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More MMR research. Or is it less? (4/10/2014)
On August 18, 2014, the anti-vaccination liar community went into pants-wetting ecstasy because a paper had been published with the title "Measles-mumps-rubella vaccination timing and autism among young african american boys: a reanalysis of CDC data". Calls for beatification, if not outright canonisation, were made on behalf of the brave whistleblowers who dared to dig deeply into the CDC's hidden files in order to expose the truth.
When comparing cases and controls receiving their first MMR vaccine before and after 36 months of age, there was a statistically significant increase in autism cases specifically among African American males who received the first MMR prior to 36 months of age. Relative risks for males in general and African American males were 1.69 (p=0.0138) and 3.36 (p=0.0019), respectively. Additionally, African American males showed an odds ratio of 1.73 (p=0.0200) for autism cases in children receiving their first MMR vaccine prior to 24 months of age versus 24 months of age and thereafter.
The present study provides new epidemiologic evidence showing that African American males receiving the MMR vaccine prior to 24 months of age or 36 months of age are more likely to receive an autism diagnosis.
People who were not blinded by this paradigm shift in vaccine-autism research (there have been more than 140 published studies showing no connection) looked skeptically at the paper and made comments based on such matters as the types of statistical tests used and the cherry-picking that seemed to have gone on. Anti-vaccination liars shrieked about Big Pharma trying to hide the truth.
On October 3, 2014, the appearance of the paper's entry in PubMed changed. You can see what it looks like now by moving your mouse over and clicking on the image at the right. The image on the left shows a statement by the relevant journal, retracting the paper.
It seems that there were undeclared conflicts of interest, and also some very suspect statistical work. Much like sensible people had suspected and reported when the paper first came out.
And are the anti-vaccination liars whining? Of course they are, that is what they do. Conspiracies involving Big Pharma, the CDC, FDA, AMA, and probably Bill Gates and the editors of high-impact medical journals have been invented. The inevitable comparisons with the fraud Andrew Wakefield have been made (by both sides). It's all a coverup and designed to deter future whistleblowers.
And what will happen to Brian Hooker now? Well, like Wakefield, he is assured of a lucrative career on the anti-vaccination speaker circuit. And just in case you think he isn't really a vaccine denier, he has apparently just published something with David Geier, Dogs, fleas, company you keep!
The placebo effect (4/10/2014)
I've been nagged recently by a true believer about the existence of the placebo effect. Apparently there is research to show that there is no such thing and it was something invented by Big Pharma to explain why things that don't really work, like almost all of alternative "medicine", sometimes look like they do something. The logic seems to be that if there is no placebo effect then homeopathy must work. As I recently experienced a large placebo response I thought I would switch to anecdote mode and write about it.
The article was eventually published in Australasian Science and you can read it here.
Dragon Unnaturally Speaking (4/10/2014)
I've been working recently with a software product called Dragon Naturally Speaking. I write a lot of stuff, and like most people I speak (and think) faster than I can type, so I thought that a dictation program might be of assistance. It certainly has been and its accuracy is quite surprising. It has to learn how I speak and I have to learn how to speak so that it understands, and most of the errors it makes are because I run words together or don't speak clearly enough. Even if I never use it again I have learnt something from it. The only problem I have with it is that it doesn't recognise Expression Web as something it can directly type into and that is the software I use to build and maintain this site. This is less of a problem that it might sound, because Dragon just opens its own window to receive the text and then drops it at the cursor point in the background program when I click "Paste". This might look tedious but it won't take me long to get used to it.
Dragon also has a facility to transcribe speech from recordings. This will be very useful as I will be able to record things using my Zoom recording microphone and get Dragon to type it up for me afterwards. It also frees me from having to be attached to a computer by microphone cords. (I bought a Bluetooth microphone earpiece but it was a dismal failure, so I usually use an excellent Logitech tethered headset. Apparently I can buy a Sennheiser Bluetooth thing for only about $400 that might work, but I have better things to spend my money on.)
Tests with transcription show that I still have to be careful with how I speak, but results are promising. Problems arise, however, if the recording contains things that Dragon can't recognise, in which case it makes wild guesses. One of the things it can't recognise is a second voice that it hasn't been trained for, specially one which has a different accent. (Dragon knows that I am Australian and makes allowances for the antipodean manners of speech. By crikey, it's bonza.) I ran the recording of my recent interview with James Randi through it, because a written transcript would have been very useful when writing up the conversation.
