Reverend Blair set me off with his Apologies For The Slave Trade on 28 November 2006:-

I see Tony Blair has apologised for Britain's involvement in the slave trade. Typical Blair gesture IMO - seems caring, doesn't actually oblige him to do anything and costs nothing.

I'm not trying to diminish the horrors of the slave trade here - you'd have to look to the Third Reich to find something worse than the Middle Passage - but a three points occur to me:

1. The people who suffered the Middle Passage are all dead - we can't apologise to them.

2. I don't hear any calls for  the North African Arabs to apologise for their slave raids on Western Europe between the 15th and 19th centuries.

3. Britain was the first country in all of human history to abolish first the slave trade and then the institution of slavery itself. If we have to take the opprobrium for the slave trade, we should get some credit for its abolition.

The next two are about The Durham Fish Oil Saga. Most of it has been covered in my entries on this blog but I'm including them just in case I missed anything:-

If you read Ben Goldacre's column in the Guardian or the commentry on www.badscience.net and www.badscience.net/forum you will be aware of the dubious uncontrolled trial that Durham Council and Equizen, the manufactures of the "Eye Q" fish oil capsules, are carrying out on schoolchildren in the LEA. When Dr Goldacre requested details of previous trials referred to by Durham plus the protocols of the current "trial", he was refused on the grounds it would be too expensive.

Numerous readers of the blog sent in requests for parts of the info Dr Goldacre had requested. These were refused on the grounds that they constituted a vexatious request, having the effect of harassing the authority and were too burdensome to comply with etc.

My own request was simply for copies of the briefing papers on the trial submitted to senior officials. I received the same refusal as the others. I am currently appealing this decision. Here is the statement I made in the appeal:

It cannot be claimed that my Freedom of Information request has no purpose or value. Dr Madeleine Portwood is making numerous claims that these supplements will benefit mainstream children. It is reasonable to presume that this initiative was approved by senior officers and/or elected members. There is a public interest in knowing the quality of data submitted to these officials to assist their decision making. A well-knownHigh Street pharmacist is using the initiative in their advertising, other schools and authorities are jumping on the bandwagon and as a parent I need to be informed about such matters.

Nor is my request "designed to cause disruption or annoyance". As I have requested copies of council papers it should be a simple matter of either emailing, or photocopying and posting, them to me. I fail to see how such routine tasks can "disrupt" or "annoy" anyone. I do not believe that it could possibly "have the effect of harassing the public authority".

It is further stated [in Durham's refusal] that during 2005 the council received 165 FOI requests but has received 106 on this matter alone and that "This clearly demonstrates that these requests have imposed a significant burden on the council".

The quoted statement does not follow from the number of requests. It could just as easily be argued that these figures demonstrate that the staff dealing with FOI requests had an easy life in 2005, or that this is a controversial issue which has generated a lot of public interest. Photocopying and posting, or emailing, some council documents cannot possibly constitute a burden. Likewise the request cannot be considered "obsessive or manifestly unreasonable".

I do not disguise the fact that my interest in this matter is brought about from reading Ben Goldacre's column and the commentry posted on the "Bad Science" website. However, I requested copies of council documents not the trial data referred to in the column and on the website. Hence my request can neither be cosidered as part of a campaign nor vexatious.

After my successful Freedom of Information Act appeal on this matter it all went quiet for a month. Last week I reminded Durham that I still existed and still wanted the information.

Today I received an email from Peter Dinsdale in which he said, in part:

"I am informed that the requested information is not held by Durham County Council, as no written reports or papers were prepared for senior officials or elected members in relation to the fish oil initiative."

I have worked within a local authority bureaucracy in the past and based on that experience, I find Mr. Dinsdale's statement very hard to believe. It may indeed be true that that is what he was told but the implication, therefore, is that the relevent decisions were taken on the basis of orally presented information, or were made by middle-ranking or junior staff. Both of these scenarios are extremely unlikely.

Next stop, the Information Commissioner. To be fair to Mr. Dinsdale, he gave me the address, phone number, fax number and email of the ICO.

Then the fact that we appear to be Sliding Into A Police State set me off on one on 4 December 2006:-

My colleague got a parking ticket last week when her car broke down on Fortess Road. She's justifiaby angry that she has to fight with Camden's bureaucracy in order to get the ticket rescinded but to me the most disturbing aspect of all this is that she wasn't issued with the ticket on the spot. Her car was spotted on CCTV by some plonker who's reaction was to read her number plate, find her details from DVLA and post her a ticket. Is there any hiding from these cameras?

And how's road pricing going to work? You're going to pay per mile, the amount depending on which road you're on. And how wiil the DofT know that?

By a black box in your car that will allow the Government to track you by sattelite, that's how.

You're always being watched.

I expanded on this a bit on 7 March 2007:-

My colleague got a parking ticket November's end when her car broke down on Fortess Road. She was justifiably angry that she had to fight with Camden's bureaucracy in order to get the ticket rescinded but to me the most disturbing aspect of all this is that she wasn't issued with the ticket on the spot; her car was spotted on CCTV by some plonker who's reaction was to read her number plate, find her details from the DVLA and post her a ticket.

Some might think that a woman on her own at night in this situation was in a vulnerable position and send someone to assist, but not this twunt. This gives the lie to the idea peddled by the powers that be that this surveillance is for our protection. Plainly they are not.

And they are everywhere, there's no escaping them. You're always being watched.

It'll get worse when road-pricing comes in. You're going to pay by per mile, the amount epending on which road you use. How will the DofT know that? By a black box in your car that will allow the Government to track you by sattelite, that's how.

In an insightful letter in the 5 January issue of New Scientist, Derek Storkey of Hampshire points out that petrol tax also serves the purpose of a price per mile levy which is unavoidable and requires no hi-tech means of collection and enforcement. He concludes:-

"If we are going to implement road pricing, let us be honest about the motives. It is either a way for rich people to use the tax revenue to make it harder for poor people to clutter up the roads or a way for the security services to be able to keep tabs on the whereabouts of anyone who uses a vehicle any time, anywhere."

And that's because they think Everybody's A Suspect:-

I read earlier this week that the Government intends to fingerprint all 11 to 16 year olds by 2010. Now I always thought that fingerprinting was only done to arrested suspects and that until they were actually charged with an offence, they could refuse to be fingerprinted.

Evidently that is no longer to be the case. If Judge's Rules haven't already been abolished, they soon will be.

Why have we got so scared of our children that they treated as felons, as guilty until proven innocent? I know their are problem kids, there's more than a few of the at the school in which I work but they hardly a majority or even a substantial minority nationally.

The Government already wants to fingerprint all new passport applicants for the biometric passports. Once they've got most adults and all secondary schoolkids fingerprinted it'll be pretty hard to resist a proposal to fingerprint
the entire population. And why stop there, if you're going to regard the entire citizenry as potential criminals? These days the police take DNA samples from everybody charged with an offence - and retain them even in the event of an acquital. How long before some apparatchik in the Home Office decides that DNA should be taken from everybody?

And don't fall for the "If you're doing nothing wrong you've no reason to object" argument. Would you like Big Brother cameras and microphones in every room of your home to record your every action and every word for analysis by the police? If you've nothing to hide, why not?

Because it is a gross invasion of your privacy. And isn't taking samples of your body without your consent an even greater violation?

Some sloppy thinking in the Love By Numbers column in the Guardian Weekend set me off on 4 December 2006:-

Saturday's Guardian Weekend contained advice from Dr Luisa Dillner to an Asian woman contemplating marriage to a white man. She quotes the fact that "white people are the least likely to marry outside their ethnic group and she implies that this means they are the least enthusiatic about mixed marriage. It is mathematically inevitable that the majority population will have a smaller fraction of its members in mixed marriages.

