So here’s an idea…

February 22, 2010

A rational/skeptic sidewiki project?


I recently discovered Sidewiki, an offering from Google which allows you to read and write wiki-like contributions that can be made to pretty much any webpage out there. It works by adding a toolbar to Internet explorer or Firefox.

Everytime you visit a webpage with a sidewiki entry a little blue “»” appears on the left hand side of your browser and you can drag it out and and read what people have written, or contribute your own entry to a webpage.

Such as this:

From XtalDave

Now – if every skeptic was to take a couple of minutes to very simply address every quack claim on the internet, maybe with a nice link to a relevant peer reviewed pubication, or at least a blog post with references within, we’d have a nice record of objections to particular claims, so when others come accross a link to them in the future, the effort to determine potential flaws in a webpage/study would be reduced.

*SIMPLES*

Let me know what you think about this (comments below) – if people are generally supportive, some sort of web hub to organise efforts might be useful.

 

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Articles about the Homeopathy Evidence Check #evcheck #ten23

February 22, 2010

A link to the .pdf of the report.

Parliament Website

MPs urge Government to withdraw NHS funding of homeopathy

http://news.parliament.uk/2010/02/mps-urge-government-to-withdraw-nhs-funding-of-homeopathy/


Le Canard Noir (Quackometer)

The Bleakest Day for Homeopathy

MPs call for the closure of NHS homeopathic hospitals.

http://www.quackometer.net/blog/2010/02/house-of-commons-evidence-check-homeopathy.html

Gimpy’s Blog

The Evidence Check on Homeopathy – a merciless punch to its vitalist organs (despite attempts to water down report)

http://gimpyblog.wordpress.com/2010/02/22/the-evidence-check-on-homeopathy-is-released-and-it-is-devastating/

DC’s Improbable science

MPs urge government to stop NHS funding, and MHRA licensing, of homeopath

http://www.dcscience.net/?p=2782

Podblack Cat

Recommendation – Homeopathy Gone From The NHS!

http://podblack.com/2010/02/recommendation-homeopathy-goes-from-the-nhs/

Press Statement from Society of Homeopaths

The Society’s response to the report of the House of Commons Science & Technology Committee Evidence Check: Homeopathy

http://www.homeopathy-soh.org/whats-new/latest-news/press-releases.aspx

BBC NEWS

NHS money ‘wasted’ on homeopathy

http://news.bbc.co.uk/1/hi/health/8524926.stm

Black Triangle

Homeopathy and Pharmacy

http://www.blacktriangle.org/blog/?p=2079

Guardian Science

Stop homeopathy funding, says Commons committee

Manufacturers should not be able to make medical claims for homeopathic products, say MPs

http://www.guardian.co.uk/society/2010/feb/22/stop-homeopathy-funding-commons

Austrailian Skeptics

UK Government commmittee recommends public funds pulled from homeopathy

http://www.skeptics.com.au/latest/announcements/featured-announcement/uk-government-recommends-public-funds-pulled-from-homeopathy/

Royal Pharmaceutical Society of Great Britain

Society reacts to house of common science and technology committee report into homoepathic products

http://bit.ly/bNa0iw  [PDF]

New Humanist Magazine

The end for state-funded homeopathy?

http://blog.newhumanist.org.uk/2010/02/end-for-state-funded-homeopathy.html

Bad Science

Parliamentary Sci Tech Committee on Homeopathy

http://www.badscience.net/2010/02/parliamentary-sci-tech-committee-on-homeopathy/

Channel 4 News

Ban homeopathy on NHS, say MPs

http://www.channel4.com/news/articles/science_technology/ban+homeopathy+on+nhs+say+mps/3555637

SKY News

Call To End ‘Placebo’ Homeopathy On NHS

http://news.sky.com/skynews/Home/Politics/Homeopathy-Should-Not-Be-Funded-By-NHS-MPs-Say-Science-And-Technology-Committee-Publishes-Report/Article/201002415556956?lpos=Politics_First_UK_News_Article_Teaser_Region_2&lid=ARTICLE_15556956_Homeopathy_Should_Not_Be_Funded_By_NHS%2C_MPs_Say%3A_Science_And_Technology_Committee_Publishes_Report

