WHAT?! — What’s the Harm?!

Quantifying the damage.

What’sTheHarm is designed to make a point about the dangers of not thinking critically. Namely that you can easily be injured or killed by neglecting this important skill.  – At last glance, the casualties, injuries, and cost of not thinking critically came to:

368,379 people killed, 306,096 injured and over $2,815,931,000 in economic damages

The website is operated by Tim Farley, who also does a segment on the Skepticality Podcast on History relevant to skeptics.

It’s a number that can only get bigger, and is far from exhaustive – I would suggest that it barely scratches the surface. Check out the topics available:

Medical

Acupuncture
Alphabiotics
Alternative dentistry
Alternative medicine
Applied kinesiology
Autism denial
Ayurvedic medicine
Chelation therapy
Chiropractic
Colloidal silver
Colon cleansing
Cranio-sacral therapy
Cupping
Detoxification
Ear candling
Energy medicine
Escharotics
Folk remedies
Herbal remedies
HIV/AIDS denial
Holistic medicine
Home childbirth
Homeopathy
Iridology
Naturopathy
Osteopathy
Ozone therapy
Psychic surgery
Vaccine denial
Vitamin megadoses

Supernatural & Paranormal

Astral projection
Curses
Exorcisms
Faith healing
Ghosts
Magick
Psychics
Vampires
Voodoo
Witchcraft

Religion

Breatharianism
Christian Science
Cults
Jehovah’s Witnesses
Religious fundamentalism
Scientology
Transcendental Meditation

Fears

Apocalypse fear
Metal toxicity fear
Satanic ritual abuse
Terrorism fear

Pseudo-Science

Astrology
Attachment therapy
Dowsing
Dream interpretation
Evolution denial
Expert witnesses
Facilitated communication
Feng shui
Hypnosis
Numerology
Reparative therapy
Repressed memory therapy

Misinformation

GPS navigation systems
Internet misinformation

Miscellaneous

Child vegetarianism
Conspiracy theories
Holocaust denial
IRS denial
Moon landing denial
Multi-level marketing
Nigerian emails
Rituals
UFOs

Chiro Survey reveals it’s not all that it’s cracked up to be!

A survey from the Palmer College of Chiropractic reveals some interesting results about Chiropractic and student abilities to understand basic research concepts that provide the foundation of an Evidence-Based practice. The study invited Fourteen institutions (two of which could not provide exact numbers of students) from Australia, Canada, US, Denmark and New Zealand participated, and of those invited over 650 responded.

Research of Relax?
The background of the survey pointed to research demonstrating Chiropractic students received little formal instruction to generate searchable questions, conduct literature searches, critically appraise the literature or apply evidence to patient management.

The survey noted that while vast majority of respondents reported having access to medical/healthcare literature through the internet, only 11% read literature every week; even more striking is that 21% did not read literature at all.

When it came to research evidence being used, 13% said that Research Evidence had LITTLE impact in chiropractic care. Approximately the same number of respondents felt that Evidence-based practice was a “temporary fad”.

Of their facilitators, a fifth felt that their institution did not incorporate research evidence into chiropractic education well. This was reflected in the data Knowledge Question tables that demonstrated:

  • About 60% reported confidence in assessing study design, but 48% failed to evaluate when critical analysis of information is needed.
  • More than 53% believed that randomization in clinical trials was for the purpose of selecting a representative sample of patients for study, rather than obtaining treatment groups with comparable baseline prognoses.
  • Only 27% were able to identify when to use a case-control study.

It should be noted almost ONE-THIRD did not even bother to answer ANY them. .. There were five.

...

Despite students having quite a positive attitude towards EBP, 71% of participants felt they need more training in EBP, and as part of the conclusion the researchers acknowledged that “based on the knowledge questions they may need further training about basic research concepts.”

The Cult of Chiropractic?

It was noted that in the US the promotion of unsupported beliefs and theories may be due to the deficient nature of the curricula, emphasizing “chiropractic philosophy” over research evidence. This has certainly apparent to myself, where I’ve had a number of Chiropractors (and those in training) go on about being “persecuted for their beliefs”, as if “belief” constituted a justification to perform non-evidence-based practice on people who are incorrectly told it is evidence-based.

You’re not serious, are you?

It has in the past been coupled with the notion that they can be likened to Galileo Galilei, the Physicist/ Mathematician/ Philosopher/ Astronomer who was persecuted by the Catholic Church for advocating the hypothesis that Earth revolved around the Sun. This is hardly the same given the evidence that Galileo was able to produce evidence to support his assertions.

News? No, not really.

