Happy New Year! Wish every reader tranquility in 2011.
In the first few days of 2011, I
read an advertisement in the newspaper condemning how western medicine could
not solve many medical problems. In the
same advertisement, the author claimed that he was able to do so by some
methods invented by his good self. It is
now a trend that some individuals, without any formal medical training, be it
western or any traditional, claim that they by some unknown reasons, or by self
study, find out the reasons of many illnesses and how they can be treated and
prevented. Sometimes they have
publications to support their claims, but most, if not all of them, are in the
form of books or interviews not scrutinized by others. The contents of such publications are mainly
case reports and circular logics.
Appraisal of evidence needs
training. The public needs to be
informed of and educated on these kinds of pseudo-evidence. I am not saying which tradition of medicine is
preferred. It is the practitioners
claiming superiority over others, but without any sound theory or evidence to
support them, who are problematic. Don’t
think that many people know about evidence-based medicine and can put it into
practice. I had, in an occasion of a
meeting, encountered a doctor who always claimed that he was evidenced-based
oriented. I challenged that the results
of a study might not be valid, or at least not accounted for solely by one of
the interventions, as there were multiple interventions involved. To my astonishment, his counter-argument was
the promotion of some sort of “black-box theory”. He claimed that the interventions could be
regarded as a black-box. By all means,
as long as it was effective, there was no need for us to bother what happened
in between. I stopped arguing back, as I
found it meaningless. If this “black-box
theory” was promoted and preferred, we might be still at the stage of witch
doctors. We need to chant and dance
together with our prescription or surgery as we are not sure what actually
cause healing.
Sometimes, even the gold standard
can be with fault and fraud. In the January
5, 2011 issue of the British Medical Journal, the journalist Brian Deer wrote
about the “MMR vaccine and autism” scam. In the BMJ Blog, Deer compared this with the
“Piltdown Man”: “On 21 November 1953, what
is now Britain’s Natural History Museum stunned both science and the public by
calling the fraud in the case of ‘Piltdown
Man.’ Fragments of
fossilized jaw, skull, and tooth, unearthed shortly before World War I from
gravel beds, 45 miles south of London, were not, as had been believed, the
remains of an aberrant part-human, part-ape ‘missing link.’ They were an elaborate, highly motivated hoax.” The MMR scam began with a press conference
in 1998 after the Lancet published a paper by Andrew Wakefield and colleagues
describing 12 children with brain and bowel disease. “Published in a five-page Lancet paper in February 1998, it triggered
media campaigns which sent vaccination rates plummeting, and caused the
most intractable health alarm in a generation. The paper claimed that in two thirds of 12
consecutive child patients with ‘regressive
developmental disorder’ and
enterocolitis, attending one London hospital’s paediatric gastroentreology
clinic, the ‘apparent
precipitating event’ was a
measles, mumps, and rubella vaccine, with a temporal link between shot and
symptoms of 14 days.” Deer cast doubt at the beginning: “Did the scientific community ever really
believe that 12 families had turned up consecutively at one hospital, with no
reputation for developmental disorders, and made the same highly specific
allegations – with a time-link of just days – and that there was not
something fishy going on?” He looked into this matter with his critical mind and diligence. In 2004, he published his investigation report
in Sunday Times and that led to a GMC hearing of the doctors involved. The hearing lasted 217 days from July 2007 to
May 2010.
Deer spent seven years to investigate into Wakefield’s work. It led to the UK General Medical Council’s
longest ever fitness to practise hearing, after which Wakefield and
his senior co-author, John Walker-Smith, were struck off the Register. The paper was also retracted by Lancet. After GMC published the hearing
findings, Deer kept on looking into this matter. He matched the subjects mentioned to that of
the original paper and interviewed their parents. He concluded that all data had been grossly
modified or fabricated. Apart from
having no ground to link MMR vaccine with autism, the whole study was a scam to
launch lawsuit against the vaccine manufacturers. However, as Deer stated: “Wakefield, nevertheless, now apparently self-employed and
professionally ruined, remains championed by a sad rump of disciples.” That might reflect how the
general public approaches evidence.
Talking about truth seeking, I
would like to gladly introduce a new featured writer for the News. She is Eve LAI and she starts a new regular
section about food beginning this issue. I would describe Eve as a doctor out of my imagination:
Like Deer, she exercises her diligence in dissecting myths to expose the truth.
However, her scope only covers food and
nothing else. I am sure that she would
present to you, in my opinions, fully biased self experience on food.
Talking about food and truth, I
have the duty to report to members my bad (yes, bad; very bad) dining
experience at our Central Club House. I
have to blame myself as I have forgotten that the contract of the chef is going
to end. I would advise and remind myself
to think three times before choosing the Central Club House again, especially
when there are guests and during these few months. If Central is chosen because of the location,
McDonald’s is definitely a better choice.
(Source: HKMA News January 2011)