^^^ Cheezus, look at the size of that URL! ^^^

Pulse

MPs call for end to NHS funding of homeopathy

http://www.pulsetoday.co.uk/story.asp?sectioncode=35&storycode=4125148&c=2

Reuters

British homeopathy funding is “bad medicine”: panel

http://www.reuters.com/article/idUSTRE61L26E20100222

Chemist and Druggist

NHS should not pay for homeopathy, MPs say

http://www.chemistanddruggist.co.uk/c/portal/layout?p_l_id=259751&CMPI_SHARED_articleId=3736035&CMPI_SHARED_ImageArticleId=3736035&CMPI_SHARED_articleIdRelated=3736035&CMPI_SHARED_ToolsArticleId=3736035&CMPI_SHARED_CommentArticleId=3736035&articleTitle=NHS%20should%20not%20pay%20for%20homeopathy,%20MPs%20say

Reality is my Religion

Huge win against homeopathy in the UK!

http://realityismyreligion.wordpress.com/2010/02/22/huge-win-against-homeopathy-in-the-uk/

British Homeopathic Association press release.

Homeopathy works and is an important part of the NHS

http://www.britishhomeopathic.org/media_centre/press_releases/february_2010_prs.html

Foundation for Integrated Health press release

Homeopathy: where is the patient in scientists’ calculations?

http://www.fih.org.uk/media_centre/homeopathy_patients.html

Science-based Pharmacy blog

British MPs Tell Gov’t: Stop Funding Homeopathy

http://sciencebasedpharmacy.wordpress.com/2010/02/22/british-mps-tell-govt-stop-funding-homeopathy/

JDC325

Evidence: Government Policy and Homeopathy

http://jdc325.wordpress.com/2010/02/22/evidence-government-policy-and-homeopathy/

Martin Robbins in Guardian Science Blogs

MPs deliver their damning verdict: Homeopathy is useless and unethical

http://www.guardian.co.uk/science/blog/2010/feb/22/mps-verdict-homeopathy-useless-unethical

Edzard Ernst in Guardian CiF

No to homeopathy placebo

http://www.guardian.co.uk/commentisfree/2010/feb/22/science-homeopathy-clinical-trials

Nature Science Blogs

UK ‘must stop funding homeopathy’, say politicians

http://blogs.nature.com/news/thegreatbeyond/2010/02/uk_must_stop_funding_homeopath.html

Thinking Is Dangerous – Dr* T

“Come in homeopaths, your time is up” – MPs urge Government to quit funding homeopathy

http://thinking-is-dangerous.blogspot.com/2010/02/come-in-homeopaths-your-time-is-up-mps.html


IT’S TEH SILLY-CATES, STOOPID!!

February 18, 2010

A paper being touted as proof for homeopathy, by homeopaths, doesn’t really look like it does anything of the sort…


This paper, regarding silicates in succussed homeopathic solutions, is being touted as proof for a homeopathic effect, particularly by US former-Homeopath and prolific Homeopathy advocate, Dana Ullman.

http://twitter.com/HomeopathicDana/status/9271036920 (Screengrab in case of deletion)

Enzyme stabilization by glass-derived silicates may explain #homeopathy mechanism. #ten23 http://tinyurl.com/ylkggbg

Obviously, it does nothing of the sort, and in fact, it just provides another potential source of false-positive in trials involving homeopathic remedies.

The paper suggests that the act of succussion (striking a homeopathic remedy against a leather-backed object) during production knocks silicates from the glass into the solution. The paper continues “silicates and other solutes are present at micromolar levels in all glass-exposed solutions, whether pharmaceutical or homeopathic in nature.”

In a nutshell, the paper does the following:

  • They conduct a series of tests with acetylcholine esterase to assay for enzyme stabilisation (enzyme activity after incubation for 24hours in various silicate containing solutions, succussed and un-succussed controls). Without delving into too much detail, the assays are fairly bog-standard endpoint assays conducted with a colourimetic substrate (a substrate analogue that changes colour upon reaction) and assayed for colour change in 96-well format in a standard issue plate reader. All standard biochemistry stuff. I’ve done a couple of plasmin activity assays this week myself using a very similar technique. Fine. They show that succussed solutions have an enhanced stabilsation effect over un-succussed solutions.
  • They also conduct some ICP-OES experiments and show that succussed solutions have ~3mg/ml silicates & boron and sodium present – more than un-succussed solutions.
  • They do some molybdate assays to show that homeopathic remedies (they looked at 30C Arsenicum, 200C Arsenicum and 30C Glutamate) contain a similar level of silicates present.
  • They then show that a 30C water solution has a similar effect on acetylcholine esterase as a 100uM solution of NaOH/Silicates.

