BBC website pushing sCAM (why am I not surprised?)

Zep said:
Chances are the "doctors" who advise the BBC on this website are "doctors" of CAM themselves. That is, the insane are running the asylum.
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Well, maybe. Earlier in this thread:

Blue Wode said:
It looks like Dr Hicks is someone we should keep an eye on.

From his BBC ‘experts’ bio:

And according to this web page he is a Maida Vale GP who practices acupuncture,
http://www.cyberspacehealthclinic.co.uk/about_us/press_reviews.html

….and who also seems to be heavily into homeopathy if this ‘Homeopathic Remedies for Mental Health Problems’ article which he “medically reviewed” in September 2005 is anything to go by:
http://www.healthyplace.com/alternative/dietary_supplements_8.asp

Is it any wonder that the public gets the wrong impression about complementary and alternative medicine when a medical doctor like this makes such an uncritical contribution to health reporting in the media?
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Here is the latest salvo:

The insufferably arrogant BBC said:
Dear Yahzi

Thank you for your follow-up email. I understand that you were unhappy with my previous response.

I can only apologise that you felt my response was in any way patronising or insulting as I assure you that was never my intention. Indeed, reviewing my response I would have to disagree with your sentiments.

I explained that our sites are constantly reviewed and updated and that the section you refer to has undergone a lot of recent changes. Our editors have informed me that the page you refer to doesn't appear to have been changed in direct response to any complaint(s) we received.

Nevertheless I trust that you may feel different about this. The BBC appreciates the comments you have made on this and I will make sure they are passed on to the relevant departments of the Corporation and to BBC Management. However, may I say that whilst this department does its best to answer enquiries and comments, we must always be mindful of the limitations of time and resources if we are to apportion an equal measure of service to the whole of our audience. In brief, we are not always able to respond to complaints on the same subject arriving regularly from one source.

I am sure you will understand the expenditure to do this can only come from the licence fee, and the result is that resources are then diverted from the core function of the BBC which is to provide programmes.

We will continue to register any further comments you may make with the site editors, but because of the demands on our time and limited resources, we may not in future be able to acknowledge receipt. I would, however, like to take this opportunity to thank you once again for your continued interest.

Thank you, once again, for contacting the BBC.

Yours sincerely


Ethan Kennedy
BBC Information Complaints Coordinator




http://www.bbc.co.uk/
This e-mail (and any attachments) is confidential and may contain personal views which are not the views of the BBC unless specifically stated. If you have received it in error, please delete it from your system. Do not use, copy or disclose the information in any way nor act in reliance on it and notify the sender immediately. Please note that the BBC monitors e-mails sent or received. Further communication will signify your consent to this.
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And my response:
Yahzi said:
I read the last missive from Mr. Kennedy with astonishment.

Just how hard is it for the BBC to acknowledge what the word "different" means? Do you not possess a dictionary? Can you not look it up on-line? Can't you trundle down to Oxford and just ask them?

In his letter, he complains that the BBC does not have infinite resources to respond to complaints. Yet he cannot simply say, "Oh, you're right - that's what the word difference means." I get a page and a half of piffle, and not even a single acknowledgement of the actual issue.

Perhaps the BBC should spend its limited resources on actually responding to complaints, instead of attempting to obfuscate until the issue goes away.

You put up a web site that claimed that Alternative Medicine was different than scientific medicine because it cared about the patient as a whole. You have since changed that web site, without ever once acknowledgeing that is what it said. It's as if you are simply incapable of reading English.

But then, given that you are incapable of doing science, medicine, or simple integrity, I don't suppose I should be surprised.

...sign me Astonished that the British Empire Lasted So Long,
- Yahzi
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I have just received an 8 page reply from the BBC's Editorial Complaints Unit. Essentially it agrees with a number of my points, but the bottom line is that they don't understand the difference between opinion and evidence. They seem to follow the post-modernist dictum that everyone's view is equally valid. PM me for a copy.

Yahzi - I am surprised that you have managed to keep the dialogue going on as long as this. Well done! The reply I got was along rather similar lines - they won't admit they were wrong, but they change the site anyway.

Blue Wode - interesting to see Dr Hicks' extracurricular activities. In fact a certain academic CAM researcher of my acquaintance was initially approached to review the BBC site, but was never engaged.
 
