Hit a Nerve: Dr. Andrew Jones’ Followers Attack

In early 2010, I wrote a post listing warning signs of quack therapies, and in this post I made brief reference to Dr. Andrew Jones, who has created a successful business marketing books, DVDs, newsletters and other sources of “secret” wisdom about animal health that less enlightened veterinarians don’t want clients to know about. Then in November of last year, I reported that Dr. Jones had been repeatedly sanctioned and fined by the veterinary licensing authorities in British Colombia for unethical and illegal marketing activities. On several occasions he acknowledged these violations in writing and vowed to comply with the authorities’ guidelines, but he repeatedly violated these promises. Eventually, Dr. Jones gave up his veterinary license so that he could continue his aggressive marketing business without being restricted by the rules other veterinarians must follow.

Like many alternative medicine practitioners, Dr. Jones offers advice that ranges from routine and well-accepted principles of well-care and nutrition, which all veterinarians offer their clients despite his claims that his insights are somehow special secrets the veterinary profession wishes to suppress, to unproven assertions about benefits from untested therapies (such as herbal remedies), to outright quackery such as homeopathy.

Dr. Jones recently Googled himself and found my article, and while none of the information can possibly be a surprise to him, it apparently hit a nerve. Not surprisingly, he made no effort at all to provide a factual defense of the “secret” remedies he recommends or any justification for his behavior. Instead, he simply rehashes the irrelevant issue of anonymity, which I have addressed in detail before. Here’s his response.

It appears that Dr Skeptvet, if this person really is a veterinarian, has a strong dislike of me.

We are all entitled to our opinions, but when they become public on the internet, I feel that the author should be public.

So this is an entire blog dedicated to bashing and discrediting alternative veterinary medicine, yet the author is anonymous.

Hmmm

I could have started my Internet business anonymously, and never had to deal with all of the ‘challenges’…in fact I would likely then still be practicing.

But that goes against all I believe in…

You have always known who I am, what I do, and even where I live

I have been very transparent and truthful.

Do you have to agree with me?

No

Do you have to buy anything from me?

No

But do I at least have ‘the balls’ to put myself out there?

Yes

Best Wishes,

Dr Andrew Jones, DVM

P.S. Ultimately it comes down to results..not what is said on the internet, but whether or not some of what I discuss actually helps dogs and cats.

My book, Veterinary Secrets Revealed literally has over 1000 testimonials from ‘real’ dog and cat owners.

So what does this boil down to?

1. Since he cannot begin to imagine why I,  the British Columbia Veterinary Medical Association (BCVMA) for that matter, would disagree with what he does, the only motive must be personal dislike for him.

2. He is a brave man for publically selling unproven or even clearly bogus therapies under his own name, and internet anonymity is far worse than selling therapies that don’t work or branding the rest of the veterinary profession as greedy tools of Big Pharma who want to deny their patients access to his treatments.

3. He can provide testimonials that claim his treatments work, so they must actually work and science is irrelevant.

Despite the fact that facts are of no interest to Dr. Jones, including the fact that he has been repeatedly judged guilty of violating the law and of reneging on promises to abide by the rules governing veterinary licensure in his country, he is still required to put his personal version of the Quack Miranda Warning.

DISCLAIMER: This information is for educational
purposes only and is not intended to replace the
advice of your own veterinarian. Dr Andrew Jones
resigned from the College of Veterinarians of
B.C. effective December 1 2010, meaning he
cannot answer specific questions about your
pet’s medical issues or make specific medical
recommendations for your pet.

There is no question that Dr. Jones has a loyal following, which resembles a personality cult in its expressions of blind loyalty and vicious condemnation of anyone with the temerity to doubt their leader. Here are some of the comments made on Dr. Jones’ site and here by his defenders.

I’m not thrilled about vets but I trust you implicitly. You are definitely a doctor of good practices, no matter if you have a license or not.

You run into “JERKS” every where you go.
Seems to me you ran into one more in your life to add to your list.
 

This idiot must not have much to do, or the jam to say who he is.
That makes him a weak minded, useless piece of dog poop!

As a life long animal lover I have met many vets and only trusted 3 of them. I have never met you, but I would have loved to have you as my pets Doctor!

What a spineless excuse for a human being. This person thinks people will believe these lies about you.
 

I’m am truly sorry for the outright lying that is being put on the internet.
I for one believe in who you are as a person and secondly how you treat animals is nothing but exceptional. It’s too bad your home doesn’t give you the respect you deserve and have earned.

every individual that challenged the establishment through history has been ousted by the establishment…Dr Merkola is in the same boat, as well as Dr Weil, and so many others( for humans)… As you know, the attacks come out of fear and ignorance- nothing more..

This sceptivet sounds suspiciously like another site run by an individual calling themselves ‘scepticat’ or ‘sceptikat’- a highly volatile dictatorial site run by a wannabe megalomaniac. A truly disturbed person with a anger management issue venting via their little site to their own personal herd of sycophants. I would dismiss them like a fly on your arm. Just troubled souls with no purpose.

Just another stooge for corporate interests such as big pharma

I cannot believe what this idiot has put up on the internet and I would do my best to shut him down.

I really find your blog quite upsetting…Why you have to be so anti is very unfair, and abhorrent. More like large companies likely to lose revenue pulling strings on the veterinary regulatory body .. There is no profit in healthy animals…

Jehovah created all of the real foods & spices for treating specific diseases. It is admirable that some vets as well as medical doctors are returning to the idea that real foods & spices are an alternative to the poisons that big pharmaceuticals invented to increase their profits and destroy their customers.

You are a lying scumbag…… eat dog shit and die !!!! you evil money monger !!!!

These comments all share the usual characteristics of blind faith in alternative therapies and distrust of scientific medicine.

1. Personal loyalty to individual authority figures and personal attacks on critics, with no reference to facts, evidence, or any substantive argument about ideas.

2. A refusal to even consider any criticism or contradictory evidence as valid in any way.

3. A reflexive and automatic assumption that any criticism must be motivated by personal antipathy, greed, fear, psychological disturbance, or anything other than a reasoned, thoughtful consideration of the evidence leading to a conclusion that their ideas are wrong.

4. Dismissal of the entirety of scientific medicine and all its accomplishments as meaningless fictions generated by the evil pharmaceutical industry or some other bogeyman.

