I have not had much time for Blogging this week. So in this weekly round-up there is a bunch of stuff that would otherwise have become Blogposts.
British Chiropractic Association v Simon Singh
This week saw public statements by both parties.
Simon Singh surveyed the adverse effect libel law has on science and journalism in the Times Higher Education Supplement.
For the BCA, their Vice President Richard Brown attempts to defend chiropractic generally and the BCA's libel case in particular in both the New Scientist and in Pulse (registration required).
An interesting digest and synthesis of the case so far is at the Lightbucket Blog.
The, Er, Unofficial Transcript Of The Preliminary Hearing
The skeptic satirist Crispian Jago (with the help of the eminent court reporter Monty Python) provides a wonderful and hilarious transcript of the preliminary hearing, which Ben Goldacre rightly described on Twitter as "surprisingly clear and easy to follow".
Crispian's work brings me back to what got me interested in the relationship between skepticism and the law in the first place: the witchcraft trials of the early modern period. Now nudged, I may Blog more about this fascinating topic, especially as elsewhere in the world there still are people being tried and punished as "witches".
Beyond the Quacklash
Yesterday I set out on this Blog my thoughts on the Quacklash which is currently taking place against UK chiropractors.
Le Canard Noir, however, has redfined this on Twitter as the "sudden recoil of Internet action against quacks who resort to legal methods to answer criticism".
I think he must be right; my Blogpost concentrated on the legal and regulatory aspects of the phenomemon (which is not surprising given my own interests), but those aspects are part of a wider internet-based action.
I gratefully accept and endorse his definition.
One comment suggested that the adverse ASA determination was the significant factor. That may be correct, but what impressed me was the sheer speed with which that was analysed and exploited (and Kudos on this in particular to Zeno).
I think that without the ASA determination there would have been a similar bout of activity, but without this one particular weapon.
Homeopathy Awareness Week
Speaking of the wise old duck Le Canard Noir, he must be congratulated for his sterling work in promoting Homeopathy Awareness Week (HAW), which starts today.
The homeopaths must be hoping that it does not turn out like the ill-fated Chiropractic Awareness Week.
In any case, the efforts of Le Canard Noir have resulted in a pleasingly high Google hit for his site.
Crispian Jago's satirical take on HAW is here and a great skeptical post on homeopathy and hay fever is here
The Implications Of Spotify
This week I discovered Spotify, the music industry's attempt to undercut peer-to-peer file sharing by providing free streamed music.
An interesting article on all this is here (hat tip to Lawks O'Lawdy).
Long term readers of this Blog will remember that, before misconceived CAM libel cases dominated my Blog, I have an interest in the intellectual property rights of music.
In my Blogpost last October, I argued that making money out of recorded music is a passing fad, a mere hundred year or so blip in the history of music.
I still think this is the case. If, to (mis)use the phrase of the great Lawrence Lessig, there is a celestial jukebox where music (and films and indeed anything which can be converted into electronic data) can be streamed for free and on demand, why would anyone pay to download it into their hard drive?
Indeed, will downloading join the "disk in a box" as something rather cumbersome we used to do?
Let me know what you think: I plan to return to this topic, and especially its implications for intellectual property rights, soon.
Recommended Blog
I have been a big fan for some time of Dr Aust's Spleen.
Those who follow UK Bad Science Blogs will already know this insightful, well-written, and usually curmudgeonly site; but what impresses me is the ease with which Dr Aust can also deal with any legal issues as they arise.
An expert Blogger is one thing, but one who shines useful light on other areas as he or she goes along is rare.
One just wishes Dr Aust would Blog more often...
Sunday, 14 June 2009
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12 comment(s):
"Indeed, will downloading join the "disk in a box" as something rather cumbersome we used to do?"
It might, but while Spotify is a great service it won't do the trick alone. MP3 players have changed music listening habits dramatically, so that people now expect to be able to listen to their music while travelling. Internet based services can't (yet) offer this sort of service.
In order to displace downloading completely, a streaming music service would have to offer connectivity everywhere, including inside buildings and on the tube, from a device no larger than a mobile phone. Otherwise people will still use their ipods on their commute and still need to download and store music.
