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Quacks & Pseudoscience

Need a little help if anyone here has the expertise.

One of our employees went home sick yesterday with a bad back. I've received an email from her today telling me that she's seeing an acupuncturist and should therefore be better soon and able to return to work.

This employee is fairly vital to the throughput of our business and cover is stretched in that department at the best of times. In other words, we cannot afford to continue without her presence over any kind of medium to long term period.

So my question is; to what extent is one's employee required to seek proper, recognised medical attention, and to what extent am I as an employer able to insist she seeks it?

To take us back where we started

Acupuncture for low back pain no longer recommended for NHS patients

https://www.theguardian.com/science...k-pain-no-longer-recommended-for-nhs-patients
 
I only believe in medical benefits that are proven to work.

Sorry if I am reading this out of context Scara...but this is one of the few things that I give a brick about to actually attempt at formulating a cogent but succinct reply...of which i will surely fail miserably. herein lies the problem with the medical profession. dogma masquerading as science and "proven to work" by drug companies that ultimately have an overwhelming profit motive.

oh..wtf...i failed...
 
I discovered this blog recently and it is great. This post on regression to mean is great

http://angry-chef.com/blog/the-unstoppable-decline-of-football-in-the-east-midlands

his one on the living evil that is Hemsley and Hemsley is worth checking out too

Good read - so true of football - I always think changes in form (e.g. dip in Harry's final season) are just regression to mean, snowballed by the psychological reaction to 1 or 2 changes in result. And yet the 24/7 nature of football analysis now means everyone's trying to attribute it to tactical changes or specific psychological changes (e.g. Harry not getting England job)

In terms of health and medicine, I think people need to be less scathing of following treatments that aren't evidence-backed - I've had chronic health problem for 7 years and only got diagnosis 6 months ago (when I suggested diagnostic tests to my GP from my own research) - I tried all sorts of alternative stuff in the meantime, because all health professionals I saw were clueless and dismissive. When robust evidence doesn't yet have all the answers, I think it's sensible (or at least very understandable) to at least try unproven things if they have some sort of convincing sounding theory and/or anecdotal evidence.
 
Sorry if I am reading this out of context Scara...but this is one of the few things that I give a brick about to actually attempt at formulating a cogent but succinct reply...of which i will surely fail miserably. herein lies the problem with the medical profession. dogma masquerading as science and "proven to work" by drug companies that ultimately have an overwhelming profit motive.

oh..wtf...i failed...

There are important problems to be solved in the medical industry. Funding of research is one such issue. Very little of what is being presented by the alternative medicine side of this is helpful in this regard.

Pharmaceutical companies overselling the evidence for their products is another issue. Compared to the alternative industry that sells products proven not to work though...

In terms of health and medicine, I think people need to be less scathing of following treatments that aren't evidence-backed - I've had chronic health problem for 7 years and only got diagnosis 6 months ago (when I suggested diagnostic tests to my GP from my own research) - I tried all sorts of alternative stuff in the meantime, because all health professionals I saw were clueless and dismissive. When robust evidence doesn't yet have all the answers, I think it's sensible (or at least very understandable) to at least try unproven things if they have some sort of convincing sounding theory and/or anecdotal evidence.

About some things one is given no choice, but to be scathing. The cost in terms of money and human suffering resulting from some alternative medicine treatments is staggering. Treatments we know are ineffective at best and downright harmful at worst.

That's not to say one shouldn't question an individual doctor or a pharma company. That's not to say one shouldn't do research and ask for second opinions.

The problem with those selling treatments that are lacking in evidence is that they all too often either want to confuse the issue of evidence or do not take steps towards actually testing the efficacy of what they're selling. Quacks are impossible to separate from naive believers in most cases, at least from the outside. But when they're peddling snake oil to some of the most vulnerable people in our society what other response than scathing is appropriate?

Lets have a serious conversation about robust evidence for various treatments at a societal level... Then we can talk about all the areas where the evidence is insufficient and where currently "alternative" methods might be appropriate.
 
There are important problems to be solved in the medical industry. Funding of research is one such issue. Very little of what is being presented by the alternative medicine side of this is helpful in this regard.

Pharmaceutical companies overselling the evidence for their products is another issue. Compared to the alternative industry that sells products proven not to work though...



About some things one is given no choice, but to be scathing. The cost in terms of money and human suffering resulting from some alternative medicine treatments is staggering. Treatments we know are ineffective at best and downright harmful at worst.