There isn’t much use in responding to such vacuous and personal attacks since there is no indication that any of these folks have any interest in reasoned arguments or scientific evidence. How exactly I could be “lying” when all I did was repeat the coclusions of the BCVMA reports (many of which Dr. Jones acknowledged as truthful in writing) is a bit of a mystery. As far as the issue of anonymity, the mindless personal comments of Dr. Jones and his followers do more than I could to explain why one might blog under a pseudonym, but I’ll just repeat what I’ve said before on the subject in the FAQ for this blog:

Who are you and why don’t you blog under your real name?

It doesn’t matter who I am. My ideas and arguments should be judged on their own strengths and weaknesses, not on the basis of whatever prejudices you may have about me as a person. Am I more likely to be right if I am a woman or a man? Does my analysis of scientific research suddenly become more or less accurate if you discover where I went to school, where I practice, or what color I am? These are irrelevant facts that people use to distract from the points I make rather than deal with them directly. I choose to blog under a pseudonym primarily so that the focus remains on the issues, ideas, and facts under discussion, not on irrelevant personal details about me.

I also choose to blog as the SkeptVet because it makes it a little easier to write about individual patients and questions that my clients ask me while still protecting their privacy. This blog grew out of my efforts to become better informed about alternative medicine and to respond thoughtfully and accurately to my clients’ questions. My clients certainly know my views on the subjects I discuss here because these discussions are simply a part of my ongoing effort to provide my clients, and the public in general, with scientific, evidence-based information. I often refer existing and potential clients to my website, so there is no question of my hiding this information from them.

I have no particular desire for attention or notoriety, but I am certainly willing to take responsibility for the statements I make here. While it is (barely) possible to blog completely anonymously, it requires a great deal of effort, and I have not made that effort (though given the amount of angry, even hysterical hate mail I get, I sometimes wish I had). It is relatively easy to discover my identity. But before you try, ask yourself if it is really relevant to the merits of my argument, or if it is just going to make it easier to dismiss what I say by applying your pre-existing biases and prejudices to me.

As for other accusations, I will repeat that unlike Dr. Jones my Internet presence is entirely non-commercial. I write these articles in my free time to provide a counterweight to the almost universally commercial sources of information on the Internet so that pet owners can have all the facts and arguments to consider when making decisions. I make no money from these efforts, and I lose no money to Dr. Jones or anyone else because they choose to sell therapies that I choose not to employ because they lack convincing evidence of safety and/or efficacy. Despite the vacuous personal abuse I receive as a result, I feel people have a right to an independent source of information and criticism of unproven or quack methods.

The timing of this outburst is particularly interesting, coinciding as it does with the recent attempts by the Burzynski Cancer Clinic to threaten and intimidate critics and to respond to criticism with empty vituperation rather than logic and facts. Such responses resemble the reaction of religious fundamentalists to criticism of their beliefs, which only highlights the ultimately faith-based nature of much belief in alternative medicine, which is impervious to any rational argument or discussion. Fortunately, most pet owners, and even many proponents of alternative veterinary medicine, are far more reasonable and open to substantive debate than these folks appear to be, and so these alternative methods will still have to prove themselves to the majority on the basis of real scientific evidence, not just the passionate faith of their adherents.

 

Posted in General | 24 Comments

Burzynski Clinic Attack Dog Marc Stephens Continues Bizarre Threatening Tirade Against Skeptical Bloggers

The initial threats of litigation against Andy Lewis at the Quackometer, for his critical essay concerning the questionable therapies and ethical practices of the Burzynski Cancer Clinic, have been superseded by a bizarre rant against a multitude of skeptical bloggers, complete with pictures!

Orac at Respectful Insolence has reposted the attack for all to see, but here’s a sample:

Andy Lewis,  Just so you know that I am very serious.  I copied Renee Trimble the Director of Public Relations, and Azad Rastegar the spokesperson for the Burzynski Clinic.  You and your supporters can stop asking if I am an attorney.  Again, I represent the Burzynski Clinic, Burzynski Research Institute, and Dr. Stanislaw Burzynski.  If your articles remain online I will pursue you in court to the highest extent of the law…

You are apart of a network started by Michael Shermer called “Skeptic Society”–http://www.skeptic.com/, which is a nonprofit 501(c)(3) educational organization that examines….alien abductions”.  Your network is linked to other fraudulent websites and individuals, such as, quackwatch.com, ratbags.com, the21stfloor, Peter Bowditch, Rhys Morgan, Stephen Barrett, Dr. Saul Green, etc…

Your Skeptic network uses the quackwatch.com website as the Bible to your mission of lying to the public.  You are not posting your “opinion” and “concern for public health”, you and your network are posting malicious propaganda against my client which stretches back over 10 years…

If your articles remain online I will pursue you in court to the highest extent of the law.

Threats to your family? You mentioned to me that you just had a child.  I advised you to spend more time with your child instead of lying to the public.  I also advised that you will be affected financially once a lawsuit is filed against you. Why would you be so selfish and inconsiderate to your family to go through the stressful and financial burden of multiple court proceedings knowing that you are posting lies and propaganda?

It would be easy to dismiss this guy as a hysterical loon, despite his attempts to intimidate people exercising their right to free speech and providing the public with the information they deserve when asked to spend large sums of money on dubious therapies. But it is doubly conccerning that the Burzynski Clinic itself has not yet made any effort to distance itself from this individual or these tactics. Is this the response of a legitimate scientist or a legitimate healthcare facility?

A detailed discussion of the Dr. Burzynski and his controversial, and unproven aproach to cancer treatment has also been posted on Science-Based Medicine.

Posted in Law, Regulation, and Politics | 1 Comment

Veterinary News Network (VNN) Video Discussing Raw Pet Diets

Here is a brief video discussing the topic of raw diets for pets. It is nicely produced

 

 

 

Posted in Nutrition | 7 Comments

Burzynski Cancer Clinic Threatens Critical Blogger with legal Action

Some of you may remember when I was obliquely threatened with litigation for posting a detailed critique of a talk given by Dr. Shelley Epstein on the scientific evidence for homeopathy. And certainly most of you will know about the British Chiropractic Association libel suit against scientist and author Simon Singh attempting to stifle his public criticism of treatment claims made by the BCA, and the legal troubles faced by Dr. Stephen Barrett of Quackwatch. CAM advocates are notorious for resorting to litigation when unable to defend their claims and practices with scientific evidence.