The paper concludes “Nonetheless, future in vitro homeopathic experiments will need to take into account the fact that significant levels of dissolved solids exist in glass-exposed solutions, and that these can have functional effects on proteins dissolved therein.

There isn’t an awful lot wrong with the paper, to be honest. It’s the homeopaths interpretation I have issue with.

This is the train of thought, as far as I can tell:

  1. Succussed solutions contain silicates at a concentration on the order of ~100uM. YES.
  2. These silicates have a demonstrable biological effect on certain enzymes in in vitro assays. YES
  3. Therefore silicates in homeopathic solutions are the seat of the efficacy of homeopathic remedies. EH?

Lets ignore the myriad caveats about scaling up from in vitro to in vivo, for just a minute. Oh yes, and the fact that the silicates found in these remedies are unremarkable, and will be found in any solution that has been exposed to glass. Oh, and that the levels of silicates found in homeopathic remedies are WAY below the level of silicates that you might find in a normal diet. As the authors note.

The fact that they are present in all three remedies tested (and the authors suggest, all homeopathic remedies produced in this way), means that silicates cannot POSSIBLY be the source of any sort of efficacy or healing effect

Given that homeopathic remedies, irrespective of the contents of the original tincture, will contain these silicates (and indeed, any solution in a glass container that has been roughly handled), how can they be responsible for the supposed healing effect of say, 30C arnica for bruising, AND for say, 30C belladonna, in whatever the heck 30C belladonna is supposed to cure?

In fact what this paper does do is give another potential explanation for the very minor effects sometimes observed in certain in vitro trials which aren’t properly controlled. Which is clearly what the authors wrote the paper and conducted the experiments to address. They also mention that conventional pharmaceuticals stored in glass would also likely have similar levels of silicates in them.

Really, the authors make it pretty damn clear what it is that they have researched, and it certainly isn’t a potential mechanism for homeopathy, rather the dissolution of silicates from glass vessels into solutions which then has an effect on in vitro assays for a specific enzyme.

I.e – if you are lucky enough to see any in vitro effect from a homeopathic remedy, it isn’t the arsenic that was once in it, IT’S TEH SILLY-CATES, STOOPID!!

Actually, seeing as we’re on silicates, the Biomineral research section of the MRC centre in human nutrition research hypothesise that silicate absorbtion in the gut “result(s) in detrimental responses in susceptible individuals such as those with inflammatory bowel diseases.”

So we should perhaps conclude that homeopathic remedies should be avoided by people with inflammatory bowel disesases, such as Crohn’s disease and Ulcerative Colitis.


Antibiotics: take the full course!

February 14, 2010

Good science, for a change. Not woo.


In this season of ear, throat and chest infections, there is a good chance that you, or someone you know, will have been prescribed antibiotics recently.

When given antibiotics, your doctor, and your pharamcist will/should remind you to take the full course of antibiotics.

This paper just out in Molecular Cell explains why.

If you fail to take the full dose of antibioitics, or you miss a dose, you are potentially exposing the bacteria to a sub-lethal dose of antibiotic.

According to this work from Boston & Harvard Universities, sub-lethal doses of a variety of antibiotics (including Ampicilin, a popular choice for GPs to prescribe), rather than killing the bacteria, cause a stress response in the bacteria, which in turns leads to prodution of reactive oxygen species (ROS). Kohanski et al showed that this increase in ROS production can cause up to an 8-fold increase in the mutation rate in E.coli. They confirmed that ROS was the cause by treating the bacterial simultaneously with sub-lethal doses of antibiotics, and thiourea (which limits ROS production). The thiourea returned mutation rate nearly to control levels.

ROS can directly cause random damage to the bacterial genome, leading to an accumulation of mutations. ROS can also lead to the activation of SOS genes, which repair DNA – however, in doing so, they can also introduce mutations.

Taken from here. No permision given, but fair use claimed.

Some of these mutations may confer antibiotic resistance upon a bacteria. Which means your bugs may now survive the course of antibiotics.