I am planning to submit the transcription as supporting documentation for my application into a Masters program in postmodernist writing. The professor can hardly say that it's meaningless, because all texts have meaning. Don't they?
I visit the dark side (4/10/2014)
My friend Richard Saunders was invited to give a presentation at the Australian Paranormal and Spiritual Expo, and part of the package was the opportunity for Australian Skeptics to have a stand (for free!) to distribute magazines and to spread the word about the organisation and its aims. As we had none of the extensive collection of magazine back issues left at the end of the day and hadn't been attacked by anyone the day has to be judged a success. We had polite conversations with many people who, we hope, went away with a better understanding of what skepticism is all about. Of course we heard some things that we have heard many times before but that was expected - we have been doing this for a long time.
The usual sorts of products were on display, with several stands offering crystals (one run by a professional geologist!), scented candles, essential oils, and other symbols of the New Age. I bought a packet of Death Mints in an attractive coffin-shaped container and a blowup alien. What was surprising was the number of people promoting ghost tours, including one at my local pub (in six years of living here I have never heard any mention of it being haunted). I happen to like ghost tours, and they can be both fun and informative. (There is one of The Rocks area of Sydney, where the first houses in the infant colony were built, which is a fascinating history tour, using the word "ghost" to attract clients but rarely mentioning them during the night.)
There was one stand by a group of UFO hunters. I was rather surprised to be recognised from a couple of TV appearances a few years ago, but who knows how far their own fame has spread? One of the featured UFO events had the obligatory photographs of strange lights in the sky, plus a daylight shot of the location. I thought I recognised it, and in fact it was at the end of the road which goes past my front door. I will have to pay more attention to the sky around my place in future.
As well as the stalls there were some talks given during the day. I attended three of them, including the one by Richard Saunders, who said all the things I expected him to say. His talk was well received, even though it was mildly critical of much else at the expo and the audience could have reasonably been assumed to disagree with him on many issues. I congratulate the expo organisers for having the courage to have a skeptical speaker and display at the event.
The first talk I attended had the title "Communicating with the dead - Modern techniques and Victorian twists". I was dreading hearing about the successes of cold readers like John Edward, but what it was was a talk about ghost hunting and the methods used to get messages across from the other side. Examples were provided of mysterious voices appearing in recordings at haunted locations, sometimes responding to calls from the investigators. A large part of the talk was given over to a technique of examining patterns in swirling water in a silver bowl lit by coloured lights, or by looking for patterns in smoke. Here is a shot of green-lit water, apparently showing a human figure:
And here is the singer Johnny Cash appearing in a swirl of smoke:
The technical term for this is "pareidolia" - the detection of apparent patterns in random data. It is not surprising that humans see faces when given very few cues (just think about :) as an example) because this is an evolutionary driven trait which allows new born babies to detect their mothers (it is not confined to humans!). The person who showed the photographs said that he "often took hundreds, sometimes thousands" of photographs when doing this sort of research. Given a large number of images containing random data it is almost inevitable that some of them will resemble real objects, including faces and human shapes. Why the spirits should choose to use this form of communication remains a mystery.
Am I convinced that psychic or ghost investigators can really contact spirits? Not really. Maybe they are really contacting aliens or time travellers from the future. Who knows?
The second talk I attended was called "Energetic Healing - are your thoughts and feelings making you sick?". It was as awful as I anticipated, maybe even more so. The audience was involved in some theatre where we imagined energy flowing through us which we then handed on to other people. It was all pretty standard hypnotist stagecraft, relying on suggestion and imagination. At one stage we were asked to imagine the "earth energy" coming up as bright white light through a portal at the bottom of our auras. "Do you feel a tingling in your feet?". I was going to reply "Yes, I have peripheral neuropathy" but that would be admitting that I had let diabetes overrule my chakras, and the presenter had already declared that despite everyone in her family having diabetes she had avoided it by careful management of her relationship with the energies of the universe. And yes, she did use the word "quantum".
I was more convinced by the ghost investigators.
I didn't stay for the two final shows. One was the world premiere of the film "Ghosts of Casula" about supposed hauntings of the very building that we were in, the Casula Powerhouse Arts Centre (which is an excellent recycling of a building used long ago for electricity generation). With the number of ghost hunters in the room I was a bit surprised that some of the detection devices they were demonstrating hadn't detected the fact that the surroundings contained ghosts, but maybe they really do only come out at night. The final event of the night was a four-hour trip to "Explore and investigate the Liverpool Asylum/TAFE". When I taught at TAFE I sometimes suspected that some of the people in the bureaucracy were a little unhinged (especially the payroll people), but I assume this was another example of reuse of a building. As I live a short distance from the decaying remains of an old TB sanatorium I can get my fill of creepy buildings with a dark past at almost any time without the risk of missing the last train home.
