British Chiropractic Association v Simon Singh

[shuttlt]

Y'all seen this:

Judge rebuked by court of appeal during Richard Desmond libel case

The judge who presided over Richard Desmond's libel battle with Tom Bower was warned by senior judges that his handling of the case risked causing "a miscarriage of justice".

In a court of appeal ruling made during the trial, Mr Justice Eady was rebuked for blocking evidence from the trial, with his decision branded "plainly wrong" by one judge.

 

[BenBurch]

Y'all seen this:

Judge rebuked by court of appeal during Richard Desmond libel case

Interesting. Do you think it is relevant to the Simon Singh case?

BTW, I think Singh should press a counter-suit as it is clear he really HAS been defamed.

 

[rjh01]

What happens if the day of judgment comes and the judge is well no longer a judge? I assume then everything goes back to square one.

 

[BenBurch]

What happens if the day of judgment comes and the judge is well no longer a judge? I assume then everything goes back to square one.

It would indeed. I have not been wishing him health and longevity.

 

[AndyD]

Meanwhile in Australia: Chiropractors want doctors banned from spinal manipulation.

Some splendid comments there.

Indeed, like this one...

Chiropractors are pulling our leg and we doctors mustn't bite. They have dabbled in asthma, otitis media, colic and a myriad of other illnesses they haven't a clue about for decades and no-one has been able to ban them. Despite that knowledge one night, lubricated with a few reds, they thought wouldn't it be a laugh if they tried to stop doctors getting backs to click, crunch, groan and then magically realign. It is quite a funny submission. But it would be funnier if you were tanked. A bit of friendly advice to chiropractors. Tidy up your own profession first.

Posted by Donald Rose, Tasmania 16/07/2009 4:36:27 PM

I recently did a search for rules on Australian chiros using the title "doctor". Almost all states and ACT require the title be clarified by notification that it relates to chiropractic. NSW doesn't allow chiros to use it all, as far as I can work out, unless they actually are a doctor too.

Despite this, you will find Australian chiros using the title on their websites as a matter of course. To repeat Donald Rose above "Tidy up your own profession first".

 

[Klaymore]

Yes, but how do you tell the best hairdresser in town? The one with the worst haircut! Rolfe.

Utterly ridiculous! One finds out who the best hairdresser is in the same manner that one finds out everything else: by lurking in people's bushes!

 

[AndyD]

<off topic a bit>
I've been engaged in a conversation with an Australian chiropractor on my blog. In his latest post, he's used:

A case study of misrepresentation of the scientific literature: recent reviews of chiropractic. http://www.ncbi.nlm.nih.gov/pubmed/11246938

as a means to effectively dismiss any views put by Ernst and Singh. I haven't read that report yet (the link is just the abstract/summary), and see it as something of a red herring, but would be interested in more informed views.

Go here if you're interested. I appreciate the chiro's tone so far, so please keep it polite and informative if you contribute.
</topic>

 

[BillyJoe]

BTW, I think Singh should press a counter-suit as it is clear he really HAS been defamed.

I think Jack Of Kent would offer him the same sensible advice he originally offered to the BCA, which is not to do so - unless he is prepared to see it through to its conclusion, and unless he is prepared for the eventuality that he may lose, and that losing might cost him a great deal of money.

 

[Blue Wode]

<off topic a bit>
I've been engaged in a conversation with an Australian chiropractor on my blog. In his latest post, he's used:

A case study of misrepresentation of the scientific literature: recent reviews of chiropractic. http://www.ncbi.nlm.nih.gov/pubmed/11246938

as a means to effectively dismiss any views put by Ernst and Singh. I haven't read that report yet (the link is just the abstract/summary), and see it as something of a red herring, but would be interested in more informed views.