Consider a minority group consisting of n individuals and a majority group having m more members i.e. n+m members in total.

Consider that a fraction x of the minority group enter into marriages with members of the majority group. Thus there are xn individuals from the minority group in mixed marriages.

Consider that a fraction y of the majority group enter into marriages with members of the minority group. Thus there are y(n+m) individuals from the majority group in mixed marriages.

If the marriages are monogomous, these terms are numerically the same

ie y(n+m) = xn

ie          y = xn/(n+m)

i.e y is always smaller than x and is due to proportionate lack of opportunity not enthusiasm.

The ignored pre-Norman Occupation portion of English history made me think "Who's History Is It Anyway?":-

I've been working on an article for an RPG site on Role playing in the Anglo-Saxon period. (A preliminary article and other good gaming stuff can be found at http://firedrake.org/roger/rpg/sharpend) During the course of my researches I've come to realise how little of it is taught in English schools.

As I recall from my own schooldays it consisted of :

Romans leave Britain. Hengst and Horsa arrive - behave in sneaky fashion and assassinate British leaders. Jump to Viking era, Alfred burns cakes and defeats Guthrum. Ethelred the "Unready" (actually "Unred" means ill-advised; an Anglo-Saxon joke as Ethelred means "well-advised"), Canute and the tides, Edward "the Confessor" (not a title used until the Norman Occupation began. His contemporaries thought of him as Edward III), Harold II Godwinson, Battle of Hastings and Billy the Bastard. Well, the text books called him William the Conqueror but I prefer my choice. Most apt whatever meaning of Bastard you choose.

And why is six centuries of history swept under the carpet? Could it be because the victors wrote a self justifying history which has been repeated without question ever since, because most of the people who own this country are descendants of the Bastard's thugs? Of course it is. Wealthy land owners are squatting on stolen property and the theft is justified by their self-serving distortion of events.

The history we are taught claims that Billy the Bastard was the rightful successor to Edward III. What crap! English Kings were elected by the great land owners. All the aetheling ("King-worthy") were candidates. OK, not a democracy as we understand it today but well in advance of the "divine right by birth" or naked land-grabbing that was more usual in the eleventh century.

Billy had no right to be King of England. He was a usurper and thus the handing out of estates to his followers were illegal acts. We English should take back our rightful history!

I might reproduce the Anglo-Saxon History for role-players articles here. Any historian who doesn't like them will understand why Ben Goldacre makes his sarky comments about humanities graduates and the fact that they don't know much science does not prevent them pontificating about it.

The Great Gas Bill Rip-Off from 9 January 2007 remains topical:-

Remember how our gas bills all shot up last year and switch suppliers as we would, our new suppliers followed with increases of their own? They blamed the international wholesale price for gas and claimed they had no option but to pass the increases on to the consumers.

There might have been something to that argument when wholesale prices were at their peak but guess what, wholesale prices are dropping. In August last year, wholesale prices were 80 pence per therm. In November it was 50 ppt and now it's 30.45 ppt. Are are gas bills dropping to match now? Of course they aren't. The gas companies want to keep the excess profits they are squeezing out of us and out of industry. I am willing to bet now that if wholesale prices increase again during the year, the price we pay will be increased again.

Not only are they costing us by squeezing us on our gas bills. These energy price increases increase industrial production costs and you can bet that those prices will also be passed onto us.

The enegy companies should all be renationalised and run on the basis of need not shareholder profit. That wouldn't protect us from increases in wholesale prices of course but if they were still state companies, unit costs would be decreasing at a time of year when use is at its highest, so our winter fuel bills wouldn't be the shock they are, in fact, going to be.

Fundies say the funniest things, particularly when they're playing the victim. As they were when they provoked Human Rights Abuse on 10 January 2007:-

 I'm talking about the bizarre abuse of the concept of human rights by the Christians who were protesting last night against the Sexual Orientation Regulations. They claim that their faith requires them to be ant-gay and that by preventing them from discriminating against gays, the Government is infinging their human rights and freedom of conscience.

They don't seem to have thought this through. This is a game anybody can play. For example, Muslims believe that Allah is the one true indivisible god and that Mohammed was his final prophet. Al Quaida and other extremist elements further say that their faith requires them to smite unbelievers. If they were to apply the logic of those moronic protestors, being prevented from murdering Christians and other non-muslims (and muslims who don't share their radical interpretation of the Koran) would infringe Al Quaida's human rights!

I'm sure the evangelical protestors would see the nonsense in this position but their own position is equally absurd.

Vitamin peddlers in South Africa provoked my thoughts on Deadly Denialism on 21 January 2007:-

Yesterday I read in the Guardian's Bad Science coloumn that one Anthony Brink has filed an accusation of genocide against Zackie Achmat, the founder of the Treatment Action Campaign, at the Hague international criminal court. In summary, his allegation is that by campaigning for antiretroviral drugs to be administered to South Africa's five million HIV positive citizens, Achmat is committing an act of genocide.

Brink is an associate of Matthias Rath, a vitamin peddler who claims his nostrums are more effective for treating HIV/AIDS than antiretrovirals. He is the leader of an allied organisation called the Treatment Information Group which claims that antiretrovirals are not only ineffective but harmful. He is the man who is credited with introducing President Mbeki to HIV denialism. These actions have contributed to the needless deaths of tens of thousands of people.

His latest action is clearly an attempt to intimidate Zackie Achmat and the Treatment Action Campaign into silence, to stifle the attempts to save the lives of five million people. Are Brink and Rath really so stupid as to not see their actions will contribute to the deaths of millions?

Well, we've since found out exactly how stupid Rath can be: sued Ben Goldacre and the Guardian for daring to tell the truth about him, lost and lumbered himself with a million-pound legal bill.

Finally, on on 7 February 2007, I expressed the opinion that The Archbishop of Canterbury Talks Cack:-

Rowan Williams, Heresiarch/Primate of all England (depending on your view of the Anglican Schism) is obviously angling for a job as a Daily Mail columnist, judging by his latest pronouncements. He accuses "Trendy metropolitan types" of mocking marriage and goes on to say "Fluid, changeable relationships may look fine to the commentating classes of North London but you can see the cost".

So far, so tabloid. Lovely soundbite but just does not match reality. It may come as a surprise to His Irrelevence but most "metropolitan types", even in North London, are in stable relationships. He is conducting the usual church propoganda of trying to present themselves as some kind of moral guardians. The hypocricy of the leader of a church founded to give Henry Tudor a divorce when the Pope wouldn't play ball is quite breath-taking. Perhaps he should lecture his future boss, Carl Battenburg, on the sanctity of marriage and stable relationships.

If we want to see how christian Williams' church truly is, let us consider the case of Andrew and Gail Wallbank, who inherited a field classified as rectoral property, making them 'lay rectors' of the Parish of St. John the Baptist in Aston Cantlow, Warwickshire. The church is making use of the Chancel Repairs Act (1932) - which is based on medieval law - to compell them to pay the £200,000 costs of repairs to the church. The Anglican Church is rich in money, shares and property but rather than pay for the repairs themselves they are forcing the Wallbanks to sell their farm to pay for them.

Alia Crum and Ellen Langer from Harvard psychology department took 84 female hotel attendants in 7 hotels. They were cleaning an average of 15 rooms a day, each requiring half an hour of walking, bending, pushing, lifting, and carrying. These women were clearly getting a lot of good exercise, but they didn’t believe it: 66.6% of them reported not exercising regularly, and 36.8% said they didn’t get any exercise at all.

