Acupuncture for infertility is pointless! Adding a veneer of ‘research integrity’ only goes skin deep.

Acupuncture for infertility is pointless! Adding a veneer of ‘research integrity’ only goes skin deep.

“We understand conflict of interest concerns, but this is why we have strict guidelines and ethics committees …..” – Prof Alan Bensoussan, director of the National Institute of Complementary Medicine (NICM), Western Sydney University (WSU). All academics, including Alan, are fully aware of the importance of research integrity, in which, potential or perceived conflicts of interests play an integral part. As such, WSU does indeed have many rules and regulations to safeguard research integrity in order to ensure that one thing remains intact – summed up in one word: trust.

These guidelines should ensure that the trust between taxpayer and scientist (or the scientific system) remains undamaged, because once it is broken or damaged it can have very serious consequences. We can notice all around us that the trust in the scientific system has been eroded over time. Just look at the number of people who do not ‘believe’ in vaccinations or climate change, then clearly, many people have grown a very healthy distrust in scientists and in the scientific system. It is therefore extremely important that universities act swiftly and decisively when a scientist endangers this trust, because the public does not necessarily look at the specific field of science where a transgression has occurred, they tend to distrust the whole academic system – and remember they keep the system afloat, financially.

So, what is this all about? About a year ago I noticed that in a large number of published peer-reviewed acupuncture papers, authored by the NICM, they failed to declare a conflict of interest. This was quite interesting because they clearly had, and probably still have, a glaring conflict of interest. For example; both Alan Bensoussan and Caroline Smith is (was) listed as consultants, for many years, of commercial acupuncture clinics (they deleted this information as soon as they became aware that I am investigating this issue – you can find an archived page here), the director of these clinics is part of the advisory board of the NICM, students of the NICM find employment at these clinics, the NICM is actively doing research where a positive outcome will clearly benefit these clinics, and the clinics have donated $20 000 to the NICM for the “IVF project” – clearly something that needed to be declared.  You can find more details about this very obvious conflict of interest here and here. But what is this IVF project? An independent journalist called it “Universities in a wacky waste of cash” whilst the NICM called it “Acupuncture to Improve Live Birth Rates for Women Undergoing IVF”, approved by a WSU ethics committee and funded to the tune of $600 000.

This is what an IVF expert had to say about this project: “IVF expert Professor Colin Matthews was outraged the National Health and Medical Research Council had allocated more than $600,000 for a study into acupuncture’s effect on IVF.” The WSU ethics committee that approved this study is fully aware that acupuncture has been shown to be nothing more than a placebo and that it is based on fake scientific principles – hence it is called a pseudoscience. This is now a problem because not only have they abandoned science but they also, seemingly, abandoned their ‘strict guidelines’ to ensure scientific integrity.

But let’s argue that the ethics committee simply did not know about this. Surely, when they are notified about this they will certainly take action to ensure that the trust between the public and academics do not further erode? So, I notified the WSU ethics committee, the advisors to the ethics committee and a number of other people at WSU regarding this issue over a number of months. And now I can reveal their response, and I will quote them; “………………………………..”. Nothing, they did not even acknowledge that they have received this information. After six months, it might be safe to assume that WSU do not plan to do anything about this issue. But then again, I am not at all surprised, as science adheres to the laws of nature (chemistry, physics, biology, etc.), pseudosciences are above those laws. Scientists are held accountable by enforcing these strict guidelines to ensure scientific integrity, sadly, these guidelines do not seem to apply to a pseudoscientist – they are just above it!

Let me try to put all of this into perspective. Most people do not consider infertility to be a life threatening medical condition.  It does, however, have a severe impact on a person’s life, causing broken relationships, severe depression and in extreme cases, even suicide. The more treatment methods a person tries in order to conceive without a positive outcome, the more prone a person is to fall into severe depression (maybe it should be considered as a life threatening condition?). And this is where a pseudoscientist strike, they feed off desperation. If a researcher knows that the method that they recommend is only a placebo, then the project is unethical by default, and it should never have been approved. And oh boy, don’t they know this. There is a reason why they want to ‘integrate’ acupuncture with IVF (which has a success rate of around 45% at 35 years of age or younger, and around 5% when 42 or older), because they know acupuncture is nothing more than a theatrical placebo, and therefore they need to piggy back on something that actually works. If acupuncture worked that well, why don’t they use it as a standalone treatment option? Why did they start these commercial clinics in 2008 and only in 2013 are they doing a ‘scientific’ study to test if it is actually effective or not – wrong way round, maybe?  And if the study turns out to be negative, will they close their clinics? For some reason, I don’t think so!

Having said that, I do not expect to receive any response from WSU. In a previous article I have written about the dishonest type of people that you need at the NICM, this article illustrates that the WSU management themselves are not much better – they are just as dishonest. Hence, the Vice Chancellor, Prof Barney Glover, who is aware of this and many other issues at the NICM, was also nominated for the Bent Spoon award in 2016. Oh, and did they try to squash this nomination, but to no avail – you can read about their hilarious attempts here. But, maybe it is a good idea if a couple of readers can email the ethics committee at WSU, just to ask what is going on with this issue. This might even prompt them to respond (email Steve Hannan at  s.hannan@westernsydney.edu.au).

This brings me to their scientific publications. Journals are usually independent of universities, and as such, they might be able to perform the important job of being the ‘gatekeepers’ of scientific integrity. I have contacted the editors of four scientific journals regarding only five of the NICMs scientific publications, where they intentionally did not declare their obvious conflicts of interest. Here I will discuss the response that I got from one editor (I’ll report separately on the response from the other editors, and the other organisations investigating this issue).