So in summary, the expo was a lot of fun, with almost nothing there that a skeptic could seriously object to (there was a noted absence of the sort of medical quackery that appears at other shows like this), everybody was friendly to the intruders, the queue for lunch was too long (there are no shops nearby as an alternative) but the food was reasonably priced, and the entrance fee ($5) was very reasonable. I hope to be back there next year, and now we official skeptics know what to expect there might even be a bigger and better presence by Australian Skeptics.
One of the features of alternative medicine is that nothing is ever discarded and once anything has been discovered it is true until the end of time. This even applies to things when incorrectly discovered because to retract something for being wrong is apparently the same as saying that absolutely everything is wrong. This is consistent with the Nirvana Fallacy, which says that there are only two values for the effectiveness of something and they are 0% and 100%. Examples of this are that vaccinations are useless because they are not 100% effective, antibiotics don't work because sometimes people don't get better, and as people still die from cancer therefore there is no cure for any form of cancer.
During one single week looking at Facebook I saw several things recycled which have been debunked on numerous occasions going back for many years. A few of these are reconsidered below.
Dr Otto Warburg (18/10/2014)
In 1931 Dr Otto Warburg won the Nobel Prize for Physiology or Medicine for, as it says on the Nobel website, "his discovery of the nature and mode of action of the respiratory enzyme". As is tradition, Dr Warburg presented a Nobel lecture which you can read here. You will note that the word cancer appears absolutely zero times in Dr Warburg's lecture, yet he is continually held up as someone who won the Nobel Prize for finding a cure for cancer. Part of the mythology is that he won a second Nobel Prize in 1944, although this fact seems to be something unknown to the people who actually issue the Nobel Prizes.
It is true that in 1966 when Dr Warburg was in his dotage he gave a presentation to some quack conference in which he suggested that may be there was some connection between oxygen and cancer, but that was not 1931 and that was not what he won the Nobel Prize for. In 2006 I had a discussion with a true believer about this and encountered a situation which Lewis Carroll would not have included Alice in Wonderland because it was too bizarre. I won't repeat it today, you can go here and here to read the exchange I had with someone who appeared to be brain-dead.
So here are the facts that you can present to the next person who tells you that oxygen cures cancer and that Dr Warburg won a Nobel Prize for identifying this: the details of Dr Warburg's Nobel Prize are no secret and can be found quite easily on the Nobel website, he did not win a second Nobel Prize, and his original research appeared to have nothing to do with cancer at all.
It goes without saying that had Dr Warburg in fact found the thing that causes cancer, then all the cancer quacks who claim to know the single cause for cancer and therefore have the single cure are all wrong. Another principle, however, of alternative medicine, and this goes back to my original comment about how things are not discarded even when found to be wrong, is that there is no logical inconsistency in a mass of self contradictory statements all being simultaneously true.
Found on Facebook but I can't identify the creator. If anyone knows, please tell me.
John of God (18/10/2014)
In November 2014 my hometown is to receive a visit from a lying, thieving, charlatan. For a price of just $295 per day (plus $14.53 booking fee) or $795 plus $25.85 for the full three days, desperate people with illnesses will be lied to by someone who claims to be a healer. This particular scamster goes by the name "John of God". And how do I know that he is a lying, thieving, charlatan you ask. Because he has been pulling this scam in Brazil for more than a decade, but even then he was recycling a scam which was going on at least twenty years before that. I first came across him in 2003 when his promoters were using x-rays to prove that he could cure cancer when even the most cursory examination of the x-rays showed that there was no evidence there at all. It's simply a fraud, designed to steal money from people who are desperate.
The normal way that he conducts his scam is to apply hands-on healing, including all the old faith healer tricks like pulling chicken gizzards out of folds in people's bodies. I'm not sure how he intends to do this in a venue which seats about 6,000 people, but I suppose he will just do what other faith healers do, which is have a few people on stage and do tricks with them and make occasional announcements that people in the audience being cured of diseases like diabetes.
In a sense faith healers like John of God are worse than even the worst of the cancer quacks, because everything is pushed back onto the sick person. If the person doesn't get better it is not the fault of the curer, it is the fault of the patient for not having enough faith.