Weirdly, measures of their health (BMI, blood pressure) were related to how much exercise they thought they took rather than how active they actually were. The researchers divided the attendants into two groups and one got an hour-long presentation on how much exercise they were really getting (including the information that they were satisfying the surgeon-general's recommendations for exercise and examples of how their work was exercise), while the control group was given no advice on their exercise levels. When, after a period of four weeks, the researchers looked again at the measures of health they had examined at the beginning of the study, they found that each measure had improved in the group that had been given the presentation while the group that had been left in the dark had no change in their measures of health. Here's how the authors put it in their abstract:

Although actual behavior did not change, 4 weeks after the intervention, the informed group perceived themselves to be getting significantly more exercise than before. As a result, compared with the control group, they showed a decrease in weight, blood pressure, body fat, waist-to-hip ratio, and body mass index. These results support the hypothesis that exercise affects health in part or in whole via the placebo effect.

In his book, Goldacre writes that the findings of this study are "bizarre" and suggests that if anyone
has a good explanation then they might like to blog it or write a letter to the journal. I don't have a good explanation, but I have been thinking about the strange finding that advice itself rather than changes in routine can affect these physical measures of health (weight, blood pressure, body fat, waist-to-hip ratio, and body mass index) and it's starting to bug me now. That the researchers have found that the placebo effect, in the form of advice, can affect such things as body fat is surprising but what's really bugging me is how it can. I started by trying to think of fairly obvious things.

Like, did being told how much exercise they were actually doing have an effect on their outlook when it came to other aspects of health? Perhaps they were feeling virtuous by dint of their new found awareness of just how active they were and this had a knock-on effect in things like food choice. When I re-read the blog post, I saw that this had been referred to already ("maybe the cleaners changed their behaviour, or their diets, in ways that the researchers didn’t pick up"), so that idea is already out there. I thought that perhaps someone would repeat the study and this time measure food consumption in both groups as well as exercise levels and so be able to at least give us a clue as to whether that idea has legs. It turns out that the researchers had asked the subjects to self-report diet so if their self-assessments were accurate and no dietary changes were made [comment on the Bad Science blog from someone who blogs as 'A Healthy Distrust'], then that's idea #1 out of the frame.

Next up, we have the idea that both groups initially underestimated the amount of exercise they were taking, and that the group that was given the presentation not only subsequently had a better understanding of how much exercise they were actually getting but also increased their activity levels. Whereas the control group simply underestimated their level of activity at both the beginning and end of the study and made no conscious or unconscious increase in their levels of activity. Not having access to the full paper made it a little tricky to evaluate this idea. However, it seems like a non-starter. The abstract states that "actual behavior did not change", so it looks like the authors may have monitored actual levels of activity. I had thought I was being really clever coming up with a hypothesis that their activity levels and awareness of their activity levels improved in tandem as there seemed to be parallels with Unskilled and Unaware of it by Kruger and Dunning (it's sort-of a paper about improving competence in order to improve awareness of competence/incompetence - pdf). It seemed neat that telling a group of people how their work was exercise, and how much exercise they were getting by working, could increase both their level of exercise and their understanding of how much exercise they were getting - but if the authors monitored the levels of activity in the two groups and these did not change then it looks like it's a duff idea, however neat it seemed at the time.

Next we have something I find particularly unlikely. Perhaps just thinking about how much exercise you take and about how fit you are has some kind of physical effect in itself. Perhaps thinking about exercise (or telling yourself you are working hard, rather) releases chemical messengers in your brain that have a "knock-on effect" in your body. Maybe (and I'm speculating wildly here), thinking about exercising causes neurotransmitters and hormones to be released that mobilise fat cells in order that your body can utilise the energy and this helps to reduce your BMI, levels of body fat, weight and waist-to-hip ratio. The only thing I've missed in that list is blood pressure, which I wouldn't be surprised to see a drop in if you've just told someone they meet the surgeon-general's recommendations for exercise. I know my first thought would either be "phew, that's a relief" or "that's bollocks, I never exercise" - if it were the former then I imagine my more relaxed outlook to that aspect of my health could have a beneficial effect on my blood pressure. The blood pressure readings don't seem as hard to explain as the other measurements, but the idea that just thinking about exercises causes a release of chemical messengers that melts away your fat seems a bit bloody dubious to me. I mean, what happens to the energy for one thing? We all know energy is not created or destroyed, but is changed so what does it change into if it is released from fat cells but is not used in order to fuel higher activity levels? Heh - maybe we should measure the participants' temperatures as well, see if they're heating themselves by burning fat through the power of thought. Or use a surrogate marker such as number of days when jumpers and cardigans are worn.

The killjoy moment: someone emailed Ben Goldacre to point out that "the researchers seem not to have corrected for clustering in their data [...] this looks like a pretty valid criticism, and might reduce the statistical significance of the findings, without the raw data nobody can tell by how much." If it turns out that the findings aren't statistically significant then there's no effect to ponder over and I've been wasting my time thinking about how revising someone's impression of their activity level can improve such physical measurements as body fat, weight and BMI. It was fun thinking about it though, and there are certainly worse ways to waste your time. [This is the comment].

As an ex-Physicist I'm familiar with the conservation laws of momentum and energy. A conservation law states that a particular measurable property of an isolated physical system does not change as the system evolves. So I propose a new conservation law to explain my body hair redistribution.

My new law states that the total amount of visible hairs in a mature and isolated human body remains constant and cannot be created or destroyed, although the hairs may change position on that body. I call this "The law of conservation of follicles".

Of course a biologist will tell you that this apparent redistribution of body hair is caused by testosterone, and a very quick Google search turned up an article entitled Root causes of the great hair migration. According to the article and the experts it quotes:

• testosterone binds to the testosterone receptor in the hair follicles and stimulates hair growth
• testosterone doesn’t create hair on the body; it merely stimulates the follicles to transform short, fine vellus hairs, which are barely visible, into longer and darker terminal hairs
• testosterone inhibits the hair follicles on the scalp but stimulates them elsewhere on the body
• hair follicles, once stimulated by testosterone, remain stimulated
• only two techniques eliminate body hair permanently - electrolysis and laser treatment

So my observations have some foundation in Biology, but is there some underlying Physics, too? Is there a lossless flux between head hair count and body hair count; does my conservation law hold? And is it the key to a Grand Unified Theory of everything?

Finally, is it significant that black holes have no hair but I do?

Asbo kids have 'mental illness'
Just another bland example of flaky overhyped unreferenced speculative reductionist comedy reporting.

Spotted on the bad science mini blog. The reporting is dire - no references to published literature, no interviews with any of the "researchers" mentioned. Just some stock footage of young people drinking, riding bicycles, walking and being arrested.

The sad thing is that this excuse for journalism refers to a paper published in Biological Psychiatry 2008, 64, 599-606 which was also covered by the BBC news website.

To precis: Cortisol is the hormone produced when we (humans) are stressed. This enables us to stay calm and deal with stressful situations. Adolescent males with conduct disorder (CD) were shown in this study to have no increase in cortisol from their normal levels when placed in a stressful situation.

The researchers acknowledge the limitations of their study (potential poor adherence to the regime, retrospective accounts) and the numbers of participants was relatively small (CD=70-42 early onset, 28 adolescent onset, control=95).

The ITN reporter, rather than reporting the facts (physiological markers may affect behaviour but do not necessarily cause it (Hodgins in the BBC news article)) has chosen to sensationalise it and misreport it as a mainly psychological problem. Whether this is wilful or merely negligent is unknown. But it once again reminds us all that there is a real need for health and science correspondents who have an actual understanding of their subject.

Edit at 1500 03/10/2008
Also blogged by jdc. Many thanks jdc!

