A Photon in the Darkness

Moving Day

2007-09-02T18:48:00.000-07:00

I've decided, based on expert advice from a number of people, to move my 'blog. It will from now be found at:

http://www.photoninthedarkness.com/

I'll keep the current 'blog in place for a while to allow time for everybody to notice that I've moved and update their bookmarks and links.

Come on over and see the new Photon in the Darkness 'blog!

Prometheus

Myths and Legends of Autism: Part 1

2007-08-24T13:00:00.000-07:00

The Myth of the Poor Excretor:

Myths have traditionally been invented to provide explanations for phenomena that were beyond the understanding of the people who made them. Thus you have fiery chariots carrying the sun across the sky, serpents swallowing the sun during an eclipse, the world being created between fire and ice or the many myths of the Cargo Cult in New Guinea and Melanesia.

Another reason for people to invent myths is to deal with unpleasant truths that they wish to ignore. This impulse has given rise, in more modern times, to “irreducible complexity” and the Myth of the Poor Excretor.

The original impetus for the Myth of the Poor Excretor was the finding, by a number of practitioners involved in “alternative” autism therapies, that autistic children often had low hair mercury levels, which conflicted with their firmly held belief that autism was due – at least in part – to mercury poisoning.

When Holmes et al completed a study of 94 autistic children and 45 age- and sex-matched controls and found that autistic children had significantly lower hair mercury levels, there were only three conclusions they could reach:

[1] Mercury protected children from autism.

[2] The hair mercury tests were screwed up.

[3] Autistic children don’t excrete mercury into their hair.

Choice [1] is strongly counterintuitive, but should not be discounted out of hand solely for that reason, since much that is true in science goes against our best intuition. Choice [3] is contrary to decades of research data on mercury metabolism in mammals and so is clearly wrong. Choice [2] appears to be the most likely explanation.

Unfortunately for the authors, the only choice that doesn’t either nullify their hard effort (as [2] would) or contradict their immutable belief that mercury causes autism (as [1] would), is the only choice that is clearly wrong. Instead of abandoning their immutable belief that mercury causes autism - as their data would suggest - they invented the Myth of the Poor Excretor.

According to this myth, autistic children are unable to excrete the mercury they receive from the environment and – more importantly – their childhood vaccines. As a result – so goes the myth – they accumulate the toxic metal and become autistic. It’s a compelling tale, except that it’s complete rubbish.

If you read the study, you will find that this “hypothesis” of "poor excretion" arrives on the scene like a deus ex machina, without any data supporting “poor excretion” in autistic children – except for their low hair mercury levels, which can be better explained in other ways - and no data supporting the implied idea that mercury accumulation in hair can be impaired by any means - apart from cutting off the blood flow to the scalp.

There are also no citations of the scientific literature to show that this “hypothesis” is supported by the researches of other scientists. There is not even any mention of how this “hypothesis” flies squarely in the face of decades of research into mercury metabolism and how that might be reconciled.

In other words, it appears to have been made up out of thin air to keep the authors from having to abandon their cherished belief that mercury causes autism.

Now, it may be true that mercury causes autism in a small number of children – the currently available data is not able to eliminate that possibility. But that is a long way from saying that mercury does cause autism. And the Holmes et al study does nothing to support either the claim that mercury causes autism or that autistic children are “poor excretors” of mercury.

As it turns out, there has been a fair bit of research into the distribution of mercury – both organic and inorganic – into hair. Stuides by Yasutake and Hachiya (2006) and Wilhelm, Muller and Idel (1996) have clearly shown that hair mercury levels are proportional to blood mercury levels at the time the hair is growing. Shi, Lane and Clarkson (1990) showed that the uptake of mercury by hair was dependent on hair growth.

And 'way back in 1986, Mottet, Body, Wilkens and Burbacher showed that the amount of mercury in the hair depended primarily on the amount of mercury in the blood. They also found that the ratio between blood and hair mercury was constant over a wide range of doses and between animals.

But, even with all of this evidence available to them, the Holmes et al authors chose instead to create the Myth of the Poor Excretor. Like most denialist myths (myths invented to ignore unpleasant truths), the survival of the myth depends largely on the existence of a large number of people who also don’t want to face reality. For whatever reason, that pool of people exists and the Myth of the Poor Excretor has persisted to the present day, some four years after its invention.

Next: The Legend of the Maverick Doctor(s)

Prometheus

Another Nail in the Coffin...

2007-08-20T13:33:00.001-07:00

Although I have begun to despair that the "mercury-causes-autism" hypothesis can ever be killed, a recent study by Zhao et al has driven another nail into its coffin.

In their study - "A unified genetic theory for sporadic and inherited autism." - the authors describe exactly how spontaneous mutations could cause both sporadic autism (autism in families without a family history of autism) and familial or inherited autism.

You see, this has been the real mystery in autism (not the faux myteries of "poor excretion" and "mercury poisoning") - how families with inherited autism can show the same mutation in all affected members yet not have the same mutation as other families with inherited autism (for example, see here, here, here, here and here).

The answer, it appears, is that females with mutations associated with autism may be resistant to developing autism. Why this is so is not yet clear, but it has been shown pretty conclusively. These women may have one of the many mutations that cause autism but they do not develop the disorder themselves.

However, even those who don't develop autism are still carriers of that genetic mutation and (on average) 50% of their sons will receive that the mutation. Of the sons receiving the mutation, a high percentage of will develop autism. Additionally, about 50% of their daughters will also get the mutation, although only a few will develop autism (all who receive the mutation will be carriers).

This, of course, is not the entire story, but it is a reasonable lay summary of the article.

For those people who will immediately say, "Aha! It's those nasty chemicals/viruses/cell phones that are causing mutations in our children!", let me point out one thing:

The mutations are in the germ cells (i.e. sperm and eggs) of the parents of the autistic children. For these mutations to happen in a child and cause autism, it would have to happen at the single-cell stage (immediately after fertilization).

I encourage people to read the article for themselves - it's available free online. Don't just take my word for it. It's not an easy read, but even if you can't understand it all, you should come away with the idea that [a] this looks less and less like a simple case of "environmental toxicity" and [b] it is a much more complex issue than many of the autism "advocates" would have you believe.

Happy reading!

Prometheus

How Science Works

2007-07-30T17:15:00.000-07:00

From reading what many of the vaccines/mercury/”toxins”/whatever-causes-autism promoters have written about the science of autism, it is clear that most of them have only the vaguest idea of what science is and how it works. Here is what I hope will be a clear and concise “debunking” of some of the more pervasive “myths” about how science works.

Vox populi:

One of the most commonly repeated misconceptions is that scientific “facts” (what scientists refer to as “generally accepted theories of reality”) are determined by popular vote. Thus you see many of the so-call autism advocates crowing about how many people “believe” their particular line of nonsense.

Unfortunately for them, reality has shown itself supremely indifferent to majority rule. For thousands of years, the majority of people were convinced that the world was flat, but that had no effect on the spherical nature of the world. For hundreds of years, the majority of people thought that the Sun revolved around the Earth – which had no effect on celestial mechanics.

So, even if seven thousand people think that Andy Wakefield’s thoroughly disproven hypothesis about measles vaccine causing autism is true, that will have no impact on the ability of the vaccine strain of measles to cause autism.

The sad fact is that the purpose of science is to discover the underlying realities of nature, not to confirm our most cherished hypotheses. When people (even people calling themselves “scientists”) set out to prove themselves right, they often overlook the data that show they are wrong. That’s why it’s so important to have independent confirmation of results.

In the end, it not the “voice of the people” that determine whether a hypothesis lives or dies, it is the “voice of the data”.

Authority figures:

As the Autism Omnibus Proceedings have shown, there are experts and there are “experts”. The plaintiffs, so far, have had the latter. It is passing strange that the people who are generally so dismissive of the findings of doctors and scientists are so willing to blindly accept whatever their doctors and their scientists say without question.

The Omnibus Proceedings should have been a golden opportunity for the parents following the advice of these “experts” (the ones who have “…found the truth…” about autism) to see how their knowledge compared to that of “mainstream” scientists (you know, the ones who are too hidebound to see the plain truth of how measles vaccine/mercury/”toxins”/immune disorders/gut problems/etc. clearly causes autism). It should have been, but for the vocal minority, it wasn’t.

Part of the problem with authority figures in autism is that the majority of parents – the grand majority, in all liklihood – have no idea what these experts are talking about. Here’s a little quiz to find out which camp you are in:

[1] If a child has a “damaged” immune system that is unable to “fight off” a viral infection (e.g. the attenuated vaccine strain of measles), what would be the effect of giving that child corticosteroids?

(a) The child will improve.
(b) The viral infection will worsen, making the child more ill or even dead.
(c) No effect

[2] When using polymerase chain reaction (PCR) to amplify the genetic material of a measles virus strain, what is the purpose of the reverse transcriptase (RT) step?

(a) It is an optional step, used in “mainstream” science only.
(b) It creates more false negative results.
(c) It copies RNA into DNA

[3] To which of the following does ethylenediamine tetraacetate (EDTA) bind with the least strength?

(a) mercury
(b) calcium
(c) magnesium

(Answers: b, c, a)

I bring this up because a number of parents I have spoken with about the Omnibus Proceedings have no idea why it was so important that the O’Leary lab had failed to do the RT (reverse transcriptase) step when they were testing for measles virus. To them, it was just another piddling technical detail that was essentially meaningless. To me, on the other hand, it was proof positive that the O’Leary results were baloney – nothing more than contamination and poor technique.

You see, the measles virus doesn’t use DNA for its genetic material, it uses RNA (single strand, negative sense) and does not go through a DNA intermediate (unlike the retroviruses). And the PCR process doesn’t amplify RNA, only DNA. So, the only way to amplify measles genetic material is to first copy it into DNA (via reverse transcriptase) and then amplify the DNA copy (cDNA).

In fact, one of the checks routinely done to rule out the possibility of contamination (or poor primer selection) is to do the test without the RT step. If you get a positive result, you know that you have a problem.

The O’Leary lab clearly had a problem.

So, what are parents to do if they lack the specialized knowledge to judge for themselves if the “experts” know what they’re talking about? Unfortunately, relying on your “gut feeling” is probably not the way to go. My experience has been that true experts in a scientific field are often not the most personable, easy to like people in the world. Some, in fact, are not good with people.

Salesmen, charlatans and confidence men, on the other hand, are marvelous with people. They have to be – it’s their livelihood. Now, this isn’t to say that a reliable expert can’t be personable and easy to trust – that’s not true. But you can’t rely on an person's charm and charisma to inform you about their accuracy.

What it often comes down to is going with the crowd. The more people who are well-informed about the field that agree with the “expert” in question, the more likely that “expert” is to be accurate. Sad to say, but the maverick who turns his back on the majority of his scientific peers is usually wrong. The very few who have turned out to be right tend to overshadow – in the public’s eye – the thousands who were wrong and simply faded into well-deserved obscurity.

One sporting gentleman on the mercury-causes-autism side has said that betting on the maverick is a long-shot with a tremendous payoff. How I wish it were so. In fact, most of the “mavericks” bucking the “mainstream” in the “alternative” autism world have already been shown to be wrong. Andy Wakefield is just one of many in that category. A more accurate analogy would be betting on a horse that has already been taken to the knacker’s and rendered into dog food, glue and baseball covers.

Science by fiat:

Another popular concept is that scientific reality can be legislated. This has been tried a number of times previously and has a dismal history. One of the most famous was the 1633 trial of Galileo Galilei, where he was forced, by threat of death, to recant his heliocentric hypothesis of the Solar system. A more recent one is the attempt by the Dover, Pa. school board to render Intelligent Design a viable hypothesis. It failed, as well.

“Science by decree” appeals to those who are absolutely convinced that there is no possibility that they might be wrong. It was supremely ironic that Andy Wakefield, facing possible censure in the UK, quoted Vaclav Havel’s famous statement: “Seek the company of those who seek the truth and run from those who have found it.” Wakefield is so clearly one of those who have “…found it…” but is unable to see that.

Science is not well suited to legislation because it needs the flexibility to change when confronted with new information. Laws must be repealed – a long and tedious process. Scientific theories and hypotheses are altered or discarded in a moment. If science needed to move at the pace of law, we would still be “texting” on parchment.

A more practical problem is when incorrect science is enshrined in law (and what other kind would need to be legislated?). We all know that the true point of the effort to make a law out of bad science is so that somebody (maybe many somebodies) will get some money. This is not inherently bad – sometimes people need and deserve governmental assistance.

But what happens when it becomes apparent that the legislated “science” is in error? What will the legislators say to those who entreated them to make the law in the first place? How receptive will they be to another group of parents who come to them, saying “Well, it turns out that vaccines weren’t the cause of autism and we need a bunch of money to research the real cause.” Do you think that any law maker is going to want to bring that before their peers?

I think that everybody knows that if the various autism “advocacy” groups had the data, they wouldn’t need to do an “end run” around science (and, curiously, the courts) to the legislature. What they are saying, in essence, is: “We can’t convince scientists, we can’t convince the courts and we can’t even convince a majority of parents with our data, so we’re asking you to force everybody to say that we’re right.”

And that’s what it really comes down to, folks - force. They’ve given up trying to prove their point; they’ve even given up trying to persuade the parents who haven’t already jumped on their bandwagon. Now they’re going to enlist the coercive power of the government to force you to pay them to do what they (the autism "advocates") think is right.

Does that seem right to you?

Prometheus

Let's do a study!

2007-07-18T23:05:00.000-07:00

A reader wrote in with concerns that I was overlooking a key point of the abysmal telephonic autism "survey" - namely, showing how many unvaccinated children were available to study the interaction of vaccines and autism... or "neurological disorders" (AKA autism spectrum and ADD/ADHD).

Actually, I think that the folks at the CDC and university medical centers all over the country (and in other countries) are acutely (even painfully) aware of the number of people who aren't vaccinated.

What GR and other advocacy groups have been agitating for is a study comparing groups that don't vaccinate their children (e.g. the Amish, although they actually do vaccinate their children) with vaccinated children. The folks at GR are pushing for this despite the fact that their baloney "survey" showed no connection between autism and vaccination.

Here are a few reasons why that study wouldn't work, followed by my own "modest proposal" for a study that would work.

[1] The unvaccinated population is not necessarily the same as the vaccinated population: People who don't vaccinate their children may not be the same as those who do. In fact, studies have shown that those who don't vaccinate their children tend to be at either end of the socioeconomic and educational spectrum. It would not be valid to draw any conclusions about the impact of vaccines on autism (or ADD/ADHD) with such marked differences between the groups (apples and oranges).

[2] Selection biases: Recruiting people for a study is one of the biggest sources of error, especially when looking for something that is a public controversy. You will tend to attract more people who believe in a connection than those who do not.

[3] Inadequate power: If the GR survey is correct, about 3% of the overall population in the 4 - 17 year age range is completely unvaccinated. On the other hand, the prevalence of autism is only 0.65% in the same age range. It will be easier to detect a statistically significant difference in unvaccinated children between autistic and non-autistic groups than it will be to detect a difference in autism prevalence between vaccinated and unvaccinated children.

[4] Loss of useful information: It would be a shame to spend the time and money to do a study and only be able to answer a single question. After all, if there is no connection between autism and vaccination - as the GR "survey" suggests - wouldn't it be nice to be able to "mine" the data for other possible connections? By looking for subjects based on their vaccination status, the only question that can be answered is whether there is a correlation between the two.

My Modest Proposal:

This is a study that could be done rather quickly and with a minimum of expense. It would eliminate many of the sources of bias and would fairly easily generate balanced study populations that would be a good match to most of the general population.

[a] Contact a large HMO with actual facilities (e.g. Humana or Kaiser) and arrange to get access to their patient medical records. This is routinely done, although the HMO will want assurances that patient confidentiality will be maintained.

[b] Obtain a list of patients with autism diagnosis in the proper age range (I would suggest 6 - 12 years).

[c] Select one thousand of these patients at random. This would allow you to detect a difference if the prevalence of unvaccinated children is less than 1/3 that in the general population (alpha error level 5%, beta error level 5%). If the difference is less than that, you'll need to select more subjects.

[d] Confirm the diagnosis by having a child psychiatrist or psychologist review the records.

[e] For each of the remaining children, select a non-autistic control child from the HMO database that is of the same age, sex, geographical region, etc.

[f] Determine how many of the children in each group have received all, none or some of their vaccinations (keep track of which vaccines, when, etc.). If the GR "survey" was right (a very big "if") about the number of children unvaccinated, each group should have around 30 unvaccinated children, unless there is a correlation between vaccination and autism.