Fortunately, the lack of factual evidence demonstrating the truth of these claims and, in the United States at least, the principles of Free Speech and Freedom of the Press, generally prevent such attempts at censorship-by-lawsuit from succeeding. It is important, however, that those of us dedicated to defending science and challenging unproven or bogus medical claims expose such transparent efforts to silence criticism of quackery.

The well-known blog the Quackometer recently wrote an expose of the Burzynski Clinic, an operation in Texas which takes large sums of money from desperate people with cancer to provide them with an untested alternative treatment. The clinic, and the “lone genius” behind it, Dr. Stanislaw Burzynski, have responded by threatening the author of the Quackometer expose. I am joining other science-based medicine blogs in publicizing this attempt to silence substantive criticism with litigious bluster rather than facts and logic because I recognize the real danger such threats present to free speech, journalistic freedom, and the kind of vigorous debate necessary to separate good ideas from bad ones in medicine. I encourage others concerned about open scientific debate and the rights of journalists to investigate and expose dubious medical practices to spread the word about this attempt to intimidate critics and suppress debate.

 

Posted in Law, Regulation, and Politics | 1 Comment

The Problem of Negative and Inaccurate Advertising of Alternative Veterinary Medicine

Advertising is a form of communication intended to influence the behavior of potential consumers with regard to specific products or services. As such, it is inherently competitive to some degree, attempting to encourage consumers to choose the advertiser’s product over those offered by competitors. However, widely accepted ethical principles, and often specific laws, require that advertising be fundamentally truthful, within fairly elastic bounds. And there is no inherent need for advertising, though it is competitive, to be negative. It is possible to promote one’s own services without claiming that one’s competitors are incompetent, dangerous, dishonest, or guilty of some other malfeasance against the customer.

We all know that in reality, advertising often falls short of the ideal of factually accurate and civil content. While many practitioners of complementary and alternative veterinary medicine (CAVM) advertise in a way that is at least civil, if not in my opinion factually accurate, I also frequently find examples of advertising for alternative veterinary products and services that are not only inaccurate but also blatantly hostile towards conventional, scientific medicine.

This makes sense in that “alternative” medicine, by definition, must consist of therapies intended to replace conventional medicine, and such therapies would have no value if conventional medicine were accepted as generally safe and effective. “Integrative” and “complementary” interventions are, at least theoretically, not incompatible with conventional medicine, so they could more easily be advertised on their own claimed merits, without the need to claim that scientific medicine is unsafe and ineffective. But even when labeled with these less confrontational buzzwords, such interventions are often promoted on the basis of at least implying, of not claiming outright, that scientific medicine is harmful and not very effective.

Despite disagreements over the theories and scientific evidence associated with alternative veterinary medicine, it seems to me that there might be some common ground possible between skeptics, such as myself, and more reasonable advocates of CAVM to agree that advertising by veterinarians which is egregiously hostile or which depends on painting one’s colleagues as incompetent, venal, or otherwise not genuinely interested in the well-being of their patients is inappropriate. Despite the fact that this blog consists primarily of critiques of therapies I believe make claims not supported by reasonable evidence, I make great efforts to repeatedly affirm that most practitioners of these therapies have honest intentions and are truly seeking the best for their patients and client. I am seldom accorded the same courtesy by my own detractors.

I have previously discussed examples of what I believe to be inaccurate and inappropriate advertising by alternative veterinary practitioners (such as Andrew Jones, Gloria Dodd, and Erik Weisman, all of whom have face legal or regulatory board action for their actions). And to be fair, I have also criticized advertising of conventional interventions that are advertised in inappropriate ways, such as Medivet’s stem cell therapy.

Recently, I came across a couple of web sites which exemplify the worst sort of advertising rhetoric and techniques found in CAVM promotion. If the more reasonable proponents of alternative methods wish to be treated respectfully they might consider challenging such practices among their own colleagues.

Dr. Jenifer Preston of HolisticVetExpert.com provides several examples of negative and inaccurate advertising. The claims and comments made on this veterinarian’s web represent the use of exaggerated and unsupported allegations, and lack of regard for fact, that characterizes the more extreme CAVM propaganda.

Dr. Preston, for example, claims to have an herbal remedy that prevents and cures heartworm disease and other parasitic infestations. Such a claim, if not supported by FDA licensure, is illegal according to the terms of the Dietary Supplement Health and Education Act of 1994 (DSHEA), which forbids prevention and treatment claims and allows only vague “structure and function” claims.

These claims are also dangerous in that they can mislead consumers into failing to properly protect their animals from this deadly disease or to treat them appropriately when they become infected. And because there is no scientific support for these claims, they are sold through disparaging and misleading criticism of truly effective heartworm preventative and treatment agents and the implication that veterinarians sell these “poisonous chemicals” knowing they are dangerous out of simple greed.

Heartworm preventatives are a huge income to both veterinary clinics and the big pharmaceutical companies that manufacture the drugs…There are other alternatives to these poisonous chemicals

Our parasite formula has been used for several years now to treat heart flukes successfully….In my holistic practice, I find flukes and a host of other rarely diagnosed parasites through radionic testing.

We are now using our HVE Parasite Formula to treat all stages of heartworms. As with heart flukes, we have found that a slow killing of these heart parasites is much safer to the patient than the immediate kill-off with drugs such as Melarsomine (Immiticide). We are recommending a therapy (by weight) of daily treatment for seven days for a total of three rounds with two- four day breaks in between. In other words, treat the heartworm-positive dog once daily for seven days; stop for four days; repeat for seven days; stop for four days and repeat daily for a third round of seven days. In severe cases, we may have to go another round or two of therapy.

So far, we have NO side effects in these positive cases–all dogs are doing very well. I also believe that HVE Parasite Formula can be used to prevent heartworm infections.”