"An ASBO is a civil order, not a criminal penalty – they are not intended to punish the offender – however, breach of the order can lead to a fine or imprisonment or both" and "ASBOs are not given lightly and the council and police need to have substantial evidence that a person has caused harassment, alarm and distress to others" are quotes from the Crawley Borough Council Website. I was concerned by the reference to a civil order leading to a fine or imprisonment and automatically wary of the words 'substantial' and 'evidence' being used in conjunction with the words 'council' and 'police' [apart from the traditional complaints about the police, you may also remember the case of the spying council misusing ant-terror legislation - BBC account] and the quote fails to make clear that the police and council are not, in fact, the final arbiters of this substantial evidence - magistrates are, which I actually find reassuring as I would prefer to have magistrates rule on my case than police or council officials. One complaint often made is that, although an ASBO is a civil order, breaching an ASBO can get you sent down for up to six months on summary conviction or five years if convicted on indictment[2]. This isn't quite as unfair as it may seem at first sight (assuming that your knee-jerk reactions are as woolly and liberal as mine tend to be). Breach of an ASBO is actually treated in a similar way to other criminal offences (remember that, while an ASBO is a civil order, breaching an ASBO is a criminal offence[3]). Petty offences may be heard in a summary trial by magistrates and more serious (indictable) offences may be heard by the Crown Court with judge and jury, while triable-either-way offences probably need no explanation. Whatever the arguments for or against ASBOs, it looks like I was wrong to assume that someone could be sent down without a proper trial.

This post was written some time ago and was intended to partner a 'sister' blog post on whether ASBOs worked or not. In order to write the sister post, I needed before-and-after crime stats to see whether crime was reduced in areas that were more likely to use ASBOs. Unfortunately, the way crime is recorded keeps changing and I was therefore unable to find comparable figures [how anyone can tell whether crime is rising or falling is beyond me]. This meant I couldn't write my sister post and I didn't think it was worth writing this as a stand-alone blog post. Today though, I read a piece about kids with ASBOs being mentally ill. Ben Goldacre described this on his miniblog as "Just another bland example of flaky overhyped unreferenced speculative reductionist comedy reporting." The Mirror has run the story here. I thought I'd take a quick look at the story and jot down a few of my thoughts. This blog post will now become what Traffic Cops must fear - a cut-and-shut job.

Everyone loves a nice straightforward, linear explanation for behaviour. The boys who killed Jamie Bulger were "evil", depression is caused by deficiency in a single neurotransmitter and now children with ASBOs are described as mentally ill because they tend not to have a typical increase in cortisol levels when placed in a stressful situation. Basically, they are saying that kids who aren't as scared as their peers are mentally ill and that this is all caused by a simple lack of a single neurotransmitter. Of all the descriptive terms used by Ben Goldacre, I think the most striking is 'reductionist' - probably because it seems to be a recurring theme in our society. There are probably many reasons why the suggestion that 'ASBO kids are mentally ill due to deficiency in cortisol' could be a load of old bollocks, but one that occurred to me was this: perhaps kids who are in trouble frequently enough to receive an ASBO are used to being in stressful situations. Perhaps they are 'acclimatised' to stressful situations because of their background, their family situation, the area in which they live? Perhaps what we call stressful is to them everyday and ordinary. Whatever - my point is that it probably isn't helpful (at least at this early stage) to make public claims that these children are mentally ill or that their antisocial behaviour can be put down to deficiency in a single chemical. Presumably, Big Pharma is looking up “cortisol agonist” in order to start R&D on a new anti-antisocial behaviour drug. Big Altie has, as ever, beaten Big Pharma to the punch. Patrick Holford recommends Pantothenic Acid to increase levels of cortisol (Optimum Nutrition Bible, p 219). Well, he points out that Pantothenic Acid is needed to produce sufficient cortisol and then claims that in times of stress you need more of the nutrients he mentions in his book. Later on in ONB (p 261), he recommends Ginseng, Rhodiola and Reishi mushrooms to ‘maintain normal levels of cortisol’. They’ve got the cure – they’ve just been waiting for someone to invent the disease.

This is the type of story I might expect to be covered by Soveda on the Musings of a phenomenologist blog or perhaps the BPS Research Digest, but I've just looked and I can't see it on either site yet. I'd be interested to see what others made of the story, so if you have any opinions on the description of antisocial youths as mentally ill or the idea that antisocial behaviour can be ascribed to deficiency in a single chemical then please leave a comment or link to your blog post on the subject. I'd love to read more opinion on this. Especially if those opinions are better informed than mine. Ooh, speaking of better informed opinions: first up is the meaningful occupation blog. Nice work OT!

1. Guess Who Is it a woman? Does she have red hair? Does she wear glasses?

2. Legal Shit an' that (The Office of Public Sector Information - their main page is here: http://www.opsi.gov.uk/).

3. Wikipedia: Summary_offence; Indictable_offence; Magistrates_court.

The first link is to a well-written story on using the scientific method to sort Alt Med claims. The journalist seems to understand the subject and is given sufficient space to write about it properly, two things that I think tend to be missing from the mainstream media outlets in the UK. He also explains things like this: RCTs - "In such trials, scientists randomly assign patients to treatment or control groups with the aim of eliminating bias from clinician and patient decisions"; Size of study - "The smaller the sample size [...] the greater the risk of error, including false positives and false negatives". It just seems to me to be less, well, dumbed down than the UK MSM reports.

The second piece is entitled "Searching for Clarity: A Primer on Medical Studies" and is very interesting indeed. They use the example of Frankie Avalon defending the antioxidant Beta Carotene to illustrate the importance of weighing up the evidence and assigning appropriate significance to the most important available evidence (if this were a UK paper, they'd probably be uncritically reporting Cliff Richard's views on antioxidants). They attempt to answer this question: "That, of course, is the question about medical evidence. What are you going to believe, and why? Why should a few clinical trials trump dozens of studies involving laboratory tests, animal studies and observations of human populations?", using the examples of Beta Carotene and the Women’s Health Initiative. At the end of this first page, they refer to compliant pill-takers - I'll mention these compliant pill takers again a little later on.* You will note that this article has two pages. You see, NYT (unlike the UK MSM) gives sufficient space to health and science stories. The article by Gary Taubes I link to below is nine pages long, for example. I think this provision of space is helpful, but you need more than that to provide decent reports on health and science - such as journalists who have some knowledge of the subject they are writing on.

Here's a recent story: Vitamin C and cancer drugs. The Daily Mail had a 283-word piece that seemed fairly reasonable - but they captioned their picture of some oranges "Vitamin C supplements could reduce the effectiveness of cancer drugs". I think it's daft to caption a picture of oranges with a scary note about vit C reducing effectiveness of cancer meds, when the authors of the study (as the Daily Mail wrote) said that patients should eat a healthy diet (i.e., they should eat fruit and veg containing vit C rather than take pills). The caption was the right one - but for the wrong picture. The Telegraph had a 345-word piece that quoted the researchers, but ended with a vitamin pill industry spokesperson pointing out that "It is important to note that this study was conducted in cancer cells, and in mice, in a laboratory setting. The researchers did not give vitamin C to human beings." Which is a rather ironic quote, given the vitamin pill industry's love of in vitro studies when they have positive results. I think the reason they gave space to both the researchers' vies and the spokesperson's views is probably for "balance". As if a pill industry spokesperson's opinion and research findings should carry equal weight. The NYT goes for a 391-word piece that is free from spurious attempts at balance and daft picture captions. To be fair, though - there's not a huge difference in the way these three newspapers reported the story.

* The bias of compliance popped up in this article by Gary Taubes on epidemiology - "Do We Really Know What Makes Us Healthy?" - and is something we should think about next time a vitamin pill salesman assures us that people who take vitamin pills live longer and are healthier, because it offers an alternative explanation to the one that is preferred by the pill salesman. See also Patrick Holford on the Gladys Block study: I blogged it here (albeit somewhat inadequately).