[g] If the autism and non-autism groups have statistically significant differences in their vaccination rates, then a correlation can be claimed. If the study shows no correlation, then the relative risk is less than 3. You'd have to have twice as many subjects to bring the minimal relative risk to below 2.

Using HMO patients eliminates any issues of affordability (which is minimal) or access to health care. Although the population of people who have HMO coverage is not necessarily the same as the overal US population, using the case control design ensures that the two groups are as similar as possible.

This study could have been done in the time - and for the reported cost - of the GR "survey". If they had done a real study - like the one I've outlined above - the answer would already be here.

If anybody would like to fund such a study, please contact me. If I can't find anyone else to do it, I'd be willing to coordinate it myself.

I doubt that any of the federal funding agencies will be interested in funding this study - not because of any conspiracy, but because the only people who want the study will probably not believe the likely outcome (i.e. no association - just as in the GR "survey").

So, this is my challenge to those who want this study: if you want it, do it. The advocacy groups have the money - all they need to do is find the will to take a chance. And make no mistake - this is a risk. There is a better than even chance that the study - if it isn't "fudged" - will show no correlation.

If they really want to know, they can find out for less than the cost of a full-page ad.

Prometheus

Survey says..... Nothing!!!

2007-06-27T19:22:00.000-07:00

Generation Rescue just published their long-awaited telephone survey results that showed - surprise! - that vaccinations cause autism.

Well, actually, it doesn't really show that vaccines cause autism, what it shows is that vaccines cause "neurological disorders", loosely defined as autism (or autistic spectrum disorder) and/or ADD/ADHD.

Except that it really doesn't show that, either.

So what does the survey show? Well, let's just take a look.

Not surprisingly, they did not publish the questions they asked, which would have given us the opportunity to analyze their survey for systematic bias. What they did do was publish the raw data, which allows us to analyze their results.

Assessing the survey:

When looking at a survey, the first step is to examine the survey structure - particularly the questions, but also the area covered and population contacted - for any flaws or biases. This survey was conducted in nine counties of California and Oregon - generally the more populous counties - which gives it a West Coast bias. Since autism, ADD/ADHD, asthma and diabetes do not show a coastal preference, this bias should not create a serious problem for the survey.

Next, looking at the data, we need to see if there are age or sex biases. Since the data do not include a detailed breakout of the ages year-by-year, it is impossible to analyze for age biases, but the sex ratio (52% male, 48% female) - although it is close to the US Census Bureau data for that age range - shows a statistically significant difference from the US population.

Looking at the sex ratios of the unvaccinated and vaccinated (both fully and partially) groups, the differences are not statistically significant, so the imbalance in the sex ratio is equal in both groups.

It would be helpful to know how many people they had to call to get the number of responses they did - this gives a good measure of how skewed the responses might be. The higher the percentage of people refusing to take the survey, the more likely that the people who do answer are not a representative sample of the population.

Unfortunately, we are not provided this information, so we have no way of knowing how many of the people who were called hung up or otherwise refused to participate, which makes it impossible to know the degree of participation bias. We'll just have to soldier on.

Assessing the data:

Looking at the data, one thing that pops up as an immediate red flag is that the prevalence of autism is greater than the prevalence of PDD-NOS. This is an inversion of the usual finding, which is that autism (with stricter diagnostic criteria) is less common than PDD-NOS (which is essentially some of the criteria for autism but not enough to diagnose autism). This suggests that the people involved in the survey may not be asking the right questions.

Looking a bit closer, the prevalence of the autistic spectrum disorders is way out of line with the most recent data. In February of this year, the CDC published a report on the prevalence of autism in six states. This prevalence was widely reported and was frequently cited as more evidence of the "autism epidemic" by the chelationistas, so it should be familiar.

This CDC report found that the prevalence of autistic spectrum disorders ranged from 4.5 to 6.5 per 1000 children, which would be 0.45 - 0.65%.

The GR survey found that the prevalence of autistic spectrum disorders was 4.7% in their overall sample and ranged from 1.3% (female, fully vaccinated) to 8.4% (male, partially vaccinated). This is nearly ten times the CDC prevalence.

To put the number into perspective, the CDC data say that somewhere between 1 in 222 to 1 in 154 children have an autistic spectrum disorder. The GR survey would suggest that 1 in 21 children have an autistic spectrum disorder. Ridiculous!

Clearly, there is a serious problem with this survey.

This is reminiscent of the infamous Holmes et al study, which found that their control subjects had over ten times the amount of mercury in their hair than the NHANES study found in children of similar ages less than a year later.

Now, the people who ordered this survey may argue that it's the difference between the two groups - not the absolute number - that is important. This sounds reasonable, but it isn't. There is no way to know if the degree of error is the same in all the groups.

If the "over-reporting factor" is only 5% less in the "unvaccinated" group than in the other groups, the difference between the groups disappears. This completely invalidates the "results".

So, with this glaring evidence of error, is there any point in looking any further?

No, not really. But we should examine the major claim being made about the survey results, just to be thorough.

"Vaccinated boys have a 155% greater chance of having a neurological disorder like ADHD or autism..."

Let me start off by saying that - even if the survey was accurate, which it clearly is not - an increase in autism and ADD/ADHD would not constitute an increase in "neurological disorders", which their conclusion implies. There may, in fact, be neurological disorders (e.g. measles inclusion-body encephalitis) that are reduced by vaccination. So, even without looking at the data, this assertion is pure nonsense.

But, back to the survey data.

To get a statistically significant difference between the unvaccinated and vaccinated boys, they had to lump the partially vaccinated and the fully vaccinated boys together and they also had to lump autism, PDD-NOS, Asperger's syndrome, ADD and ADHD together.roups, with the partially and fully vaccinated boys having - as a group - 55% more reported "neurological disorders".

However, if you look at the "autistic spectrum disorders" by themselves, there is no statistically significant difference between unvaccinated and vaccinated (partially plus fully) boys.

Curiously, there is a statistically significant difference between the partially vaccinated boys and both the unvaccinated and fully vaccinated boys. Partially vaccinated boys have a higher prevalence of autistic spectrum disorders than either the unvaccinated or fully vaccinated boys.

Now, if you want to show that an exposure causes a disorder, it is generally a good idea to show a dose-response relationship. In the case of this survey, a little vaccination is worse than none or a lot. This doesn't sound like a dose-response relationship to me.

Well, so the autism-vaccine connection doesn't work - how about ADD/ADHD?

Out of 17,674 children in the survey, 1,875 had either ADD or ADHD. That works out to a prevalence of 106 per thousand or 10.6%.

That seems a bit high.

If you look at the USDE data from 2005, the percentage of children ages 4 - 17 years with "other health impairment" (the catch basin for ADD/ADHD and many other disorders) was 9.5 per thousand or 0.95%. This is over ten times lower than reported in the GR survey. And remember - the USDE "other health impairment" category includes a variety of diagnoses other than ADD/ADHD.

So, it seems that there are some serious problems with the GR survey data. I don't know what the cause of the problem is (although I have my suspicions), but one thing is painfully clear:

The survey data is garbage.

So, what does the GR survey show?

Absolutely nothing.

Prometheus

The Next Revolution?

2007-05-29T11:07:00.000-07:00

As the chelationistas rediscover/redefine/remarket themselves, surely there are parents who are feeling a little misled, deceived or perhaps even exploited. Maybe it's time for another "revolution" in autism? And this time, it's the chelationistas who need to be overthrown.

For years, the various organizations representing the chelationistas have been telling parents that they are their advocates, that they respect parents, listen to parents and learn from parents. It's the "other side" - the doctors, "the government" and, worst of all, Big Pharma (cue spooky music) that lies to parents, disrespects parents, ignores parents.

Now, it turns out, the chelationistas are admitting that they don't respect parents - they don't even trust the parents' intelligence enough to tell them the whole truth. And telling less than the whole truth is....that's right; lying.

The chelationistas are now claiming that they knew all along that autism wasn't just mercury poisoning - despite earlier claims to the contrary (see here, also). The fact that they didn't tell parents is explained as "not wanting to confuse the issue". Or, it could be argued, not wanting to risk losing parents' support on a complicated and complex issue.

So, the chelationistas respect parents, but not enough to tell them the truth.

And the chelationistas listen to parents, but don't hear them when they say, "we want the facts".

And the chelationistas learn from parents, but only in order to better market their product.

Many people may now find themselves unsure when the chelationistas are telling the truth (hint: only when their lips aren't moving).

After all, if it is true - as the chelationista revisionistic propaganda says - that the chelationistas hid the full scope of possible causes of autism from the parents, then those parent have the right - no, the duty - to ask a simple question:

Why?

Ironically, it appears - again, from the chelationistas' own "clarifications" - that the chelationistas didn't trust the parents' ability to understand a more complex issue. The chelationistas didn't want to muddy the water with facts.

In other words, they are claiming that they lied to parents in order to further the chelationista movement.

Funny - that's pretty much what the chelationistas accuse the government and "mainstream medicine" of doing.

Of course, another possibility is that the chelationistas really did believe that mercury caused autism (and may still believe so) but are afraid that parents will start to doubt them as the mountain of data refuting the mercury-causes-autism hypothesis bears down. So, in order to keep from looking like uninformed dolts, they lie about having known "all along" that autism was "more complex than just mercury poisoning".

Either way, the chelationistas have been caught in a lie.

Now, the majority of parents caught up in the chelationista's web will buy the "clarification" and will not be offended by the blatant condescension that it contains. A few will have their eyes opened and will leave. Most will leave quietly, burning in silent resentment, but we can only hope that a couple of parents are angry enough at this travesty to lead a revolt.

After all, the only way to bring down a cult is from the inside.

I have a theme song in mind for this revolt:

Devo, Jerkin' back 'n' forth
(from the album "New Traditionalists")

I know I let you tell me what to do
You were confident, you knew best
Now things aren't working like you want them to
Your confidence is what I detest

You got me lookin' up high
You got me searchin' down low
You got me - I know you know
You got me jerkin' back 'n' forth

That pretty much sums it up, doesn't it?

It's time for parents of autistic children to stand up and say they won't be manipulated, deceived or dismissed - not even by organizations that claim to represent them. It's time for parents of autistic children to demand the truth - especially from organizations that claim to represent them.

It's time for a new revolution.

Prometheus

A Crisis of Faith or "Bait and Switch"?

2007-05-19T08:17:00.000-07:00

Over the past year, I've noticed an odd trend among the supporters of the mercury-causes-autism hypothesis. It began gradually, as trends often do, with a few seemingly random phrases like "...and other toxins...", "...and environmental exposures...", "...other vaccine components...", "...formaldehyde, aluminium and benxyl alcohol..." and "...viruses and bacteria...".

But now, the shift in emphasis is unmistakeable. Kev, Orac and others have blogged about specific attempts at historical revisionism among the chelationistas, but I'd like to assess the "bigger picture" and what it means to the hypothesis-formerly-known-as-mercury-causes-autism.

For those who are not intimately familiar with the daily ins and outs of the chelationistas' arguments (you lucky people!), the Central Dogma of the chelationista faith has been - since the infamous Bernard et al paper, in which a group of people who had never seen mercury poisoning compared it to autism - that mercury causes autism. Period. Full stop. The end.

Apparently, that is no longer true.

In a move reminiscent of George Orwell's 1984, the chelationistas have changed their minds about mercury being the cause of autism, but they are claiming that they haven't actually changed their minds - they're simply "clarifying their position".

That's newspeak for "the data don't support our position, so we're doing our darndest to keep from having to admit we were wrong."

So, what does cause autism, according to the chelationistas?

"Heavy metals" (does this include Def Leppard?)
Aluminium (not a "heavy metal")
Live viruses
Bacteria
"Maternal toxic load" (perhaps from watching Oprah?)
Antibiotics

Note that they haven't given up on their favorite cause: mercury. They have just provided it with some camouflage.

The advantage of this "clarification" (translation: "obfuscation") is to make it impossible (or at least highly impractical) to ever prove them wrong. Let me demonstrate.

In order to show that the mercury-causes-autism hypothesis was wrong, we just needed to show that there was no correlation between mercury exposure (i.e. thimerosal exposure, environmental mercury, etc.) and autism. While correlation does not equal causation, a lack of correlation is essentially equal to a lack of causation.

That was relatively easy to do, although many of the chelationistas are still struggling with that unpleasant lump of reality.

However, in order to definitively squash the new "heavy metals"-aluminium-live viruses-bacteria-etc.-cause-autism hypothesis, you would need to explore all possible combinations of these "exposures". If you don't, it is a sure bet that the next "hypothesis" will be that the one combination you didn't check is the real cause of autism.

Just like mercury was... until it wasn't.

So, how many combinations would that be? It seems simple enough - there are only six items on the list. Except that some of the items are a bit broad.

You could lump all "heavy metals" together (if you can get a ruling from the chelationistas on exactly which metals are included in this group), which would leave you with a manageable number, right?

The "live viruses" could just be the ones in vaccines, or they could be any live virus that the chelationistas care to claim (without having to provide data) are in vaccines. Or they could be any live virus in "the environment". It is a number with a great potential for flexibility.

"Bacteria" is another ambiguous category. Are they referring to the killed bacteria in vaccines, or will they want to expand that into all environmental bacteria (a number in the millions, if not billions)? Or will they want to reserve the right to claim that vaccines - or any other product with a manufacturer they can sue - are contaminated with bacteria that only the DAN! doctors and their faithful laboratories can detect?

Of course, the "maternal toxic load" is another extremely broad (one might even say deliberately vague) category. We'd need to get a ruling from the chelationista high court on which "toxins" they have in mind. And we'd better get that in writing, in case they try to "clarify their position" later. I suspect that this is another "trapdoor" they've left in their new "hypothesis" in order to allow them to escape again.

Simply defining the problem is impossible, given the vague and fuzzy nature of the new "causes of autism". And even if we were to get the problem defined - and get it to stay defined - there is another factor to consider.

If we were to assume (naively) that there were only six variables to examine, how many combinations would that make? If we have n items ("n" is a variable) and we group k ("k" is another variable) of them at a time, the number of possible combinations (where order doesn't matter) is: [see here for a tutorial]

n! / (n - k)! k!
(the "!" stands for "factorial")

So, if we have six possible causes and we examine possible combinations of any two, we have fifteen (15) possible combinations. A large number, but not an impossible task.

But, we have to count all possible combinations, including groups from one to six of the possible causes. This gives us a grand total of sixty-three (63) possible combinations.

And that's what we get by considering "heavy metals" and "maternal toxins" as one category. What happens if we expand "heavy metals" to the "big five" of toxic metals (mercury, lead, arsenic, cadmium, antimony)?

Total combinations = 1023

And if we expand "maternal toxins" to include the five toxic metals?

Total combinations = 16,383

Mind you, we haven't even begun to exhaust all of the potential "maternal toxins", "live viruses" or "bacteria" - the potential number of those could be in the thousands, if not the millions.

So now you see the shrewd cunning of the chelationistas. By making their "position" more vague, they have ensured that they will never again find themselves in the bind they are now. Never again will science be able to say - with any certainty - that the chelationistas' "hypothesis" about the cause(s) of autism is unfounded.

That's because it is practically untestable. It is not absolutely untestable - if we were to commit the entire scientific resources of the world to searching various combinations, it would probably take slightly less than an infinite amount of time to check them all. But it will never happen.

And that's exactly what the chelationistas want.

Prometheus

But we have to do something!

2007-04-23T15:06:00.000-07:00

I always find a little shiver of fear going down my spine whenever I hear someone - especially someone in elected office - say the words, "We have to do something about [X]!"

In my experience, those words have been the prelude to innumerable disasters, debacles and misadventures. The problem is that the urge to action is rarely accompanied by any planning or investigation. What we end up with when we rush to "do something!" is the equivalent of "Ready. Fire! Aim."

In other words, we miss the mark. In fact, we're lucky if we don't hurt somebody in the process.

Over the past several years, I have heard a number of parents with autistic children say, "We can't wait for scientific studies, we have to do something for our children!" While I can completely sympathize with them, I continue to urge caution. Doing something is only better than doing nothing if "something" isn't harmful.

Why do I bring this up, you might ask?

In February, a study was published that showed - for the first time - that treatment with DMSA (a chelating agent) can improve the intellectual functioning of lead-poisoned rats. This was a big deal because human studies (on children poisoned by lead-containing paint) had failed to show any improvement in behavioral or neuropsychological development.

Unfortunately, the study also showed that treating rats who were not lead-poisoned decreased their cognitive abilities. Permanently.