This is the most beautiful natural wormer we have found. It is a liquid herbal wormer that we have found to be effective against:

Intestinal Flukes
Liver Flukes
Lung Flukes
Heart Flukes
Intestinal Flukes
Blood Flukes
Cryptostrongyloides (roundworms in the lungs)
Sparganosis (migrating tapeworm larvae)
Pin Worms
Threadworms
Hook Worms
Whip Worms
Roundworms (in any organ including the brain)

Dr. Preston tests for these in her practice, and this is the number one wormer she uses.

There is no evidence to suggest that the undisclosed ingredients in this product, or any herbal product, is a safe and effective preventative or therapeutic agent for heartworm disease, and even many proponents of herbal and holistic therapies acknowledge that conventional medications are the safest and most effective agents for this purpose. What is more, though there are well-known risks to conventional prevention and treatments, these pale in comparison to the tens of thousands of dogs who have been spared illness and death by these products.

Regardless of what I am sure is Dr. Preston’s genuine, though deluded, belief in the statements she makes here, there is no justification for regulatory agencies, or responsible proponents of alternative veterinary medicine, to allow these kinds of claims to go unchallenged.

The rest of the site contains many other cases of misleading and unsupported claims about the dangers of conventional medicine and the superiority of her approach. Dr. Preston’s bio contains a fairly typical conversion story indicating that she began practicing as a conventional veterinarian and then became convinced that she was doing far more harm than good, which led to a conversion to alternative methods. The narrative contains the usual unsupported claims that vaccines and medicines are terrible toxins responsible for most of the diseases science hasn’t yet found a clear cause of or cure for, laments about the unpleasant fact that not all illness can be prevented of cured, and claims that alternative medicine is obviously safer and better but that it is suppressed by greedy corporations and the blindness of  unenlightened mainstream veterinarians.

Dr. Preston practiced allopathic medicine for twenty five years before realizing that the vaccinations and drugs she dispensed daily were causing more problems than they ever solved and often to a more severe degree. So the leading income-producer in her practice–vaccines–was obviously creating havoc in most of her patients. The drugs prescribed every day were literally destroying healthy organs and shortening lives.

Ten years ago, Dr. Preston turned to holistic veterinary medicine–it seemed to be the only answer to the overwhelming set of diseases that were not responding to conventional therapy. For decades, allopathic medicine has been revered and taught in every veterinary college in this country without exploring alternatives! One only needs to realize that many of the biggest subsidizers of veterinary schools across America and Europe are Big Pharma. Who donates new, expensive equipment? Who provides large scholarships? Who provides most of the grants to research veterinarians? Major pharmaceutical companies. She realized that their goal was not to improve the lives of millions of companion animals but to line their own pockets.

She is confident that HolisticVetExpert supplements will tackle diseases that have up to now baffled you and your pet, such as:

-cancer
-mild to severe arthritis and degenerative joint diseases
-joint injuries
-hypo- or hyper- thyroidism.
-cushings disease
-liver and kidney disease
-cystitis-acute or chronic
-urinary incontinence
-constipation
-asthma
-allergies
-obvious or unobvious underlying parasitic diseases
-chronic infections in any system or organ
-vaccinosis–diseases caused by vaccines themselves

As is common in the advertising of “holistic” medicine, the emphasis in this site is on sweeping statements about the dangers of conventional care  and sweeping claims about the superiority of alternative care, all presented with no supporting evidence beyond opinion and anecdotes. The ignorance of conventional veterinarians is portrayed as a positive danger to their patients.

Allopathic veterinarians are trained to relieve symptoms with little or no emphasis placed on the consequence(s) of the treatments selected…

Over the years, drugs and vaccines have made our pets, our beloved companions, seriously sicker and have shortened their natural life span. Why do we so often see premature aging? How do we STOP this trend? Treat holistically! Naturopathic veterinarians have found that these alternative products are accepted so much easier by the animal’s body and therapy is so much quicker and more complete!

By using natural, holistic supplements, we all enjoy a better quality of life, because we ourselves are not exposed to the toxins that go onto or into our pets’ systems!

Here’s another example.

Epilepsy in dogs and cats can develop at any age. Allopathic veterinarians do not give you any real reason that this develops in your beloved dog or cat.

What the vets don’t realize is that they themselves have very likely created this syndrome with vaccines. Yearly administration of multi-valent vaccines assault the animal’s immune system over and over. More and more animals are developing ‘auto-immune’ diseases and the allopathic community has no idea why.

The culprit for seizures – except for the cases of malignancies of the brain or chemical poisonings-is often distemper and/ or rabies vaccines.

One other common contributor to seizures is the use of topical flea products-any brand-they are all nasty.

Another case of dodgy advertising that caught my attention recently, though I have discussed the individual’s advocacy of alternative veterinary nutrition before,  is the site of Dr. Tom Lonsdale, who promotes his book, products, and overall agenda with inflammatory statements like these:

Why there is an alliance between junk pet food makers (‘barfers’ included), many veterinarians and fake animal welfare groups designed to keep pet owners confused and in the dark?

See how incompetence and maladministration characterise the veterinary endeavour.

 The situation is grim and starts with the veterinary profession’s inattention to detail. Whilst it is obvious to most folks…that junk foods are bad for health the veterinary profession appears to have been too busy to notice. Once pointed out, the fact that an artificial diet fed monotonously either directly or indirectly poisons animals, the profession should have risen up and acted. Instead the professional ethic ruled that a mass cover up should apply. With the cover up safely in place profits were to be made. Increasingly elaborate ploys are now used in persuading the populace to a. keep more animals and b. feed them high priced artificial concoctions.

It is my belief that the profession’s political mismanagement and acquiescence is matched by a naive scientific methodology… Our way out of the mire is via a holistic assessment…. Since the holistic approach is not usually taught or practised, here are a few tips which may be of help. Firstly, make sure to have fun. There are no columns of meaningless figures in this approach nor disembodied dry facts.

We have standardised error such that incompetence has become the standard.

Such negative advertising may not be the rule for alternative veterinary practitioners, but it is by no means rare. There is a natural tendency for proponents of alternative methods to promote them in terms of the inadequacies or dangers of conventional medicine. Insofar as they present reasonable evidence to support their criticisms, this is fair play. However, at a minimum, there should be some attempt to offer such evidence, and efforts to claim superiority by insinuating greed, ignorance, or stupidity on the part of the majority of veterinarians practicing conventional should be eschewed.