Go here if you're interested. I appreciate the chiro's tone so far, so please keep it polite and informative if you contribute.
</topic>

Re the quoted case study, don't take too seriously anything written by FCER authors (including Anthony Rosner). See here:
http://chirotalk.proboards.com/index.cgi?board=leadership&action=display&thread=540

As for the report offered by the chiropractor in the link you provide ('Haldeman, S, Carroll LJ, Cassidy JD, and the Scientific Secretariat (2008) A Best Evidence Synthesis on Neck Pain: Findings from the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Spine 33(4S):S1-S220') I understand that Edzard Ernst will be critically evaluating it. In the meantime, this is worth a read:
http://www.sciencebasedmedicine.org/?p=170

BTW, there have been more Rapid Responses to Fiona Godlee's editorial in the BMJ,
http://www.bmj.com/cgi/eletters/339/jul08_4/b2783

and to Ernst's piece as well:
http://www.bmj.com/cgi/eletters/339/jul08_4/b2766

 

[Mojo]

I see William Alderson, author of Halloween Science, another desperate attempt to discredit Ernst, has turned up now (See the Quackometer's review). I came across a copy of the 11 page summary of his effort the other day. It happened to fall open at section 4:

Similarly, in the case of homeopathy the authors allege that "hundreds of trials have failed to deliver significant or convincing evidence to support the use of homeopathy for the treatment of any particular ailment" (p. 139), yet they then go on to use this alleged lack of evidence to claim that "the scientific evidence indicates that homeopathy is wholly ineffective"

Er, nope - evidence from hundreds of trials is not a "lack of evidence".

 

[Badly Shaved Monkey]

Alderson's letter is almost unbelievable awful.

And now up have popped another pair of homeopaths to discuss "cherry-picking" again. They carefully cite Linde (1997) but unaccountably failed to cite Linde (1999).

 

[AndyD]

Thanks Blue Wode. I managed to get over that bump and the conversation continues. I did find a bit of hyperbolic sniping from Rosner and that gave me some idea of what might have been in the original since it was pretty unconvincing.

I'll check the links you gave too.

 

[blutoski]

I think the parachute analogy is relevant, just not in the way Milgrom would like it to be.

The effect and benefit of a parachute is self-evident. It is also not entirely uncontrolled. Even if nobody has set up a formal trial, there have been quite enough naturally-occurring instances of falls from particular heights without parachutes to give us a pretty good idea of the probability that the parachute is having a real effect.

As I'm pretty fed up pointing out, if homoeopathy (or chiropractic, to keep this on-topic) had anything even closely resembling a self-evident effect, we woudln't actually be having this conversation.

Rolfe.

I treat the parachute scenario as analogous to the medical standard of "all or none" which is a lower level of evidence, but can be considered sufficient to go forward with recommendations.

This is why Dr. Novella distinguishes between 'evidence based medicine' and 'science based medicine' - there will always be a flurry of crap studies for altmed. But if the proposed mechanism of action is basically magic, the papers acquire a suspicious air.

Personally, I still think you can get some evidence-based decisionmaking with literature reviews, especially by employing funnel-graphs. If there's an inverse relationship between the quality of the study and the magnitude of the result... that's a bad sign for claims of a probable real effect.

 

[fls]

I treat the parachute scenario as analogous to the medical standard of "all or none" which is a lower level of evidence, but can be considered sufficient to go forward with recommendations.

"All or none" case series are considered Level I (i.e. the highest level) evidence.

Linda

 

[blutoski]

"All or none" case series are considered Level I (i.e. the highest level) evidence.

Linda

Ah, there you go.

My guess is that these series are prospectively designed (to exclude confirmation bias).

 

[fls]

Ah, there you go.

My guess is that these series are prospectively designed (to exclude confirmation bias).

Yeah. Think about how you'd go about using a novel treatment that leads to dramatic results. You'd try it out on everyone who showed up with that condition over the next few days/weeks/months.

Penicillin is a good example.

Linda

 

[Blue Wode]

http://scepticsbook.com/2009/07/29/the-simon-singh-article-that-caused-all-the-fuss-reproduced-here/

In a worldwide campaign released today, 29th July 2009, the Guardian article originally posted by Simon Singh back in April 2008, is being republished across the world.

The edited version has the libelous sentence removed, but is reproduced to allow the public at large to understand the intentions of Simon’s original post. Given the current legal action currently in progress by the British Chiropractic Association against Simon, this provides insight into the claims for all to see.

Spearheaded by Sense about Science, the intention of campaign is to alert the public to the potential implications of libel or defamation as it pertains to free speech and journalism, not only in the UK but also across the globe.

Below is the article produced in full, as approved by Simon and Sense about Science.

Beware the spinal trap

Some practitioners claim it is a cure-all, but the research suggests chiropractic therapy has mixed results – and can even be lethal, says Simon Singh.