To those that have been critical of Chiropractic care, these results are not surprising. Medical Professionals and Skeptics (and I mean capital “s” skeptics) alike have been pointing to evidence that this was the case for years, with some being taken to court about their criticisms (eg. Simon Singh) in an effort to silence them.

The best that can come from this is for Chiropractic practitioners to seek out that training, and I don’t mean in some bullshit context about how it “should apply” to Chiropractic way – That’s pandering to pre-scientific chiropractic philosophy.

I mean the proper “standard by which all other therapies are handled” lessons about Evidence-Based practice.

For those thinking about entering Chiropractic, it will make a world of good; non-sense concepts can be “bred” out of the stubborn old guard opening the doors to greater scrutiny than is currently being applied. Those already doing Chiropractic may be open to this, though it may be hard for hardliners like Australia’s own Anti-Vaccination advocate Warren Sipser (You’re welcome for the SEO) to understand basic research concepts, such as.. oh, I don’t know.. the Dunning-Kruger Effect.

The Dunning-What effect?

Its a psychological phenomena – a cognitive bias. Essentially, when the unskilled make mistakes, their incompetence prevents them from acknowledging them.

How is this relevant?

The study discusses the difference between a similar survey of Allied Healthcare Professionals, and the results generated by this survey:

“our chiropractic student respondents had greater confidence in their ability to assess research study design, generalisability, evaluate bias, sample size and statistical tests. However, student responses to very basic critical appraisal concepts revealed low levels of knowledge that did not match confidence levels.”

The study speaks volumes, really.

Props to whomever made the Memes. Quite helpful.

Chiropractic “Doctor” tries to validate their treatment for Autism

Autism is a often claimed by Chiropractic practitioners as something they can treat through spinal manipulations; and while there is no robust evidence for this, nothing stops them from trying to make up conclusions about research papers.

Case in point is below, where an Autism Research who presented a hypothesis caught wind of a Chiropractor using his research to validate his Chiropractic Treatments.

I’m famous. Well, sort of. Earlier this week, one of my colleagues sent me a link to a YouTube video in which chiropractic doctor David Sullivan discusses one of my papers on autism and how it influences his “evidence based practice”.

httpv://www.youtube.com/watch?v=loJP3TFavQA

Our paper was called “The temporal binding deficit hypothesis of autism” and came out in the journal Development and Psychopathology nine years ago (now there’s a scary thought). In it we suggested that autism might be caused, at least in part, by a reduced interaction between different brain regions.

We didn’t show anything; there was no evidence, no data; we had an idea and ran with it. As it happens, there have since been a number of studies suggesting that autistic brains on the whole are less well-connected than your average brain.

Different studies find that different neural pathways are disconnected. Some studies even suggest heightened connectivity. And while there’s lots of evidence for abnormal brain oscillations, look more closely and the actual pattern of abnormality isn’t very consistent. Another big problem is that evidence for abnormal brain connectivity has been found for umpteen other disorders that are quite different to autism. And there’s a fairly compelling counter-argument that anomalous brain connections might be a consequence of autism rather than its cause.

Last time I checked, autism wasn’t considered to be a form of back problem. Sullivan doesn’t provide any evidence that chiropractic is a suitable treatment. He doesn’t explain how it might be beneficial, even in theory. More to the point, he doesn’t elaborate on how the insights gained from our paper are at all relevant to his practice.

From: Cracking the enigma: Autism, temporal-binding, and … Chiropractic

Damage Control: Chiropractic Association of Australia

CAA in Damage Control

The CAA (Chiropractor’s Association of Australia) is the “peak body representing chiropractic” – and has been in Damage Control Mode after a recent article featuring Warren Sipser and his dangerous infant manipulations.

The outdated mentality of Traditional Medicine and Therapies was to “Use it because it seems to work” and was surpassed decades ago by Modern Medicine as critical thinking and statistical analysis has come to the forefront in the investigation of medicine, technology, and the understanding of the world around us.

Widespread acceptance of “therapies” only two centuries ago involved standing in a circle around a tree and being “mesmerized” and sitting around a bathtub full of iron filings to feel better. To their proponents, these “seemed to work”. You may laugh, and rightly so, but this is a result of accepting “Direct Experience” as good evidence. Direct Experiences gives us nothing more than an indicator on which to further investigate critically.

Remembering where we parked the car is “Direct Experience”. This doesn’t prove we parked it where we thought, it only gives us a basis on which we can further investigate. How many times have you forgotten or misremembered where you parked the car?

Direct Experience can be misleading, and Memory is a fallible human function.

It is therefore concerning that in response to customer inquiry, chiropractic practioners are being instructed by the CAA to validate their profession through appeals to tradition, popularity, and introducing safety as a red herring to side-step questions of efficacy – throwbacks to the “use it because it seems to work” age of fallacious reasoning.