Here is my original message to the editor of the ‘European Journal of Integrative Medicine’:

“Dear Prof. Robinson

 I am contacting you in regard to a recently published article in a special issue in the European Journal of Integrative Medicine of which you are the Editor, “Participation in a randomised controlled trial of acupuncture as an adjunct to in vitro fertilisation: the views of study patients and acupuncturists. Kylie Barr, Caroline A. Smith, Sheryl L. de Lacey. 8 (2016) 48–54”

The authors state under Conflicts of Interest that “There are no known conflicts of interest and no competing financial relationships exist”

 Senior author Caroline A. Smith is a Consultant for a chain of acupuncture fertility clinics in Australia who in turn has donated a substantial amount of money to her research group. The information regarding her consultant capacity for these acupuncture clinics has since been removed from their website but can still be found on the internet archive which you can access here. The reason for this removal appears to be based on an article that I’ve written regarding this matter.

This is not an isolated case, with four articles published in 2016 on acupuncture and fertility related issues where their conflict of interest is intentionally omitted. The editors of the other journals have also been contacted.

 I hereby request that this matter be investigated.

Thank you in advance.”

And here is her response dated 17/01/2017:

“Dear Dr Van der Kooy

I have contacted my Elsevier publisher and she is investigating as you requested and will get back to you in due course.

Regards

Prof Nicola Robinson”

This was unfortunately also the only response that I received from this editor and needless to say, nobody from Elsevier contacted me. As this is now more than 6 months ago, with all my subsequent follow-up emails being ignored, I believe it is safe to assume that this editor never intended to do anything about this issue. So, I had a look at this editor and it turns out that Prof Robinson happens to be an acupuncturist and that she has co-published with the research group in question – and the title of the research paper? “Does acupuncture improve the outcome of in vitro fertilization? Guidance for future trials”. So, she knows the people at the NICM quite well, she know the project quite well, and hence she is also aware that pseudoscience does not abide by the laws of nature nor does pseudoscientists abide by the laws that should ensure scientific integrity. They just need to remain quiet and ignore any complaints, and hopefully everything will blow over and they can happily continue to mislead the public. So, in this case, don’t expect anything from this ‘gatekeeper’ of science – she apparently has way too many vested interests.

In a next article, I will report on the feedback from the other editors, the NICMs attempts to mislead one editor and a couple of corrections to their ‘scientific’ publications that they have been forced to publish.

“All I do is satisfy a public demand”- Al Capone and the Complementary Medicine Empire. Part 2: The profitable political and regulatory connections.  

“All I do is satisfy a public demand”- Al Capone and the Complementary Medicine Empire. Part 2: The profitable political and regulatory connections.  

Al Capone’s “…mutually profitable relationships with mayor William Hale Thompson and the city’s police meant that Capone seemed safe from law enforcement.” If you want to build, maintain and expand a dubious empire, then this is the way to do it. Popularity and a positive public image alone won’t do it, you need strong ties, with mutual benefits, with politicians and regulators.

In Part 1 of the Capone series of articles, the well-known ‘appeal to popularity’ was discussed with Capone’s famous quote “All I do is satisfy a public demand”. Capone was very popular and improved his already positive public image by opening up soup kitchens during the great depression. This is strikingly similar to what the Complementary, Alternative and Integrative Medicine (CAIM) Empire is doing by ‘only satisfying a public demand’ while their proverbial soup kitchen is to provide some very good advice such as a balanced diet, exercise etc.  To understand the context of the current article Part 1 should first be read.

Political and regulatory connections

Capone was big buddies with the mayor, as well as with key figures in the police force (the regulators). To such a degree that he basically got away with murder. The CAIM empire achieve the same feat via organisations such as Complementary Medicines Australia (CMA), Australasian Integrative Medicine Association (AIMA), the National Institute of Complementary Medicine (NICM) etc. Every country has similar organisations, which again link up on an international level. These organisations lobby endlessly to achieve further legitimisation of disproven therapies, for example, through mandatory registration of disproven CAIM practices and therapists (TCM, Osteopathy, Chiropractic etc.). They aggressively defend against any negative scientific evidence and advertise their proverbial soup kitchens via ‘friendly’ journalists – to name but a few things.

But let’s focus on Australia; the deputy mayor of Sydney, Kerryn Phelps, has very strong ties with the NICM and is currently listed as an adjunct, she was the former president of the AIMA and, of course, she operates two integrative medicine clinics in Sydney. The NICM provides the ‘scientific evidence’ and she puts it in practice via her clinics. So, what type of political protection will she wield over the Sydney branch of the Empire, including the NICM? How will they further legitimise disproven therapies? But this is only the deputy mayor of Sydney, here is list of other Australian politicians that have been approached. Here is one senator that has clearly fallen for it – resulting in gems such as genital acupuncture that cures infertility.

What they want is protection, they want to be safe from prosecution, while continuing with their dubious activities. So who better to ask than the big champion of the CAIM Empire, HRH Prince Charles, to join the Sydney club.  Who will dare to touch you when you have the big guns on your side. But we have to be fair. Some politicians and other high profile people will reject the advances of the Empire, problem is, many might not. Be as it may, political connections are of utmost importance making them pretty much untouchable – same as with Capone.