Posted in General | 7 Comments

From Occam’s Razor: A Scientific View of Pseudoscience

One of my favorite podcasts is Occam’s Razor, the science podcast of the Australian Broadcasting Corporation’s (ABC) Radio National. In a recent episode, A Scientific View of Non-Scientific Beliefs, Dr. Craig Cormick of Canberra does an excellent job of laying out a cogent view of how intelligent people come to and maintain unscientific beliefs despite powerful evidence against them. Though not as comprehensive a treatment of the subject as a book like Michael Shermer’s Why People Believe Weird Things, this short essay outlines some of the key issues, and points out some of the major challenges for those of us trying to counter pseudoscientific, or simply inaccurate, beliefs.

Dr. Cormick Begins with some frightening statistics (which are also oddly comforting only in that they challenge the assumption I sometimes make that the United States is the center of gravity for antiscientific thinking).

So what are we to make of the facts that in Australia roughly every second person believes in psychic powers such as ESP, one in three believes in UFOs and one in five believes in magic?

And a 2005 survey published in the Medical Journal of Australia stated that half of all Australians are taking alternative medicines with one in four not even telling their doctor they are taking them.

Other surveys conducted in Australia and in the USA indicate that about 80% of the population hold at least one paranormal belief which includes astrology. One in ten Americans said that astrology was ‘very scientific’, in the UK belief in UFOs is about evenly divided into thirds between those who say UFOs have visited the earth, those who say they have not and those who were undecided…

According to the US Centre for Disease Control, one in five Americans believes that vaccines can cause autism and two in five Americans have either delayed or refused vaccines for their children. And in Australia according to the Australian General Practice Network vaccination rates have been dropping over the past seven years, with now only 83% of 4 year olds covered which is more likely to lead to outbreaks of fatal, but preventable, diseases.

And in some areas, usually where there are high pockets of alternative lifestyle supporters such as south-east Queensland, the northern rivers of NSW and Adelaide Hills and the south-west of Western Australia vaccination rates are as low as 70%.

He then goes on to point out that providing facts and data which contradict unscientific beliefs doesn’t seem to be very effective in undermining these beliefs. As an example, he points out that despite the comprehensive disproof against the notion that childhood vaccines cause autism, and despite the retraction of the original paper by Andrew Wakefield and the revocation of ex-Dr. Wakefields medical license, belief in a vaccine-autism connection has not been much reduced. Dr. Cormick then gives examples of a number of factors that promote pseudoscientific beliefs based on current research.

The first on our list is scales of belief. People don’t divide into simple for and against camps on those things…There’s usually a wide scale, or a continuum of strengths of belief. So just because you believe in homeopathy and think that genetically engineered crops are unnatural it doesn’t mean that you don’t prescribe to a scientific view of the world on other things. But the further along the continuum you travel towards extreme anti-science thinking end, the more science-thinking is rejected and people at that end are very unlikely to ever shift their position.

It seems quite true that there are such scales of belief. I know of one prominent advocate for alternative veterinary medicine who seems reluctant to criticize the more mystical and obviously faith-based alternative approaches despite being an outspoken critic of religious belief (though I cannot say if the person is truly a believer in these spiritual forms of alternative medicine or is merely being politic). I know another perfectly rational person who proudly claims to be an advocates of evidence-based medicine and who also practices Healing Touch, a non-denominational form of faith healing. So it can be difficult to clearly identify exclusively pseudoscientific thinking because it is often accompanied by perfectly sound scientific thinking in the same brain.

However, as well as being a problem, this could potentially be an opportunity for those of us advocates of the scientific approach. Recognizing that promoters of approaches that are unscientific in some aspect may also me supporters of science in other domains might give us common ground and a common language, which could facilitate dialogue and perhaps education. Or am I being too optimistic?

Next, Dr. Cormick talks about heuristics, the “mental shortcuts” that lead us into false beliefs and keep us there. I have discussed these many times before, but Dr. Cormick takes a slightly different approach to the subject.

It’s the way we respond to rapid and complex information being fired at us. We need to quickly sort it into categories and an easy way to do this is to sort it according to our existing belief systems or values…the cultural cognition effect which put simply, argues that our values are more strongly going to influence our attitudes than any standard demographic like age, gender, race or socio-political status…And through ongoing affirmation and reinforcement of wacky ideas, they become values or beliefs and don’t easily move for anything. If you doubt this, just google “The Royal Family are Seven Foot Shape Shifting aliens’ and look at the sheer amount of confirmation on different sites about this.

Access to the enormous breadth of opinions on the internet has revealed that people, when swamped with information follow up by ‘motivated reasoning’ which means only acknowledging information that accords with our beliefs and dismissing information that does not accord with them.

The next item on Dr. Cormick’s list is the depressing reminder that because of this values-based, motivated reasoning, facts don’t change beliefs very often.

Brendan Nyhan at the University of Michigan undertook a study that found that when people were shown information that proved that their beliefs were wrong they actually became more entrenched in their original beliefs. This is known in the business as ‘backfire’. And what’s more, highly intelligent people tend to suffer backfire more than less intelligent people do, making us immune to any facts that are counter to our strongly held beliefs…

Dr Andrew Binder at North Carolina State University found that most people when faced with an issue related to science and technology fairly quickly adopted an initial position of support or opposition based on a variety of mental shortcuts and predisposed beliefs. Dr Binder stated ‘This is problematic because it suggests that individuals are very selective in choosing their discussion partners and hearing only what they want to hear during discussions of controversial issues.

Dr. Cormick then addresses the “fear factor,” the phenomenon by which the emotional content of issues, particularly those that generate anxiety or fear, impedes a reasoned judgement based on facts. When an alternative medical approach, for example, is marketed through fear, fear of toxins, chemicals, or other nebulous dangers, then people are more likely to accept it despite the evidence against it.

Lastly, Dr. Cormick touches on what I believe is one of the most important factors, one related to the issue of fear: control. Alternative approaches are especially attractive to those who feel a need for more control, over their health or other sources of fear. Simple, confident, direct answers are reassuring and appealing even if they aren’t consistent with the often complex and ambiguous nature of reality. Pseudoscience has an inherent marketing advantage over science in catering to people’s anxiety and need for control because it is not constrained by the true nature of reality.