Asolepius said:
Blue Wode - interesting to see Dr Hicks' extracurricular activities. In fact a certain academic CAM researcher of my acquaintance was initially approached to review the BBC site, but was never engaged.
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That's a real shame. So they had good intentions, once upon a time.
 
For the edification of all I am attaching my complaint and the reply. I haven't tried this before so I hope it works!
 
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Sorry, the reply is too big for the forum so if you want it please PM me your email address.
 
Just to let you know, even if you think you are tilting at windmills, there are people like me cheering you on.
 
I had problems with attachments so here is my complaint in full:
Sent: 28 December 2006 17:22
To: 'ecu@bbc.co.uk'
Subject: Complaint - BBC Health website

Importance: High
Dear Sirs

This is a formal complaint about misleading and unbalanced content in the section of the site of which the top level URL is http://www.bbc.co.uk/health/healthy_living/complementary_medicine/. I have been directed to your department after a protracted dialogue with Alison Wilson, Divisional Adviser, Factual Programmes, after my original complaint via the BBC website. I am especially disappointed that it took three months to get any kind of substantive reply from the BBC. Moreover, all replies have totally repudiated all my complaints, while tacitly accepting them by making a succession of changes to the site. However I still have a number of concerns about the following sections of the site:

What is it? (http://www.bbc.co.uk/health/healthy...ne/basics_whatisit.shtml#how_is_it_different?)
Although as a result of complaints this section has been substantially changed, I still take issue with the statement "Complementary medicine focuses on the whole person, with lifestyle, environment, diet and mental, emotional.......". This is not stating anything different from orthodox medicine. A doctor seeing a new patient always takes a full history, and explores factors which ordinarily may seem unrelated to the cause of the consultation. This section perpetuates a long-standing myth created by the complementary and alternative medicine (CAM) community.

Does it Work? (http://www.bbc.co.uk/health/healthy_living/complementary_medicine/basics_doesitwork.shtml)
This gives the strong impression that the main reason for lack of evidence is lack of research. This is very misleading, as a great many controlled clinical trials have been carried out on many CAM modalities. For example, over a dozen systematic reviews of homeopathy have shown no effect beyond placebo. As you may be aware, a systematic review is at the top level of evidence and pulls together the best available data from individual trials. It is true that placebo-controlled trials can be difficult to design for some CAMs, but you should not give the impression that this is not an appropriate approach. The randomised controlled trial is not the preserve of medicine, and underpins most of science. It is well documented that the better the design and conduct of a trial, the weaker the observed effect of CAM. CAM's proponents continually attempt to undermine the value of controlled trials, for this very reason.

Under "Is it safe", it is rather a serious omission to mention chiropractic without any warning of the risk of vertebral artery dissection, a significant cause of strokes.

Selecting a Therapy (http://www.bbc.co.uk/health/healthy_living/complementary_medicine/basics_selection.shtml)
This is totally unbalanced, as only sources of information supportive of CAM are provided. There are no links at all to impartial sites where evidence can be found, such as Bandolier, Clinical Evidence, or the Cochrane Library. Neither are there any links to sceptical sites such as www.ebm-first.com or the health sections of www.senseaboutscience.org.uk. When selecting a therapy, it seems obvious that the first question will be whether it is likely to work, and you provide nothing relevant to this.

In a Consultation (http://www.bbc.co.uk/health/healthy_living/complementary_medicine/basics_consultation.shtml)
Quote: "Although many of these diagnostic techniques are widely used, some remain unproven by the clinical standards of western medicine and aren't necessarily accepted by the medical or scientific professions. Don't be afraid to ask the practitioner to explain the type of test being done and its level of accuracy." The truth is that almost all of the diagnostic tests outlined here have no evidence to support them, and are not based on science at all. If the patient asks the practitioner for an explanation, they will get the usual non-scientific one. The patient should be advised to obtain objective information from independent sources.

Aromatherapy (http://www.bbc.co.uk/health/healthy_living/complementary_medicine/therapies_aromatherapy.shtml)
Towards the foot of the page there is a claim that aromatherapy can be used for pain, with a link to the NHS Complementary and Alternative Medicine Specialist Library. In fact the study described on the NHS site did not find any evidence in support of this statement. It is extremely misleading to make this claim.