Interestingly, various phone manufactures (Nokia in particular) are trying to establish music services. The Nokia download-based service seems not to have been a huge success, I suspect because it tied the user to just their phone and one PC if they wanted to access their music collection.
Yes, more on witchcraft, please.
Would someone please tell me of all the ramifications of the BCA/Singh issue?
Does this mean that every health care provider (G.P., physiotherapist, cosmetic surgeon etc.) will now have to look at their websites and advertising to ensure that they are not providing treatment that is not absolutely 100% bullet proof and valid? Does this also mean that every medication whether it be Over the Counter or by prescription must be absolutely valid and able to be justified by the highest level of scientific analysis. (I pity the poor psychiatric drug industry).
Does this mean that the cosmetic surgeons and skin rejuvenation specialists must validate all of their care.
How will all the other health care providers cope, when the same pressure is put on them as is being put on members of the BCA? Maybe there is more to this than was initially intended. the pharmaceutical industry must be cringing. Any comments?????????????
Does this mean that every health care provider (G.P., physiotherapist, cosmetic surgeon etc.) will now have to look at their websites and advertising to ensure that they are not providing treatment that is not absolutely 100% bullet proof and valid?
Let us hope so.
But target the transparently obvious parasitic frauds first, eh?
Does this mean that every health care provider (G.P., physiotherapist, cosmetic surgeon etc.) will now have to look at their websites and advertising to ensure that they are not providing treatment that is not absolutely 100% bullet proof and valid?
Let us hope so.
But target the transparently obvious parasitic frauds first, eh?
Ah, the voice of reason is back!!
Thanks for the unsolicited testimonial, Jack.
I really must try and post more often. I suspect it is mainly that, like many academics, I have a pathological fear of putting out anything "half done". Although the two children and the dying computer don't help either.
Re the point Anonymous 08.08 was making, I don't think so. If the chiropractors had simply said "people bring us babies with infantile colic", that would have been completely without advertising or legal ramifications. It is what you can claim to help with, treat, or say your therapy is, quote, "effective for".
PS I see it's now 10,000 signatures and rising
Bravo Dr. Aust! "If the chiropractors had simply..." Nobody would possibly disagree with you on that. If it werent that there is some evidence, come to think of it actually quite a lot of it. Mind you that's probably irrelevant as the mind is set and the evidence just follows from that, right?
The whole process has been very entertaining so far,... I wonder what the word will be when Mr. Singh is shown up and when the good people of these sites look at the actual evidence as opposed to that selectively chosen by said "scientist". Maybe, just maybe, Mr. Singh should "have simply said" that on the basis of his research and the papers he selected for this research, he concluded that... Would have been a great deal more respectable, scientific and helpful.
Stefaan Vossen
Hmm. For the conditions Singh mentioned, there is quite a bit of anecdotal evidence, and trials that are so low quality that they tell us little or nothing.
There is less high-quality evidence, but almost all of it tells us chiropractic is ineffective.
To me, a reasonable way to characterise this would be:
"there is no believable evidence that chiropractic works for this stuff".
Is what the chiropractors are complaining about that Singh left out the word "believable"?
If that is the basis of their complaint, then it seems to me that what they are really whinging about is someone calling them on their right to cherry-pick the evidence flagrantly, whilst simultaneously "donning the mantle of medical professionalism" as part of their self-promotion.
Basically, you cannot have it both ways. If you want to join the game, you have to accept all the rules, not just the ones that suit you.
Ah! The game! Yes, and what game would that be exactly?
I respect your, and for that matter Mr Singh's positions entirely, I think good critical work has been done here, no doubt about it. In fact I cannot but respect your position (although i may disagree with the course of action drawn from it, as a staunch believer in free speech I have simply no choice than to respect anyone's position, cue Noam Chomsky) What I do question though are whether the motives are indeed as impartial as one would be lead to believe. And that Dr Aust is the crux of the matter. It is not the work in itself that is being put into question, itis the motive and the manner in which this was expressed in the press that is put into question and to tribunal. Science is a wonderful thing of great importance and by en large hand in hand with law the pinnacle of our humanity, that which elevates (although I find that a dubious choice word) us from our animal state.