At the heart of a lot of our non-science beliefs is control. We live in an ever uncertain and more out of control world, but superstitious beliefs and pseudoscience can give people a sense of control and certainty, providing simple answers, which reduces our level of stress which again is a necessary adaptive mechanism and something we tend to be wired to seek out. But here’s the cruncher – science is predominantly based on uncertainty and the simple answer to this simple statement is that unfortunately there is no simple answer.

So what to do? Well, Dr. Cormick doesn’t claim to have a comprehensive answer (which increases his credibility, since any such answer would likely be wrong), but he does have some sensible suggestions.

…good science education can help. There is some evidence that adults with more science training will more often reject astrology or lucky numbers and more often accept things like evolution. Likewise a 2002 PhD study by Alyssa Taylor in Queensland found that a course on critical thinking led to significant decline in belief in paranormal claims.

So we need to educate people before attitudes and beliefs are strongly formed and in this it is more important to teach them how to think than what to think. The only way to make people bullet-proof to pseudoscience is to effectively teach the values and ways of science thinking whilst still young before alternative belief systems have formed.

 

 

 

 

 

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Cooking increases the caloric value of meat and starches

I have reviewed the claimed benefits of raw pet diets previously, as well as the potential risks of these diets (1,2,3). The bottom line is that there is no credible evidence that these diets have any health benefits or that they are safer or more nutritious than conventional commercial diets or properly formulated cooked homemade diets. Given they have small but clear risks, there is reason to avoid them. There is now a small bit of additional evidence arguing that, in fact, the nutritional value of cooked meat is actually greater than that of raw meat.

Carmody, RN. Weintraub GS. Wrangham, RW. Energetic consequences of thermal and nonthermal food processing. Proceedings of the National Academy of Sciences. 2011 [EPub ahead of print)

One of the authors, Richard Wrangham, is an ecologist who has studied the impact of food on the evolution of humans and other primate species. Last year, in his book Catching Fire: How cooking made us human, Dr. Wrangham presented the thesis that a key event in human evolution, the rapid development of a large brain, was made possible by the discovery of cooking, which not only made food safer by destroying parasites and infectious microorganisms, but also increased the energy available in the food. He was able to cite extensive evidence that the difficulty finding adequate calories is a key constraint on the health and reproduction of animals in the wild, including early humans, and that cooking made dramatically more energy available from plant foods. As the authors of the current study put it, “Energy availability is a routine constraint on metabolic processes, including growth, disease suppression, and reproduction, and therefore, it is a key variable for human nutrition and evolutionary fitness.’ The same is, of course, also true for other animals.

In his book, Dr. Wrangham was also able to report studies showing that modern humans relying on exclusively raw foods, for ideological reasons, are chronically undernourished as a result. A missing piece in his argument for the value of cooking, however, was evidence that cooking increases the caloric value of meat, which was suggested by a number of indirect studies but which hadn’t ever been clearly demonstrated. This new study supplies this missing piece.

The study compares the energy intake and weight gain of mice fed either sweet potato or beef. Different groups were fed these foods unprocessed, pounded but not cooked, cooked but not pounded, or pounded and cooked. The results for both sweet potato and beef showed that the mice gained more energy from the cooked foods than from raw or pounded foods, and that cooked foods were preferred.

Of course, dogs and cats are not mice, and they are not fed individual ingredient diets. The point of this study is not to evaluate the issue of the benefits and risks of raw pet diets, which is a much more complex subject. However, it does challenge one common claim made in support of raw diets, which is that raw foods have greater nutritive value. While cooking does reduce the levels of some nutrients, it makes others more available. One crucial nutritive component of food is the energy it provides, measured in calories. And this study demonstrates that the energetic value of both starches and meat are increased by cooking.

Since many of our pets are overweight, one could argue that we shouldn’t care about the greater calorie value of cooked foods since calories are not a limiting resource for domestic animals, as they are for wild animals. Clearly, we need to limit the caloric intake of our pets to maintain a healthy body condition. However, there is still no reason to think that raw diets are superior to cooked diets for this purpose, since the best way to ensure appropriate calorie intake in our pets is to feed them an appropriate quantity of nutritionally balanced food and monitor their body condition. The notion, often advanced by proponents of raw diets, that cooking is an entirely destructive process in nutritional terms is clearly not supported by this study, which reinforces the fact that cooking has been universally practiced by human populations for tens of thousands of years because it improves the nutritional value and safety of food.

Posted in Nutrition | 3 Comments

Homeopathy for Nasal Fungal Infections in Dogs?

A case report recently appeared in the Journal of the American Animal Hospital Association (online only edition) describing the complete resolution of nasal aspergillosis (a fungal infection) in a dog following the use of an ultradilute homeopathic remedy. So what does this mean? Is this evidence for a clinical effect from homeopathy? Is it justification for further research? Is it justification to start giving these remedies to dogs with aspergillosis along with, or instead of conventional treatment?

Epstein, S. Hardy, R. Clinical Resolution of Nasal Aspergillosis Following Therapy with a Homeopathic Remedy in a Dog. Journal American Animal hospital Association 2011;47:e110-e115.

To begin with, a case report is the least useful form of published evidence. It is essentially an anecdote, though with more detail than the usual testimonials and anecdotes used to advertise unproven therapies. It is a story told about a single individual patient, with no attempt to control for the biases that make all anecdotes of very limited usefulness in figuring out whether a medical treatment works or not. Case reports are useful for identifying new observations that might or might not ultimately lead to useful conclusions based on more formal investigation. What they cannot do is prove any particular hypothesis. So on the most basic level, this case report is not evidence that homeopathy is an effective therapy for nasal aspergillosis, or anything else.

The conclusion of the paper, and the conclusion almost always drawn from such case reports, is that further study is needed to determine if the apparent association between the treatment and the outcome (in this case, the apparent resolution of the disease) is a true association or a coincidence, and if there might be a causal relationship between treatment and response. However, there is ample reason, both within this case report and in other evidence and information available to us, to argue that no further study is in fact justified by this report.