That's not to say one shouldn't question an individual doctor or a pharma company. That's not to say one shouldn't do research and ask for second opinions.

The problem with those selling treatments that are lacking in evidence is that they all too often either want to confuse the issue of evidence or do not take steps towards actually testing the efficacy of what they're selling. Quacks are impossible to separate from naive believers in most cases, at least from the outside. But when they're peddling snake oil to some of the most vulnerable people in our society what other response than scathing is appropriate?

Lets have a serious conversation about robust evidence for various treatments at a societal level... Then we can talk about all the areas where the evidence is insufficient and where currently "alternative" methods might be appropriate.

If they're knowingly prescribing something that doesn't work then being scathing is appropriate. If they are prescribing something they believe could work, and there are no evidence-backed proven alternatives, then I think being scathing might not be appropriate.

I do confess though that I don't know why there aren't more RCTs done on alternative treatments - I can imagine it might be the case that no one who would want to has the money to carry them out. Whereas if it's purely down to lack of will, I agree that those who could but don't fund RCTs deserve a scathing response.

However, I agree that actually the most sensible and productive response is what you end with - a serious conversation about evidence, recognising that most (or at least a lot) of medical practitioners, whether alternative or mainstream, have the same goal - helping people get back to health.

And in any case I've drifted from my main point, which was about patients not being treated with disdain for using alternative medicine - but maybe that was just a straw man argument on my part.
 
If they're knowingly prescribing something that doesn't work then being scathing is appropriate. If they are prescribing something they believe could work, and there are no evidence-backed proven alternatives, then I think being scathing might not be appropriate.
If such an alternative worked then there would be more than anecdotal evidence to show for it. There are plenty of mechanisms for getting real doctors and/or scientists to peer review your ideas.

Selling your solution directly to the afflicted is nothing more than taking advantage of the desperate.

I do confess though that I don't know why there aren't more RCTs done on alternative treatments - I can imagine it might be the case that no one who would want to has the money to carry them out. Whereas if it's purely down to lack of will, I agree that those who could but don't fund RCTs deserve a scathing response.
RCTs are done all the time on alternative "medicine" its proponents just dismiss the results as they repeatedly prove their products to be no more than snake oil.

No seller of alternative treatments will pay for RCTs because they know what the result will be.

However, I agree that actually the most sensible and productive response is what you end with - a serious conversation about evidence, recognising that most (or at least a lot) of medical practitioners, whether alternative or mainstream, have the same goal - helping people get back to health.
Evidence would suggest otherwise. The fact that alternative 'medicine' providers continually avoid/ignore evidence suggests to me that it's purely profit driven.

And in any case I've drifted from my main point, which was about patients not being treated with disdain for using alternative medicine - but maybe that was just a straw man argument on my part.
I agree that patients shouldn't always be treated with disdain - it depends on the level of stupidity being displayed.

In the case of homeopathy, for example, there's so much readily available evidence that anyone using it deserves my ridicule.

The trouble is, it's very difficult for a layman to detect the difference between medicine and flimflam. The flimflam pushers intentionally use sciencey words and most laymen wouldn't know how to tell the difference. It can take hours of research just to prove a single point - flimflam merchants will usually make a dozen claims at once so you just don't have time to disprove them all.
 
There are important problems to be solved in the medical industry. Funding of research is one such issue. Very little of what is being presented by the alternative medicine side of this is helpful in this regard.

Pharmaceutical companies overselling the evidence for their products is another issue. Compared to the alternative industry that sells products proven not to work though...

the issues are intrinsically linked in a feedback loop.

John Ioannidis is a Professor of Medicine and of Health Research and Policy at Stanford University School of Medicine and a Professor of Statistics at Stanford University School of Humanities and Sciences. He has a medical background AND is a statistical expert. He has done a tremendous amount of research in this area.

He even published a paper entitled "Why Most Published Research Findings Are False". Watch his dry but superb presentation on youtube discussing bias in current scientific research.

Current Editor-in-Chief of The Lancet Dr.Richard Horton made this statement:

The case against science is straightforward: much of the scientific literature, perhaps half, may simply be untrue.
Afflicted by studies with small sample sizes, tiny effects,invalid exploratory analyses, and flagrant conflicts
of interest, together with an obsession for pursuing fashionable trends of dubious importance, science has
taken a turn towards darkness. As one participant put it, “poor methods get results”.