As for the regulators; they have a very strong presence and even chaired the ‘Advisory Committee on Complementary Medicine’ advising and influencing the Australian regulator on CAIM issues. Currently a tremendous effort goes towards further relaxing the already extremely lax regulations governing CAIMs in Australia; “….excessive regulatory burden from the Therapeutic Goods Administration (TGA) as the biggest challenge affecting their business” They want to be able to make it easier and cheaper to sell the public whatever they fancy.

As for their global aspirations. There is one document that seems to have had a major impact on their credibility and expansion drift more than any other, and it is used to defend against any scientific evidence that a specific CAIM does not work. A respected global authority clearly gave them the thumbs up and a green light to go.

“….on the stance that Australia’s peak medical science authority takes towards the aspirations and commitment of the WHO 2014-2023 Traditional Medicines Strategy” (letter from the Australian Homeopathic Society in response to the negative NHMRC Homeopathy report).

The recent release of the World Health Organisation (WHO) Traditional Medicine Strategy 2014-2023 provides an important message to all world Governments that TM is an important and underestimated part of health care found in almost every country in the world, and community demand for it is increasing.”

“…will be in line with the World Health Organization’s strategy of increasing public awareness and strengthening the role traditional (indigenous) and complementary medicine plays in keeping populations healthy.”

The WHO Traditional Medicine Strategy 2014-2023 recommends member states, in effect, to integrate disproven and unproven CAIM therapies with conventional healthcare. This is, surprise surprise, exactly what the CAIM Empire wants and now they use this document as an ‘order’ from the WHO to aggressively expand their operations – because who can argue with the well-respected WHO? Does this report say anything regarding the horrific trade and use of human body parts, ‘harvested’ from children while alive, or the use of endangered animals in their products? (apparently, donkeys are being skinned alive nowadays for their purported ‘medicinal’ value). The NICM approved a thesis in 2008 where the lifesaving properties of Rhino horn was being promoted and currently they direct consumers on their website under the ‘CM resources’ tap, to a site where Rhino horn is listed as a ‘herb’ for when ‘your blood feels hot’! Just 1-2 grams will do the job.

What is their strategy to root out these horrific practices? You would expect at least a chapter on this issue, but no, it is completely ignored and instead a lovely ‘soup kitchen’ strategy is presented. This WHO strategy clearly has the fingerprints of the CAIM Empire all over it, and lo and behold, it was indeed compiled by another adjunct (a naturopath) of the NICM. Anyone that raises serious concerns? Well, it is not us that want to integrate CAIM, the command comes straight from the WHO (they just fail to tell you that they have written it) – and they just continue as before.

Politicians and regulators; it worked wonders for Capone, but the CAIM empire makes him look like a boy scout. They are indeed a very clever, although unethical, bunch of people. Part 3 will deal with breaking the law –  another similarity between the Capone and CAIM Empires.

The NICM’s undeclared conflicts of interest. Is there some ministerial interest in this? An update.

‘Competing interests: The authors declare that they have no competing interests

-‘Conflict of interest: There are no known conflicts of interest and no competing financial relationships exist.’

-‘Competing interests: The authors of this article do not have any financial and personal relationships with other people or organisations that could inappropriately influence their work.’

Three examples (of the many that do exist) where no Conflicts of Interests (COI) were declared. In my previous post, it was made clear that being involved as consultants, with a ‘for profit’ organisation who donated a substantial amount of money to the National Institute of Complementary Medicine (NICM), is a clear COI. Something that has to be declared and yet this is intentionally not being done. You can read about it here.

This COI information was send to three journal editors where the NICM published some of their acupuncture papers. It was also send to the Director of the acupuncture clinics to ask for clarification regarding the NICM’s role and any (financial) benefits coming from this – past and present. And to find an answer to a relatively simple question; is there anyone working at Western Sydney University (WSU), who hosts the NICM, that understands the problem at hand (pseudoscience being promoted and protected at WSU and the subsequent detrimental impact on science and on society) and who are willing to do something about this? The only way to find out is to ask. Therefore, this COI information was also send to about 1500 employees of WSU to ask for their opinions.

So, what happened since?

Only one journal responded, first by telling me that the info has been passed on to their ‘production team’, and a second message; that this matter is being investigated and the outcome of the investigation will be passed on to me – and hopefully the NICM and WSU. No response has yet been received from the two other journals and as for the Director of the acupuncture clinics – no response from either the director, who was send this information twice, nor from the clinics general email address.

That leaves us with the employees of WSU – but first a bit of stats. The number of views that a particular post generates is logged, as well as the country where these views originates from. Another interesting aspect is when you send this large number of emails, approximately 10-20% will immediately bounce back with an automatic out of office reply. Using these two parameters it is possible to see if the emails have actually been send and how many people (you don’t know their identities) have actually read it – or at least clicked on the article link. So, you can make a rough estimate of the number of people at WSU who have accessed your article. So, of the roughly 1500 emails (of the 4000 that I have), about 300 unique visitors viewed, on average, two articles each. The remaining 2500 emails could not be send because the out of office responses suddenly and completely dried up and the number of views from Australia flattened out. And this can only mean one thing; my email address has been blocked. This has happened before but at least a couple of hundred WSU employees have seen this information. So, the question is; did anyone respond?

A grand total of five people responded whereas four of the responses was a simple ‘please remove me from this email list’. The remaining response contained useful and thoughtful comments on this particular issue. Thus, there is at least one person, of those who have accessed this information, that was prepared to give this issue some thought. Is there anyone else out there at WSU who has some thoughts on this matter?