Ayurvedic medicine (http://www.bbc.co.uk/health/healthy_living/complementary_medicine/traditional_ayurvedic.shtml)
While the descriptions on this page are of interest, it should be pointed out that there is absolutely no evidence of any kind to support the view of the human body set out here. There is only one systematic review of ayurveda in the published literature, which shows no effect for rheumatoid arthritis.

Traditional Chinese Medicine (http://www.bbc.co.uk/health/healthy_living/complementary_medicine/traditional_chinese.shtml)
The claims under "What is it good for?" are unsupported and dangerously generalised. Curiously, there is nothing whatever in this section about safety, despite well publicised cases of toxic materials in products sold by Chinese medicine shops. Again there is no evidence for the view of the human body presented by such imaginary concepts as `chi', `jing' etc.

Manipulation (http://www.bbc.co.uk/health/healthy_living/complementary_medicine/therapies_manipulation.shtml)
As noted above, there is no warning about vertebral artery dissection caused by chiropractic. Cranial osteopathy is a completely bogus technique with no evidence to support it. Chiropractic has been shown to be no more effective for back pain than physiotherapy and/or exercise, and there is no clear evidence that it is effective for anything else.

Alexander Technique (http://www.bbc.co.uk/health/healthy_living/complementary_medicine/therapies_alexander.shtml)
There are only two clinical trials as identified by a PubMed search. Only one of these provides an abstract, showing efficacy in Parkinson's disease. No evidence to support the other claims made on this page was found.

I note that the section on homeopathy has been removed. I previously objected to the ridiculous ideas presented there, and in particular to the citation of the study by Benveniste et al that was discredited and withdrawn by the journal Nature. If it is intended to provide an updated section, I hope that this will reflect the current scientific evidence, and in particular that the controversy is not one of differing opinions between scientists. It is one between the overwhelming majority of scientists who do not accept imaginary concepts, and others who do not accept science.

Overall, I am not suggesting that the traditional concepts for many CAMs should not be presented on your site. It is fine to tell people what the thinking is behind a particular type of CAM, but this should not be presented in any way as representing the truth, unless scientific evidence exists to support it. Neither should you imply that there is some sort of intellectual conflict between science and tradition, with both sides equally valid. This is not the case - science seeks to uncover the truth, and to reduce uncertainty. This is why it is constantly changing. Tradition by definition stays the same, and is not interested in being challenged. Your site would benefit greatly from making this clear, and by including a balanced range of links to external sources. At present these are almost all for partisan organisations which are not going to provide objective information. Indeed, balance is not necessarily achieved by giving both sides equal exposure (and you are not even doing that). It is better achieved by giving prominence to that which is supported by evidence. I note that the site is the responsibility of the Factual Programmes department. This suggests that the content should be factual and not speculative. Facts are supported by evidence, so you have an obligation to base the material on that and not on imaginary concepts. Even astrology is mentioned on some pages, without any comment that it is totally without foundation.

I accept that there are limitations as to the level of detail appropriate for media aimed at the general public. But the strength of the Web is that it is multi-layered, and it is very easy to direct readers to further levels of detail if they are interested. You are directing readers to a great deal of material which is biassed in favour of CAM and is not critical. You are also generalising to a dangerous level, for example by stating that evidence exists for Tibetan medicine, without qualification. A review of the literature shows that the only studies reporting benefit are of Tibetan herbal medicines. Indeed what little evidence for CAM as exists is largely explained by orthodox phenomena, such as chemicals in herbs, physical effects of massage, and neurological effects of acupuncture. This is not to dismiss their value, but to clarify that they do not derive from mystical principles.

Your disclaimer does not absolve you of the need to address all the foregoing points. In a court of law the principle that obtains is that of the overall message which the reader takes in. In cases of advertising, disclaimers are largely ignored by judges if the impression given is misleading. The BBC is respected worldwide for objective and factual reporting, and the material on this website falls a long way short of that standard.