The case against homeopathy in general has been exhaustively made many times (e.g. 1, 2, 3). In brief, the theory of like-cures-like and potentization by dilution and succussion are inconsistent with the well-established fundamental principles that underlie all of the rest of chemistry, physics, and medicine, and there is no evidence that suggests these principles might be true despite this inconsistency. Decades of research has failed to establish any consistent benefit from homeopathy greater than placebo. So for this case report to be taken as evidence that homeopathy cured this patient requires, essentially, that it be seen as a miracle that defies established science. It is not simply an extension of previously documented theory and evidence, but a narrative akin to the healing miracle stories told in support of religious claims. If it is true, it represents a fundamental change in how we understand reality.

The alternative, which seems far more plausible to me, is that this dog experienced a resolution of his disease, or at least his symptoms, that was either spontaneous or aided by the conventional therapy he had received prior to being given the homeopathic remedy. Spontaneous resolution of nasal aspergillosis in dogs has not been reported in the literature. However, other kinds of aspergillosis have been demonstrated to go away without treatment, including invasive pulmonary aspergillosis in humans, and aspergillus granulomas in humans. And in my own practice, I have seen presumed spontaneous resolution of nasal aspergillosis in a dog. The patient, a middle-aged golden retriever, had been having nosebleeds for several weeks when he was brought to see me. Rhinoscopy with biopsy and culture ultimately confirmed invasive nasal aspergillosis. The owners declined treatment due to the cost, and after a couple months the nosebleeds ceased. The dog never had any further nasal symptoms and died of an unrelated disease several years later. I know one other veterinarian with a similar story of a dog whose symptoms went away with no anti-fungal treatment.

I doubt if the authors of the current report with consider spontaneous resolution as an alternative explanation for the result seen in their case even had these two cases been published, but it is a far more plausible explanation than that homeopathy cured the patient. The only way to know for certain, of course, would be to compare homeopathic treatment with no treatment to see if those cases treated only with homeopathy recovered any more often than those not treated at all. However, this would be unethical since spontaneous resolution is likely rare, the disease is serious, and there are established effective conventional therapies available. I would argue that even comparing homeopathy with conventional treatment would be unethical since there is no sound, plausible case to be made that homeopathy has any benefit, and using it exclusively would amount to not treating the patients at all.

That leaves using homeopathy as a “complementary” or “integrative” therapy along with conventional treatment as the only ethical option. Again, there is no reason to think it would increase the chances of success for conventional therapy, but such a study could be rigorously and ethically done. If it turned out homeopathy significantly improved the outcome in a properly designed and conducted study, it would indeed be miraculous and require skeptics such as myself to re-evaluate the whole method of homeopathy. This is certainly a reason for practitioners of homeopathy to seek such a study.

For myself, I think the limited resources available for clinical research in veterinary medicine could be better spent on more plausible approaches, but I see no reason such a study should not be attempted if proponents of homeopathy are willing to fund it. But given the paradigm-changing nature of a positive result, the quality of the research would need to be extraordinary (e.g. independently replicated double-blinded, randomized, controlled trials). Such studies have never before succeeded in proving the benefits of homeopathy, so I would not expect this case to be different.

Unfortunately, if such studies are never done, or if they are done and no benefit from homeopathic treatment is found, this case report will continue to be cited as a justification for trying homeopathy on dogs with nasal aspergillosis. The appearance of an anecdote in a journal doesn’t make it any more valuable as evidence, but it makes the story far more valuable as marketing. The American Holistic Veterinary Medical Association (AHVMA) has exhorted its members to publish such case reports for exactly this reason. In fact, a previous report of homeopathic treatment for nasal aspergillosis by the same author is specifically cited as an example of the kind of report needed to promote CAVM. That case was published in the AHVMA journal because mainstream journals declined to publish it due to limitations in the quality of the information gathered and provided.

The emphasis in this effort is clearly not identifying whether or not CAVM methods work but convincing mainstream veterinarians that they do, which presumably practitioners of these methods already know from personal experience despite the absence of supportive scientific evidence. This is a classic example of scientific publication used as marketing rather than as a genuine effort to figure out whether therapies actually are effective or not. Below is an excerpt from a paper in the AHVMA journal encouraging CAVM practitioners to publish case reports (emphasis added).

The Research committee of the AHVMA has recently been reactivated with the purpose of increasing the amount of published material, which can be used by veterinarians and other interested parties to demonstrate effective clinical uses of CAVM, as well as, to assist legislative and regulatory bodies such as state boards in properly evaluating consumer complaints and legislative requirements regarding CAVM practitioners and practices. (AHVMA 2006a) This committee is working to increase the number of high-quality, useful pieces of literature, which can be used to establish the validity and applicability of CAVM, and sees this as an important action at this time. It is hoped that competent CAVM clinicians and researchers will use EBVM to document their successes. Establishing proper scientific literature and making it more readily available allows for more interested parties to learn about many of the miraculous results seen in CAVM practice. (AHVMA 2006b) Doing such actions allows for the expansion of knowledge, the expansion of CAVM acceptability and for the improvement of our profession;”

Case reporting is one way that CAVM practitioners can record their results publicly so that others can benefit from their labors. We know that investigator bias can affect research results and quantum physics has clearly demonstrated that the observer can affect the results of phenomena in the physical universe. This effect can lead to positive results that are not repeatable by others, as well as negation of procedures due to improper environment….

Critics of CAVM are quick to point out the lack of double-blind randomized studies in our field, often without recognizing the situation present in conventional veterinary practice. In many situations, this type of study is not readily applicable to CAVM processes as therapy is individualized to each specific patient’s particular situation. As an example, homeopathic cases are not easily studied in this manner, while acupuncture and herbal medicine can be.

CAVM procedures do work. We all see this daily. Because of the increasingly cooperative efforts by board certified referral practices and CAVM practitioners, it is hoped that such barriers to publication will be minimized in the future as more and more cases are occurring which have excellent conventional and alternative documentation. Case reports have been perceived to be less important in the present environment of scientific literature as they form a lower level of scientific evidence. However, case reports are an important area of scientific enquiry and one that is entirely appropriate for the CAVM community.