Great, so one might argue that it is mainly silence as usual with not that many people appearing to care much about this or all other issues raised in this blog. But there is some good news. Some journalists made contact, granted not solely because of this COI issue, but rather because of the bigger issues facing Australia regarding complementary medicine. Hopefully this will lead to something happening. But then there is a potential humdinger. Normally one would not expect the minister of health to just send you a letter out of the blue and yet this happened. Again, granted I have send all ministers of health letters regarding the NICM’s modus operandi, but that was almost a year ago – at the time some replied but most did not. So, what is going on here? Why now?

Any politician will be (or should be) concerned if the government dished out more than $600 000 to conduct another controversial acupuncture study. This particular study was even called a ‘wacky waste of cash’ in the media when it was announced. If it now turns out that this study, and most other acupuncture studies conducted at the NICM, has serious COI issues, then this has the potential to make headlines (there is a lot of taxpayers’ money involved).

And if that happens, then it is usually the minister of health that will be grilled. Hence, a simple way of avoiding this would be to say that the matter is under investigation, or that they are still gathering more info or that the matter has been deferred to a different department who can, or should be able to, better deal with this issue – importantly, this needs to be done before it makes headlines. But, the good news is that they might actually be investigating this matter. Hopefully, the investigation will not be limited to this COI issue but the whole modus operandi of the NICM and WSU and the subsequent impact on science, scientific education and the impact on society. Only time will tell.

So, no concrete progress yet, but the ball is starting to role. Let’s see if anything happens in the next week or so.

The NICM and their undeclared conflict of interest. An example of scientific misconduct!

Let’s say you are a highly experienced scientist. You’ve been an academic for decades, you’ve supervised many students and published hundreds of scientific papers. Due to your experience, you’re also on the editorial board of scientific journals, involved in your university’s management structures and you act as a consultant for, or are involved with, various governmental bodies and even with different companies and industries.

Because of your experience you are also well aware that it is of critical importance that your involvement with any company from any industry has to be declared. All scientific journals ask authors to declare any possible, financial or otherwise,  conflicts of interests (COI) that they  might have. Most universities also require academics to publicly declare any type of possible COI’s. There is nothing strange about this – everything has to be transparent and above board.

But what will happen if you intentionally fail to declare that you have a COI? For example: you publish numerous scientific research papers on products or services sold by a company, and you intentionally omit to declare that you are also a consultant for this company? Well, if people find out about this, all of your research results will suddenly become highly questionable because you intentionally did not declare your COI. To be clear, there is nothing wrong with being a consultant but there is a problem if you don’t declare it. The problem gets even bigger if you receive consultation fees or donations from this company – if this goes undeclared, then you are in serious trouble.

Unfortunately, this type of thing does happen and usually the scientists involved will be found guilty of scientific misconduct and depending on the severity of the case they might even lose their jobs. It should however be about the principle and not the amount of money involved, but having said that, a $10 dollar infringement will typically be ignored whilst a million dollar undeclared donation will get you into serious trouble.

The example given above is not hypothetical –  it is a real. It is just another example of how the National Institute of Complementary Medicine (NICM) operates. A recent article explained the issue, that as an acupuncturist turned researcher you have a COI by default – but let’s ignore that for the moment. The acupuncture gurus at the NICM, Alan Bensoussan and Caroline Smith, never seem to declare their COI’s in their acupuncture publications – and they have been publishing quite a lot of them lately. This is interesting for a number of reasons.

-They are both highly experienced scientists and therefore they are fully aware of what a COI is and hence they intentionally omit to declare a COI,

-They are both consultants for a chain of acupuncture clinics in Australia (they tend to delete this kind of information from the website when they are caught out – you can find a screenshot here),

-The NICM did receive a substantial donation from these clinics (so there is financial gain),

Students of the NICM/WSU find employment at these clinics (info used to attract new students?),

-WSU, in all likelihood, know about this COI because donations have to go through their research office,

-Neither of the two researchers have declared involvement with these clinics in the researcher portal under ‘Consultancy’ (you can find it here and here) or in their staff profiles,

-The clinics use their research publications as well as their presence on the team as a marketing tool (Here is a wonderful example. First read how they describe it on their website and then the paper – obviously missing that important declaration of having a COI),

-WSU will probably do zilch about this, because the NICM is one of the Institutes that generates the highest amount of external income for the university – it is after all, all about money.

-WSU is known to delete information once they are exposed and are therefore brothers in crime with the NICM.

So, a clear case of a COI which was intentionally not declared. Now the question needs to be asked; why didn’t they just simply declare to have this COI?

The reason is rather simple. Scientists know that acupuncture is a pseudoscience – it doesn’t really work for the treatment of anything. As soon as the NICM publish an acupuncture paper and they include their COI with these clinics, scientists, and for that matter, anyone reading the paper will question the results – and rightfully so. Therefore, they have to look as if they are conducting their research completely independently – it is supposed to give their results a bit more credibility. But even without this COI issue, they will struggle because external scientists looked at some of their acupuncture publications and the statement was made that it constitutes scientific misconduct – and this was based only on their experimental design, results and how they market their results in an overly positive way to the public. Add the COI issue to this mix, and all their acupuncture publications becomes highly questionable.

The risk that they took by not declaring their COI is, of course, once people find out about it they will lose their credibility – or what is left of it. But then again, who will now actually go and study the modus operandi of the NICM – well, that is what we are here for!