Dr. Marcia Angell, a physician and longtime Editor in Chief of the New England Medical Journal (NEMJ) said this:

“It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine

Neuroscientist Dr.David Diamond has two devastating critiques of the widespread use of statins in treatment of cholesterol & heart disease on youtube.

Author Gary Taubes's bestseller "Good Calories,Bad Calories" is a scathing assessment of current medical/dietary guidelines in the face of a global epidemic of type 2 diabetes, metabolic syndrome & obesity.

Even engineers are getting in on the act with people like Ivor Cummins and his analysis of sugar, cholesterol & heart disease and Vitamin D. His interview of 95 year old pathologist & Professor of Nuclear Science Dr.Joseph Kraft is a revelation despite being a culmination of decades of work.

Watch Micheal Holick MD,PHD (Boston University School of Medicine) or Prof.Robert Heaney MD,PhD with more than 60 years of collective scientific wisdom advocating Vitamin D. The latter and his dry but eloquent case for why Randomised Control Trials are not scientifically optimal to providing conclusions when it comes to investigation of essential vitamins and minerals in human physiology as opposed to drug outcomes.

Or Pediatric Endocrinologist Robert Lustig from UCSF and his many presentations on sugar, processed foods and regulation in the face of toxicity.

Practicing low carb physicians like Dr.Eric Westman at Duke (with a six month waiting list) or Dr.Jason Fung, a Canadian nephrologist that advocates "Intermittent Fasting" as a solution to Type 2 Diabetes.

Prof.Richard Feinman (PhD Cellular Biology, New York) and about a dozen colleagues from all over the world published a well researched paper on dietary intervention in type 2 diabetes instead of medications in first line treatment, contrary to medical/nutritional guidelines in all developed countries.

Or Dr.Richard Bernstein, a 77 year old type 1 diabetic who was an engineer who then went to Medical School in order to get the medical world to listen to him and allow him to publish his findings on basal/bolus insulin. Dr.Bernstein knew 3 past presidents of the American Diabetes Association and has stated on record that the ADA refused to advocate his views for fear of loss of business and litigation. Ironically, basal/bolus or "quackery" in his time has become standard medical practise today.

Dr.Mark Hyman MD who for decades advocated root cause solutions in medicine and was branded under the "alternative" curse. After years of training thousands of disgruntled doctors who realised conventional medicine was all about treatment of symptoms by dispensing drugs, was finally rewarded in 2014 by the world renowned Cleveland Clinic that decided to try to integrate functional medicine into their current practices.

David Ludwig (MD, PhD, Harvard) or Chris Gardner (PhD Nutrition & Prof Medicine, Stanford University). Both published highly controversial papers on dietary guidelines that contravene medical/nutritional mainstream.

I could go on ad infinitum.

My litany is in service of two points.

Firstly, all the aforementioned experts merely constitute a small sampling of a growing movement that is still classified as quackery and not part of "the mainstream medical community".

Secondly, most modern chronic diseases are now being linked to inflammation and metabolic/hormonal dysregulation whether it be Hyperinsulinemia, Insulin Resistance or Non-Alcoholic Fatty Liver Disease and thus adopting the approaches advocated by these researchers & physicians is central to arresting the problems of cardiovascular disease, cancer and neuro-degenerative diseases such as Alzheimers.

Herein lies the crux. Most of these approaches mean an end to the proliferation of drug therapies, treatment of symptoms and unrealistic dispensing guidelines, occasionally bordering on malfeasance....and consequently, billions in loss profits. And returning to my feedback loop in first sentence, the drug companies use the same arguments. Our research is overwhelming and correct. Almost no research to support your thesis. Except that the research is not overwhelming & not correct.

I encourage you to read the publications and watch the numerous presentations by a litany of medical professionals questioning the validity of the current treatment methodologies.

Interaction of drugs is another area that I now find interesting. For all the gold standard RCTs being conducted, there are no multi drug trials being conducted due to the infinite number of permutations so welcome to the uncontrolled drug infested trial known as the human condition. that is for another day.
 
@spasm I agree fully that there are several issues with the way medical research is being funded and conducted that needs fixing. Though I must say the current cost and time it takes for a drug to be developed and come to market makes me somewhat doubtful that introducing more delays and costs into the process will be beneficial. Serious discussions about how modern drug development should happen should take place, in the end politicians decide these things. There needs to be oversight, there needs to be independent researchers and both of those need a lot of funding.