Now, people who are treating their children with DMSA for mercury poisoning would be right to be concerned about these findings, especially if they are relying on doubtful laboratory tests to determine that their children are "mercury poisoned". And those folks who are treating their autistic children with DMPS have no reason to smirk. There is currently no known mechanism to explain these cognitive impairments, so DMPS could be just as bad...or worse.

I hadn't planned to 'blog about this study - too many unanswered questions - but then I got an disturbing piece of news. It seems that a proposed autism-chelation study is being held up while the researchers test the DMSA for lead and mercury. I'm still trying to get confirmation of this, but it seems important enough for parents to know right now.

DMSA and DMPS are absolutely wizard at binding to lead, mercury, cadmium, arsenic and other "heavy metals". It's what they do. As a result, they will grab onto and carry along any lead, mercury, cadmium... that they come in contact with during their synthesis and subsequent handling. Given the ubiquitous nature of lead, mercury and arsenic, it is not improbably that these chelating agents could come in contact with - and grab onto - some in their progress from synthesis to final user.

Might this be the reason that so many parents using chelation report that the mercury is "...pouring out..." of their children? If you're pouring it in, you would hope that it would pour out.

I must emphasize that I have not yet confirmed that the proposed chelation study is being held while they test the DMSA for lead and mercury, but I feel that it is important for people who are doing chelation with DMSA (or DMPS) to get the news.

I'll keep you posted as I know more.

Prometheus

Theories of Everything

2007-04-21T08:10:00.000-07:00

Physics, that most pure of pure sciences, has been pursuing the "Theory of Everything" - a theory that will explain the four fundamental forces and their interactions - for some time now. Nobel Prize aspirants hope to connect the electromagnetic, strong nuclear and weak nuclear forces with gravity in a Grand Unified Theory. They've managed to connect the electromagnetic and weak forces into the "electroweak" force, but the other two forces obstinately refuse to join the game. For now.

Chemistry, which is sometimes referred to as "applied physics" (usually by physicists), has quantum chemistry, which is a close approach to a "theory of everything" in that field.

Biology (which snide chemists refer to as "applied rudimentary chemistry") has yet to develop anything even remotely resembling a "theory of everything". This is due to the immense complexity of the systems involved (so say the biologists) or the immense simplicity of the biologists involved (so say the chemists and physicists), take your pick.

However, I have noticed that at least one small segment of the biological sciences seems to be developing a "theory of everything". In fact, it seems to have developed several.

I refer, of course, to the field of autism "alternative" research.

The Grandmother of Grand Unified Theories of Autism

The first truly successful (in the sense of "popular" rather than "accurate") candidate for the "Grand Unified Theory of Autism" has to be the "mercury-causes-autism" hypothesis, first published (in Medical Hypotheses) by Bernard et al in April 2001. This hypothesis asserted that autism and mercury poisoning were one and the same, based on the use of similar words (in English) to describe certain features of both disorders.

Despite the fact that none of the authors had actually seen, let alone diagnosed a person with actual mercury poisoning, this hypothesis resonated with the zeitgeist of the community of parents with autistic children and resulted in massive popular support. Its scientific support has been less massive, unfortunately, and it stands in peril of fading to a mere cult phenomenon.

As a "theory of everything" in autism, the mercury hypothesis has met most of the requisite criteria. It is flexible enough to "explain" the features of autism, even as the definition of autism continues to change. In part, this is due to the protean nature of mercury poisoning, which has a wide variety of symptoms and signs.

However, a large part of the credit goes to the flexibility of the people applying the mercury-causes-autism hypothesis, who are willing to overlook significant ways in which autism differs from mercury poisoning. It is this willingness to suspend critical thinking, more than any inherent validity of the hypothesis, that accounts for its continued survival despite its lack of supporting data and the vast amounts of direct and indirect data refuting it.

With only a vague and easily disputed connection between signs and symptoms of autism and mercury poisoning and a few unrelated (and some might say also trivial and obvious) studies to support it, the mercury-causes-autism hypothesis is in trouble. The few studies that have been held up in support of the hypothesis, on closer examination, do not support it.

Some of these studies merely confirm what is already known (trivial), e.g. that mercury is neurotoxic. Others have shown that mercury can cause other types of disorders, e.g. autoimmunity, without connecting that to autism. In the end, most of the studies used to support the hypothesis are of three basic types:

[1] The study fails to show a connection to autism - i.e. mercury causes X, X is a bad thing, but no indication that either X causes autism or that X is part of autism, with X being a sign or symptom.

Example: Hornig, et al, "Neurotoxic effects of postnatal thimerosal are mouse strain dependent". This study demonstrated that mouse strains that were known to be prone to develop autoimmune disorders were more likely than other strains (which were not prone to develop autoimmune disorders) to develop autoimmune disorders after exposure to thimerosal. This is the trivial part of the study.

They then go on to posit that a variety of behavioral responses of the mice - decreased movement and decreased reaction to novelty - were signs of mouse autism. This is more than a bit of a stretch, as there are several alternative explanations, including the simple explanation that the mice were not feeling well, having developed autoimmune disorders.

[2] The study shows association without data supporting causation - i.e. the sudy shows that X is found in children with autism, but fails to show that X might cause autism. X might be caused by autism or simply be a co-traveler.

Example: James, et al, "Metabolic biomarkers of increased oxidative stress and impaired methylation capacity in children with autism", which demonstrates signs of increased oxidative stress in autistic children without showing that the oxidative stress led to autism or what the cause might be. Significantly, when they corrected the signs of oxidative stress with betaine and folinic acid, the children remained autistic.

[3] The study proposes mechanisms that are either unsupported by the data and/or are contrary to known physiology

Examples: Kern, et al, "Sulfhydryl-reactive metals in autism", and Holmes, et al, "Reduced levels of mercury in first baby haircuts of autistic children". Both of these studies found reduced levels of mercury in the hair of autistic children and both propose - without providing a single citation or shred of data to support the proposal - that autistic children excrete less mercury into their hair.

This is contrary to decades of research into hair physiology, and so should have been accompanied by at least a paragraph of explanation. However, neither group of authors have found it necessary to provide support for their astounding claim that hair excretes mercury. Until they can, both studies are merely sources for scientific amusement.

The mercury-causes-autism hypothesis also has no explanation for the continued rise in autism numbers (from data sources that its proponents used to establish the "autism epidemic" in the first place) despite falling mercury exposure (both in vaccines and from the environment) and so its supporters have resorted to circular reasoning.

Despite having failed to establish that mercury causes autism, the proponents have boldly claimed that trace amounts of mercury remaining in vaccines, along with environmental mercury (which has been dropping since the 1960's), are sustaining the rise in autism.

This, of course, completely negates their earlier assertions that it was the rise in vaccination - and exposure to thimerosal - that caused the rise in autism, since the mercury exposure to children born after 2000 has been less than that of children born before 1980 (before the onset of the "autism epidemic").

What they have done - or tried to do - is say that the continued rise of autism (in USDE and California CDDS numbers) supports the mercury-causes-autism hypothesis because of the continued exposure to mercury - this continued exposure being proven by the continued rise in autism. And so, even though it took mercury exposures far in excess of what children are presently receiving to start the "autism epidemic", it takes only trace amounts to sustain it. Anyone want to go around again?

Another tactic used in support of the mercury-causes-autism hypothesis is to claim that chelation "cures" (or treats, if you like) autism. This supposedly establishes that mercury is the cause of autism, although it conveniently overlooks the fact that the chelating agents - if they do work - have effects beyond removing mercury.

Even more fundamentally, the proponents of the modified mercury-causes-autism-because-chelation-cures-autism have failed to support their claim that chelation has an effect on autism that is greater than placebo. Until this is established, they have no argument. They are trying to "prove" one unproven statement with another unproven statement.

Other "Theories of Everything" in Autism

Other "theories of everything" have arisen in the field of "alternative" autism research since the rise of the mercury-causes-autism hypothesis, although none have generated as much press or excitement. What these lesser hypotheses share with the mercury-causes-autism hypothesis is an emphasis on anecdote, unrelated (to autism) studies and hype.

Some of the current contenders for the "theory of everything" are:

[1] Nitric Oxide - since this is a widespread inter- and intra-cellular signalling molecule, it is not surpising that it is found in association with a variety of disease states. It is also not surprising that it is affected in a variety of conditions, both normal and pathological. This is roughly equivalent to saying that calcium is associated with autism, since calcium fluxes are critical in release of many neurotransmitters, including those thought to be important in autism.

Unless nitric oxide can be shown to either cause or treat autism, it remains just an interesting footnote. Considering the amount of hype that nitric oxide has in the "alternative" medicine and "nutraceutical" fields, it is no surprise that it has found its way into "alternative" autism therapy.

[2] Allergens (especially latex) - what could be more ubiquitous than latex? It's in car tyres, surgical gloves and a myriad of medical, industrial and household products. Latex allergies are on the rise - probably due to increased exposure, although this can be debated - and so is autism. Coincidence? Almost certainly, but this hasn't stopped some people from seeing a connection. It's not their fault - finding connections is what our brains are "hardwired" to do - even when there isn't a connection.

[3] RF energy (from cellphones, of course) - this seems to be a revival of the old "cellphones cause brain tumors" urban legend and should be as readily dismissed. Yes, the use of cellphones has paralleled the rise in autism. So has use of the Internet, popularity of Britney Spears and numbers of hybrid automobiles.

Doubtless, there are many others that I have overlooked. Feel free to e-mail me your favorite "theory of everything" for autism.

Prometheus

The Age of Unreason

2007-04-08T16:22:00.000-07:00

Before I get too far into this narrative, I should divulge that I am a “Baby Boomer”. This is not something I am proud of, as “My Generation” was one of the most spoiled and self-centered generations of all time. The fact that there are innumerable members of the Baby Boom generation who are rational, selfless and modest does not change how history will see the generation as a whole.

Our legacy will be one of self-absorption, greed, obsession with youth and – at the end of our lives – pitiful attempts to shift the blame for our actions and inactions. This latter failing is clearly shown in Billy Joel’s immortal song, “We Didn’t Start the Fire”. It is the story of how T-shirts and bumper stickers failed to have any significant impact on world events.

But I digress.

The 1960’s were often referred to – by the generation we now call the “Baby Boomers” – as the “Age of Aquarius”. This simply shows their appalling sense of reality, since the earliest that astrologers place the dawning of the “Age of Aquarius” is 2150. By then, the “Aquarian generation” will all be dead. Even those who don’t believe in such negative things as “death”.

Astronomers, incidentally, place the beginning of the “Age of Aquarius” at 2600.

In the 1960’s, the Baby Boomers felt that an era of peace and worldwide love was in the offing and that they were the generation that was going to make that a reality. Their beliefs could be summed up by something I found on an astrology site:

“The key phrase for Aquarius is ‘I Know,’ but that knowledge is not a righteous, superior or exclusionary knowledge. It's a sort of wisdom that draws people together, for Aquarians are, above all else, social animals.“

I couldn’t have said it better. So, the Baby Boomers spent their twenties trying various magical means to bring about world peace and brotherly love (or just getting stoned out of their minds) and then got distracted by making a fortune in the stock market, buying loft condos and finding a way to keep from getting old.

However, the magical thinking never left them – and they’ve passed it on to succeeding generations.

So, after centuries of slow but steady progress against the forces of unreason, a single generation is trying to send us back to the Dark Ages. After centuries of scientific progress in medicine, a single generation brings back homeopathy, naturopathy and introduces any number of new variations on shamanism. Crystals, “The Secret” and Quantum Healing are all the result of this steady erosion of critical thinking.

It is this sort of unreason that has led people to make the most absurd statements without any apparent fear of contradiction, since – as the postmodernists tell us – there is no privileged reality. It has reached the point where many people believe that wanting something to be true will make it true. Some examples:

[1] Iran’s nuclear program is much in the news of late and all reports include a comment to the effect that “Iran claims that the nuclear program is solely for power generation”. What I never hear said is that Iran is a net exporter of oil and has an infrastructure that is so dysfunctional that it has to import gasoline.

It seems extremely unlikely that Iran would put the money and effort into something so complicated as nuclear power when it could buy oil-fired power plants for a fraction of the cost. And without stirring up the threat of UN sanctions.

Still, the talking heads and pundits seem to all be of the mind that by not actually saying that Iran’s rationale is full of baloney, they won’t have to face the ugly truth that Mahmoud Ahmadinejad is trying to make a nuclear bomb in order to destroy Israel – as he has repeatedly said he was.

[2] Ardent believers in “Intelligent Design” (the belief system formerly known as “Creation Science”) repeatedly claim that their brand of bunkum is a “science”, despite the fact that it has no data to support it (it is, in fact, unfalsifiable and so untestable) and makes no predictions about the universe. Some of the top people in the “ID” world are scientists who should know better. Yet, somehow, they have the conviction that by saying that “ID” is a science that it will become one.

In the end, “Intelligent Design” is not science, not even bad science. It is religion dressed up to look like a science – if the light is bad and you squint a lot. And yet it has a serious following, even among people who call themselves “scientists”.

[3] “Quantum connectedness” continues to be all the rage in the Western world, as demonstrated by the number of people who mindlessly repeat bits of the movie, “What the #$*! Do We Know!?”. People who wouldn’t recognize a wave function if it bit them on the bum splutter on about its collapse by an observer which, so they claim, means that we can create our own reality by thinking it. Or they will wax eloquently about how quantum entanglement shows that we are all connected.

One of the most famous of the quantum-confused is Deepok Chopra, whose many books cash in on the general public’s ability to understand only that quantum physics is strange and seemingly paradoxical. He has repeatedly claimed that he has studied quantum physics, but his writings convince me (and others) that he may have studied it, but he surely hasn’t understood it.

[4] Much of “alternative” medicine encourages people to abandon scientific principles that have brought us in the West to a level of health and longevity that are unrivalled in human history. If we want to see what happens when that happens, we only have to look to those parts of the world where – for economic or philosophical reasons – scientific medicine is unavailable.

Yet, in the midst of the best medical care in the world – now or ever in history – a growing number of people are turning to magic. Whether it’s “quantum healing”, homeopathy, chiropractic, “energy medicine”, “thought field therapy” or any of a thousand others, it’s magic if it invokes unmeasurable “energies” or other undetectable properties.

This is not to say that there aren’t energies or other properties of the universe that we can’t currently detect or measure – not at all. It’s just that if we can’t currently detect or measure them, how can anyone propose that they exist? To echo that infamous movie, “How the #$*! Do They Know!?”. What special power do they have that allows them to know that these energies or other properties exist?

One of the common responses from these folks is that Newton didn’t know about radio waves, even though they existed (from the Sun other natural sources) in his time. True enough, but Newton also didn’t make any hypotheses that required radio waves. That’s the difference.

I could go on, but I won’t. I hope you get the point.

Our society is growing more and more dependent on rationality, science and technology to keep it from collapsing. It’s too late to turn back, now – giving up on reason and returning to magical thinking will cause a human (and probably environmental) catastrophe that would beggar the imagination. And, at the same time, the forces of Unreason encourage us to turn our back on reality in favor of “The Secret” or other such nonsense.

The technology that most people take for granted is far beyond the knowledge of the “average” citizen – not because they can’t understand it, but because they don’t. We run a very real risk of having an increasingly smaller proportion of our population that understands how critical technologies work or – even worse – the principles behind them.

Now is the time to take a stand – to come out on the side of Reason over Unreason, of Science over Magic, of Reality over Fantasy.

Or, we can all sit and meditate on a happier future.

Prometheus.

If Everything works, is Anything Working?

2007-04-06T13:00:00.000-07:00

A few weeks ago, I wrote about ARI’s parental survey and how that could be used to show the natural progression of untreated autism. Today, I’d like to delve a bit deeper into some of the implications of all of those “effective” (or not) treatments.

Even with the caveats previously noted about the shortcomings of the survey results, one thing that can certainly be said is that a rather large number of therapies are felt to be effective in the treatment of autism. Picking a threshold level of 10:1 on ARI’s “better:worse” scale (see previous posting for a discussion on this), the following treatments are felt to be “effective”:

Antifungals: Diflucan
Antifungals:Nystatin
Calcium
Candida Diet
Cod Liver Oil
Detox.
(Chelation)
Digestive Enzymes
Fatty Acids
Feingold Diet
Folic
Acid
Food Allergy Treatment
Gluten- /Casein-Free Diet
Removed
Chocolate
Removed Eggs
Removed Milk Products/Dairy
Removed
Sugar
Removed Wheat
Rotation Diet
Vitamin A
Vitamin B3
Vitamin B6
with Magnesium
Vitamin B12
Vitamin C
Zinc

Again, even if these treatments aren’t actually effective (and most, if not all, probably aren’t), this still speaks to the dizzying number of treatments that parents are claiming work to treat autism.