This brings us to the current large acupuncture clinical trial at the NICM, funded by the NHMRC to the tune $ 600 000, focusing on acupuncture and IVF (this also happens to be the ‘speciality’ of the clinics for which they are consultants). When this funding was awarded to the NICM in 2013 this study was labelled “Universities in a wacky waste of cash”. That pretty much sums it up, but will the NICM declare their COI when they publish these results? Highly unlikely – for some reason they consider themselves to be above the law.

We have written a letter to the editors of three different journals where they’ve published some of their acupuncture research to ask them for their thoughts on this matter. We have also written a letter to the director of these clinics to clarify what kind of (financial) benefits the NICM receive in return for their consultation services. No response from anyone yet, but let’s give it a week or so.

A horror movie called “traditional and complementary medicine”

A group of burly men surrounds a delightful three-year-old toddler playing in the park. Out of nowhere, the one man rips off the one arm from the unsuspecting toddler while the other man starts to cut off the other arm. The trembling legs follow and the bloody, unconscious, dismembered body is thrown into the bush to die. In this movie, the bone chilling screams from the toddler is needed as this enhances and strengthens the medicinal properties of the blood-spattered limbs.

A scene from a Hollywood horror movie? No, this horrific scene is not from a movie, it is everyday life in some parts in the world. We are living this movie, although not many people want to talk about it. This horrifying slaying of a toddler happened just the other day – you can read about it here. The reason that this incident barely made the news is because this is not a unique case, it happens way more often than most people would think (for those who can stomach it – you can find more examples here and here – or google “muti killings” or “muti murders”).

How can human beings do something like this to an innocent child? Because most traditional, complementary, alternative and integrative medicines are belief based medicines underpinned by pseudoscientific principles. It is based on “magic”, something that modern science cannot explain nor confirm – or at least that is what advocates of these medicines claim. These people truly belief that a toddler’s limbs, and other body parts, have medicinal value. That many people from all cultures in the world continue to belief, and use their respective traditional health care systems, is due to many different factors.  It ranges from lack of knowledge, distrust of modern medicine (advocates love to promote this aspect), inaccessibility to modern healthcare especially in rural areas in Africa, Asia and maybe even outback Australia, costs involved etc. Another aspect, and a growing cause of concern, is that trusted institutes such as universities defend and promote these pseudoscientific principles in order to balance their books.

The trade in body parts for medicinal purposes, called the ‘muti’ trade, is obviously banned and any perpetrator faces stiff penalties, and yet this heinous practice is not declining it is actually on the increase. Harvesting body parts from people (if you suffer from albinism you are a prime target) and children who are alive, as opposed to corpses, because this augments the medicinal properties makes it all the more horrific. Similarly, the banned trade and use of endangered animals in Traditional Chinese Medicine (TCM) does not seem to have much of an effect, looking at the exponential rise in the number of rhinos that has being blasted to smithereens over the last couple of years. And here again you have people who belief in the magical healing powers of Rhino horn and people at respected universities who promote and support the underlying pseudoscientific principles which dictates that rhino horn, and everything that they fancy, is “lifesaving medicine”. This is the wisdom of traditional medicine! But can we, in western countries, point a finger to Africa with their muti murders or to Asia with their use of endangered animals, bodily fluids and parts and tell them that they are completely bonkers?

I wish I could, but unfortunately I can’t. They can point a finger right back at the West because most western countries have embraced and are increasingly promoting their own pseudoscientific medicines such as homeopathy and chiropractic, and to some degree, TCM and acupuncture. They use clever marketing strategies and fake scientific terminology to achieve this and at the end of the day, children also die horrific deaths as more and more people are being misled or persuaded to use these modalities (deaths occur mainly due to a failure to provide effective treatments in time). But it gets worse in Western countries. Whilst the people harming their children with these “medicines” receive jail time the professors who defend and promote these practices are handsomely rewarded.  Scientists complaining about these practices are ostracised whilst scientists promoting these practices are seen as local hero’s at these universities simply because they bring in loads of money from the CAM industry. So you find these pseudoscientific healthcare systems all over the world and in all cultures.  The golden thread that runs through all of them; a superstitious belief that every single modality works for its intended purpose and nearly zero scientific evidence that any of it works. In a previous article I have written about the opposing and irreconcilable worlds of pseudoscience vs science.

But how to create a happy ending to this horror movie? Most cultures used body parts in one way or the other albeit for sacrificial purposes, for medicinal purposes or even cannibalism – it is (or was) a common occurrence. Whilst this practice is still lingering on in some African (and maybe Asian) countries, the main current aim should be to take the magic out of it. So what better than expert advice and guidance from an independent and truly global organisation such as the respected World Health Organisation (WHO). They should work towards taking the magic out of it and the only way to do this is to convince governments to provide mass education regarding modern healthcare. Other issues that the WHO should focus on is to come up with strategies to overcome the logistical problems hampering modern medicine reaching rural areas and to make it affordable and accessible to all. They should even work towards an exit strategy to provide for the thousands of people making a living from traditional healthcare systems.  To name but a few things.