Hat tips: PV posted one of the NYT stories on the bad science forum recently and holfordwatch posted both on their miniblog. I also first spotted the Taubes piece on the Holford Watch blog.

As Rob Jameson pointed out in "The Blunders That Led to Catastrophe" (New Scientist 27 September 2008 pp 8-9), the world's financiers assumed that models which described the behaviour of straightforward financial instruments such as shares would also apply to more complicated financial instruments which bundle up assets such as high-risk mortgages. This turned out not to be the case.

Ten years ago the hedge fund Long-Term Capital Management failed and almost precipitated a liquidity crisis of the kind currently afflicting world finance. LTCM had relied on their use of statistical models to keep track of the risks involved in their investments. Regrettably, the world's financiers carried on using such models, despite the evidence that they did not work as advertised and that their predictive powers were hopeless when it came to extreme events.

To me, it appears that the modellers were - ironically - ignoring  one of the major assumptions of modern capitalism, which is that we all behave as individuals pursuing our own selfish interests. If you read in the paper that the bank which holds your life savings has a liquidity problem (due perhaps to losing money on sub-prime mortgage lending) what is the rational thing to do? Clearly it is to get hold of your money while you still can. This excacerbates the problem, of course, so the movers and shakers of the financial world say that the account-holders are "panicked" rather than admit that they are making a purely rational decision as to where their own best interests lie.

It seems to me that the reason for so much sub-prime mortgage lending is that there was not enough of the traditional market to go round. And why was that? One reason was that banks had been allowed to enter the mortgage market by the financial deregulation introduced by Margaret Thatcher. Competition is good, regulation and red tape are bad, you see. As part of this same package, Building Societies were allowed to de-mutualise and become banks. All the Societies that went down this route no longer exist; Bradford & Bingley and Northern Rock went bust, the rest have been taken over by other banks. Sorry, what was that about competition?

Another problem is that there is some evidence that even when patients bring up the possibility of side-effects with their doctor (and there exists scientific evidence to support such a link), the doctor will tend to dismiss the association. It occurs to me, therefore, that if someone is having side-effects such as fatigue, muscle pain and muscle weakness as a result of taking a statin, then they can’t necessarily rely on their doctor for help.

Previously, I have written about this problem, and have discussed the ability of statins to cause the depletion of the nutrient coenzyme Q10 in the body. Lower levels of this substance does seem to be a common causative factor in the common side-effects seen with statins. More importantly, though, is the fact that in practice coenzyme Q10 supplementation very often relieves what can be really quite debilitating symptoms. Not only that, but last year saw the publication of a study which supports the effectiveness of coenzyme Q10 for the reversal of statin-related symptoms.

Briffa states that lower levels of Q10 seems to be a common causative factor in the common side-effects and claims that "in practice" Q10 supplementation can relieve the symptoms. Well, that's not what I'd heard. What does Briffa cite as evidence? "A study" A single study? Bit thin as evidence for prescribing Q10, isn't it? Especially when there are reviews on Pubmed that say things like "Although there is not much of a safety concern with coenzyme Q10 supplementation, there is also not enough evidence to support its routine use for preventing the adverse effects of statin therapy, and it is therefore not recommended for this purpose at this time." Cardiol Rev. 2005 Mar-Apr;13(2):76-9. And "In those limited studies that have assessed the effect of statin treatment upon tissue CoQ(10) levels, none have shown evidence of a fall in CoQ(10) [tissue] levels" Drug Saf.2005;28(8):659-76... and "Routine CoQ10 supplementation for all patients taking statins to prevent myotoxicity is not recommended." Ann Pharmacother.2006 Feb;40(2):290-4.

Anyhoo, Briffa's study was this one: Caso et al. "In conclusion, results suggest that coenzyme Q10 supplementation may decrease muscle pain associated with statin treatment. Thus, coenzyme Q10 supplementation may offer an alternative to stopping treatment with these vital drugs." Sounds fair enough - and if CoQ10 is a potentially useful adjunct to statins that could help patients then great. But it was only a single study with 18 subjects taking Q10 and 14 taking Vitamin E. I still think it's a bit thin as evidence on which to make judgements about which treatments to recommend or not. [Edit] Apart from anything else: This trial lacked a placebo-control design and patients were not on a standardised dose or type of statin. [linky] [/Edit]

Links: Briffa's Q10 post; A Classic Briffa Q10 post. The first link is to the blog post I quoted from - if you want to read John Briffa's full, unexpurgated views on Q10 and statins then I recommend you start there.

As always your comments corrections, and criticism are welcome.

Quite distinctly fishy

Durham's special trial ishy*

When nurr vote got done...”

(With apologies to Alex Glasgow, David Fanshawe, and North-Easterners in general.)

*"Initiative"

In a strange bit of synergistic convergence, the very week that I found myself reading a Ph.D. transfer report dealing with fish oils (of which more later), the Durham Fish Oil Zombie rose from the dead to haunt the national press once more.

The Fish Oil Zombie story (a.k.a. “Fishy Business at Durham Council”) is one of the things that first got me commenting on Ben Goldacre’s Badscience blog over two years ago. I know the story is old, because I started using it as a 1^st year student exercise in spotting bad science back in the 2006-7 academic year.

If anyone doesn’t know the history, the place to start is over at Bad Science on the Fish Oil category tab, where you will find the whole history and all the posts. But it is worth pointing out that the Fish Oil Zombie story attracted attention in part because it seemed to epitomize all the things that are bogus about the promotion of unproven nutritional supplements.

Yes, the Fish Oil Zombie story had it all.

To list a few only:

- “Pills for Ills”, with shiny capsules as a solution for social problems;

- PR spin masquerading as scientific investigation, and “Big Quacka” bullshit;

- the co-opting of public servants (with their apparently enthusiastic connivance) by the clammy embrace of the fish-oil salesmen and the desperate pursuit of column inches;

- a large experiment on a load of kids without anything like “ethical approval”, and indeed without Durham Council ever having formally voted on it;

- the public, and especially the parents and children of Durham, as pawns and dupes;

- a “cover story” from Durham Council’s PR flacks that seemed to change every day

- and - above all – reams of fawningly credulous press coverage.

Ben Goldacre’s Guardian column today nicely summarises both the background and the recent revival. The short version is that, having eventually admitted that their “study” / “initiative” / publicity stunt could in no way be described as a piece of science, Durham Council’s Dave Ford (ex Chief Schools Inspector for Durham and now “Head of Achievement Services”) and Dr Madeleine Portwood (Chief Educational Psychologist and enthusiastic conference attender) have now – eighteen months down the track - magicked up some data.

Ben Goldacre has already pointed out exactly why Durham’s relentlessly massaged figures don’t show anything in their new form, just as they showed nothing when the GCSE results appeared; the “study” “Initiative” trial was incapable of producing reliable data, because it was designed that way from the outset. It was, from Day One, a PR stunt and a piece of let’s-be-seen-to-be-doing-something-ness. And all the post hoc finagling in the world can’t change that - or make a silk purse out of a sow’s ear.

The shorthand for this, in science as in many other walks of life, is:

“Garbage in - garbage out”

Or: if you run a study giving kids fish oil capsules with no control group, you cannot reach any meaningful conclusion on whether the fish oils do anything, regardless of your (claimed) sample size.. This is, as they say, not exactly rocket science.

More interesting than the details of this rather desperate attempt to generate a bit more PR and publicity out of re-animating the Fish Oil Zombie is the timing.

I don’t mean the full moon, or the approach of Halloween. I mean the fact that the Zombie has risen from the grave precisely three weeks before the ”Food for the Brain” conference in London, organised and promoted by fish-oil friend and enthusiast Patrick Holford’s crew… and at which Portwood is scheduled to give the assembled Nutritionistas The Word From Durham.