Now, I’ve read the chelationista apologists’ hypotheses of how all (or most) of these treatment “successes” can be explained by mercury poisoning, but I’m still waiting for the data. “Could be explained…” is a long, long way from “Is explained by…” – despite what many of the chelationistas might wish.

So, we have a large number of treatments with no discernible connection that are all reported to be effective in the treatment of autism. And that’s if we apply a pretty high cut to the pack.

And what does it usually mean when a disparate group of treatments are all felt to be effective for a single disorder?

[1] The disorder isn’t a single entity; it’s a group of several disorders with similar presentations (but different causes and underlying abnormalities).

[2] None of the treatments is effective, which is why so many of them seem equally effective. Placebos all trend toward the same degree of effectiveness with prolonged use.

[3] Both [1] and [2] are true.

Case [1] is what we saw up to the late 1800’s in the treatment of “fever”. A variety of different (and usually unrelated) treatments showed true effectiveness, but only in certain patients. Quinine worked for some, willow bark for others but it wasn’t until modern microbiology developed that we understood why (it wasn't until the late 1900's that we understood how willow bark actually worked).

Case [2] was widely seen up to the early 1900’s, when not only a variety of treatments but also entire treatment philosophies had relatively equivalent efficacy. Homeopathy, naturopathy and chiropractic were equally as effective (or equivalently ineffective) as “mainstream” medicine of the time. It was only when “mainstream” medicine developed safe and effective treatments and medicines that it began to show a distinct “edge” over the others in effectiveness.

It is only fair to say that some of the myriad of “alternative” autism therapies may eventually be shown to be effective in a subset of autism – or whatever autism fragments into in the future. All that can be said today is that the few “alternative” treatments that have been studied in a scientific manner have been found wanting (e.g. secretin).

You would think that, having seen secretin burst onto the scene, become wildly popular (with countless anecdotes of success) only to crash and burn when it was tested, that the others would be somewhat more cautious in their claims.

But it hasn’t worked out that way. The pattern to date has been one of over-ambitious claims (one might even say hyper-inflated claims) followed by dozens of testimonials and speaking engagements, then disappointment, retrenchment of the “true believers” and eventual consolidation into a core of die-hard followers.

In a way, it reminds me of the evolution of a white dwarf star.

http://imagine.gsfc.nasa.gov/docs/science/know_l2/dwarfs.html

The sad thing is that the people in the middle of it all – the poor parents – don’t have the historical perspective to see it coming (or they are assured, “This isn’t like secretin – our treatment really works!”). So, they are either consumed in the inflationary helium burning stage, blown out with the planetary nebula or remain as the white-hot core of “true believers”.

Oh, if they could only know and believe the history of such things!

Here is another point to ponder.

“Mainstream” medicine is not a very fastidious entity; it will absorb anything that works, regardless of its history. When H. pylori was found to be a causative agent in stomach ulcers, “mainstream” medicine gulped it up without so much as a “by your leave”. The same thing has happened time and again – whenever “alternative” medicine comes up with something that really works, “mainstream” medicine takes it, like a schoolyard bully taking a ball.

Poor “alternative” medicine is left with the dregs – the therapies that don’t work or haven’t (yet?) been shown to work. To take the bully analogy a bit further, they are left with the broken toys and the ones they can’t figure out.

My point is this: if these therapies actually worked - if they could truly be shown to work – then they wouldn’t be “alternative” anymore. “Mainstream” medicine would have scooped them up and claimed them for itself.

Maybe that’s why the “alternative” practitioners won’t release their data – they’re afraid of the playground bully: “mainstream” medicine.

So, to get back to the title of this post, if there are so many disparate "therapies" that "work", what does that tell us in the absence of any hard data? Again, if everything works, then it is all too likely that nothing is working and we are simply seeing the unaltered natural course of the disorder.

We have some hint of this in that many of the "alternative" autism practitioners are still using secretin (again, a therapy very thoroughly discredited in the treatment of autism) and claiming that "it works!". If secretin - which is no more effective for autism than placebo - works as well as the rest of their "therapies", well, that's all we need to know.

Prometheus

A Tale of Two Studies

2007-03-24T18:56:00.000-07:00

“It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness…”

In March of 2007, two studies on different aspects of autism have been published. These two studies, although they are both published in peer-reviewed journals, could not be more different in quality.

The first study is “Sulfhydryl-reactive metals in autism”, by JK Kern, et al. This study attempts to correct the shortcomings of the dreadful Holmes et al study, which I have discussed in depth some time ago.

My mother used to tell me, “If you can’t say something nice, don’t say anything at all” – so, to follow the letter of that maxim (if not the spirit), I will begin with the positive aspects of this study:

[1] They did do their statistics correctly, using non-parametric statistics when it was clear that their data did not follow a normal distribution. Bully for them!

[2] They explained their reasons for picking the statistical analytical method they did (the Kruskal-Wallis test)

[3] The values they obtained for hair mercury for both subjects and controls were within the range found in the larger NHANES study, unlike the Holmes et al study, which had control values that were completely off the scale.

[4] Their use of the case-control method reduced concerns that the controls might be different from the subjects in some way unrelated to autism.

Now, unfortunately, we come to the major shortcomings of this study - shortcomings that are as fatal to its conclusions as those of the Holmes et al study. In fact, the major shortcoming is the same in both studies:

Hair Doesn’t Excrete Mercury

I’d like you to keep that sentence in mind for the next few paragraphs.

You see, despite their perseveration on the idea that mercury is excreted into the hair – which would, in turn, make a low hair mercury level indicative of “poor excretors” – mercury uptake by hair is completely passive. There is no excretion mechanism that can be “impaired”. Mercury in the blood flowing through the hair follicles is passively bound to the sulfhydryl groups of the amino acid cysteine, which is especially abundant in hair.

It’s as simple as that. No excretion, just passive absorption and binding to the growing hair.

But don’t take my word for it.

[1] Akira Yasutake and Noriyuki Hachiya “Accumulation of Inorganic Mercury in Hair of Rats Exposed to Methylmercury or Mercuric Chloride”. Tohoku J. Exp. Med., Vol. 210, 301-306 (2006) .

“These findings suggest that the inorganic mercury is also taken up by rat hair from the blood circulation, as is the MeHg, irrespective of the consequences of the biotransformation of MeHg or exposure to inorganic mercury itself.”

[2] Shi CY, Lane AT, Clarkson TW. Uptake of mercury by the hair of methylmercury-treated newborn mice. Environ Res. 1990 Apr;51(2):170-81.

“Distribution of mercury in pelt and other tissues was measured. The level of mercury in pelt was found to correlate with hair growth. The amount of mercury in pelt peaked when hair growth was most rapid and the total amount of mercury in pelt was significantly higher than that in other tissues, constituting 40% of the whole body burden. [Note: the hair of mice contains a larger percentage of body mercury than it does in humans. This is because the hair (pelt) of mice is a larger fraction of the mouse body mass than the hair of humans, especially human children]

However, when the hair ceased growing, the amount of mercury in pelt dramatically dropped to 4% of whole body burden and mercury concentrations in other tissues except brain were elevated.

Autoradiographic studies with tritium-labeled methylmercury demonstrated that methylmercury concentrated in hair follicles in the skin. Within hair follicles and hairs, methylmercury accumulated in regions that are rich in high-sulfur proteins.”

[3] Mottet NK, Body RL, Wilkens V, Burbacher TM. Biologic variables in the hair uptake of methylmercury from blood in the macaquemonkey. Environ Res. 1987 Apr;42(2):509-23.

“The total mercury (Hg) in hair and blood of 45 young healthy adult female Macaque fascicularis given 0, 50, 70, or 90 micrograms MeHg/kg body wt orally in apple juice daily revealed a close and constant ratio between blood Hg and hair.

The amount of hair Hg does not increase with time (maximum period of observation 490 days) at a given dose level. Also the ratio was unchanged between background and subtoxic dose levels. Individuals at a given dose level with a higher-than-average blood level had a proportionately higher hair level.”

”This was the most unkindest cut of all…”

The last article, you will notice, was authored by none other than Thomas Burbacher, who is currently on the chelationistas “Most Favored Scientists” list.

Bottom line: hair mercury (and presumably other sulfhydryl-reactive metals) reflects the blood mercury (etc.) at the time that portion of the hair was forming. If the hair mercury (etc.) is low, then the blood mercury (etc.) was low.

And the only way mercury (etc.) can get into the brain is via the blood, unless you inject it directly into the brain.

So, low hair mercury (etc.) equals low blood mercury (etc) equals low brain mercury (etc.).

Any questions?

Now that we have rather thoroughly demolished the idea of mercury being excreted into the hair, what else does the Kern et al study have to say?

The only graph in the entire article (Figure 1) is rather puzzling – it lists the mean ranks of the arsenic, cadmium, lead and mercury levels of the autistic and control groups. For those not familiar with non-parametric statistics (and for many that are), this may seem odd. Frankly, it is odd to show the mean ranks instead of the data themselves. It suggests that the data, seen naked and unadorned, might not be as convincing as the authors would like.

Table 3 gives the mean (average) and standard deviation of the various hair metal levels of the two groups. This, too, is odd, since they went to great lengths to explain that their data did not follow a normal distribution and yet give mean and standard deviation – two measures that imply a normal distribution. Better would have been to give a median (the middle value of the ranking) and range. But they didn’t.

And when you look at the numbers they did give, you begin to understand why they didn’t show a graph of their data.

Zooming in on the mercury levels, the mean (SD) of the autistic subjects was 0.14 mcg/g (0.11) and that of the controls was 0.16 mcg/g (0.10). You’d be right if you thought that these levels were awfully close, although the Kruskal-Wallis test showed them to be statistically different.

Even if there are statistically significant differences between the two groups, the question remains if they were clinically significant.

I might also point out that not only are these values far lower than those measured by Holmes et al, they are also a bit lower than the NHANES levels (mean 0.22 mcg/g). And, curiously enough, they used the same lab as the Holmes et al study.

Curious.

It was especially curious to see them cite Holmes et al as supporting their hypothesis without once mentioning how very different their numbers were.

So, what can we make of their data, then? Clearly, their hypothesis that autistic children are “poor excretors” based on hair metals is unsupportable in the face of data showing (over and over) that mercury and other metals are passively taken up by hair.

Perhaps, the “take home message” from this study is that autistic children absorb less mercury. That wouldn’t sit well with Kern et al, but there is data to support that hypothesis.

[4] Ballatori N, Wang W, Lieberman MW. 1998. Accelerated methylmercury elimination in gamma-glutamyl transpeptidase-deficient mice. Am J Pathol 152:1049-1055.

“There were no differences in methylmercury excretion between the wild-type and heterozygous mice; however, the GGT-deficient mice excreted methylmercury more rapidly at both dose levels. Wild-type and heterozygous mice excreted from 11 to 24% of the dose in the first 48 hours, whereas the GGT-deficient mice excreted 55 to 66% of the dose, with most of the methylmercury being excreted in urine.”

Since gamma-glutamyl transpeptidase also has a profound effect on the redox state of the cell and gluthathione, (both of which have been linked to autism by another of the chelationistas Most Favored Scientists, Jill James) what Kern et al are seeing may be nothing more than the effects of altered gamma-glutamyl transferase activity, which may be related or unrelated to autism.

So, by doggedly perseverating on a hypothesis (autistic children are "poor excretors"), two sets of researchers have missed a possible implication of their findings: that autistic children may actually be "over-excretors" of mercury.

After all, that's what the data seems to be saying.

And it's a lot more likely than hair being a significant excretory organ for mercury.

End of Part One.

Next:

Strong Association of De Novo Copy Number Mutations with Autism.

Sebat J, Lakshmi B, Malhotra D, Troge J, Lese-Martin C, Walsh T, Yamrom B, Yamrom B, Yoon S, Krasnitz A, Kendall J, Leotta A, Pai D, Zhang R, Lee YH, Hicks J, Spence SJ, Lee AT, Puura K, Lehtimaki T, Ledbetter D, Gregersen PK, Bregman J, Sutcliffe JS, Jobanputra V, Chung W, Warburton D, King MC, Skuse D, Geschwind DH, Gilliam TC, Ye K, Wigler M.

Science. 2007 Mar 15; [Epub ahead of print]

Prometheus

Note: Prometheus will be attending a conference of minor mythological figures next week and will not be able to moderate comments. Rest assured, when he returns, all pending comments will be dealt with in a firm but fair manner.

A Tale of Two Studies – Part the Second

2007-03-23T23:50:00.000-07:00

”…it was the epoch of belief, it was the epoch of incredulity, it was the season of Light, it was the season of Darkness, it was the spring of hope, it was the winter of despair, we had everything before us, we had nothing before us, we were all going direct to Heaven, we were all going direct the other way…”

We now return to our previous story…

Strong Association of De Novo Copy Number Mutations with Autism.

Sebat J, Lakshmi B, Malhotra D, Troge J, Lese-Martin C, Walsh T, Yamrom B, Yamrom B, Yoon S, Krasnitz A, Kendall J, Leotta A, Pai D, Zhang R, Lee YH, Hicks J, Spence SJ, Lee AT, Puura K, Lehtimaki T, Ledbetter D, Gregersen PK, Bregman J, Sutcliffe JS, Jobanputra V, Chung W, Warburton D, King MC, Skuse D, Geschwind DH, Gilliam TC, Ye K, Wigler M.

Science. 2007 Mar 15; [Epub ahead of print]

In this study, the authors used ROMA, a type of comparative genome hybridization, to look for de novo mutations in autistic children. They looked at 195 autistic children and their parents (need to look at the parents’ genome to know if the mutation was inherited or arose spontaneously) and 196 unaffected children and their parents.

What they found was – to put it mildly – very interesting.

The size of the human genome limited the resolution of the technique (in this study) such that they could detect only about 15% of the mutations that cytogenetic techniques indicate to be present. Even with these limitations, they found:

[1] Spontaneous mutations were more frequent in patients with autistic spectrum disorder (14/195) than in unaffected individuals (2/196).

[2] The frequency of spontaneous mutations was higher (12/118) in sporadic cases of autism – children with no affected relatives – than in cases from multiplex families (2/77).

[3] The frequency of spontaneous mutations in unaffected individuals was 1% (2/196).

[4] Most of the mutations in autistic individuals were deletions (12/15 – one child had two mutations), while the two mutations in the controls were duplications.

[5] None of the mutations were seen more than twice and most were seen only once.

[6] The mutations seen in autistic children were on chromosomes 2, 3, 6, 7, 10, 12, 13, 15, 16, 20 and 22.

If, as they suspect, their technique was only able to pick up 15% of mutations, then the actual mutation rate in autistic children may be much higher.

What it means is that there is a statistically significant (p less than 0.0005) association between spontaneous mutations and autism. Now, I've often argued that association is not causation, and so do the authors of this study.

However, the locations of many of the mutations were highly suggestive of a connection. For instance, one mutation - a 1.1 Mb deletion from chromosome 20 - deleted 27 genes, including the oxytocin gene OXT. This is particularly notable, as oxytocin has been shown to regulate social behavior and awareness.

Five of the mutations involved only a single gene, which indicates that these genes are prime candidates for further study.

Now, what does this mean for the people who claim that autism can’t be genetic, that it’s all the result of exposure to (fill in the blank with environmental toxin de jour)?

Well, it means that they need to start thinking up a way to “spin” these results.

Doubtless, they will find that some of the authors have – at one time in their careers – been supported by the pharmaceutical industry (“Big Pharma”) or “the government” or maybe they’ve ridden in black helicopters.

Or they’ll find some other equally ridiculous claim of bias, corruption or conspiracy.

But they won’t be able to stem the tide.

"What tide?", you ask.

There’s a tidal wave of data bearing down on the “reality deniers” in the autism world, and they’d better start heading for higher ground.

Or learning how to swim.

Prometheus

Note: Prometheus will be attending a conference of minor mythological figures next week and will not be able to moderate comments. Rest assured, when he returns, all pending comments will be dealt with in a firm but fair manner.

