Benefits of working with Prof Ernst.

When I first contacted Dear Professor, back in 2008 I was very naive in terms of systematic reviews and CAM research in general. As far as I can remember, I wanted to do research related to ethics in CAM, compassionate attitude of CAM practitioners or something similar. I received moderately enthusiastic response and I continued working at the UEA as a research associate and had had to wait another two years for our next encounter. I contacted Prof again in 2010 when I was fed up with the Polish academic institutions. At that stage I began to realize the pros and cons of systematic reviews. I did a scoping search in PubMed and found out that quite a few CAM modalities were not researched properly. For instance, I noticed that several RCTs of guided imagery had been published and no systematic review existed. I emailed Prof asking for collaboration on the above mentioned topic. To my amazement, his response was positive and he agreed to participate. This was a pivotal moment in my research career. We started exchanging emails with draft versions of that SR; and after a month or so the paper was ready. I then applied for the post of Associate Research Fellow, attended the interview and got the job of my dreams in Aug 2010. Since then the research has flourished and more than 50 SRs were published on various aspects of CAM (safety and effectiveness). We  still more or less liase with one another, and o hope this will thrive.

I recently have not failed but noticed that our critical publications might have closed several doors for me at world famous research institutions. I emailed the guy in charge of CAM research at Harvard Uni asking him of collaboration on a yoga project. To my surprise, he wrote me that my research collaboration with Prof Ernst had caused a lot of damage to CAM and that I was persona non grata in some CAM environments. I haven't replied him back because I was too busy with  projects. Of course one would ask why? Now I believe that writing this blog is a better way of exploring the plausible answers.

First and foremost, the question would be: Have I done something wrong? Apart from several critical reviews on osteopathy and chiropractic, the vast majority of our projects' conclusions were positive. Take for instance our yoga projects; 75% have reached optimistic conclusions. The same direction would be for guided imagery, herbals and so on. For these reasons I do not think I did something wrong. Conversely I often get emails thanking me for what I have done. Answering this rhetorical question, I firmly believe that ain't. 

Anyway I am extremely grateful for what he did for me. He taught me a lot-a new ways of using my brain and exploring CAM research using objective but critical thinking.

Here is an example: I personally do believe in qigong and its effectiveness in preventing diseases and maintaining overall health; and exercise it a lot. But I do not understand why should I mix my personal experiences with  evidence and state that it is effective for X or Y disorder where the research data would show otherwise?

The fact is that most people know Prof's views but they do not know him personally. I think, he as the person is full of sense of humor, friendly, modest and down-to-earth guy. Meeting him was one of the most valuable experiences of my life and I strongly believe that some doors might eventually open as the result of our nearly two years long cooperation. Thanks for reading.

Men's Health Updates: Supplements don't help with prostate cancer

Men's Health Updates: Supplements don't help with prostate cancer: NEW YORK (Reuters Health) -  Despite dietary supplements being popular among prostate cancer patients , a new review of ...

The safety of homeopathy

We have recently written the article about safety of homeopathy. A total of 1159 of adverse effects were reported in 38 primary reports and we concluded that homeopathy has the potential to harm consumers in both direct and indirect ways. Following that publication in International Journal of Clinical Practice, we faced a fiery critique (not surprisingly) from angered homeopaths.

In our factual (rather than emotional, personal, etc.) response, we addressed point by point any more or less reasonable comments posed by our opponents. I admitted making several mistakes- a few typos, one example of inaccurate translation, and misinterpretation of the heart disease case in a reply to the Letter to the Editor. Unfortunately, there were several issues raised by other authors, which I believe were less rational. We were accused of ‘lack of logic’ in our review. Some researchers could not understand how on earth homeopathy might have caused cancer, death, dialysis, toxic polyneuropathy and quadriparesis. We had to explain them the fact that low dilutions of arsenic, mercury, aconitum, or thallium are highly toxic and poisonous. Therefore it comes as no surprise that such undiluted ‘remedies’ can be lethal. 

Another, rather biased comment, we faced, concerned the alleged logical fallacy in our review. The question/comment was something like this: “why did we dare to address the safety profile of homeopathy when in fact it is totally harmless”?  To be perfectly frank, I do struggle to  understand such argument. People spend millions of dollars on homeopathic remedies and therefore they deserve to know whether homeopathy is safe or not. I never said that homeopathy is pure placebo, nor that it is devoted from any pharmacologically active ingredients. I strongly believe that we had a right to ask the question: how safe the intervention is?  It is as simple as that – homeopaths believe that a remedy works, I believe it should be thoroughly checked for safety-end of the story. For me personally, writing this review was ‘job as usual’. I had not had any preconception or bias prior to this article. I was simply doing my job, i.e. answering the research question, whether they accept it or not.

Anyway, in the discussion section we emphasized both strengths and limitations of our paper. I think some critiques of us did not read to whole article though. We stressed the often problematic nature of case reports. More specifically, their often poor quality and our inability to establish a cause-effect relationship between the homeopathy and the adverse effects. We never aimed at comparing adverse effects of homeopathic remedies with those of conventional drugs (even though such a publication is missing). One cannot also draw any meaningful conclusion regarding the possible incidence rate of adverse effects from our review.

To wrap-up this short post, I believe that our paper addresses important albeit in some environments neglected topic. To our delight, the EIC wrote that, they “will not retract the article, but will encourage continuing debate”.

Thank you for reading and understanding.

The author : )

Dietary supplements and prostate cancer

Hi All~!

We have recently published a systematic review of double-blind placebo controlled trials of dietary supplements for prostate cancer. Having searched five electronic databases, eight trials met our eligibility criteria and all of them were of high methodological quality. Of those 5 reported no significant effects compared with placebo. Only two manufacturer sponsored trials with a small number of prostate cancer patients reported that a cocktail of vitamins, minerals and other plant derived substances significantly decreased prostate specific antigen levels (markers of cancer progression/regression) compared with placebo; and one trial did not report between-group differences in prostate specific antigen levels.

Following the publication I had an interview with the Reuters in which I said that “by no means is the evidence [for the effectiveness of dietary supplements in prostate cancer] conclusive. I was also asked whether any of these supplement combinations could help? Well, I replied that these supplement combinations are rather useless in the treatment of prostate cancer. I was also asked what sort of recommendations I would offer for such patients? My only recommendation for prostate cancer patients would be a healthy lifestyle and balanced diet. This includes reduced caloric intake, diet low in animal fats, animal proteins (including dairy), and rich in fruits and vegetables. Other 'natural substances' might include green tea, pomegranate seed, turmeric or capsaicin.

The main message from our review would be that no miraculous supplement for PC exists and no supplement can replace a balanced diet. I personally doubt that these results would affect sales of supplements. Market or the internet is full of bogus claims and I would not be surprised if companies were marketing these supplements as effective for PC and generating large profits as a result. 

Surely one must consider that supraphysiological doses of vitamins or minerals can be toxic/hazardous. In fact several studies have shown that supplementation with folic acid, calcium, vitamin E or multivitamins actually increases the risk of prostate cancer in smokers. We also discussed that in a survey, 79% of physicians and 82% of nurses had reported recommending dietary supplements to their patients. This is quite striking finding bearing in mind lack of benefit of supplements and their potential to harm.

The average person should also refrain from alcohol, tobacco or excessive stresses, maintain a healthy body weight, think positively and exercise regularly. As a physio I was also taught that weak or imbalanced pelvic floor muscles might be the contributing factor to the imbalances of prostate. If that is true (I do not have any evidence in mind to support these claims) one could also prevent PC by exercising regularly.

Thanks for reading this post. : )