Oddly unmentioned in the recent stories is that the fish oil capsules in Durham’s trial “Initiative” were provided free by the fish-oil manufacturer Equazen. The FFTB conference is being run by Dear Patrick’s acolytes (FFTB and the supplement company Biocare), but is also supported by Equazen.

Biocare, of course, is the company where Mr FFTB, Patrick Holford, is Head of Science and Education, according to the gang over at Holfordwatch. Biocare sell an extensive range of fish oil products. And Patrick’s face, name and endorsement are on lots of branded fish oil products too.

Equazen’s website front page prominently states:

“EyeQ [Equazen’s fish oils] used in Food For The Brain Schools Campaign” and:

“The Omega Oils used in the Durham Schools Trial”.

Indeed, the line

“Omega-3 fish oils including Eye Q Proven in the Durham Schools Trial”

turns up on Google whenever your search lights upon “equazen.com”.

In other words – it’s a very small fishy old fish-oil world.

Or… evidence, once again, that everything Evil Big Pharma can do – e.g. run “vanity PR” meetings with hand-picked speakers, all designed to act as a surreptitious plug for the company’s drug(s) and message(s) - “Big Quacka” (“Big [Fish] Oil”...?) can, and does, do as well.

There will, of course, be some real scientists speaking at the FFTB meeting – for instance Dr Joe Hibbeln of the US National Institutes of Health. No-one is saying there shouldn’t be fish-oil research. What scientists and skeptics are saying is that there should be good research, done properly, so that we can get some real idea whether fish oils are any good for anything.

Which brings me to my Ph.D. transfer report.

The thesis concerns two things – a smallish human study on the use of fish-oils to reduce cardiac arrhythmias after surgery, and a feeding study in rats to see whether fish oils alter cardiac cell electrical parameters.

This human study, the Ph.D. student told me, was to repeat one that had been done in another country that had shown apparent arrhythmia-reducing effects of the fish oil. He was repeating the study, he said, to check if the effect was real, to check if the effect was as big as the other workers had reported, and to look at whether any clues could be got as to the basis of any effect. This last bit would be done by making sophisticated measurements on ion channels and hormone receptors in small samples of tissue that are routinely taken from the heart during surgery.

As we were discussing the work, I asked the student (who is actually a Cardiology Registrar – a doctor training to become a consultant - taking some years out to do a Ph.D.) about the blinding in the clinical study. The study was double blind, he explained. The oil was given as a capsule, containing either fish oil or olive oil. The patients were asked to swallow it whole, so that they got no taste of the oil in the mouth. As the primary experimenter, he would not know who was in which patient group – who got fish oil and who didn’t - until the study ended after about three years. We talked for a bit about whether there was any way the patients might work out which group they were in (“fishy burps”, for instance – nice), and other issues of the experimental design.

The rat study, too, has the main experimenter (our cardiologist again) blinded as to whether the rat whose cells he is studying had been on the fish oil-supplemented diet, or on a “placebo oil”. Once again, he will not know until the study finishes which animal was which.

Now, these designs are not absolutely perfect, but what they testify to is the desire of scientists to get the answer as free as possible from “confounding effects”. These include “expectation effects” – the tendency of experimenters to see a result when one isn’t there, because they want there to be a positive outcome from the study.

Note, also, the repeating of the earlier clinical study. When something potentially interesting shows up in the scientific / medical literature, the first thing people want to know is - is it real?. So it will get repeated by other investigators in other labs, on other patient populations, in slightly different ways, and so on. It will be confirmed, or sometimes disproved.

Small clinical studies, though, can only tell you so much. They need to be tested on a larger scale. So the next step, if something looks promising in several small trials, will typically be a much bigger study, usually on multiple sites, to look at whether the possible therapy holds up in a bigger patient group, perhaps with more diverse characteristics (age, extent of any disease, diet and so on). Any such bigger study will have to go through extremely extensive ethical approval (is the study and what it asks patients to do justified on the grounds of the benefit likely to be derived? Is it safe?). The big study will also have to have as good a blinding procedure as can be devised, and so on, and so on.

Slow and a bit plodding, perhaps, but all exemplifying the desire to find out the truth about whether the stuff really works. And reflecting, as ever, the desire not to fool oneself:

"The first principle [of scientific integrity] is that you must not fool yourself - and you are the easiest person to fool" - Richard P Feynman in his lecture on Cargo Cult Science

And if we are ever going to get real answers on fish oils, that is the kind of work we need. Proper study design; proper blinding; proper data analysis; professional investigators.

In contrast, what we don’t need is PR-over-spun garbage, designed to polish up peoples’ and companies’ public images but devoid of any scientific usefulness whatsoever.

Ben Goldacre is continuing to campaign, via his Guardian column and blog, for journalists who write about science and health stories to take the fairly elementary steps to be able to spot the difference.

Let’s just hope his message is getting through.

[BPSDB]

Now, for the sake of argument - or rather actual facts - let's also say that 2,168 of your subjects drop out of your trial. And let's then say that you don't include them in your results. And that of the 832 remaining kids, you only match 629 of them to children who didn't participate in the trial (and thus didn't take the fish oil) to see if they performed better.

Recap: No control. No double blind. No IRB. 60+% of subjects not reported in the results. Comparison group found after the trial had run.

Yes: you are Durham City Council in the UK and that all of the above actually happened this past year and you are guilty of perpetrating  what Ben Goldacre calls 'possibly the greatest example of scientific incompetence documented from a local authority'.

All of which makes me think: is this just an example of municipal incompetence, or is it evidence of a more widespread ignorance about how experimentation can help us construct generalisable knowledge?

You may recall that Durham County Council ran a trial that was not a trial that was intended to boost GCSE scores but not come to any conclusions about the validity of using fish oil capsules to improve academic performance. They have now published their conclusions - based on scrapping their original method of measuring the effect and replacing it with another one based on selected pairs of pupils (I believe this is what is known as "cherry-picking" data).

I am not going to go into any detail on them on this blog because Ben Goldacre has already thoroughly fisked their press release here.

They are not being let off the hook locally either. Paul Thomson, a former Durham headteacher, has been pursuing this matter through the local press, letters to his MP and questions to council members.

He has recently submiited a freedom of information request for:-

1. David Ford's fish oil study plan

2. All e-mails to participating schools (on the DCC extranet)

3. All correspondence between DCC officers and Equazen

4. All minutes and briefing papers from any meetings of members on this subject.

 I hope Mr Thomson starts a blog dedicated to his campaign. I think it would be excellent reading.

First, as we are all aware, there are many people on the 'net who have a rather loose grasp of reality (9/11 Truthers spring to mind here). Their arguments need to be countered but if you attract their ire you really do not want them knowing who you are.

Second, some bloggers make use of anonymity to blow the whistle on malpractice and corruption. Leaving themselves open to retribution could make people less inclined to speak out. Obviously, this could not possibly be the intention of the European Parliament but the consequence is there nevertheless.

Third, many bloggers (including myself) must avoid giving the impression that they speak for their employer. Hiding ones identity achieves this.

Fourth, Mikko appears to be under the impression thast one must know the identity of bloggers in order to evaluate what they say. This is the sort of sloppy thinking that Ben Goldacre criticizes in "Bad Science". Surely, it is what is said that is important, not who says it? Would my posts on education in Britain become any more (or less) true if you knew my real name and where I work?

The way to decide whether bloggers are worth reading is to note what evidence they provide to back up their assertions and whether or not they link to original material so that you can check the facts for yourself.

Dear x,

I wondered if you would like to comment on the actions of Matthias Rath in South Africa? I would say that Rath's actions in recommending his vitamin pills over antiretrovirals were not just irresponsible but dangerous. I think this is too important to ignore and actions like Rath's should be challenged by responsible members of the industry he works within.