Finding Truffles amongst the Clods

2007-03-20T11:09:00.000-07:00

ARI’s Parent Ratings of Behavioral Effects of Biomedical Interventions

For years I have advised people to avoid this site because it presents poor data in a poor fashion. The “data” is gathered (if that is the proper word) from an on-line survey (it started as a paper survey) of parents. The parents, by and large, are people who already have a favorable opinion of “biomedical interventions” (meaning: “non-drug”, or at least, not the FDA-approved use of “drugs”) and – by corollary – an unfavorable opinion of “mainstream” medical therapies for autism.

As a result, the “data” gathered is skewed in favor of “biomedical interventions” – as the results so clearly show.

There is also no attempt made to confirm the reported results or to control for the initiation of other therapies at the same time.

In addition, the arrangement of the categories of interventions – into “drugs”, “biomedical/non-drug/supplement” (with Pepcid and “chelation” listed as non-drugs) and “special diets” – biases the survey, as a PhD psychologist like Dr. Rimland (and his heir-apparent, Dr. Edelson) should know.

Finally, the way the “data” is “analyzed” is … well, unusual. They take a six-point scale (another oddity, with three favorable ratings, two unfavorable and one neutral) and bin the results into “got better” (top two favorable ratings), “no effect” (the “possibly helped” and “no definite effect” responses) and “got worse” (the two unfavorable responses).

They then effectively discard the “no effect” responses to come up with a “better:worse” ratio. This may have some utility, but a better rating would be to lump all the favorable responses together and compare that to the sum of the neutral and unfavorable responses. If you do that, then some of the current favorites start to look a bit less attractive:

Examples:

Antifungals: Diflucan -
ARI better:worse = 11:1 -- better:not better = 1.2:1

Secretin: Intravenous -
ARI better:worse = 6.7:1 - better:not better = 0.9:1

Vitamin A -
ARI better:worse = 23:1 -- better:not better = 0.7:1

Pepcid (non-drug?) -
ARI better:worse = 3.2:1 - better:not better = 0.4:1

Vit B6 and Magnesium -
ARI better:worse = 10:1 -- better:not better = 0.9:1

You might agree, after seeing those numbers, that the ARI “better:worse” rating is a bit misleading.

And what about that all-time autism treatment favorite: chelation? Well, ARI lumps it with “Detox. (Chelation)”:

Detox. (Chelation) -
ARI better:worse = 35:1 -- better:not better = 3.2:1

Still, if you were to believe in the numbers generated by this poorly designed survey, you might think that some of these treatments had something to offer. You might be right – you might also be wrong – there’s no way to tell from this “data” because it was gathered in such a poor way.

But there is something you can glean from the ARI Parent Ratings of Behavioral Effects of Biomedical Interventions (PRBEBI). You can find what the natural progression of autism might be.

You see, buried in the ARI-PRBEBI is a treatment that has been rigorously studied – a treatment that was extensively tested in a multi-center, placebo-controlled, double-blinded study. That treatment is secretin.

Secretin has been exhaustively tested for effectiveness in autism and found to be no better than placebo (i.e. no effect). This is not in question. Even the company that held the patent to make recombinant secretin, which could have earned them a lot of money if it had been an effective treatment for even 10% of children with autism, has admitted that secretin has no effect in autism.

Let me repeat that: Secretin has no effect in the treatment of autism.

But, if we look on the ARI-PRBEBI, we find that the parents who had secretin administered (intravenously) to their children rated it effective (“got better”) 48% of the time, ineffective 44% of the time (“no effect”) and saw their children worsen 7% of the time.

This is pretty much all you need to know about the validity of the ARI-PRBEBI. It rates secretin as an effective treatment for autism despite the fact that large, well-designed and well-funded studies have found secretin no better than placebo.

But wait, there’s more!

Since we now know that secretin is without positive effect (and the studies also found very few negative effects), this is a fair placebo trial for the natural progression of autism without treatment: 48% get better, 44% are unchanged (at least over the short time the parents waited for an effect from secretin) and 7% worsen.

Of course, this result also carries with it the limitations of the ARI survey, namely:

[1] The reported results are not confirmed by anything other than parental impressions.

[2] There is likely to be a confirmation bias, i.e. the parent population taking this survey is more likely to report improvement than worsening.

[3] This is certainly not random or evenly distributed parent or patient population.

[4] It is likely that other “treatments” were instituted at the same time as the secretin, which would confuse the issue.

Still, as a first approximation of what parents might experience as the untreated progression of autism, it isn’t bad. And it rather confirms the clinical impressions of physicians and psychologists who treat autistic children – that most of them show improvement over time.

Given that the time period over which improvement was looked for after secretin injection was probably a matter of weeks to months, the fact that 44% of the children showed “no effect” (i.e. no change) is also confirmation of the periods of stasis (no discernible developmental progression) that autistic children experience.

So, having tried my darnedest to derive something positive and useful from the ARI-PRBEBI, I leave you with the following summary points:

[1] The ARI Parent Ratings of Behavioral Effects of Biomedical Interventions (ARI-PRBEBI) is not a reliable gauge of how effective a treatment really is.

[2] The ARI Parent Ratings of Behavioral Effects of Biomedical Interventions (ARI-PRBEBI) can be used to demonstrate that a significant percentage of untreated autistic children can be expected to show noticeable improvement over a short time course (weeks to months).

This pretty much puts an end to the claim (oft-repeated but never substantiated) that, but for the brave use of “biomedical interventions”, autistic children would be stuck at the same developmental stage they were at the time of diagnosis. It should also help people realize that autistic children do continue to develop – to improve - even without treatment.

I can only hope that some people will take notice.

Prometheus

Note: Prometheus will be attending a conference of minor mythological figures next week and will not be able to moderate comments. Rest assured, when he returns, all pending comments will be dealt with in a firm but fair manner.

Listening to Autism

2007-03-12T13:17:00.000-07:00

Periodically (every other day, if not more frequently), some outraged parent will send me a blistering e-mail about how I am "not listening to the parents" or "not listening to the autistic children" or (even more curiously) "not listening to autism".

I assume that these people are not being strictly literal in their complaints, as I listen to anyone who cares to speak to me (and read what people send me).

I suspect that their core complaint is that I listen but don't agree.

Here is the gist of the matter:

Parents have a great deal of observational data about their children - what they do, how they respond etc. - and many of them feel that this translates into understanding their children's emotions and thought processes.

How many of these parents will have cause to question this "understanding" when their children reach puberty?

But, to the matter at hand.

Many parents of autistic children also feel that their wealth of observational data gives them a special insight into their child’s physiology, as well. They feel – and many feel this way because they have been told by well-meaning “experts” – that they know more about autism than the people who study it, simply by the virtue of having “lived with it”.

These parents often lose patience with doctors and scientists who are hesitant to accept at face value the parent’s claims of dramatic improvement with “alternative” treatments or their explanation of what caused their child’s autism. The parents see the doctors’ cautious skepticism as a direct challenge to the parents’ innate knowledge.

Why is it that I don’t “trust” the parents’ stories of how (fill in the blank) improved their child’s autism? Well, at least a part of the reason is the track record of autism “cures”.

As an example, let's review the history of a "breakthrough" treatment for autism: secretin.

Secretin first hit the public scene in 1998, when it was reported that a single secretin injection (done as a routine part of endoscopy) dramatically improved the language and social functions of an autistic child. These initial reports led to a massive run on secretin and a number of studies - good, bad, short-term and long-term - were rapidly started.

The excitement for secretin kept building, even after some initial studies failed to find the dramatic results. In fact, the interest in secretin continues even after a large number of studies, including a focused, multi-center, multi-million dollar study sponsored by a drug company that had the patent for recombinant secretin, have failed to find secretin any better than placebo.

Should I be listening to the parents that believe that secretin improved their child’s autism? Even though well-designed studies sponsored by a company that had every financial reason to want to find an effect failed to find any effect? Would that be wise?

Enlarging the view a bit, a brief survey of parent-focused autism websites and newsletters reveals a dizzying number of “cures” for autism. Special diets, vitamins, minerals, and a growing (and worrying) number of prescription drugs (off-label uses) are being used to good effect, if parental reports are to be taken at face value.

So, if all of these treatments are effective, as the parents claim, then what are we to make of it all? As I see it, there are two overall possibilities:

[1] Autism can be improved by an amazingly broad range of “biomedical” therapies (as distinguished from behavioral therapies).

or

[2] Autism shows a pattern of alternating developmental stasis and progression, which fools parents into believing that the last “treatment” they tried before the improvement was the “cure”.

Interestingly, normal child development shows a pattern of alternating developmental stasis and progression. Most parents are vaguely aware of this, but the parents of children with developmental disabilities are hyper-aware of the developmental progress of their children.

Thus, if a “treatment” is proposed (or promoted) for autism and a large group of parents try it on their autistic children, the possible outcomes, even if the treatment is completely ineffective, are:

[a] If given at the end of a period of progression, the “treatment” will be assessed as having made the child worse.

[b] If given at the end of a period of stasis, the “treatment” will be assessed as having made the child better.

[c] If given in the middle of a period of stasis or a period of progression, the “treatment” will be assessed as being ineffective.

Remember, these are the possible outcomes even if the treatment is utterly without effect (either good or bad).

Hopefully, you are getting an idea of why I don’t put a lot of stock in parental reports of “treatments” for autism.

Let me try to explain the parental fervor for some of these “treatments” with a small fable.

The Tale of the Lucky Stockbroker

Long, long ago, a smart fellow decided that he would try to make a lot of money in the stock market. Having watched the market for some time, he realized that the best way to make money on stocks wasn’t to buy and sell them, but to sell expert advice.

Knowing that most people who invested in stocks were wary of advice, he set out to prove to people that he had a special power for knowing when stocks were about to go up or down. He got a list of a ten thousand people who were avid stock traders and sent each of them an e-mail describing his services (and fees) and giving them a “sample” stock pick.

Half of the prospective customers got an e-mail saying that the stock would go up in the next week, and half of them got an e-mail saying that the stock would go down. At the end of the week, the stock he picked had gone down, so he sent another e-mail to the five thousand people who had received the “correct” stock advice.

Half of the five thousand got an e-mail saying that another stock would go up in the next week; half got an e-mail saying it would go down. At the end of the week, he sent out another e-mail to the remaining 2500 would-be customers.

At the end of six weeks, he was down to a little over 150 potential customers, but those 150 has seen him make six correct stock predictions in a row! The last e-mail he sent them was to tell them that they could continue to get these predictions only if they bought a five-year subscription to his service.

In autism therapy, much the same system is at work, although I don’t claim that anyone is doing it deliberately, unlike the stockbroker in the story. Parents who get results will convince themselves that the “treatment” is working. They may have seen improvements in the past, but without a “treatment” to hang them on, these improvements would have seemed maddeningly random (as, in fact, they are).

The parents who don’t see any improvement will quietly drift away from the “treatment”. If they choose to tell other parents that the “treatment” didn’t work for their child, that is easily explained away by “every child is different – you need to find what works for your child”. And so, they head off into the sunset on a search for the “treatment” that will work on their child.

When you take in a broader view of the autism “treatment” landscape, it seems painfully clear that this is happening. Every therapy has its own group of parents who swear that it has “cured” or “recovered” their children. And each therapy also has a rather pitiful group of people who haven’t seen the “cure” yet, but are hoping that it will happen soon.

And there are dozens (if not hundreds or thousands) of “treatments” out there that are just like secretin – a few anecdotal stories (or even just one), a hint of biological plausibility (which, given that nobody knows what autism is, can be pretty vague) and a cluster of “me too!” stories.

In fact, even though secretin has been very thoroughly shown to be ineffective, there are still large numbers of “alternative” practitioners using it to “treat” autism. Apparently, no amount of good science is going to penetrate the core believers.

Unfortunately, most of the other “treatments” for autism are not going to get as thorough scientific evaluation as secretin did. Many of them have so little “biological plausibility” that no real scientist is going to want to bother submitting a proposal to study them. The rest have so little biological plausibility that they don’t even seem worth debunking for the fun of it.

And, given what happened with secretin, why would anyone bother? If people are going to “listen to autism” and ignore the science, what’s the point?

Prometheus

Fear Pressure

2007-03-07T22:48:00.000-08:00

For some time now, I’ve wondered why promoters of the mercury-causes-autism get so hostile when they talk to us skeptics. Time after time, I’ve been accused of:

[1] Preventing parents from treating their children with (insert therapy).

[2] Preventing parents from hearing about (insert therapy).

[3] Keeping kids from getting (insert therapy).

This, of course, is utter nonsense.

I’m not standing in the way of parents who want to “treat” their autistic children with whatever voodoo they want to use. I’m just a single person writing a single ‘blog – I’m not blockading their homes, picketing “supplement” stores or standing in the doorway of even one DAN! doctor.

Parents have a wide variety of woo-based websites, parental support groups, newsletters etc. to inform them of the latest in woo-based autism therapies. I can’t hope to compete with the amount of baloney available to parents. I’m just a single voice shouting (actually, writing) in the wilderness.

I’m not hacking websites (although folks on the “other side” have done that), I’m not buying up web domains with similar names (although folks on the “other side” have done that) and I’m not trying to harass, intimidate or litigate against people who want to tell their side of the story (although folks on the “other side” have done that).

Finally, I’m not doing anything to keep the children from getting whatever therapies – woo or otherwise – their parents see fit to inflict on them. Nothing but quietly telling my side of the story.

Yet, they are offended by my skepticism. More than offended – enraged. People have said things to me and about me that are offensive, accused me of base and dishonorable behaviors and have told me – in no uncertain terms – to SHUT THE F**K UP!

Why does my lack of belief in their viewpoint make them so angry?

To be honest, it’s not just me. They seem to hate anybody who’s not on board with their “program”. And "hate" is the correct word - make no mistake about that.

A few days ago I found myself with a bit of unstructured free time, so I decided to spend the time trying to understand the anger I seem to provoke in the mercury-causes-autism believers.

I started by imagining that I had a child with a poorly-understood disability of unknown origin and uncertain prognosis. That was the easy part.

Then, I pictured what it would be like to have someone – or a group of someones – tell me that they had discovered THE CAUSE and THE CURE of the dread illness that was afflicting my child. So far, so good.

Then I tried to imagine what it would be like to have other people, perhaps people with expertise in medicine and science, disagree with THE CAUSE and THE CURE.

How would that make me feel?

Frankly, I was at a loss to see why I would give two shakes of a lab-rat’s tail what the “experts” might think if I had (or thought I had) a cure for my child’s ailment. As long as they weren’t getting in my way, why should I care they thought?

After all, in the post-modern world, people ignore the experts all the time. In the US, they’ve raised it to a cultural icon. The only thing that “the people” distrust more than “experts” is “the government”.

Indeed.

But then I considered how I would feel if I was doubtful about whether or not THE CURE worked.

That would change things. A lot.

If I was harboring secret doubts, doubts that I scarce could admit to myself, then someone else doubting THE CAUSE and THE CURE would be a big problem.

As long as everyone around me was chanting the party line (“Mercury causes autism and chelation is its cure.”), I could bury my own doubts. After all, if I was the only person with doubts, then it must be true.

Right?

But once I started to hear other people doubting THE CURE or THE CAUSE then my own doubts would start gnawing at me. They’d start keeping me up nights.

And why, you might ask, would I have doubts?

Well, maybe the improvement wasn’t as dramatic as I was making it out to be. Of course, my child was getting better, but he wasn’t CURED, not like all the other kids were being CURED. And the other kids I saw, they weren’t as CURED as they were made out to be.

Of course, I wouldn’t be tactless (or stupid) enough to tell the other parents that their “recovered” kids didn’t look all that “recovered” to me. And I certainly wouldn’t be bold enough to say that I didn’t think that my child’s improvement was as much as I expected, based on their descriptions.

Of course not. That would be like saying…oh, I don’t know…like saying, “The Emperor has no clothes!”

And we wouldn’t want to say that, would we?

So, what are my options? I can’t admit to myself – or my spouse or fellow mercury-causes-autism parents – that I have doubts about THE CURE or THE CAUSE. That would cause unacceptable mental anguish, since I’d not only have to admit that I was wrong (never an easy thing to do, in the best of circumstances), I’d have to admit that I didn’t have a cure for my child’s illness.

That’s not going to happen. Uh-uh. Nope. Never.

And the other option? I can get angry at the doubters. I can accuse them of bias, corruption, ignorance, arrogance, insensitivity, or whatever else comes to mind. I can circle the wagons and excommunicate anyone who admits to doubt.

And why would I do these things?

Because I’m afraid.

Very afraid.

Because without THE CAUSE and THE CURE, I’d have nothing to offer my ailing child.
I would be defeated.
I would have no hope.

Or so I might think.