You talk of a game and the rules that go with it. It used to be that if you believed it then it was true, then it was the religious leader who had to believe it for it to be true. Then it was what the papers said and now it is what the scientist says. We have thankfully come miles ahead from that (albeit debatable whether we are as a culture any richer for that, but I'd rather invite you for a cigar to debate that). The game is being refined and the rules are being adapted as we see which rule or combination of rules yields the best predictors and the greatest dependability. But surely, you don't believe that we have reached the actual peak of this progression? This is the very essence of what we are debating here, and I would argue with you that Mr Singh broke a few rules of decency, scientific, and journalistic which are also part of the game he played. But that's by the by now, I would like to focus on something more constructive and I for one think that you have hit the nail on the head when you speak of "the game" and I think it would not be unfair to look for one splitsecond at the objections thrown up by those scientific heretics some people here seem to hold chiropractors to be.
No they are not "anti-science", they are clinicians. Ask any clinician what percentage of their practice today is based on research analysis and what percentage is based on what they now has worked in the past and you have your answer there and then. Yes there is overlap, and of course that which has been shown the work in a lab, rct etc. may make it through to market, the imperative word being "may", but it only gets to market and only ever stays in market if it shows itself to work in clinic. I don't think it is unfair to say that something that works in a lab but cannot be duplicated in real life will last long in practice, so in fact good sir, the whole process of science "making it into clinic" and that of "staying in clinic" are entirely different. The latter is simply one of collecting sufficient anecdotal evidence, one clinician at a time.
The former deserves credit, don't get me wrong, but this is where we have to look at the clinical nature of what the constituents of the arena chiropractors deal with actually are to understand their "disgruntled" position: there are clear indications that back pain can be and is infact in my opinion in most cases multi-causal. Broadly speaking biomechanical events have physical, psychological and biochemical constituents. They each have a myriad of subcomponents. Just in the physical we have anatomical anomalies, gait anomalies, descending malocclusion problems, all very real stressors which either aggravate an injury, increase the statistical likelyhood of injury or slow down the rate of recovery from an injury. They are all very hard to assess and hard to treat. Not all people know about this stuff,...in fact very few people know, and that is just the physical!Now let's just throw into the equation some dietary considerations, a few hormonal issues and maybe a psychological issue to boot... I think you catch my drift and may (or may not) agree that predicting in those circumstances becomes quite difficult.
We look at backpain and look at something that is in some cases purely one issue, some cases a mix of two, or three or four, and now you start to become aware of how it is possible for somebody to getresults with a treatment which shouldn't work according to the books.But the books made one big mistake, they looked at "back pain" and used the same methodology for all of the sample group, and it may indeed be that the treatment for a large sample group doesn't work, as the percentage of people within this sample group with an underlying issue which responds to that form of treatment is small.
Simply put a significant amount of the research done until recently is completely useless due to a lack of discrepancy and definition and a lot of the research which should be done is difficult to do due to the enormous size of samples required to do it at good quality level. Not impossible mind you, just difficult.
One thing that seems to be missed regularly in the debate held about chiropractors is that they are not "spinal manipulators". They do a lot of that and are pretty damn good at it, but it's not what they are. They are also motivator, part time exercise coach, fatclub manager and will try their hand at most things which they can see have a beneficial effect for their patients, including some awful stuff (which they should, and for 99% of the profession's population do know better). Maybe they could be better at those things, but don't you think they are trying hard (maybe too hard?) because they understand the complexities at hand, they understand that the patient wants help and they will try -that which they've seen work before (see my previous comment of "making it into clinic"). Lots of people talk about back pain as if it is monocausal, what a load of crock! These people have either never seen a patient with back pain or just don't want to acknowledge the complexities and are deluded that because the patient didn't come back they were cured (a belief widely held and supported by the financial reward structure of our British NHS). So polycausal assessment and treatment analysis it is then. With fairly broad subcategorisations in the analysis I once calculated that you are looking at in excess of 5 million potential permutations... (with a probable spread of 3 to 4 million being significant) makes life a tad difficult wouldn't you agree.
That said we're working on it.
Regards,
stefaan Vossen
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