The CAA encourages their members to use weasel words such as “regulated” when speaking with customers, as if by virtue of invoking this magical word they are to be accepted as “doing the right thing”, or indeed “have a clue about medicine”. And yet, many of those involved in the running of Chiropractic Associations provide financial support to one of the most dangerous misinformation groups in Australia – The AVN – a group whose work are having real effects on the health and safety of infants, children, and adults alike.

It’s good to see that the CAA coming under the scrutiny it deserves – still far from the level of scrutiny other medical professions are under, but scrutiny none the less.

It seems odd that while the rest of the medical community regularly scrutinises each other (an act that promotes evidence-supported best practice), the CAA is vehemently against such scrutiny of their profession – defending their outlandish beliefs with evidence garnered from poorly controlled studies, research using inappropriate method of investigation or analysis, or with an outright absence of critical thinking.

That being said, I find it amusing – if it is true, that the CAA should then be so afraid of the endeavors of “one particular individual”. Surely, if they are in possession evidence supports the claims their Chiropractors make, there should be no problem!

While not having access to the document in question, I have these points about the CAA’s interpretation of the much of the criticism towards the Chiropractic profession, and the CAA’s failure to effectively regulate their industry.

These types of criticisms:

  • are borne out of a proliferation of practitioners who make claims that are unsubstantiated by robust evidence,
  • are of Chiropractic practitioners who insist on advocating pseudo-scientific theories for mechanisms;
  • who insist on making outlandish extrapolations of unrelated data to support their theories, and
  • who practice methods of manipulations that are not evidence based to treat indications when there is no robust evidence to support its use.

The CAA needs to ensure its members:

  • understand that Chiropractic as a profession must FIRST demonstrate a method is effective for a particular indication then bring it in to practice, and
  • are acting appropriately

While the CAA’s Code & Guidelines has resounding rhetoric, the CAA has proven itself either impotent in addressing those that do not follow them or they are demonstrating they do not care to do so.

The CAA needs to step up to the modern standards of medical practice and ensure their members do too.

The Australian | The chiro kids

Well how about that, Anti-Vaccination Warren Sipser is in the newspaper again: The chiro kids | The Australian. The article from The Australian is quite good and paints an accurate picture of how Chiropractors take advantage of their clients’ lack of background, espousing to clear up allergies, coughing and “DNA repair” with a few cracks of an infants fragile spine.

After talking about Sipsers’ clinic, Loretta Marron gets a great write up about her work in “quackbusting”.

… she once demonstrated that a “pain-relieving” magnetic mattress underlay has the equivalent energy field of a jar of jellybeans – earned her a Skeptic of the Year award in 2007. But behind her lampooning lies a serious intent. Her campaign began after she was diagnosed with breast cancer in 2003 and attended a support group where a naturopath bombarded desperately ill women with mumbo-jumbo. Two years ago, with the help of the Nine Network’s A Current Affair, she used a hidden video camera to expose a Queensland “healer” who charged terminally ill cancer patients $2000 for a “miracle mineral” cure administered intravenously in a suburban garage.

The Old Guard

It’s been long known that Chiropractors fall in at least two camps, those that only treat musculoskeletal conditions, and then those (like Sipser) who is a fundie. – He goes the whole 9 yards and sticks with Chiropractics’ “Magnetic Healer” inventor who believed that illnesses were caused because GODS SIGNALS WERE BEING BLOCKED! I tell ya, you’d think someone made it all … OH right! They did, didn’t they?!

The Australian | The Chiro Kids

With the two camps in mind, I was amused to read that the vice president of the Chiropractic and Osteopathic College of Australasia, was having a go at the university of teaching “pseudo-science” to its students. In addition to that, Britain’s General Chiropractic Council reiterated that it is a purely theoretical concept “not supported by any clinical research evidence”.

It is, but another profession that is seeking to support it’s ON GOING PRACTICE by trying to find scientific evidence for it. This is NOT good medicine.

Could you imagine the uproar if “Big Pharma” had the ability to sell whatever product they wanted without (the current $800m or so price tag for) clinical testing, or if eccentric doctors were granted the freedom to perform proven  fringe surgeries whenever they wanted?

Elizabeth remembers that unlike the doctors, Sipser confidently told her he could “fix everything”.

And yet, as much as Alt-Med Practitioners scream and shout about the established medical institutions, they still continue to advocate that it is THEY who are doing the right thing, “they” who are fiddling with baby spines to treat infections, ADHD, and all other manner of illnesses are apparently so ethically justified to perform unproven medical techniques that they claim victimisation and conspiracy whenever they are criticized for doing so – However, in “real doctor” land, criticism is not just the norm, but is essential to ensuring professional codes of conduct are adhered to,  out-of-line doctors are reprimanded, and erroneous research papers are not published as factual.