So, when the mercury-causes-autism proponents take their next poke at me, I’m going to try my very best to remember that, although their actions are hostile and belligerent, they aren’t really angry with me.

They’re just afraid that I might burst their bubble. That I might force them to face their own doubts.

And they’re not ready for that.

Yet.

Prometheus

The Power of Critical Thinking: Bias and Self Deception

2007-02-26T12:56:00.000-08:00

Bias:

Some time ago, during one of those post-conference informal discussions, I heard a fellow give the best description of bias that I've ever heard. I will attempt to paraphrase:

Bias is the natural result of every person's self-centrism. We all - except for the few who are incapacitated by self-doubt - are utterly convinced that our beliefs, actions and opinions are absolutely correct at the time.

The caveat "at the time" is an essential part, because all of us (except for those who are pathologically incapable of acknowledging error) have had occasion to realize that we have made a mistake, that our beliefs, actions and/or opinions were wrong.

However, at the moment we thought that, we were convinced we were correct - correct about us having previously been in error.

You can see how this could rapidly get out of hand.

But it holds together very well as a general statement of how people view their own thinking process. We (with very few exceptions) are sure that we are doing or thinking the "right" thing at the time that we are doing it or thinking it.

So, what has this got to do with bias? Plenty.

Bias is a sort of "blind spot" in a person's thinking - a place where their assurance of being right makes them vulnerable to imagining the world to be different from how it truly is. It is, in short, a minor delusional state.

As Mark Twain is reported to have said: "It ain't what you don't know that gets you into trouble. It's what you know for sure that just ain't so." So it is that the blind spot of bias gets people into trouble. Ignorance is merely a need for information or education; error - especially when it is believed wholeheartedly - is a calamity waiting to happen.

A good analogy would be a map. If your map of reality has blank spots, you are likely to be more cautious in those areas. You'll ask questions, listen to what people who have been there have to say and keep you eyes open. On the other hand, if your map has roads where there are none and smooth plains where there are cliffs and pits, then you are standing into trouble.

Bias can lead to self-deception (more about that later) when it convinces a person to ignore good information because it conflicts with their pre-formed (and self-corroborated) view of reality. Some spectacular examples of this have occured in the media in recent years, when otherwise sage and seasoned journalists were completely taken in by fakes and phonies. That they often did so in the face of evidence that they were being hoodwinked only serves to underscore the pernicious nature of bias.

As an aside, it is laughable in the extreme to see people state that they are "not biased". Ridiculous! Everybody is biased in some way - everybody has an opinion on everything, even if that opinion is "That's too unimportant to think about." As a result, everybody is prone to - biased toward - a particular view of reality.

To reiterate: no matter what you think, you think that's the right thing - at that time. If it were a conscious decision, it wouldn't be bias. Bias influences, shades and slants conscious decisions, in ways that we are not aware of at the time. Looking back, we may be aware of how our assurance of correctness led us to disaster, but we don't - we can't - see it at the time.

To be sure, people are often aware that they are doing or thinking things that "aren't right", but that is the imposition of an external measure of correctness. It has nothing to do with whether the person feels that their thoughts or actions are right for them, in their situation, at that time. The person who is shoplifting a loaf of bread knows that it is a crime (possibly even a sin), but is assured that they are doing the right thing for their own reasons.

Self Deception:

Bias is usually a necessary precondition for self-deception. It would take an incredible strength of will to truly believe something you know to be false. I'm not sure that it can be done this side of insanity.

However, humans have shown themselves to be masters of convincing themselves that the real is false and the false is real. And the first step in this process is to be assured of the correctness of one's own thinking - our old friend bias!

In some ways, it's rather amazing that people can ever avoid self-deception. What keeps most people sufficiently grounded in reality to allow them to carry out the day-to-day activities of living is a regular contact with aspects of reality that cannot be easily ignored.

Someone who has convinced themselves of their ability to fly (sans aeroplane) will rapidly (at 9.8 m/sec/sec) be disabused of this notion. They may even survive to "internalize" the lesson. Likewise, reality intrudes its unwanted self into most self-deceptions, sometimes, sooner, sometimes later; sometimes subtly, sometimes dramatically.

But there are some self-deceptions that are resistant to reality therapy. Some of them lack a sufficient grounding in reality to ever run across a contradiction. Most religious thought is of this nature. There is simply not enough contact between religion and reality - with some notable exceptions - to provide a convincing "whack" to the deceived... er, the devout.

Other times, the collision with reality is a long time coming, allowing people a "grace period" to believe (and perhaps entrench) their self-deception. For example, people who try quack remedies for real illnesses often have a period of time before the reality of their unchecked disease breaks through their belief. Even worse off are the people who try quack remedies for imaginary illnesses - they will now have two mutually-reinforced self-deceptions!

Additionally, there are some counter-reality thoughts that can diminish the impact of reality. Some of these are (not an exhaustive list by any means):

- It would be so embarrassing if I were wrong!
- I've invested too much time/money/effort/reputation on this to admit that I was wrong!
- People would be so mad at me if I were wrong!
- I really trust the person who told me this...they can't be wrong!
- I really need for this to be right!

You'll notice that I haven't included anything like "It's all a conspiracy!" or "They're lying to me!" That's because these sort of thoughts are the result of self-deception (and might even be considered diagnostic of it) rather than contributing factors. Once a person has convinced themselves that the cost of being wrong is (for them, at this time) greater than the cost of persisting in error, then the mind will generate a suitable set of excuses (sometimes called "rationalizations" or even "delusions") in order to maintain their denial of reality.

Rationalizations are a way of covering up the gap between reality and a person's conception of reality. The more their mind-generated world-view comes in conflict with reality, the more rationalizations are needed. At some point, they may even cross the imaginary line between denial and delusion.

People who are in denial are often very hostile toward people who try to bring them back to reality. After all, it's hard work to maintain all those rationalizations and they do not appreciate visitors who want to track reality all over their snug, safe sanctuary. They will often lash out at people who have the temerity to disagree with them.

As a result, people in denial often seek out others with the same - or similar - world-view. The Internet has aided this process immensely, providing innumerable places for people to gather to share, refine and reinforce their denial of reality.

Avoiding Self Deception:

While it would be nice if we could all look reality in the face at all times, this simply is not the human condition. Failing a complete refit of the human psyche, what can we do to avoid self-deception?

[1] Check your ideas with someone else.

This is the basic concept behind "peer review" in scientific journals. Your ideas, methods, data and conclusions are put before a number of independent (they aren't all sitting in one room, influencing each other) reviewers who read it and give their critique (and usually criticisms). This provides a number of minds that - in all probability - do not have the same biases (the same blind spots) as the author(s).

For the average citizen, "peer review" can be a bit harder to find. A common mistake is to ask someone who already thinks as you do to critique your idea. Thus we have UFO conspiracists asking other UFO conspiracists if the small sharp thing in their bum is a splinter or an alien mind-control device, with the predictable bizzare answer.

This is also where a lot of the news media have fallen foul of self-deception. In a group with the same political and social mindset, it may be hard to find someone to say, "Gee, Dan, that memo doesn't sound very believable to me. Maybe you ought to check it out better." It's also unreasonable to expect people to tell the boss that they think he's gone crackers. Better to find an independent appraisal.

[2] Be skeptical of everything you hear, especially if you agree with it.

Again, the news media would have saved themselves a number of black eyes and bruised egos if they had followed this simple rule. For that matter, a number of people in science would have been better off if they, too, had heeded this advice.

You are very much more likely to be taken in by a falsehood that conforms to your world-view (your biases) than to believe a truth that doesn't. Keep that always in your mind. Question the basis for any statement that claims to be "fact"; question it twice if you find yourself wanting to believe it.

[3] Occasionally step back and ask yourself, "What would it take to make me believe/not believe this?"

When we are self-deceived, the answer to this simple question - if we are honest with ourselves - is most often "There is nothing that would change my mind." This is a very bad answer because it means that your belief (or non-belief) in something is a matter of religious devotion, not reason. If that's OK for you, so be it. But it might just prevent a nasty misstep if you can recognize that you are not seeing the world as it really is.

This has just scratched the surface of a topic that could fill volumes (and has!). Perhaps I'll add another volume to the world's collection someday. It's on my list (right after cleaning out the attic).

Until next time!

Prometheus

The Power of Critical Thinking: Scientific Method

2007-02-18T16:04:00.000-08:00

“Science is a way of trying not to fool yourself. The first principle is that you must not fool yourself, and you are the easiest person to fool.” Richard Feynman

(from the lecture “What is and What Should be the Role of Scientific Culture in Modern Society”, given at the Galileo Symposium in Italy, 1964.)

There’s really no better definition of science than that.

So, how do we do science? It’s really quite easy. Just follow these four simple steps.

[1] Hypothesis.

Contrary to what some people think, a hypothesis is not “just a guess” – it is a proposed model of how the universe works. Usually, it is a model of how a small part of the universe works, but it is still a model of the universe.

The most important requirement is that the hypothesis be testable - it must be falsifiable. There must be some way to determine if the model is correct (or incorrect), otherwise, it is useless. Hypotheses that invoke unseen beings, undetectable forces or supernatural beings are all untestable.

Needless to say, a hypothesis must explain the available data on the topic in question, although it can explain that some (or all) of the data is wrong. However, hypotheses that start out with the claim that all of the existing data are wrong usually don’t fare too well.

[2] Observation / Experimentation.

The reason that hypotheses need to be testable is that the second step is to test them. No matter how “brilliant” or “progressive” a hypothesis is, it is utterly worthless if it either cannot be tested or makes no testable predictions.

This is the core problem of “Intelligent Design” – it makes no predictions that can be tested. Since “Intelligent Design” essentially states that everything is as it is because some supernatural being – the “designer” – made it that way. No matter how things are – no matter what a researcher might find – it is all exactly as it was made by the “designer”. It’s a tidy bit of religious philosophy, but it isn’t a hypothesis.

Once you have a hypothesis in hand, the very next step is to come up with a way to test it. The best way is to see if a prediction made by the hypothesis comes true. This can either be an observation, such as the bending of starlight as it passes close to the sun, or it can be an experiment, such as the Yellow Fever experiments. The distinction between observation and experiment is a subtle one, but either one can be used to test a hypothesis.

One thing that many want-to-be scientists fail to realize is that they aren’t the only ones who get to test their hypothesis. Anyone can do it – and will, if your hypothesis is interesting enough. This leads us to the next step:

[3] Evaluation.

Once a hypothesis has been tested, the time comes to see how well it did. An unsuccessful test – one where the results were not what the hypothesis predicted – indicates that the hypothesis is not a valid model of reality and needs to be revised. Sometimes, the needed revision is drastic – such as completely abandoning the hypothesis. Either way, a hypothesis that fails to predict what will happen is not valid – it needs to be fixed or discarded.

This step is the one that separates the real scientists from the pseudoscientists. It is especially revealing when a researcher refuses to respond to criticism of their hypothesis, especially when that criticism includes data that contradicts their findings. This is a recurring problem in science and – in my experience – indicates a serious flaw in the research.

Peer review is an integral part of the evaluation process. Peer review starts with the review prior to publication but continues long after. It is a critical part of the process because it exposes flaws or weaknesses that the original researcher failed to think of – it illuminates any potential blind spots. Peer review also has the uncomfortable effect of forcing the researcher to explain their assumptions, their methods, their results and conclusions.

[4] Repeat.

That's right. Repeat. And repeat again. No hypothesis gets confirmed by just one test. Not even theories - which are veteran hypotheses that have been tested and confirmed so thoroughly that they are given a certain degree of respect - get to rest on their laurels.

Sooner or later, somebody will find a new way to test, say, the theory of gravity and find a problem. Then they get to propose how to correct the theory. And then everybody else gets to critique that proposal and offer their own changes, tweaks and suggestions. And the process goes on.

The process has its flaws, to be sure. It slows down the acceptance of radical new ideas and can prolong old ideas beyond their time. However, it is the best system that the human has yet devised for sorting the few grains of “truth” from the vast amount of chaff. And if it slowed the widespread acceptance of some ideas – such as stomach ulcers caused by Helicobacter pylori, a favorite of “scientific method bashers” – it also prevented the premature acceptance of ideas like cold fusion.

Imagine, if it hadn’t been for stodgy old scientific method, our homes would be powered by cold fusion – and we’d all be sitting in the dark.

Up next – bias and self-deception.

Prometheus

Word Play: Believing

2007-02-11T13:56:00.000-08:00

The English language is often tricky, even for those of us who grew up speaking it. One problem is that some words have several - often somewhat contradictory - meanings. One such word is "believe":

be·lieve /bɪˈliv

–verb (used without object)

1. to have confidence in the truth, the existence, or the reliability of something, although without absolute proof that one is right in doing so: Only if one believes in something can one act purposefully.

–verb (used with object)

2. to have confidence or faith in the truth of (a positive assertion, story, etc.); give credence to.

3. to have confidence in the assertions of (a person).

4. to have a conviction that (a person or thing) is, has been, or will be engaged in a given action or involved in a given situation: The fugitive is believed to be headed for the Mexican border.

5. to suppose or assume; understand (usually fol. by a noun clause): I believe that he has left town.

"Believe" crops up in the context of this 'blog because of the disparate ways in which people have validated the assertions that they make.

In my business, "believe" is used in the sense of definition 2, with the additional caveat that our confidence in the truth of some statement is based on examination and understanding of the data used to support that statement.

Thus, when I say, "I believe in the Theory of Evolution.", I am not expressing a religious faith (as the Creationists/Intelligent Designers would have you think), but am stating:

"I have examined the theory of evolution and have found it consistent with the available data from current life and the fossil record"

It's just shorter to say that I "believe" it.

Another way in which some people use "believe" in the realm of science (as opposed to religion, where definition 1 would be entirely appropriate) is to indicate that they trust the source of their information such that they are willing to accept it without actually understanding it. In essence, they are simply "parroting" what they have been told.

Now, most of the people who are acting as "parrots" don't see it that way. They are usually convinced that they understand the topic quite well enough to see that their assertions are correct. They assume that a superficial - and usually over-simplified - understanding of an issue can make them equal to people who have studied the topic in depth.

To some extent, this belief (definition 1) that "everyday people" can understand a topic as well (or, in some instances, better) than the "experts" is a lingering zeitgeist of the 20th century, epitomized by many in the "Baby Boomer" generation (my generation, regrettably). It is, unfortunately, no more a reflection of reality than most of the philosophical nonsense to come out of that generation.

Moral philosophy, no matter how good it makes you feel, never trumps reality. The Soviet Union had to learn this lesson the hard way (see: Trofim Lysenko) and it appears that many in the Western World are determined to repeat their mistakes.

No, as much as we might like it to be different, there is no substitute for actually learning the subject. Reading "Molecular Biology for Dummies" will not put you on par with someone who has put in the hours and effort required to really learn the subject. This is not to say that people with lots of education and advanced degrees cannot be wrong - that is most definitely not true (see: cold fusion)! However, when discussing their field, the smart money is betting on the "expert" over the "self-educated".

So, why is it that so many people think that they know more about, say, autism and mercury than the people who have studied it for decades? For the answer to this question, we have to go to the source - literally.

These days, it is considered indelicate for a doctor or scientist to say (or imply) that a topic is too complex for the "public" (i.e. the "average" person) to understand. This despite the all too obvious fact that many - if not most - topics in science have grown too complex even for scientists outside the field to fully grasp. The "average" person, with at most a semester or two of college science, hasn't a chance.

As a result, people read about some aspect of biology, chemistry or physics in Scientific American and think that they can intelligently discuss the matter with someone who does research in the field (true story). And in situations where the source either doesn't have a full grasp of the topic or has a personal reason to over-simplify the matter (actually, those two aren't mutually exclusive), the potential for deception - intentional or not - is extreme.

For example, there is currently a belief that the GnRH agonist, leuprolide (Lupron) will help autistic children. On the part of the people originating this idea, the belief (definition 2) in Lupron's effectiveness is based on two other beliefs (definition 2?):

[1] Autism is caused by mercury toxicity

[2] Testosterone and mercury form a complex, with sheets of testosterone surrounding mercury atoms

The validity of belief [1] is very doubtful at present, but belief [2] is valid - with one caveat:

The complex of testosterone and mercury has only been seen when equimolar amounts (equal number of molecules of each) were mixed with the minimal amount of hot (50 degrees C, about 120 degrees F) benzene.

Now, it is entirely possible that the people who started this idea are unaware of the little caveat above. But I'd be willing to bet a largish sum that the people who are parroting the "lupron helps cure autism" claim are completely unaware of it. Yet it is information that is freely available...if you can understand it.