What is particularly annoying about this money gouging trip to Sydney is the publicity that it has been given by major media outlets. Two of the leading newspapers in Australia have weekend supplement magazines and because they are magazines they are not subject to the deadlines and time limits of the news sections of the papers. Journalists writing for these magazines have time to research the stories and find out the facts. On Saturday, October 3, both of these magazines carried uncritical, laudatory stories about John of God. Much of the information was provided by a hotel in Brazil. One of John's claims is that he treats people for free, but if tradition is being observed either he or his family own the accommodation that victims stay in and the pharmacies from which they buy the medications that he prescribes. The journalists apparently didn't notice, or didn't care, that there was a massive conflict of interest in receiving information about the scam from an active participant and beneficiary.
They also hadn't bothered to see whether anybody had had anything to say about this charlatan before. I emailed the two journalists concerned:
It was surely a remarkable coincidence that your article about the faith-healing fraud should appear on the eleventh anniversary of something I wrote about him.
Only one of them bothered to reply:
what are you saying, that we timed the story to somehow coincide with a web post that you put up 11 years ago?
The only conclusions I can draw from this reply is that the journalist in question is either too dense to understand English or he simply doesn't care about whether what he writes is correct or not.
The fraud being perpetrated by John of God is so transparent that is almost impossible to think that any responsible journalist being asked to write a story about it could not see what is happening but would instead present a story that makes it appear that there is not even an iota of doubt about legitimacy.
I headed my original article about this "Faith healer? Fraud!". Nothing I have seen in the last eleven years suggests that I might have been even slightly incorrect.
Doctors are Pharma shills? (18/10/2014)
One thing that never goes away is the story about how doctors only prescribe things because they're paid to do so and they will never prescribe anything which is not patented and can't make lots of money for Big Pharma. The list below shows the ten most prescribed drugs in Australia (it's from 2011, which for some reason is the most recent set of figures available from the Pharmaceutical Benefits Scheme). Of the ten drugs, nine are well out of patent and are supplied as generics. They can be manufactured by any company with the capability of following the recipe and manufacturing to the required standard. The patent on the 10th drug, Rosuvastatin, expires in 2016.
Amoxycillin with clavulanic acid
Another myth promulgated by the quackery industry is that real doctors only treat symptoms, not underlying conditions (I have pointed out to people that according to the inventor of homeopathy it can only be used to treat symptoms, with underlying causes being totally ignored, but this usually just results in blank looks and repeating of the stupid statement that doctors only treat symptoms). I take three of the drugs in the list, one of which I will probably have to take the rest of my life (which isn't really a problem because it possibly adds 20 years to the "rest of"). The other two are being used temporarily and continuation of their use is evaluated on a regular basis. The conditions that these three drugs treat are almost totally asymptomatic, and can only be discovered by pathology and other tests on the body. They do not treat symptoms because there are no symptoms to treat. I should point out that apart from paracetamol and the antibiotics in the list of 10, most of these drugs treat asymptomatic conditions.
So in about ten minutes of work at the PBS website I was able to find evidence that two of the strongest myths propagated by the alternative medicine industry are in fact untrue. As many of the proponents of alternative medicine claim to have highly sophisticated research skills, the most charitable assumption one can make is that these people knowingly tell lies about real medicine. This is another case of exploitation of a fallacy, because even if real medicine was as bad as they make out it would not add one scintilla of legitimacy to quackery.
Speaking of which ... (18/10/2014)
Medicines Australia is the industry body for pharmaceutical manufacturers and distributors and they have a Code of Ethics. The code is periodically examined by the Australian Competition and Consumer Commission and the latest review addressed transparency of benefits provided to health care professionals. (I was a lay member of a consumer committee giving input to the latest review. As I was paid $60 plus lunch for this I am now an officially paid-up Big Pharma Shill, so suitable weight should be given to anything I say about real medicine.) The ACCC has looked at the suggestions for changes to the Code and has made some recommendations which will make it even stronger. You can read the ACCC media release here.
The Australian Competition and Consumer Commission is proposing to grant conditional authorisation to edition 18 of Medicines Australia's Code of Conduct (the Code) for five years. The Code sets the standards for the marketing and promotion of prescription pharmaceutical products in Australia by member companies.
The issue of individual disclosure has been a matter of debate for a number of years, When authorising edition 17 of the Code in 2012, the ACCC made clear that it expected Medicines Australia to complete its review of transparency and introduce greater disclosure around sponsorship and fees paid to individual doctors.