It’s worth mentioning that we get by without antibiotics for most colds, coughs, and headaches – By far the majority of our illnesses are rather passive and will go away without treatment given enough time. I don’t think anyone serious thinks that what we grab at the local supermarket is there to “cure” something – It’s there to provide relief.

Quack Medicine: It’s the thin edge of the wedge

What can be problematic however is infections, both bacterial and viral can be quite severe with deadly consequences  – Patients are brought in to a false sense of security by using these treatments as frequently as they do, and if an infection is particularly nasty, and you have some some kind of pre-existing condition that may weaken your defenses – You may just end up dead because you opted for a garlic juice ear drop rather than an antibiotic.

Sure he may be a CrackerQuack – but Anti-Vaccination?

Now, one may think I am jumping to conclusions about his Chiropractic base and the ties to his unfettering and erroneous crusade against vaccines, but alas – I am not – Warren Sipser is a card-carrying supporter of the Australian (Anti) Vaccination Network.

Available for $2.50 from the Australian Vaccination Network is Warren’s interview piece with them (Obviously, I would not buying as it funds the deaths of babies who’s parents are misinformed by good-intentioned, but dangerously deluded individuals). However, the blurb makes an interesting comment about his qualifications:

This caused him to set out on a crusade to become a paediatric chiropractor! He just graduated with his Masters in Paediatrics and Warren is now one of only about 10 doctors in the world with both these qualifications.

I’m guessing he’s not heard of the International Chiropractic Pediatric Association? Very strange.

But, I did say he was in the news again, didn’t I? Earlier this year Sipser … well, you can read more here: Court Ordered Vaccination & SMH False Balance

My name is Bayani, and I have a fat neck.

Now, I should start with correcting the title, that is – my name is Bayani, but –  I don’t have a fat neck – or at least if I do, I’m hiding it well. For years I have been dealing with the pillow-suffocating, shin-kicking, and shouting of my girlfriend who has put with my Obstructive Sleep Apnoea – oddly enough, for the same amount of time (could be correlation); and while I did some research some years ago in to fixing it, I never actually followed through with it.

Not a fat neck, so I think.

Previous pseudo-attempts at fixing the problem included some haphazard exercise that happen to come my way – you know, walking, getting up in the morning, that sort of thing.

Late last year however I signed up at a local, 24-hour gym – Anytime Fitness – and like anything you’re SUPPOSED to do, I did it frequently at the start, but other things got in the way, and to date this year, I’ve got no more than 5 times. I work that out to be about $50 a visit.

So tonight I had another shot and asked the Twitterverse for an answer. Almost immediately I got responses, including spam, and while the information wasn’t necessarily new, it was sobering – I have a fat neck. Again, I don’t – but that was the most brutal way I could put it to myself, which was still slightly true.

Sleep Apnoea?

Sleep Apnoea is characterized by abnormal pauses in breathing or instances of abnormally low breathing, during sleep. Low breathing is called a hypopnea, and Pauses are called an apnoea and can last from a few seconds to minutes, and may occur from 5 to upwards of 30 times an hour.

Personally, I also eventually choke on my saliva and wake up coughing – well, I sort of wake up. I’ve grown so used to it that I barely remember the event; but it certainly interrupts a good nights’ sleep – or a days’ sleep, in my case.

What’re my options?

Gym.

Gym.

Gym.

Failing that, some form of dental splint or surgery, but – I will look at those options with a Doctor when the time comes.

What are the bullshit options?

Chiropractic – not a doctor.

Homeopathy – not a doctor.

Acupuncture – not a doctor.

Hypnotherapy – not a doctor.

Sure, if there was evidence that any of the above was effective, I might be inclined to give it a shot – but all robust investigation in to the above show that they work no better than placebo. What’s a placebo? Essentially, a replacement therapy deemed to be as useful as doing nothing.

What’s it going to be?

The only real non-invasive way I am going to be able to tackle this is through exercise – I’m still going to resolve to getting some more advice from my GP, but if I want to sleep easier (and have less sore shins in the morning) I am going to need to get to the gym more often.
The staple. The fancy version.

While a quick-fix is a favorable option, I should really be doing  exercise, given the amount of junk I eat on a regular basis.

My diets’ a worry, but I know it’s going to have to be something I change over time, rather than over night.

So, baby steps.

I’ve swapped the cans of V with Sugar-free V (What’s an Energy Drink with no Sugar?), I get small Cheeseburger Meals from McDonalds, rather than the Medium Quarter Pounder Meals I used to get, and well, I can’t give up the girlfriends’ cupcakes.

That’s just silly.