So in 2013 the WHO stepped up to the plate and published its much anticipated “Traditional Medicine Strategy 2014-2023”. This 76-page report, funded by China and the WHO Collaborating Centre for Traditional Medicine in Hong Kong, unfortunately contains very little or even no scientific information. No discussion on the trade and use of body parts or the pseudoscientific principles on which these “medicines” are based. No discussion of any science stuff such as promoting education, improved accessibility and cost effectiveness of science based effective medicines. There is an  inability to accept that a specific CM is ineffective and should not be used. Instead the whole report revolves around the words “integrate” or “integrative”. This is what this WHO strategy calls for – how to better integrate T&CM, which is based on magic, with mainstream conventional medicine which is based on science. And this goes for homeopathy, chiropractic, acupuncture, TCM – disproven complementary medicines! It is as if the Australian based National Institute of Complementary Medicine (NICM) hosted at Western Sydney University has written this report.  The agenda of the NICM? Accept millions of dollars from the CAM industry, lobby regulators including the WHO to give blanket support for all T&CMs, integrate pseudoscience with science and this in turn increase the sales figures of the CAM industry. So did the NICM write or influence this WHO report?

Who do we find in the acknowledgements section?  Michael Smith, an adjunct of the NICM and a registered naturopath (a.k.a. a pseudoscientist). The NICM would not be the NICM if they didn’t have a finger in the pie in compiling this WHO report and as stated on the NICM’s website “He was one of the primary technical drafters of the WHO Global Strategy for Traditional & Complementary Medicine (2014-2023) and continues to participate in WHO projects, working groups and consultations notably dealing with the regulation and policy setting related to traditional and complementary medicines.” And Michael is not the only one at the NICM who is intricately involved with the WHO. You can find more examples here, here and here. Lobbying and promoting T&CM – that is all that the NICM does.

For the NICM this WHO report is extremely important because now they have a directive from the authoritative WHO and who can argue with that – they can use it to silence their critics. So they proudly follow the WHO’s directive, which they have pretty much written themselves, to; “promote universal health coverage by integrating T&CM services appropriately into health service delivery and self-health care.” That very few of these T&CM’s are effective does not seem to bother anyone, that supporting these pseudoscientific underlying principles is causing untold harm and death to many, including endangered animals, is flat out ignored. But the WHO rather chose to be politically correct, to be sensitive to cultural differences and to be influenced by institutes such as the NICM – who has a financial agenda. They use the logical fallacy, an appeal on popularity, as evidence for effectiveness and based on this the pseudoscientific T&CM needs to be integrated with conventional healthcare.

So this horror movie does not have a happy ending – yet. As long as organisations such as the WHO can be influenced by the NICM and similar institutes there will be a continued, and dare I say, a growing support for the underlying pseudoscientific principles of these T&CM healthcare systems on a global level. This implies that you can go and ban the trade in human body parts or rhino horn all you want, if the underlying principles are not addressed, and people educated accordingly, these atrocious practices will continue unabated.

So what is my issue. I hold anyone of any culture or from any country, and especially experienced scientists such as at the NICM, who promotes and defends pseudosciences responsible for these atrocities. I don’t care if you are involved directly or indirectly or intentionally or unintentionally, if you promote it you are responsible.  And the consumers of all of these pseudoscientific products? Just remember, these companies use their sales figures, even if it is for “harmless” water as in homeopathic medicines, as main justification of effectiveness – an appeal to popularity! Buying their products leads to you unintentionally promoting a pseudoscience with the subsequent atrocities committed in far flung regions of the world. The WHO report might be music to the ears of the NICM and the CAM and TCM industry but spare a thought for the children whose ears are being cut off because of its purported “medicinal” value – they can’t hear the music.

Should one use Wikipedia to share information regarding the unbridled support of pseudosciences by Western Sydney University? Updated 06/07/2016

On the 12th of May 2016 I made a decision to add an informative, but factually correct, paragraph on Western Sydney University’s (WSU) Wikipedia page. Why? Because it is extremely important that students and researchers, current and future, knows about WSU’s decision to fully support pseudosciences. This Wikipedia paragraph tells a story about how WSU view science, scientific research and how they view their responsibility, as a publicly funded entity, towards the public. The impact of WSU’s decision, taken early in 2016, is truly a milestone in the university’s short history and hence deserves mention on their Wikipedia page. This comes after being warned by myself, and other researchers, to investigate the National Institute of Complementary Medicine hosted by WSU.

The paragraph that I’ve added is given below (deleted by WSU after about four weeks).

“Early in 2016 some controversy surrounding the University’s full support of complementary medicine emerged in the press. Former employees, as well as eminent scientists, criticised the biased and unbridled support of the University for complementary medicines such as homeopathy, acupuncture, energy healing, Reiki etc. The main controversial aspect was the continued support of these pseudo-scientific fields in exchange for continued funding from the naturopathic Jacka Foundation of Natural Therapies. The University has since reacted to the critique by bestowing a honorary fellowship upon Judy Jacka, vice-chairperson of the Jacka Foundation. As a result the current vice-chancellor Prof Barney Glover, the Dean of the School of Science and Health Prof Gregory Kolt and the Director of the National Institute of Complementary Medicine Prof Alan Bensoussan were nominated for the prestigious annual bent spoon award of the Australian Skeptics society bestowed upon the “perpetrator of the most preposterous piece of paranormal or pseudo-scientific piffle“.

On the 14th of June 2016 this paragraph was removed. The reason given by Nicole Swanson, digital and social media manager at WSU, was:

“Claims made in removed content are not substantiated and are vexatious. The person who added them refers to his own article which is a skewed version of the truth. The content has no major relevance to the University so does not warrant appearing here.”

But is this true?

Let’s look at the first sentence: “Claims made…” The added paragraph does not contain any claims but only facts. The controversy was reported in an article written by an independent journalist who verified the information with an independent scientist as well as their in-house lawyers before publishing the story in the newspaper. The NICM and WSU was also contacted by the journalist and they were given time to respond – they could not!; “former employees and eminent scientists” – myself and a well-known independent Australian scientist, as reported in the newspaper article, presented the facts regarding WSU and the NICM – fact! (recently an international eminent scientist has joined the choir) etc. etc. This paragraph is based on facts and not claims!