Regards,
x.

and:

Dear x,
 
As EHPM represent a number of trade organisations such as CRN and HFMA, I wondered if your organisation would like to comment on the actions of Matthias Rath in South Africa? As far as I can tell, Rath's actions in recommending his vitamin pills over antiretrovirals were not just irresponsible but highly dangerous and led (directly or indirectly) to an increase in the number of deaths there from HIV/AIDS. I think this is too important for organisations such as yours to ignore and actions like Rath's should be challenged by responsible members of the industry he works within.
 
Kind regards,
x.

The emails to Holford and EHPM went out on Monday evening. I'm writing this on Thursday afternoon and... I've heard nothing. The bottom line is this: No-one in the $50bn food supplements industry gives a fuck about Matthias Rath telling people to quit their antiretroviral medication. No-one in the $50bn food supplements industry thinks they need to tell us whether they approve of heavy-handed legalistic tactics to silence criticism. No-one in the $50bn food supplements industry is willing to countenance critical apprasial of their work. No-one in the $50bn food supplements industry is capable of self-regulation.

“The term [RDA] recognises that particular groups of individuals (E.g. infants and those over 60) have different needs and for each group, the intention was to be sufficiently generous to encompass the presumed (but unmeasured) variability in requirement among people. This meant that the value was usually set deliberately high” [Derek Shrimpton]

Those setting RDAs have recognised that we are all individuals, with nutrient requirements that vary. They set the RDAs deliberately high in order to compensate for this variation in the amounts of nutrients require. Given that RDAs are usually set deliberately high it’s actually more likely that they are over and above our needs rather than being 'sub-optimum'. But that won't be enough to reassure some people - they will still worry about the low levels of vitamins they assume they are consuming. Or, perhaps, they may be worried about the perceived low intake of vitamins and minerals they are burdening their children with due to their failure to buy supplements. Here's some reassurance for parents: the average child gets the recommended level of most vitamins and minerals. Don't believe me? It's been reported that: "the National Diet and Nutrition Survey found that the average child consumed levels of vitamins and most minerals that met recommendations, and in many cases, comfortably exceeded them. These conclusions were based on records from 7-day weighed food diaries and were confirmed by biochemical measurements of blood samples" [I think this is the study: doi: 10.1017/S0007114508981484, and here's a linky]

This story was linked to on the Bad Science miniblog, under the heading "Here's something you won't read in the papers". To them, it would only be a story if the survey had shocking findings about the terrible state of our children's health and all the horrible deficiency diseases they were at risk from. Good news like this does not sell papers. Or vitamin pills, come to that.

I remember laughing at my mother when she stated that she thought of studying naturopathy after a naturopath had cured her of the hand dermatitisthat had plagued her for decades. This was no mean feat. This dermatitis so severe that she would often scald her red raw hands in hot water just to relieve the maddening itch and pain for those glorious few seconds before the burning set in. But what was my arrogant teenage riposte to her revelation? "Why don't you go study real medicine?". Thankfully I grew out of my malapert adolescence but it wasn't until an acupuncturist prevented me from requiring a spinal fusion due to a work injury that I finally came around.

Skepticism comes naturally to me. I am after all a bona fide hick and don't have time for much of what I like to call the wank factor that abounds in complementary medicine. My grandmother and grandfather were buffalo hunters, of all things, and my mother grew up just outside what is now Kakadu National Park. I still remember going to high school every morning smelling like smoke from the fire we used to heat the water for our outdoor shower. I guess what I'm trying to say is that the pragmatism of rural Australia has rubbed off on me more than a little. This was further compounded when I trundled off to do a Science degree at Griffith University (though I must admit I was a much better teenager than I was a student during this time and embarked on several tangents in the course of these studies). I later went on to work in an operating theatre as an assistant nurse for six years whilst I was studying naturopathy. I like to think I am well-versed in scientific skepticism. However, the reason I am passionate about naturopathy is because it works. And really that's all that matters. Just ask any rural person.

An interesting tidbit of information surrounding CAM use is that people in rural areas use complementary medicines more than people in urban areas. Don't get me wrong, if you start talking about Qi, Prana or centering your core you are going to alienate yourself from them. But people in rural areas will gravitate to whatever works - usually on the advice of someone they trust - no matter how flipped out it sounds. This permeates through all aspects of rural life. I remember when the creek behind our house stopped flowing for the first time in living memory (it incidentally didn't start again for another five years and hasn't been flowing regulalry since - there's one for the climate change skeptics). The decision was made that drawing our water out of the stagnant pools that remained was not viable and that we would need to sink a bore. As everyone in the area did we employed the services of the local water dowser- Ted - to find our water for us. For the princely sum of $50 and a couple of tallies of beer he found us three good sites and furnished us with some pumpkins from his garden. though not one reference to earth mother, ley lines or Patchouli to be found. The engineers that come to dig the bore laughed and sunk sites of their own. They stopped laughing when they had to fill them in and go to Ted's sites instead.

I personally think that sometimes we can over-intellectualise complementary medicine. But the truth is that it is many things to many people. Rural people may not appreciate the esoteric side of therapies but they will use them nontheless. They will embrace the principles holism if for god sakes you just don't call it that. Sometimes it's the added wank factor that can get everyone off side. My aim is to cut through the wank factor and get through to the guts of what makes complementary medicine tick. Don't get me wrong, I enjoy the esoteric side of these therapies too, I just want to make complementary medicine more accessible for those who don't.

The aim of this site is to try and restore some of this common sense to discussion surrounding complementary medicine. Irrational responses fly thick and fast on both sides of the fence. Those maintaining they are defending scientific credibility in their arguments against complementary medicine often do little to suggest credibility and are very rarely scientific in their approach. Likewise some of the complementary medicines pushed down our throats are simply snake oil manufactured by those with interests other than the health of their customers.

Zealots can and do exist on both side. Hopefully I will not sound like one of them. The aim of this little blog is to finally add what I hope is a rational voice to this debate. No bollocks, no wank factor just a rational and scientific approach to what can be a valuable healthcare option.

Please feel free to drop me a line via my website if you'd like to suggest a topic or get in touch. I hope you enjoy the blog.

Woo is All Around (The Alternative / Placebo Therapist’s song)

(tune: ”Love is All Around” by The Troggs)

I feel it in my fingers

I feel it in my toes

The Force is all around us

And so my income grows

It’s written on my website

It’s ancient healing lore

So if you all believe it

You know I can help you, I most certainly will

I’m not a harassed doctor or a Pharma Shill

There’s no beginning,
There’ll be no treatment end
’cause on your naivety I can surely depend

------------------------------------------------

You’ve told me all your problems

And I’ve looked most concerned

Now I’ll dish out some Placebo

Whatever New Age crap I’ve learned

There’s probably nothing wrong with you

(Which won’t reduce my fee)

But if you should feel better
I’ll say that it was me (oh yes I will)

------------------------------------------------

(You know) I look sympathetic, and I always will,
It works most excellently

‘Til you’ve paid off the bill
There’s no beginning,
And there’ll be no end
’Cause on your neediness I’ll happily depend

-------------------------------------------------

I wouldn’t call it lying

If I tell you it’s all real

Because if both of us believe it

All that matters is what we feel

It’s what the punters want, mate

(And) It’s all over the press

And wouldn’t it be better

If you got it on the NHS (oh yes it would)

------------------------------------------------

(You know) I look sympathetic, and I always will,
It works most excellently

‘Til you’ve paid off the bill
There’s no beginning,
There’ll be no end
’Cause on your cheques I’ve come to depend

-------------------------------------------------

I feel it in my fingers
I feel it in my toes
There's one born every minute
And so my income grows

(repeat last line to fade)

--------------------------------------------------

Alternatively:

Repeat entire song ad infinitum.