So why do I worry about people repeating nonsense they don't understand?

A large part of the problem with the parroting of bad (or unsubstantiated) information is that people - so the psycholgists tell me - tend to give credence to things they hear from numerous other people. "Everybody's saying it, so it must be true!" Such tempting logic, but false.

This same sort of "logic" crops up in the various autism polls, surveys and questionaires that litter the Internet. The folks running them must believe (definition 1, I suspect) that a collection of "average people" will generate an above average understanding of the topic. The myth of the "wisdom of the common man" is repackaged as the myth of the "wisdom of common parents".

Don't get me wrong; I think that parents know a lot about their kids - I know a lot about mine. I also know a lot about my car, but I don't think for a moment that I understand its inner workings better than my mechanic. I still get peeved when she can't find the rattle or shimmy that I describe, but I don't think that I know more about how my car works than she does.

In the end, scientific "fact" has traditionally shown no respect for opinion polls. No matter how many school children want Pi to equal 3, the mathematical relationship between a circle's radius and circumference remains obstinately the same (3.14159...). And even majority support on the school board won't make "Intelligent Design" a valid hypothesis - let alone a theory. The same will happen with polls and surveys about the cause of autism - no matter how many people "vote" for mercury, the facts will remain unchanged.

You can choose to believe that or not.

Prometheus

What You Want is What You Get

2007-02-07T01:01:00.000-08:00

A few weeks ago, a reporter interviewed me about my research. During the interview, she asked me, “What do you want the result to be?” I was flabbergasted – it truly had never occurred to me to “want” an outcome to my research. I want to find out what really happens, what reality is – at least in the small world of my research project.

“Wanting” an outcome is what starts a lot of pseudoscience. The Holmes, et al paper is a great example of what happens when you “want” a certain result. Certain that mercury was the cause of autism, the authors took their very screwy results and spun a “Just So” story that, as it turned out, “Just Isn’t So”.

This is not always a conscious distortion of reality. Too often, it is the absolute certainty that their hypothesis is right that leads otherwise rational scientists over the edge and into the abyss. Just ask Stanley Pons and Martin Fleischman, “discoverers” of cold fusion . Neither of them was a “crackpot”, but they let their belief in their own hypothesis blind them to the flaws (major flaws) in the data.

Which leads us to the question of mercury and autism.

Let’s go ‘way back to the beginning of the hypothesis. Some folks thought that the apparent rise in autism prevalence (the “autism epidemic”) starting around 1985 could be due to the increase in thimerosal-containing vaccines that happened at about the same time. The timing wasn’t particularly close, but it wasn’t the worst hypothesis ever written. The known neurotoxicity of mercury made it biologically plausible (but didn’t prove that thimerosal could cause autism).

In real science, a hypothesis needs to explain the data – all the data – or it needs to be revised (or replaced). Things started to go wrong with the mercury-autism hypothesis when the Madsen, et al study failed to show a drop in Danish autism prevalence after Denmark removed thimerosal from its vaccines. There were some methodological problems with the study (which were spelled out by the authors), but it certainly raised a lot of doubt.

Before too long, more studies came out showing the lack of association between thimerosal dose and autism prevalence (Verstraeten, et al and Andrews, et al; Fombonne, et al). Rather than modifying (or abandoning) the mercury-causes-autism hypothesis, its proponents concentrated on attacking the motivations and ethics of the researchers.

A few studies using the thoroughly discredited VAERS database (see Goodman and Nordin) attempted to refute the better-designed studies, but were generally disregarded, except by those who were desperately trying to keep the mercury-causes-autism hypothesis alive. A report of declining autism prevalence (Geier and Geier) was not only poorly done but, as later data revealed, wrong.

Here is the crux of the matter: the autism prevalence data from the California Department of Developmental Services (CDDS) and the United States Department of Education (USDE) have not shown a decline in autism prevalence. That is not an issue in question – it is simple fact. Whether or not this data is valid (and there is some doubt about that, see Shattuck, Newschaffer and Laidler), it was what the original mercury-causes-autism hypothesis was based on.

The reason that the prevalence of autism is so critical to the mercury-causes-autism hypothesis is, of course, because thimerosal was removed from children’s vaccines in the US sometime between 2000 and 2001 (depending on which source you use). No matter when it was finally completely removed, the thimerosal dose received by children in their vaccines has [a] not risen since 1999 and [b] has significantly fallen since 2000.

Thus, even if thimerosal had remained in all children’s vaccines at its 1999 concentration – which it hasn’t – the autism prevalence should have reached a plateau by now. And it hasn’t.

Let me repeat that, for emphasis.

Even if the total amount of thimerosal that a child received in vaccines had remained at the 1999 level, the prevalence of autism would have reached a plateau by now if thimerosal was a major cause of autism.

Given that the thimerosal dose received by children born after 2001 (to allow an overly generous time for all the “on the shelf” doses to be used) has been significantly reduced, we should have seen a decline in autism prevalence by now, if thimerosal caused a significant fraction of autism cases. And we haven’t – decidedly not.

Now, the mercury-causes-autism proponents have been forced to resort to a variety of “bait and switch” tactics to keep their supporters’ eyes off of the poverty of their hypothesis. Mercury from power plants, China and crematoria has been invoked – despite the fact that mercury deposition rates have been declining since 1961 (Roos-Barraclough, et al ).

They have also proposed mercury in dental amalgams, Rho-Gam shots and flu shots as potential sources of mercury.

The basic problem with all this “bait and switch” is that they are acting as though the core assertion of their hypothesis – that mercury can cause autism – has been proven, which it decidedly has not!

The failure of US, UK, Danish, Swedish and Canadian autism prevalence to fall following the removal of thimerosal from children’s vaccines has not supported their claim – in fact, it has weakened it. In addition, showing that mercury can cause autoimmune disorders, “oxidative stress” and neuronal injury is not the same as showing that it can cause autism.

Pretty much everybody knows that mercury is not a good thing for you. This is not the question. The question at hand is whether it can cause autism. And the answer to that question – at least so far – has been “No.”

So, asking if I’m in favor of exposing kids to mercury or if I think that mercury is a good thing for kids is simply a ploy to shift attention away from the glaring absence of data supporting the mercury-causes-autism hypothesis.

And pointing out that flu shots have mercury, or that there is mercury in our food, water and air is just more of the same. The onus is on those who propose that mercury causes autism to bring sufficient data (data, not testimonials, stories about “recovered” children or wild fantasies about governmental conspiracies) to the table to show why their hypothesis is a better explanation of how the universe (and neurobiology) works than the “null hypothesis” (that mercury doesn't cause autism).

A few ground rules:

As a personal pre-condition (a promise made to myself) of returning to ‘blogging, I have elected to moderate all comments. I do this to prevent the sort of free-for-all insult-fests that are all too common from certain individuals (who need not be named).

I expect people to behave themselves in a civilized fashion. Do not bring fights from other ‘blogs into this one simply because you have been banned somewhere else. Fore Sam has already gotten himself banned for a day for doing just that. And because he has already used up his lifetime allotment of second chances. Fore Sam, consider yourself on permanent probation – you’ve earned it.

If it upsets you that your commentary is not appreciated here, then you are free to set up your own ‘blog and rant about my arbitrary justice to your heart’s content. You are free to say what you want here, as long as you remain within the bounds of civilized discourse.

Finally, do not be surprised or upset if your assertions ("It's right because I say it's right! Are you callin' me a liar!?!"}, anecdotes ("It worked for me!"), unsupported hypotheses ("I don't have any data! I don't have time to get data - I'm busy saving lives!") and conspiracies ("It's a guv'mint plot!") fail to convince. That's just the way science works.

Enjoy!

Prometheus

Prometheus Rises

2007-02-04T17:08:00.000-08:00

Sorry to have bugged out so suddenly and for so long. I hope that I still have a few readers left after all this time.

I unexpectedly received a grant (these days, almost nobody expects to get an NSF grant) and have been busy getting things underway. With only a year to show results, I decided it was better to scurry now than scramble later.

Anyway, life has returned to the usual degree of insanity, so I'm going to take a foray back into blogging. In the six months that the blog has been cooling, I have continued to monitor the blogosphere. And what I've seen has not been encouraging.

Mercury/Autism Madness:

Despite several goalpost moves, time is running out on the thimerosal-causes-autism hypothesis. Autism numbers from the USDE and Cal DDS continue to rise in blatant disregard of several predictions from prominent mercury/autism spokespeople that autism numbers will be falling "in 2005", "in 2007" and "sometime real soon".

Anticipating the inevitable demise of the thimerosal-in-vaccines-causes-autism hypothesis, the promoters of mercury/autism are branching out. Their strategies to date (and I may have missed a few) are:

[1] Trace amounts of thimerosal remain in the vaccines -

This tactic has an almost homeopathic ring to it. According to its advocates, the trace amounts (nanograms) of thimerosal in vaccines are as effective at causing autism as the larger amount (micrograms) previously in vaccines. This ignores the fact that the amount of thimerosal in current vaccines is orders of magnitude lower than the amount children received in the 1960's and 1970's - before the "autism epidemic" started.

[2] It's the aluminium, formaldehyde, or other additives in the vaccines.

This is the old "bait and switch" tactic. They have no data to support their proposed link between thimerosal and autism, but they have created a public uproar about it. This strategy is an attempt to transfer the "buzz" they created about mercury to some other vaccine component.

It took years to put a stake through the heart of mercury/autism and it would take just as long to accumulate the data to refute the aluminium/autism hypothesis. This would be a tremendous waste of time and money, since there is even less reason to suspect that aluminium in vaccines can cause autism.

[3] Mercury from other sources is causing autism.

Considering the numerous studies that have shown that terrestrial mercury deposition is lower now than any time since the early 1960's, this is an obvious desperation shot. It is clearly aimed at the general public, rather than anyone in the scientific community, where it was dead on arrival. Mercury from power plants, crematoria or China are not going to push exposure above where it was in the 1960's (or 1880's), so this has no real hope of success.

[4] Data from USDE and Cal DDS are not valid.

This one is almost embarrassing, since it's what their opponents have been saying all along. However, there are a few arguments in the blogosphere from mercury/autism proponents that are using this line of "reasoning". Having used the USDE and Cal DDS data to support their "autism epidemic", they now argue that the same data source cannot show the expected decline. In other words, the data can only show a rise in autism prevalence, not a decline.

Of course, more than a few people have argued for years that the USDE and Cal DDS don't show anything useful about real autism prevalence - up or down. Now, having (ab)used the data to come up with an "autism epidemic", they argue that the data is no good. Amazing!

Autism "Therapies"

The insanity continues unabated. Risperidone is an evil pharmaceutical and Lupron is a wonder drug. Amazing. There are numerous studies showing that the former is a useful treatment for some children with autism and nothing except some wild (and nonsensical) supposition to support the latter. Yet parents are told to fear and shun "drugs" and treat their children with Lupron (not a drug?) instead.

I eagerly await the news that the "alternative" autism treatment community has found a single therapy without merit and abandoned it. But it hasn't happened yet. And I suspect that it will never happen.

Real medicine periodically finds therapies lacking and discards them. "Alternative" medicine appears to make no mistakes and adopts nothing but effective therapies. This would be in keeping with the larger-than-life superhuman nature of its practitioners, no doubt.

Creationism ("Intelligent Design")

Having undergone several painful and public drubbings, the Creationists have returned to their holes to lick their wounds. But, they will be back - count on it. In fact, they are already sending out some tentative feelers to see how they can get their religion back into the science classes. The first of these may be an attempt to cast "Darwinism" as a religious faith. Another is the portrayal of the recent court cases as attempts to "suppress scientific dissent".

In either case, we will have to remain vigilent against the intrusions of the creationists into the science classrooms. I have my own ideas, which I will in due course trot out for evaluation right here.

For the meanwhile, it's good to be back in the blogosphere.

Prometheus

Another Autistic Child Murdered (Take Two)

2006-07-22T11:30:00.000-07:00

I have deleted the previous post under this title after reading the comments - including my own - and reflecting on them. In what may be a once-in-a-lifetime occurence, I find myself in agreement with JB Handley on one thing - that I was wrong to suggest that Generation Rescue or any of the other autism advocacy groups bear part of the blame for this latest string of killings. People are responsible for their actions, regardless of their mental state at the time, and so the only people who can be fairly blamed in these killings are the killers themselves.

As I reflected on this, I found myself wondering why these four murders - Alison Davies, Christopher DeGroot, Katie McCarron and William H. Lash, IV - had affected me so deeply. The obvious answer is that any death should affect me, but the hard, cold truth of the matter is that, with people being killed in wholesale lots both in this country and elsewhere, it is hard to maintain that sort of intensity for long.

Another plausible answer is that these are murders of children, which seems somehow worse than the murder of an adult. This is certainly true enough, but still seems a bit too pat. In 1993, the Chicago Tribune put all murdered children (defined as age 19 and less) on their front pages - ending with a massive front-page photo spread on December 31st. As I recall, the number was well over 100. It was saddening and shocking, but somehow it didn't hit me the same way - it didn't get under my skin and into my head the way these four murders have.

Quite possibly, the reason is that I also have a disabled child, and so these murders resonated with me more strongly than others. But then it hit me - what was different about these murders when compared to the hundreds that happen every years was that they were so terribly premeditated.

For some reason, I find it easier to understand the "heat of the moment" murder - probably from years of television shows, starting with Perry Mason, in which otherwise reasonable, normal people kill in a moment of anger. Even in the Chicago Tribune's year-long series on murdered children, almost all were clearly done in the heat of anger (over half were teenagers killed in gang-related violence, the next largest group was infants and toddlers murdered by their mothers' "boyfriends").

I have tried to understand how someone could kill their own child, tried to put myself in their shoes, as it were, with little success. I have been angry at my children, have even wanted to hit them, but I have never wanted to kill them. For me, that emotion is like the blank areas on ancient maps - "Here there be monsters" - terra incognita.

As part of my reflection, I tried to visualize what it would be like to deliberately kill my child. It just doesn't work for me - I get to the point of raising the weapon and see their sad or fearful face and I just melt. I actually wept, just from the thought of it.

In all four cases, the parents who killed their autistic children had time to reconsider what they were doing - they had to push their child off the bridge, smother them, set fire to their apartment and lock their child inside, or take down the shotgun, load it and fire (I doubt that the Lash family kept a loaded shotgun above the fireplace, not in Washington , DC). I can't even begin to comprehend the frame of mind that this would require.

And this is not to say that I haven't experienced hopelessness and despair. There have been times when I saw my entire life stretching out - past retirement and into death - as the tireless and thankless caretaker of a disabled child. But it didn't drive me to murder - it drove me to set up a trust fund. Because no matter how thankless the job may be, it's my job and I'm going to see that it gets done, even after I'm dead.

Another part of the stories that has bothered me is the way that the last two - Katie McCarron and William Lash - seemed to put a lie to the usual "explanations". In neither of these families was there serious financial want or a lack of support. More government programs or more volunteer respite care would not have materially changed the situations these families were in. Neither did it apear that there had been a pattern of irrational behavior that - in retrospect, at least - could have been seen as "warning signs".

I would like to point to the heated and polarizing rhetoric surrounding autism as a factor in these crimes, but the fact is that I just don't know. And that's because I can't even get a glimmer of what these parents must have been thinking when they set out to deliberately and with malice aforethought to murder their children.

Years ago, I went to a wonderful lecture about the origins of the Universe - the "Big Bang". At one point, the lecturer mentioned that the condition of the newly-born Universe - the extremes of temperature and pressure - so far exceeded anything that exists in our time that he wasn't sure that our current physical laws would apply.

That's how I feel about these murders - they are so foreign to what I know and what I've experienced that they are as incomprehensible as the first microsecond after the "Big Bang".

Prometheus

The Seven Most Common Thinking Errors of Highly Amusing Quacks and Pseudoscientists (Part 3):

2006-07-10T18:02:00.000-07:00

Thinking Error 4 – Conspiracy Theories:

To paraphrase Samuel Johnson, “Conspiracy is the last refuge of a quack.”

Assertions of conspiracy receive a great deal of play in the claims of quacks and pseudoscientists. These range from the ridiculous to the…well, even more ridiculous. No matter what their details may be (e.g. whether the enemy is “the government”, Big Oil, Big Pharma, the AMA or all four), all conspiracy claims serve the same function:

They divert attention from the failures of the person making the claim.

And, no matter what the details of the particular failure may be, at the root is the same issue:

The failure to provide data to support their claim(s).