“..are not substantiated…”. I give nine references to substantiate the facts and I can easily give many more references. “…are vexatious….” Very interesting choice of words. Synonyms of vexatious are “annoying, irritating, upsetting, troublesome, bothersome”. With this I can agree. I do believe that what I am saying must be extremely annoying and irritating to WSU, because they know that I am right. They just do not seem to know how to get away with it without anyone noticing.

Let’s look at the second sentence. “The person…” guilty as charged.  “….refers to his own article…”. I reference nine articles, some of them written by myself (in these I use multiple references as evidence) whilst the rest is written by independent persons. And again, I can easily delete all of my references and replace them with references written by independent authors. “…skewed version of the truth.” This is incorrect. The added Wikipedia paragraph contain facts, presented by myself and others. To substantiate this I can also refer to Wikipedia’s explanation on what homeopathy, and many other complementary and alternative medicines, is – it is called quackery and pseudoscience. Not my words but those of scientists around the world.

This is unfortunately the truth unless you are a homeopath or a university receiving millions of dollars from a foundation (Jacka foundation) supporting homeopathy. These facts, as presented in this paragraph, will only become more pronounced as other researchers start to reveal the inner workings of the pseudoscience that is being practiced and supported by WSU. Clearly not a skewed version of the truth, but the truth – they just don’t want to admit it.

Let’s look at the third sentence. “The content has no major relevance to the University so does not warrant appearing here.” I beg to differ. This is a turning point in the history of WSU. They are intentionally misleading students and researchers, current and future, by claiming that they focus on world class scientific research and education while they actually allowed pseudosciences a foot in the door (this is the difference between a claim and a fact). Not even to mention the impact that their pseudoscientific research will have on the public. Will they continue to fight for pseudoscience? Will they decide to have a look at this issue? What will they do? The paragraph that I have added is hence of major relevance.

Wikipedia is a self-correcting medium for sharing information based on facts. It should not be used by companies such as WSU to present a one-sided overly positive view of the company. It is not a marketing platform! It is therefore important that facts, such as what the WSU stand for, is made publicly known. This is who they choose to be and the public, future students and researchers deserves to know this. These are the facts and they should stand by it and be proud of it!  Question is; should I continue to be “vexatious” and continue to add these important facts about WSU on their Wikipedia page? Or will people reading this post join me by continuing to add this paragraph whenever it is missing on WSUs Wikipedia page? (takes about 5 min as the references has to be added manually). As it is, I am alone and WSU has an whole army of people!

22/06/2016

After a discussion on Wikipedia’s “Talk Page” about conflict of interest policies I decided to add a shortened version of the paragraph to WSUs Wikipedia page under section 1.2 Recent History (after my original paragraph was deleted  by WSU on 14/06/2016). This time using only independent references as evidence – how long will it take before they remove it? Below is the paragraph:

“Early in 2016 some controversy surrounding the University’s full support of complementary medicine emerged in the press. An employee, as well as eminent scientists, criticised the biased and unbridled support of the University for complementary medicines such as homeopathy, acupuncture, TCM, energy healing etc. The main controversial aspect was the continued support of these pseudo-scientific fields in exchange for continued funding from the naturopathic Jacka Foundation of Natural Therapies.”

24/06/2016

As expected my paragraph was removed by ‘NeoWalker’ with the reason given “not relevant in context of recent history”. This time though, an unknown person reverted the removal of NeoWalker within the hour stating “unexplained removal of content”. To follow the action, please go to Western Sydney University: Revision history.

02/07/2016

The paragraph is still there! So why not push my luck a bit and add a whole new paragraph. In the contents section under point 8 WSU proudly announce that they won the Ig Nobel prize – strange because this usually means that you are guilty of conducting “useless” research. So I added a new paragraph, using only independent references, under point 9: Bent Spoon Nomination. See below.

“Bent Spoon Nomination

In the same spirit as the Ig Nobel prize for improbable research that first makes you laugh and then think, the university has also been nominated for the bent spoon award. Nominees for this prestigious award is independently evaluated by the Australian Skeptics society and is annually bestowed upon the “perpetrator of the most preposterous piece of paranormal or pseudo-scientific piffle”. The university received this nomination based on their reaction to the controversy surrounding their continued biased support for complementary medicine as reported in the press. WSU reacted to this controversy by bestowing an honorary fellowship upon the naturopath Judy Jacka, vice-chairperson of the Jacka Foundation who also happens to be one of the biggest funders of the National Institute of Complementary Medicine hosted by WSU. As a result, the current vice-chancellor Prof Barney Glover, the Dean of the School of Science and Health Prof Gregory Kolt and the Director of the National Institute of Complementary Medicine Prof Alan Bensoussan were nominated for the prestigious annual bent spoon award.”

05/07/2016

As expected my new paragraph “bent spoon nomination” was removed quite quickly. This time by an independent person with the statement “not notable unless awarded“. I do think this is fair enough, but this only means one thing; I have to make sure that the NICM receives this prestigious award. Or if anyone reading this can “undo” the changes made by Jack Upland on the 5th of July 2016 I would be grateful. I cannot undo these changes because I have a conflict of interest and Wikipedia will block me from editing.

 

Conflicts of Interest: Is there a difference between Doctors and Acupuncturists turned researchers?