Nothing in that criticism makes a valid argument for the alternative medicine argument. The "evidence" presented by the alternative side makes what the pharma companies present for new drugs look outright solid. And the valid criticism of "big pharma" isn't coming from the alternative medicine side, it's coming from actual scientists and others within the field.

I'll put this forward as our canary in the mine on quacks and pseudoscience. As long as homeopathy is a huge industry we're most certainly failing. It's the lowest bar possible, there's no plausible way for homeopathy to work and significant research shows that it's not working. Yet the industry still prevails and to an extent thrives.
 
I think this is probably the right place for this controversy.

I have just seen the film Vaxxed which is about a cover-up by American Government of the extent of vaccine damage.

In a World where America is moving to obligatory vaccination and the NHS wants the same, it is relevant contribution to the debate.

The key points in the films are this.

1. Millions of people in America claim that their kids have been damaged by vaccination. Pharma dismiss this as coincidence.
2. American Government has paid out $3 billion in compensation for safe vaccines and this is only the tip of the iceberg of claims
3. Autism rates are so high now that if the rate continues within 20 years 1 in 2 boys and 1 in 4 of all children in America will be on the spectrum
4. Vaccines are not a drug so do not have to comply with drug testing regulations. There has never been a vaxxed / non vaxxed study as if would be "unethical". All studies both pro and anti vaccination up to this point have been observational.
5. Pharma and the American Government cover up data on vaccine damage. A whistleblower provide data on this. For instance black kids are four times more likely to be vaccine damaged.
6. Pharma have a track record of lying about the safety of vaccines. They told us MMR1 was "safe" when they knew it was not yet they sold it to Brazil for their national vaccination day with disastrous consequences.
7. Phama's strategy for managing the consequences of vaccine damage is to pay compensation - a cost of doing business. However, the autism situation is so out of control that they can not keep a lid on it. However, the American government has indemnified them so they can not be sued.

Worth seeing before you vaccinate your kid.
 
I think this is probably the right place for this controversy.

I have just seen the film Vaxxed which is about a cover-up by American Government of the extent of vaccine damage.

In a World where America is moving to obligatory vaccination and the NHS wants the same, it is relevant contribution to the debate.

The key points in the films are this.

1. Millions of people in America claim that their kids have been damaged by vaccination. Pharma dismiss this as coincidence.
2. American Government has paid out $3 billion in compensation for safe vaccines and this is only the tip of the iceberg of claims
3. Autism rates are so high now that if the rate continues within 20 years 1 in 2 boys and 1 in 4 of all children in America will be on the spectrum
4. Vaccines are not a drug so do not have to comply with drug testing regulations. There has never been a vaxxed / non vaxxed study as if would be "unethical". All studies both pro and anti vaccination up to this point have been observational.
5. Pharma and the American Government cover up data on vaccine damage. A whistleblower provide data on this. For instance black kids are four times more likely to be vaccine damaged.
6. Pharma have a track record of lying about the safety of vaccines. They told us MMR1 was "safe" when they knew it was not yet they sold it to Brazil for their national vaccination day with disastrous consequences.
7. Phama's strategy for managing the consequences of vaccine damage is to pay compensation - a cost of doing business. However, the autism situation is so out of control that they can not keep a lid on it. However, the American government has indemnified them so they can not be sued.

Worth seeing before you vaccinate your kid.
I'll answer this properly in due course when I have some more spare time.

But in the interests of everyone's safety, this film is pure flimflam. Worse than flimflam, it's dangerous lunacy.

Do not risk your child's and everyone else's lives by skipping vaccines - there is no science whatsoever behind this film.

Sent from my SM-G925F using glory-glory.co.uk mobile app
 
Written and directed by Andrew Wakefield. Yes, that one. Guess he has to find something to do these days.
 
I'll answer this properly in due course when I have some more spare time.

But in the interests of everyone's safety, this film is pure hogwash. Worse than hogwash, it's dangerous lunacy.

Do not risk your child's and everyone else's lives by skipping vaccines - there is no science whatsoever behind this film.

Sent from my SM-G925F using glory-glory.co.uk mobile app

You have seen it?
 
There are more kids on the spectrum because the spectrum has been widened.
OK. You think this adequately explains the increase from 1 in 10,000 in 1970 to 1 in 50 now? Also I pretty sure it is a statistians job to make allowances for this type of variance. It seems that the incidence of autism has increased since 1970. And continues to do so
 
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