 

 

 

 

 

 

Posted in Homeopathy | 7 Comments

Aural Hematoma Review and Other New Info from the EBVMA

The Evidence-Based Veterinary Medicine Association (EBVMA) is continuing to try and support evidence-based medicine for veterinarians, and the latest activity in that effort is producing a series of brief, pragmatic literature reviews on common clinical problems and therapies. The first in the series is now available:

Aural Hematomas in Dogs. Prepared by Annette O’Connor, DV and Teresa Hershey, DVM. Sept., 2011

The review illustrates well the process of locating and evaluating the available evidence for a particular intervention. It found, as is all too often the case, that the evidence was not sufficient for a definitive conclusion to be made.

There are many ways that aural hematomas are treated in dogs. The articles reviewed examined hematoma drainage in combination with either oral or local injections of steroids and traditional surgical treatment. There was no evidence that adding steroids to treatment protocols reduced the number of dogs that needed to be retreated. The quality of the evidence was poor which limits any interpretation that may be made.

This is often the case in veterinary medicine, and even in human medicine. However, it is important to understand the true meaning of this outcome. It is not that any and all approaches to aural hematomas are equally likely to be useful. The application of magnets or color therapy, for example, is not justified by the fact that the evidence is not strong enough to clearly say whether or not adding a steroid to treatment improves outcomes. The fact that the evidence concerning a particular question is of limited quality and quantity means only that sweeping and definitive statements about the efficacy of particular treatments aren’t supported, not that anything anyone can dream up is reasonable.

The EBVMA is also beginning to collect other educational materials from members and make them available to the public and other veterinarians. The most recent additions include two excellent lectures by Bob Larson, a professor at the Kansas State University veterinary college.

Evidence-Based Medicine-An Introduction
Here’s my favorite slide:

Four Myths of Small Numbers and Other Biases
My favorite slide:

Posted in Science-Based Veterinary Medicine | 8 Comments

Guidelines for Minimizing Commercial Influence in Veterinary Medicine

The potential bias introduced into research, medical education, and individual clinician judgment by relationships with commercial entities is a perennial and serious issue in medicine, including the veterinary field. While critics of mainstream veterinary medicine frequently raise this issue when challenging the claims made for conventional diets, medications, and other healthcare interventions (e.g. 1, 2), alterative practitioners and organizations are no less involved with industry (e.g. 3). While financial bias is only one potential influence on the judgments and practices of veterinarians, and by no means the biggest problem we face, it is a source of bias that can be limited and monitored through transparency and rules concerning the kinds of interactions between veterinarians and industry.

The American Association of Veterinary Medical Colleges (AAVMC) has published a new set of guidelines addressing this issue specifically for veterinary schools, and it provides a sensible list of principles for minimizing the potential bias created by relations between industry and academia: Guiding Principles and Considerations: Ethical Interactions Between Schools/Colleges of Veterinary Medicine and External Entities. Though the document is not intended to be comprehensive, and AAVMC specifically recommends each institution develop their own rules appropriate to their unique circumstances, these guidelines identify many of the key areas in which inappropriate industry influence can arise, and they make reasonable suggestions for preventing this.

AAVMC begins with, “the expectation that educational, clinical, research and outreach programs will be based on the best, current and unbiased scientific knowledge. That information must be free of biases or inappropriate influences that may result from interactions with external entities, especially with companies that provide goods and services of value within veterinary medicine.The same should, of course, be true for private practices. While it is clear that research and the development of new and better therapies cannot happen without the resources provided by commercial organizations, it is equally clear that it is all too easy for these organizations to inappropriately influence the content and outcome of research and the practice of individual veterinarians, and strict ethical guidelines are needed to control for this source of bias.

The document then details many of the ways in which industry can attempt to influence the veterinary profession through veterinary medical schools, including:

  • Gifts of goods and service to students, faculty and staff.
  • Gifts to individuals in the form of scholarships, research grants, and other forms of financial support.
  • Gifts to the institutions themselves, in the form of money, products, services, land, etc.
  • Remuneration for speaking, consulting, and other activities.
  • Funding and organization by commercial entities of educational events.

One of the key principles identified in this document, and often not clearly understood, is that the size or specific nature of gifts from commercial organizations to individuals is not relevant to the potential for such gifts to introduce bias. It is not simply a case of crass, direct buying of influence. Sales representatives, who often genuinely believe in the products they are marketing, build relationships and trust and a sense of personal rapport, which subtly bias the decisions of their customers through a sense of personal obligation, through a greater awareness of the products one is most frequently reminded of, and other mechanisms not requiring any malfeasance on any individual’s part. Pens and coffee cups and pizzas are laughable as bribes, and most individual veterinarians are ethical and not likely to accept deliberate bribes anyway, yet the evidence from studies of physicians shows quite clearly that interactions involving even such trivial gifts do influence the behavior of recipients even when those recipients don’t believe it does.

The principles suggested by the AAVMC for minimizing the bias introduced by relationships between industry and academia are not very detailed, but they do touch on a couple of  key elements in such an effort.

  • Transparency and the disclosure of any and all relationships with commercial entities, regardless of how trivial or legitimate they may seem.
  • Managing any and all gifts to the schools, financial or otherwise, centrally so that individual faculty, students, and staff are not directly receiving such gifts from commercial organizations.

Specific rules promulgated by individual schools will need to be considerably more specific. And in many cases, it seems to me that it would be appropriate to ban outright many of the gifts students and faculty receive from commercial entities, including food, medicine, sponsorship of events, and all the innumerable trinkets marketing departments devise. If industry wishes to contribute resources to the advancement of veterinary medicine, financial support filtered through the school administration, or better yet through independent non-profit organizations supporting research and education, would be more useful and ethically less problematic than these sorts of gifts.

What is more, similar ethics policies would be appropriate for private practices as well. I personally no longer attend continuing education dinners and other such events provided to our practice by vendors of veterinary products and services because I have come to believe the risks of such relationships outweigh the benefits, even though I personally have no influence on the product choices made by the management where I work. And while I cannot see how most clinical research could happen in veterinary medicine without industry funding, since government and private non-profit funds for small animal research are incredibly scarce, I would love to see industry support such research indirectly, through grants made to independent organizations which distributed such funds according to pre-defined and transparent criteria of scientific merit. This would allow industry to continue to support the development of needed therapies without such a risk of biasing the outcome of research studies. Such would be a truly philanthropic activity, rather than just a form of marketing. 

Posted in Science-Based Veterinary Medicine | 17 Comments