Some serious flaws in the scientific reporting of two acupuncture clinical trials, for the treatment of infertility and allergic rhinitis, were recently published on Prof Edzard Ernst’s blog. The overly positive way in which the researchers made their mostly negative results public was also of concern. Both these studies were published by the researcher of the year, Prof Caroline Smith, of the National Institute of Complementary Medicine (NICM), Australia. The stream of comments and discussions that followed made me think of another commonly overlooked aspect when it comes to acupuncture clinical trials. Conflict of interest! In both these studies the authors declared to have no conflicts of interest and in other similar studies by this author this also seems to be the case. The question can be asked; If you are a practicing acupuncturist conducting a clinical trial in acupuncture, isn’t that, by default, a serious conflict of interest? The intention of this article is not an in-depth discussion of what a conflict of interest is, but rather to compare medical doctors with acupuncturists turned researchers. Let me explain.

Some medical doctors (GPs, surgeons etc.) decide to leave their practice after practicing 10-20 years to become full time researchers (and visa versa). Universities accept these people with open arms because they bring with them a wealth of knowledge regarding the practical side of medicine and healthcare in general. They are thus seen as an asset to any medical research project including clinical trials. Can the same be said about an acupuncturist? They also bring with them years of experience and thus they should also be a major asset to any acupuncture clinical trial. But I am afraid not!

Why? Medical doctors have a multitude of tools (drugs, surgical procedures, diagnostic kits etc.) at their disposal to diagnose and treat all types of medical conditions. Yes, there is medical conditions that cannot be treated and to say nothing about the issue of misdiagnosis. But when will it now be a conflict of interest? When they publish a positive clinical trial of a specific medical intervention in which they have a vested interest. e.g owning shares in the company producing the medical intervention (financial interest) or if they have been staunch supporters of this intervention during their years of practice (emotional interest). Just imagine that you have been prescribing a specific intervention to hundreds of patients over a long period of time, and now you have to face them with a negative clinical trial result – that will be difficult. The former is easy to declare whilst the latter might be slightly more difficult.

Doctors also tend to focus on a specific disease e.g. cancer and will perform research with the existing tools at their disposal but also try to find new tools in order to improve the risk-benefit profile of the disease treatment. Thus, for a doctor there is the possibility that they might run into a conflict of interest but due to the multitude of medical interventions this is by no means a given.

What about acupuncture practitioners turned researchers? An acupuncturist only has one tool at their disposal to treat all medical conditions. I can hear them say; but we stick needles in different places and depths etc. depending on the medical condition! Yes, but the fact remains that they can only stick needles into people – and that is a single intervention. So is this a conflict of interest by default? I would argue, yes, it is like having a single drug, packaged differently or in different doses, to treat all medical conditions. If you have treated hundreds of patients for various medical conditions and now suddenly you publish a negative clinical trial, you will not only be red faced when you run into your former (current) patients – who paid for their treatment – they might even sue you for misleading them. As an acupuncturist you cannot allow acupuncture to be ineffective for a specific medical condition otherwise people might start to query the effectiveness, in general, of the only tool you have. And not only that, they might start to question the unscientific principles that acupuncture is based on! And this, no acupuncturist want and hence they will have a conflict of interest by default – no matter what medical condition they aim to treat.

Likewise, if you have been emotionally and financially invested in acupuncture as a cure-all for 10-20 years it will be very difficult, if not impossible, to publish a negative result. In addition, the acupuncture fraternity is a very tight knit community, where negative results are frowned upon because of vested interests – surely they will expel you from this community if you publish negative results and thereby question the only tool that they have?

Keeping the above in mind, how do acupuncture researchers go about conducting clinical trials? An example: Prof Smith and Bensoussan, both at the NICM, are currently registered as practicing acupuncturists. This means that they can legally practice acupuncture and because they have been active for decades they are also well known and respected in the acupuncture fraternity. It is unknown if they’re still actively practicing or maybe practicing part-time in someone else’s practice, or if they have a financial stake in their former or someone else’s practice. Based on the fact that they are still registered it can be expected that they have a current emotional and/or financial interest in the positive outcome of their acupuncture clinical trials.

Because of this inherent conflict of interest and due to the current strict clinical trial regulations, which makes it quite difficult (although not impossible) to fabricate or falsify data, they target the next best thing which is the design of their clinical trial e.g. the A+B versus B design. But it doesn’t stop there. As soon as the clinical trial give a neutral (and thus negative) result, which in their books doesn’t happen very often, the results will be inflated to make it sound positive (another example here). Why? because they must protect the single tool that they have, they must keep the acupuncture fraternity happy and they must protect themselves against potential lawsuits from former (current) patients or a decrease in patient numbers (and thus financial income). On top of that – how would the media and the public react to an acupuncture clinical trial if the lead researcher declare that they have their own acupuncture clinic?  Surely this is a conflict of interest and it must be declared as such?

So what is the main difference between a doctor and an acupuncturist? A doctor has a multitude of medical interventions and might have a conflict of interest – but this is not a given. An acupuncturist has one intervention only and therefore they have a conflict of interest by default –  this is a given and one which they never seem to declare!

Forthcoming attractions: Currently the biggest ever complementary medicine clinical trial in Australia is being conducted by Prof Smith. This large trial is looking at the effectiveness of acupuncture on IVF outcomes and was branded a waste of money in the media when the NHMRC announced that they granted $600k for this project. Question is; when they publish the (inevitably positive) results will they also declare to have a conflict of interest? For some reason, I strongly doubt it.