The upshot of which is you need more antibiotics, and you may have created your very own drug resistant form of a pathogenic strain of bacteria (think MRSA).

WooHoo! Go YOU!

 

 


Mis-quoting. Quote mining. Quotology. Quotography. LYING.

February 11, 2010

A little piece about mis-quotage, and how it irks me so.


In the space of about 12 hours this week, I read two articles concerning the gross perversion of peer-reviewed scientific literature, and people selectively quoting from said peer-reviewed publications to push forward their own agendas.

The first was Martin Robbins excellent demolition of the BHA’s evidence to parliament. This comes in two parts – the Guardian Article, and his response to the BHA response.

I have touched upon homeopaths doing this before, so it should come as no surprise really.

A particularly insidious example (taken from Martin’s blog at layscience.net) was:

BHA

Cucherat 2000: “There is some evidence that homeopathic treatments are more effective than placebo.”

The full, unabridged quote

There is some evidence that homeopathic treatments are more effective than placebo; however, the strength of this evidence is low because of the low methodological quality of the trials. Studies of high methodological quality were more likely to be negative than the lower quality studies.

Lets us be crystal clear about what is going on here – this is not a mistake. This is not a simple error or omission. Nor is it stupidity or incompetence.

This is lying. Deliberate misdirection. Fabrication. Falsification. Bearing false witness. Mendacity. Fraud. You get the idea.

In the case of the BHA, they misrepresented evidence in front of the UK parliament science and technology committee.

The report is due out on the 22/02/10. I’ll wait and see how far their mendacity gets them.

The second instance of quote-mining lying was discussed in the Guardian piece on how climate change skeptics has mis-quoted the e-mails (so not peer-reviewed) leaked in “climate gate”. Now I’m not a climate scientist, (If you want more info, go to Andy Russell’s excellent blog. He is a climate scientist) but it strikes me that this is probably more important, in that it potentially effects the whole world, and not just the UK. “Climategate” was touted in the international press, and by climate change “skeptics” including Sarah Palin., as example of how global warming is not real, and it is just an artefact created by climatologists… for what reason I have yet to fathom.

(Note: As a general rule –  If Sarah Palin agrees with you then there is a very good chance you are wrong.)

The most prominent example of quote-mining in this case was saying that “tricks” were used to alter/obscure data when they were in fact referring to a visual trick to display data.

The trouble facing people at the wrong end of these mis-quotes, is that the initial mis-quote is often seized upon by the press, and then hurtles around the world faster than you can say “Intergovernmental Panel on Climate Change”. The following “erm, actually, I think you’ll find” article rarely gets any coverage, and thus, the general public only see the lies. In such cases the ball lies firmly in the court of the media – “erm, actually, I think you’ll find” articles are not big and sexy – but they are an incredibly important part of maintaining journalistic integrity, and ensuring that the general public is kept well informed. After all, we cannot expect a democracy to make informed choices when the voting public do not have the necessary information.

The point I am trying to get around to making (probably quite badly,) is that the nature of peer-review keeps scientists honest. This is important, as it tends to have the effect of removing personal bias, hyperbole and egos from the science discussed. It may not be perfect – but it is the best system we have for ensuring that good science is published, and bad science is weeded out.

Perversion of peer-reviewed articles and of scientific discourse in general is the domain of the quack and the charlatan – the fact that the BHA and climate change skeptics have resorted to such underhand tactics speaks volumes about their integrity.


Homeopathy and Anaesthesia.

February 6, 2010

Addressing the oft-repeated mantra – “you don’t know how anaesthetic works”


When considering homeopathy, an obvious bone of contention is the lack of a plausible molecular mechanism .

When proffering this as a reason why homeopathy is not feasible, a homeopath will typically counter with “well what about anaesthesia – we don’t know how that works either.”

So lets explore this a little further…

“General anaesthesia is administered each day to thousands of patients worldwide. Although more than 160 years have passed since the first successful public demonstration of anaesthesia, a detailed understanding of the anaesthetic mechanism of action of these drugs is still lacking.” So states the opening gambit of an excellent and fairly recent review of the potential receptors for general anaesthetics.