In edition 18, Medicines Australia has proposed a new reporting regime which requires reporting of ‘transfers of value' (such as speaking fees, advisory board fees or sponsorship to attend a conference) made to individual healthcare professionals, subject to the healthcare professional's consent.
"The ACCC supports the introduction by Medicines Australia of a regime to provide transparency about payments provided to individual doctors by drug companies," ACCC Commissioner Sarah Court said.
"However under the proposed regime, if a doctor does not consent to the reporting then the individual payment will not be disclosed and will only be reported in aggregate."
This issue was raised in submissions received by the ACCC. While there was near unanimous support for an individual transparency regime, a number of interested parties raised concerns about ‘opt-in' reporting.
"If a patient does not know what payments made to doctors by drug companies have and have not been reported, it will be difficult to use or rely upon the reporting. This will result in incomplete information and may fundamentally undermine the potential benefits of individual disclosure," Ms Court said.
The ACCC is therefore proposing to require changes to the Code that will mean that all relevant transfers made by pharmaceutical member companies to individual healthcare professionals are reported. To ensure any privacy issues are addressed, this will mean that member companies must confirm that a healthcare professional has agreed to have their details reported, or is reasonably aware that their details will be reported, prior to the transfer taking place.
In Edition 18 of the Code, Medicines Australia has removed the requirements to report hospitality provided by member companies and instead imposes a $120 per meal cap on food and beverages. The ACCC supports a cap on hospitality but is considering imposing a condition requiring some form of continuing transparency around the provision of hospitality, given the potential conflict of interest that can arise. The ACCC has posed several possible approaches and is seeking interested party feedback.
More generally, the ACCC accepts that the Code continues to provide a framework for interactions between pharmaceutical companies and healthcare professionals and that the Code is likely to result in public benefits including protecting the public from inappropriate advertising, setting consistent standards for medical and promotional material and providing the potential for greater transparency around the relationships between pharmaceutical companies and healthcare professionals. The ACCC also notes that the Code results in minimal detriment.
As such, subject to the proposed condition of authorisation, the ACCC is proposing to grant authorisation for five years.
Medicines Australia states that it represents the interests of the innovative medicines industry in Australia. The Code provides standards for appropriate advertising, the behaviour of medical representatives and relationships with healthcare professionals. All member companies of Medicines Australia must adhere to the Code, although membership of Medicines Australia is voluntary.
Authorisation does not represent ACCC endorsement of a code. Rather, it provides statutory protection from court action for conduct that meets the net public benefit test and that might otherwise raise concerns under the competition provisions of the Competition and Consumer Act (2010). Broadly, the ACCC may grant an authorisation when it is satisfied that the public benefit from the conduct outweighs any public detriment.
Further information is available on the Public Register.Release number: MR 254/14
Hillsong and the Royal Commission
Someone finally decided to take a close look at reports of child abuse coming out of various churches and other institutions, and I spent a day as an observer at the Royal Commission into Institutional Responses to Child Sexual Abuse. My particular interest was in revelations about Hillsong, but I also heard testimony from a very brave lady who detailed the abuse she suffered and the dreadful way it was handled at a school run by another church. I was only there on the 89th day of the enquiry, but another journalist had attended every day and had to listen to many such stories before. One day was enough for me, so I can only congratulate and sympathise with the journalists, lawyers, commission staff and commissioners who have had to sit through the whole harrowing experience. And there is a lot of it still to come.
I will write a longer report once I have had time to read and digest the transcripts related to Hillsong's appearance, but the initial thoughts are that even though there was only one case referred to the Commission from there it was handled very badly by people with no concept of conflict of interest, no idea of what to do next, and in some cases a distorted view of right and wrong. Something can be the wrong thing to do even if there is no law against it.
I must congratulate the Commission on the amount of information made available to the public. Hearings are live streamed and all witness statements and transcripts of spoken evidence are available for free. The only thing not made public is the list of full names of witnesses who have asked to be anonymous, and they are always referred to by code. (The brave lady I mentioned above was originally anonymous but applied on the day to have her anonymity lifted.) As true anonymity can't be allowed if evidence is to be credible, an embargoed list of names and codes was provided to journalists, but anybody releasing any of the details would have to be very brave indeed - a Royal Commission is perfectly capable of punishing contempt and this particular piece of secrecy was taken very seriously indeed.
And one last thing (18/10/2014)
I probably could have included this picture as a joke and nobody would have thought it was serious. It is from the label of a can of muscle-building protein powder ("fruit punch flavour"). There is a saying of bemusement used on the Internet, and it was made for times like this: "I don't even".