You might be surprised to know that the founder of chiropractic therapy, Daniel David Palmer, wrote that “99% of all diseases are caused by displaced vertebrae”. In the 1860s, Palmer began to develop his theory that the spine was involved in almost every illness because the spinal cord connects the brain to the rest of the body. Therefore any misalignment could cause a problem in distant parts of the body.

In fact, Palmer’s first chiropractic intervention supposedly cured a man who had been profoundly deaf for 17 years. His second treatment was equally strange, because he claimed that he treated a patient with heart trouble by correcting a displaced vertebra.

You might think that modern chiropractors restrict themselves to treating back problems, but in fact some still possess quite wacky ideas. The fundamentalists argue that they can cure anything, including helping treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying – even though there is not a jot of evidence.

I can confidently label these assertions as utter nonsense because I have co-authored a book about alternative medicine with the world’s first professor of complementary medicine, Edzard Ernst. He learned chiropractic techniques himself and used them as a doctor. This is when he began to see the need for some critical evaluation. Among other projects, he examined the evidence from 70 trials exploring the benefits of chiropractic therapy in conditions unrelated to the back. He found no evidence to suggest that chiropractors could treat any such conditions.

But what about chiropractic in the context of treating back problems? Manipulating the spine can cure some problems, but results are mixed. To be fair, conventional approaches, such as physiotherapy, also struggle to treat back problems with any consistency. Nevertheless, conventional therapy is still preferable because of the serious dangers associated with chiropractic.

In 2001, a systematic review of five studies revealed that roughly half of all chiropractic patients experience temporary adverse effects, such as pain, numbness, stiffness, dizziness and headaches. These are relatively minor effects, but the frequency is very high, and this has to be weighed against the limited benefit offered by chiropractors.

More worryingly, the hallmark technique of the chiropractor, known as high-velocity, low-amplitude thrust, carries much more significant risks. This involves pushing joints beyond their natural range of motion by applying a short, sharp force. Although this is a safe procedure for most patients, others can suffer dislocations and fractures.

Worse still, manipulation of the neck can damage the vertebral arteries, which supply blood to the brain. So-called vertebral dissection can ultimately cut off the blood supply, which in turn can lead to a stroke and even death. Because there is usually a delay between the vertebral dissection and the blockage of blood to the brain, the link between chiropractic and strokes went unnoticed for many years. Recently, however, it has been possible to identify cases where spinal manipulation has certainly been the cause of vertebral dissection.

Laurie Mathiason was a 20-year-old Canadian waitress who visited a chiropractor 21 times between 1997 and 1998 to relieve her low-back pain. On her penultimate visit she complained of stiffness in her neck. That evening she began dropping plates at the restaurant, so she returned to the chiropractor. As the chiropractor manipulated her neck, Mathiason began to cry, her eyes started to roll, she foamed at the mouth and her body began to convulse. She was rushed to hospital, slipped into a coma and died three days later. At the inquest, the coroner declared: “Laurie died of a ruptured vertebral artery, which occurred in association with a chiropractic manipulation of the neck.”

This case is not unique. In Canada alone there have been several other women who have died after receiving chiropractic therapy, and Edzard Ernst has identified about 700 cases of serious complications among the medical literature. This should be a major concern for health officials, particularly as under-reporting will mean that the actual number of cases is much higher.

If spinal manipulation were a drug with such serious adverse effects and so little demonstrable benefit, then it would almost certainly have been taken off the market.

Simon Singh is a science writer in London and the co-author, with Edzard Ernst, of Trick or Treatment? Alternative Medicine on Trial. This is an edited version of an article published in The Guardian for which Singh is being personally sued for libel by the British Chiropractic Association.

More:
http://www.layscience.net/node/621
http://www.zenosblog.com/2009/07/what-fuss-is-all-about.html

ETA - Official link on this latest development:
http://www.senseaboutscience.org.uk/index.php/site/project/380

 

[volatile]

Ooooh, ballsy. Spiteful, but ballsy. I like it.

What does "republished worldwide" mean? Print media?

 

[Roadtoad]

Ooooh, ballsy. Spiteful, but ballsy. I like it.

What does "republished worldwide" mean? Print media?

Hopefully far more than that. I say we post links ourselves.

 

[BenBurch]

Our goal should be nothing less than the outlawing of Chiropractic. They started this war, I say we finish it.

I will see to it that entire piece is read on the radio in the next week or so.