Kopp Lugli, A., Yost, C.S. and Kindler, C.H. (2009) “Anaesthetic mechanisms: update on the challenge of unravelling the mystery of anaesthesia”. European Journal of Anaesthesiology, 26(10), p 807–820

A general anaesthetic has to do three things: cause immobility, amnesia and unconsciousness. Many potential molecular targets are being researched – these are summarised in the table below.

Taken directly from Kopp Lugli, A., Yost, C.S. and Kindler, C.H. (2009) “Anaesthetic mechanisms: update on the challenge of unravelling the mystery of anaesthesia”. European Journal of Anaesthesiology, 26(10), p 807–820. Fair use claimed.

We don’t know for sure what all the molecular targets are, but Franks, N.P. (2006) “Molecular targets underlying general anaesthesia” Br J Pharmacol. 147(S1): S72–S81, is a decent review of what is known about the molecular mechanism of two types of Anaesthetic, propofol and etomidate, and their interaction with the GABA-A receptor. The GABA-A receptor is a ligand-gated ion-channel, a complex of proteins that allows ions (in this case Chloride ions) to cross an otherwise impermeable membrane. GABA-A receptors are found in most areas of the brain. Propofol and etomidate are positive allosteric modulators of the ion channel – they bind at a site on the ion-channel distinct from the pore through which the ions pass and make the ion-channel more easily openable, and Cl- ions can flow freely accross the membrane. This will lead to hyperpolarization of the neurons, which in turn, inhibits neurotransmission, which eventually leads to the anaesthetic effect.

Science doesn’t know the precise ordering of molecular events that leads to sucesful anaestheisia – but it is working on it – and it is making progress. But for all anaesthetics we have “leads” – potential, rational, explainable targets for their mode of action.

So we actually know a lot more about the mechanism of action of anaesthetics, than we do about homeopathy.

Now lets look at the formulation of a typical general anaesthetic.

Propofol is distributed as Diprivan – a 1% solution in combination with various inert stabilisers and anti-microbial agents.

The dosing guidlines for Diprivan states: “adult patients under 55 years of age and classified as ASA-PS I or II require 2 to 2.5 mg/kg of DIPRIVAN Injectable Emulsion for induction when unpremedicated or when premedicated with oral benzodiazepines or intramuscular opioids. For induction, DIPRIVAN Injectable Emulsion should be titrated (approximately 40 mg every 10 seconds) against the response of the patient until the clinical signs show the onset of anesthesia. ”

Lets assume we have a 100kg adult, and we are going to dose them at 2.5 mg/kg.

So that’s a total of 2.5mg x 100 = 250mgs of Diprivan.

The molecular weight of propofol is 178.271 g/mol.
This is 0.25g / 178.271 = 0.00140235 moles of Diprivan.

Multiply this by Avagadro’s Constant and you discover that this 250mgs has got 8.44×10^20 molecules of pharmacologically active ingredient.
844,000,000,000,000,000,000 molecules.

Contrast this with a Homeopathic anaesthetic, which would have zero molecules of pharmacologically active ingredient.

Interestingly enough, given all the things homeopathy claims to cure (cancer, AIDS, Homosexuality, etc) – a cursory piece of googlage actually reveals that one of the few things homeopathy doesn’t claim to do is general anaesthetic – fear of pain is a great leveller, I guess.

(If you can find a reference to a Homeopathic Anaesthetic – please leave a comment below!)

However, homeopaths naturally claim that homeopathy can help with after effects of anaesthesia and surgery – after effects which coincidentally, will resolve naturally more often than not.

This reference sheet entitled “Homeopathic support during surgery” is particularly shocking.

The first thing to note is that it states: “Use 30c potency for these acute treatments.”
As previously established – 30c potency contains zero pharmacologically active molecules.

Of all the treatments outlined by this sheet – the most dangerous and irresponsible are those that detail treatment for symptoms of surgical site infection (SSI).

“Hepar Sulph wounds that have become weeping and pustulent”
“Pryogen indicated when there is necrosis, gangrene or dead flesh, in the wound”

That is exceptionally irresponsible – Between 5% and 10% of people who undergo an operation suffer from an SSI. Dangerous pathogenic bacteria such as MRSA and Clostridium difficile can thrive in the wounds left after surgery, and if left unchecked, infection can be fatal. The correct treatment for an SSI is antibiotics.

If anyone were to rely on homeopathy rather than conventional antibiotics, they would be putting their lives in jeopardy.