- Or until the money runs out.

[BPSDB]

]]> http://jdc325.wordpress.com/?p=540 Tue, 23 Sep 2008 16:12:43 +0000 jdc325 http://jdc325.de.wordpress.com/2008/09/23/polymva-website-encouraging-patients-to-ignore-their-oncologist/ The PolyMVA survivors website is advising cancer patients to ignore their oncologist, to refuse chemotherapy and/or radiotherapy and to choose an alternative cancer treatment instead. I do hope this PolyMVA group are basing their approach on the best possible evidence. Let's see... Apparently, "POLY MVA has been scientifically designed to CORRECT DNA BREAKDOWNS and return the damaged cell to normal cellular function". Oh good - at least it's been scientifically designed. Designed by whom though? "This product was developed by Dr. Merrill Garnett, a highly regarded biochemist, who has been conducting research since 1959 with the objective of creating an electronic frequency specificity to restore the DNA exchange energy pathway". Excellent. Who is Merrill Garnett? "Dr. Garnett is a former naval dentist who took up medical research in 1959". And what, precisely, is a 'DNA exchange energy pathway'? Well, it is something that gives you two hits on google* - one is the PolyMVA survivors website and one is a PDF written by someone called Joe Demers who "would like to share with you an alternative cancer treatment protocol". In other words, the phrase has been made up by the inventor of a dietary supplement. It is, in all probability, complete bollocks - designed to give the appearance of scienciness and to baffle the layperson.

There is a section of this page: cancer decisions, that looks at the evidence for PolyMVA and is titled "Where's the Proof?" - the evidence is very thin indeed. Quite apart from the fact that what evidence is available is being misrepresented by the PolyMVA survivors site. A talk at a symposium is described as a "clinical study" by the PolyMVA survivors site and they rely heavily on animal data - from a study that they fail to cite, with a nameless author, that does not appear in any Pubmed-indexed journal (nor does it appear anywhere else, except for this single webpage - according to the author of the cancer decisions site).

It strikes me that the PolyMVA website is run along the same lines as Matthias Rath's South African AIDS business.

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A bit more linkage: polymvasurvivors - PDF'd for posterity, because this is the bit that most pissed me off. Website: http://www.polymvasurvivors.com/. More on Poly MVA from the American Cancer Society. My dodgy-supplements-for-serious-diseases post; the original cancer drugs post. The online reporting form that I am (over-)using to take on PolyMVA.

*Very nearly a googlewhack - 2 hits for bullshitting about DNA energy.

Edited to Add: Google's motto is "Don't be Evil" but they seem to be having trouble living up to that ideal. Jon at Holford Watch has posted on Cancer Quackery in Google ads.

We've been here before, and fairly recently too. The Reform paper was pretty rubbish, has OFSTED done any better?

Not really. The Guardian article linked to above quotes OFSTED as saying that nearly half of school maths lessons are "not good enough" with 10% being inadequate and "45% being satisfactory or below". To me, satisfactory means good enough but could do better. In the bizarre use of language on Planet OFSTED, satisfactory means unsatsfactory.

The situation is not good but nowhere near as bad as the unsubstantiated "narly half are not good enough" claim implies. Sorry OFSTED; D- for critical thinking. Go to the bottom of the class and write out one thousand times "I must not distort the English language to support my preconceived notions".

Another criticism is that teachers spend to much time drilling pupils to pass exams and not enough time making sure they fully understand mathematical concepts. That strange thudding noise you hear is that of thousands of teachers banging their heads against their desks in frustration.

For crying out loud, is it surprising that this is happening? SATS and GCSE results are used to compile league tables - schools which are low down in the tables are insulted by the press and Government. Parents withdraw their children so the school appears to be failing and merits special attention from OFSTED. Naturally, school managers are going to want their establishments to rise in the league tables so pressure is put on teachers to get better results. Drilling in exam techniques at the expense of education is an inevitable consequence of that - as are revision classes aimed at pupils on significant boundaries such as that between grades D & C at GCSE.

Teachers have been saying this would happen ever since SATS and league tables were introduced. Government Minister after Government Minister has ignored them. If OFSTED are genuinely concerned about standards of teaching and wishing to raise them, perhaps they could focus on central government's obsession with targets and micromanagement and not shoot the messenger.

http://www.badscience.net/2008/09/dont-let-the-facts-spoil-a-good-story/

No further questions, your honour. Ben Goldacre has this one wrapped up.

Given the statement in the first headline (I know it's in single quotation marks, but really - do they honestly think that single quotes will stop someone concluding that it is definitely the case?) and the Daily Telegraph's assertion that regular users of paracetamol are nearly three times more likely to suffer from asthma, you might be forgiven for assuming that this is a done deal. After a quick glance at the stories, I took a look at the NHS "Behind the Headlines" take on the coverage of this. The Daily Telegraph's and the Daily Mail's assertions are of particular interest given that Behind The Headlines says this:

The study behind this report is a case-control study and by virtue of its design, it cannot prove causation (that paracetamol increases asthma). It also cannot rule out reverse causation (that asthma causes people to take more painkillers). However, when considered alongside the findings of other studies, these results suggest that there may be an association between use of paracetamol and asthma that needs further exploration. This is not a new concern, and researchers have been investigating this for some time.

So while the media reports are implying that causation has been shown, it appears that the Behind The Headlines team (BTH) tell us it would be impossible to do so in a study of this type. I don't know why the media seem to feel unable to use the phrase "x is associated with y" rather than the inaccurate "x causes y". Also of interest is the last sentence of the quoted section above - this isn't new. It's something that has been looked into for some time now and still needs further investigation, but you wouldn't know it from the media coverage. I tink the Daily Mail were aware it wasn't new though.

Weirdly, when I looked through google's news search the Mail's report stated that the study was published today in the Lancet. The site had the story down as being updated at 8:21 AM on 19th September 2008, so I assumed the Mail story related to a paper published today in the Lancet. The only thing is, I couldn't find a Lancet paper on Pubmed relating to asthma and paracetamol from as recently as 2008 - I got a single hit from 2000. BTH has the paper down as being from Eur Respir J 2008, doi:10.1183/09031936.00039208. I think that perhaps what happened was that the Mail updated an old story because they had a new story about paracetamol and asthma. The Mail report that showed up on google news is here. The Mail report on the current study is actually here. Confused? I was. Maybe they should have an 'originally published' tag on stories they update, if nothing else it would at least save morons like me from ending up in a state of confusion over what is today's asthma news and what was 2000's asthma news. Attempting to understand science stories in the press can be a real pain in the arse sometimes.

Also of interest: The news reports stated that "Paracetamol tripled the risk of asthma". Given that I have no idea what the chances were of someone having asthma if they haven't taken paracetamol, I have no idea what it might mean for their chances of having asthma to triple if they do take paracetamol. This is something that Ben Goldacre has raised in his book Bad Science [it's in chapter 13, if you're reaching for your copy as you read this]. Newspapers tend to give the scariest/most impressive figures (for example, the relative risk instead of the absolute risk - see here for more on relative v absolute risk). In the case of the media reporting of a Mischief PR press release, there was a statement that there had been a 39% increase in household reports of wasps following introduction of fortnightly bin collections. Perhaps the press should have found the time/space to inform us of the "natural frequency" of asthma attacks, which might mean more to me than being told there is a "tripling of the risk". Bandolier briefly explains natural frequencies here. Their explanation concludes with this: "Natural frequencies help people to make sound conclusions, whereas conditional probabilities tend to cloud minds".

Links: Click here for the abstract of the paper.