Yours faithfully
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Here is a summary of the response:
The site should offer links to external sites which represent a reasonable range of views about a controversial subject like complementary medicine.
The "Selecting a Therapy" page needs to be balanced with some alternative views on complementary medicine (Point 3).
A link to an NHS study gave the misleading impression that aromatherapy has been proven to be effective in managing pain relief. This has been removed (Point 5).
The "What Is It Good For?" section on Chinese medicine has been removed (Point 7)
The first sentence on the "What's it good for?" section on Manipulation has now been reworded so it does not sound like a statement of indisputable fact (Point 8).
The sentence stating the Alexander Technique is "particularly effective " at treating a range of complaints has been similarly reworded (Point 9).
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I have OCRd the full response and it's still too big to post here so if you want it please PM me your email address.
 
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I’ve had a slow read through the reply that Asolepius received from the Head of Editorial Complaints at the BBC and although it’s good to see that a few positive changes have been made/are going to be made to the site, the HEC does make some rather fatuous remarks.

Firstly, he seems to think that CAM therapists’ qualifications, expertise, and Codes of Conduct offer protection to the public when in reality they often do little more than lend respectability to quackery.

Regarding vertebral artery dissection and spinal manipulation, he says:
"The BBC Health site frequently includes warnings where these are thought to be appropriate, but I think it is under an obligation to do so only where there is concrete evidence of significant risk."
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Although he says that there is now going to be a warning on the site about the risks of spinal manipulation, it obviously doesn’t bother him that there’s very little concrete evidence for most of the CAM therapies that the site’s promoting.

There’s also an admission that some of the wording
“is deliberately couched in the use of ‘can’ rather than ‘does’…”
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which suggests that the Factual Programmes Department, which is apparently responsible for the site, condones the use of weasel words.

And he also says that:
The Editor of the site describes it like this: “What we are saying through the site is ‘This is what complementary medicine says it is’. We are saying what is available, what it is used for but we are not making claims for its effectiveness.”
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Well some might say that they’ve been using language distortion to imply that various CAM therapies are effective.

Most revealing of all are the HEC’s own views on the evidence base for CAM:
“The vast majority of readers of the complementary medicine site are presumably already aware of the fact that the therapies it covers are an alternative to orthodox, mainstream medicine, and don’t rest on the same kind of evidential basis. I therefore think there’s a limit to the extent to which the evidential position in relation to each therapy needs to be spelled out."
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(My bold)

That’s a pretty irresponsible presumption. Great to see Asolepius pursuing this.
 
I wouldn't really call this closure, but the BBC has published its adjudication. Try as I might, I could not get them to understand the difference between opinion and fact. They think that to say something is `controversial' is a universal let-out, and they don't have to come off the fence and say that one side is simply wrong. They really don't see how damaging such a view is for society.
 
Hmm:
The general approach of the pages was appropriate for readers who could be expected to be aware that complementary therapies are alternatives to orthodox medicine and, by virtue of that fact, don't rest on the same evidential footing.
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Shouldn't they have some sort of disclaimer saying that the pages should only be read by people who realise that there is no good evidence that sCAM works?
 
However, the range of external links didn't reflect the controversies in this area, and failed to fulfil the requirements of the BBC's Online Guidelines.

In addition, the Unit found the complainant had made a number of valid criticisms of individual pages, though these were addressed by changes to the site made during the course of the investigation.
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Well done! It's not a complete victory but it's most definitely progress.
 
Been looking at CAM pages. They do not appear to have added 'appropriate external links ...to the relevant pages..' The ruling was made a month ago?

1. Timing?
2. What are 'appropriate external links'?
3. What are 'relevant pages'?
 
rjh01 said:
Been looking at CAM pages. They do not appear to have added 'appropriate external links ...to the relevant pages..' The ruling was made a month ago?

1. Timing?
2. What are 'appropriate external links'?
3. What are 'relevant pages'?
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Yes, I noticed that. I only just got a letter from BBC enclosing a print of the ruling. They have indeed not added any sceptical links. Methinks a chasing email.......
 
Interestingly I just fed this site to the Quackometer.

Web site titled 'BBC - Health - Healthy living'

The black duck says...


This web site has more quackery than my village pond. It is full of scientific jargon that is out of place and probably doesn't know the meaning of any of the terms. It shows no sceptical awareness and so should be treated with a suspicious mind. It also looks like this site is trying to sell stuff. Buyer Beware!

This site has a has a currently measurable quackery content of 10 Canards
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