So, whether it’s the automobile engine that runs on water (suppressed and sabotaged by Big Oil) or the “fact” that chelating out mercury cures autism (suppressed by “the government”, Big Pharma and the AMA), the reason that these conspiracy “theories” are proffered is always the same:

They can’t prove their claim(s).

After all, if someone had a working model of an automobile engine that could run on water, or the clinical data showing that chelation could cure autism, there wouldn’t be any reason to complain about interference from “the government” or Big Oil or etc.

So, what is it that the conspiracy claims do? They allow the quack or pseudoscientist to make their unsupported claim(s) and blame someone else for their lack of support. This is really no different than claiming that “the dog ate my homework”, except that there is no “dog” (and, of course, there was never any “homework”).

This brings us to the other problem with the conspiracy excuse: plausibility.

Ask yourself, which is more likely; that a single person (or small group of people) might lie (or be self-deceived) or that an entire bureaucracy or corporation, filled with people who might have something to gain by revealing a guilty secret, might conspire to suppress information?

Before you answer that, consider this – the difficulty of keeping a secret rises with the number of people who know the secret. This can be mathematically represented thus:

D = n^(n-1)

Where D is the difficulty of keeping something secret and n is the number of people who know the secret.

Even without the math, anyone who can read the newspaper knows the ability of “the government” or other large organizations to keep embarrassing information secret. What makes you think that the “secrets” about water-fueled automobile engines and chelation curing autism would be any different?

In short, claiming conspiracy is a near-certain indicator of quackery and/or pseudoscience. It is the adult (or, more properly, “pseudoadult”) version of “the dog ate my homework”. In addition, it is not even plausible, given the inability of “the government: and other large organizations to keep secrets.

Thinking Error 5 – Personal Infallibility:

One thinking error that comes up extremely often is the error of personal infallibility. This one seems to be shared not only by the quacks and pseudoscientists but also by their victims.

Personal infallibility does not necessarily mean that the person thinks that they are never wrong (although some do), but refers to a more subtle belief that their observations are an infallible source of “fact”. I find this a particularly amusing belief, especially in the context of modern technology’s ability to deceive the senses, displayed every day in movie theatres across the world. Yet, despite this near-daily demonstration that “seeing is NOT believing”, quacks, pseudoscientists and their faithful followers and apologists persist in deferring to their own experiences as if they were infallible.

The root of this problem is the human ability to find patterns. We are genetically adapted to find patterns in the world around us; we are so good at this that we are continually finding patterns when none exist. We “connect the dots” in optical illusions and we see causation in coincidence.

One of the most important steps on the path to what we now call “science” was the philosophy of the Empiricists. They held that the only way to learn about the universe was to observe it. This contrasted starkly with other “natural philosophers” of the time, who felt that they could sit in their drawing rooms and libraries, drinking brandy and philosophizing about how the universe worked. Like many of the quacks and pseudoscientists of our day, they felt that actually getting in the lab or in the field and seeing if their hypotheses worked was irrelevant. After all, some of the finest minds in the world (theirs and their associates) had agreed that the sun and planets circled the earth, so what was the point in getting cold and tired peering through some blasted telescope?

Although the Empiricists eventually won the day (although their opponents continue to populate the chiropractic and naturopathic colleges), there was a small flaw in the philosophy of Empiricism that needed correcting. You see, while large-scale physics and chemistry are fairly deterministic, there is a great deal of variation and even randomness in biology (and in physics and chemistry on the smaller scales). As a result, it is often difficult to tell if a change seen in a biological system is due to an experimental intervention or simply due to random variation.

Because of the stochastic nature of biology (which, by the way, includes medicine), it is very easy for a researcher to see a change in an organism and erroneously attribute it to some intervention they have made when, in fact, the change was not related at all to that intervention. In addition, since many of the changes seen in biological organisms are hard to measure quantitatively (e.g. pain, depression, language ability), the observer is often called upon to not only observe but to be the “measuring instrument”.

This is the reason that the multiple subject, double blind, placebo-controlled study is considered to be the “gold standard” in research (except by those whose “claims” are disproven by such studies). This is not to say that good data cannot be gotten any other way, but this is the standard to aim for.

So, what’s so great about the multiple-subject, double-blind, placebo-controlled study? Let me explain in parts:

[1] Multiple-subject:

Since biology has a great deal of inherent random variation, a single organism (a single person) is not a good indicator of what the population is like. After all, I am not a good example of what the human population is like since approximately half of the world’s population is of a different sex. Likewise, there are people shorter and taller than me, lighter and darker in skin color, etc.

The way to arrive at what the population looks like is to take a larger sample. You can predict mathematically the likelihood that your sample is an accurate representation of the population based on the sample size (and the population size) – the bigger the sample, the greater the probability that it reflects the reality of the population.

In addition, biological organisms change over time – if they don’t, they’re probably dead. As a result, certain changes will happen regardless of whether an intervention occurs or not. Studying a larger group will “average out” these spontaneous changes, since – by random chance – a roughly equal number will occur before and after the intervention.

[2] Placebo-controlled:

Taken out of order (for reasons that will become apparent), placebo-control is a critical part of biological experimentation, especially when the subjects are humans. A placebo, in general terms, is a treatment that is similar enough to the studied intervention that the subject receiving it (and, ideally, the person giving it) cannot tell it apart from the “real” treatment, but it has no effect. Most classically, it is a sugar pill or saline injection that is the same color and consistency as the treatment under study.

Failure to use placebo control has tripped up any number of medical researchers, including some who are legitimate scientists. Among "real" researchers, this most commonly occurs in behavioral interventions (where interaction with the “therapist” can be as big a factor as the “therapy” is supposed to be) and surgical interventions (where questions of ethics may prevent a “placebo” surgery in human subjects). Unsuspecting quacks often fail to realize that their interaction with the patient may be causing the change they measure, rather than their “therapy”. Charlatans count on it.

In human studies, failure to use a placebo can lead to falsely believing that a therapy has a beneficial effect when, in fact, it is the expectation of benefit that causes the subject to feel better. This has been borne out time and again in pain control research, where supposedly effective therapies have been overturned because subjects receiving a placebo had the same degree of relief. In pain studies, approximately 30% of subjects will report "good" or better pain relief with a placebo.

This is sometimes erroneously referred to as the “placebo effect”, which is an oxymoron. A placebo has – by definition - no effect. It is the psychological effect of the subject believing that they will feel better that causes the effect.

[3] Double-blind:

Double blind means that neither the subject (the organism being studied) nor the observer knows whether any particular subject is receiving a placebo or the studied therapy. A single-blind study would be when the observer knows but the subjects do not.

The advantage of a double-blind study is that not only do the subjects not know who is “supposed” to feel better, but neither do the observers. This is especially important if the measurement of “success” or “failure” of the treatment is not completely objective. When measuring blood pressure or heart rate, it is not so important that the observers not know who received the placebo, since these measures leave little or no room for observer interpretation. However, if the measures are more subjective - such as behaviors, pain, depression, social interaction, etc. - then observer interpretation can be affected by the knowledge of who is “supposed” to get better and who is not.

None of this is hidden knowledge and none of this is particularly new. Yet, every day I read about patients, parents and practitioners who declare, “I see an improvement – are you calling me a liar?” These people are unaware – or are in denial of their awareness – that we humans often see exactly what we want to see and hear what we want to hear. To think that we can be truly objective – especially when it involves ourselves, our loved ones or a hypothesis we are in love with – is to claim an infallibility we are not capable of.

So, when you hear someone say, “I saw it with my own eyes!”, be sure to ask (at least to yourself), “Yes, but what would someone else’s eyes have seen?”

Coming up: Cherry picking – it’s not just happening in the orchard.

Prometheus.

We interrupt this blog for breaking news...

2006-07-08T06:40:00.000-07:00

Extreme Humiliation - A New Sport for the Mercury-Autism Crowd?

Kathleen Seidel, in her Neurodiversity website, has broken what may be the "story of the year" about the "dysfunctional duo" of Geier and Geier (the subjects of many posts on this humble blog). The story is told, with great skill, by Kevin Leitch on his Left Brain/Right Brain blog.

In a nutshell (which is where Geier, Sr. belongs, it would seem), in an opinion handed down on 6 July, 2006, pertaining to a lawsuit alleging that the thimerosal in RhoGam caused a young child's autism, District Court judge James Beaty addressed the qualifications (or patent lack thereof) of Mark Geier, MD in excruciating detail. Kevin covers the published legal opinion thoroughly, but there were a few aspects that I personally found too delicious to pass by.

On page 9 of the opinion, Judge Beaty discusses how Mark Geier has testified in "about one hundred cases before the National Vaccine Injury Compensation Program" and how his testimony, since 1995, has "...either been excluded or accorded little or no weight based upon a determination that he was testifying beyond his expertise." He then proceeds to enumerate those humiliations in a footnote. Ouch! To have your personal failings summed up in a footnote - how humiliating!

Judge Beaty then describes how Mark Geier "...relied on a number of disparate and unconnected studies, including the findings of Dr. Haley [more about him later] and Dr. Lucier, to reach a piecemeal conclusion..." That one's going to leave a bruise. And it just happens to be what I've been saying about the mercury-autism cohort for some time - but Judge Beaty said it so much more eloquently.

Not content with just saying the obvious, Judge Beaty then methodically dismantles Mark Geier's case for thimerosal causing autism, study by study. He even takes the time to dismantle the Hornig "Rain Mouse" study and - my favorite - the Holmes/Blaxill/Haley baby haircut study (see here and here). It's like we're the same person! He then restates what he has made so painfully obvious:

"It is also significant in the review of his methodology that Dr. Geier could not point to a single study that conclusively determined that any amount of mercury could cause the specific neurological disorder of autism."

Bang! Another hickory stake through the heart of that undead spirit, the shade of mercury-autism.

And in yet another painful restatement of reality, Judge Beaty concludes:

"Moreover, Dr. Geier's conclusion that the peer-reviewed literature he has relied upon supports his theory [more properly termed a "hypothesis" or even "ridiculous obsession"] that autism can be caused by thimerosal is flatly contradicted by all of the epidemiological studies available at this time."

Bang, bang! Yet another stake through the heart!

In a footnote, Judge Beaty points out that irrational public statements can come back to haunt a person:

"Dr. Geier has also exhibited some bias against health agencies that have criticized his methodologies on other issues to the extent that he has publicly accused the Centers for Disease Control ("CDC"), the World Health Organization, the American Academy of Pediatricians, and the National academy of Sciences of deceiving the American public as to the dangers of mercury and has specifically called the CDC a 'rogue organization' "

And it keeps getting better! Judge Beaty sums up his assessment of Mark Geier's ability to be an expert witness on the ability of thimerosal to cause autism thusly:

"Thus, while Dr. Geier's presentation of the literature as part of his methodology might at first glance appear convincing, the disconnected literature he presents does not add up to the opinion and conclusion that Dr. Geier is offering."

He then rips into the Geier and Geier dumpster-diving (VAERS database) studies in a most thorough fashion. Having dismantled them, he concludes that he need go no further in discrediting Mark Geier's testimony and then, like an encore after a virtuoso performance, he proceeds to shred Mark Geier's qualifications in general. He criticizes the elder Geier's diagnostic abilities, points out that he is neither a pediatrician or a pediatric neurologist and brings up the painful (to Mark Geier - I found it delightfully ironic) fact that Mark Geier failed his pediatric genetics board examination.

After all that, there wasn't much else that could be said about the thoroughly discredited Mark Geier, unless Judge Beaty wanted to comment on his taste in ties.

And Mark Geier wasn't the only person getting a solid dose of ego-spanking in this opinion. Boyd Haley, who should be eternally grateful that he didn't come fully into the spotlight in this case, also got his measure of ego-trauma. In a footnote (which makes it even more humiliating, somehow), Judge Beaty describes the contributions of Boyd Haley, PhD, MCDU (Mad Child Disease Unapologist) thusly:

"...Dr, Haley's report does not state an expert opinion that thimerosal causes autism, rather just that he has a theory about how such a thing could happen." [emphasis in the original]

Were I Boyd Haley, I would be glad to have been accorded so little notice and thus have escaped a more detailed humiliation. However, the ego of this "great scientist" must smart a bit after being dismissed so casually.

So, all in all it was a happy outcome for the forces of reason and honesty. It also may be a foreshadowing of things to come when the massive (and long-delayed - by the plaintiffs) class-action vaccine lawsuit reaches the put-up-or-shut-up stage later this year.

I'll have the popcorn ready for that one!

Prometheus

The Seven Most Common Thinking Errors of Highly Amusing Quacks and Pseudoscientists (Part 2):

2006-07-05T11:30:00.000-07:00

Let me begin by apologizing for my prolonged and unannounced absence from the blogosphere – the requirements of job and family prevented me from pursuing my blog for a period of time. With luck (and assuming that grant applications are accepted and funded), I should continue to have “fair sailing” for the next few months.

Thinking Error 3: Post Hoc Correction of Hypotheses:

Before we get into this “thinking error”, I need to make abundantly clear what it is we’re talking about. One of the most fundamental characteristics of real scientists is that they are always revising, modifying and – when necessary – discarding their theories and hypotheses in light of new data. To many people outside of the scientific disciplines, this looks like indecision or just plain waffling – a “bad” thing if you’re a politician trying to stake out a position for legislation or electioneering.

However, a failure to “change with the wind” – as one politician put it – is a certain sign that a researcher has abandoned science and turned their hypothesis into a religion. Real science often means having to abandon a cherished hypothesis, one that you have nurtured and raised from a mere pup of an idea, like it was yesterday’s newspaper – if the data warrant it. To fail in this most solemn duty is to turn down the path to the “dark side” – to pseudoscience and quackery.

At issue here is the basic purpose of a hypothesis or theory. Although many people outside of the sciences (and, regrettably, some inside as well) equate “theory” (and “hypothesis”, if they are acquainted with that term) with “idea”, the fact is that it is much more than that. A hypothesis or theory (more about the difference later) is a model of how the universe works. Now, it may be a model of a very small part of the universe (such as the replication of a virus) or it may be a model of the entire universe (e.g. theBig Bang).

No matter what the scale, the purpose of a hypothesis or theory is to give us a deeper understanding of our world by showing us the workings of the parts we can’t see. Or, sometimes, by explaining why the parts we can see do the things they do. Either way, the model – the proposed explanation – has to conform to the behavior of the real world if it is to survive. And that – in a nutshell – is the difference between a hypothesis and a theory. A hypothesis is a model that has not yet been extensively tested to see if it predicts what the real world does – a theory has already survived a number of tests successfully.

Having survived testing does not necessarily mean that the hypothesis (or theory, if it has gotten to that point) has survived unchanged. In the process of testing even the most inspired hypothesis, discrepancies are found between what the hypothesis predicts will happen and what actually does happen. Sometimes these discrepancies can be explained by flaws in the measurements or data collection, but any consistent difference between what the hypothesis predicts and what the data show must be seen as evidence that the hypothesis – the proposed model of how the world works – needs to be modified or abandoned.

The problem is knowing when a hypothesis or theory should be revised and when it should be abandoned – something that is often difficult to see until enough contradictory data has amassed. But, like that favorite old pair of jeans that you keep patching and patching, eventually a hypothesis becomes more patches than whole cloth and needs to be revamped or rejected. On the other hand, many of today’s solid, tried and tested theories went through a period where they needed some “tweaking” (or even major overhauls) in order to function.

The thinking error of post hoc correction occurs when someone tries too hard to keep a failing hypothesis “in the game”, crossing from legitimate modification of the hypothesis to frantic attempts to keep it alive at all costs. This can be – and probably usually is – done without any intent to deceive. And it can be done by people who have an impeccable record of excellence in science – as the mutual fund people always say, “past performance is no guarantee of future yields”.

The hallmark of post hoc correction is the modification of a hypothesis in response to contradictory data in a way that is:

[a] Not supported by any existing data
[b] Not tested or not testable

Let me make this clearer by two examples – one of a legitimate modification of a hypothesis and one of an illegitimate post hoc correction:

[1] Lost a star but gained a planet.

In the early 1800’s, the French astronomer Alexis Bouvard undertook to publish a corrected table of the orbit of Uranus due to observed discrepancies from the orbital tables published by Jean Baptiste Delambre in 1792. He was unable to get all of the observations to fit into the predicted orbit (predicted by the theory of gravity) and so published his new tables in 1821 with the comment that he was unable to determine if the discrepancy was due to errors in the earlier observations or a “foreign and unperceived cause”.

By 1841, however, it was clear that even Bouvard’s calculations were failing to account for the actual orbit of Uranus. At this point, there were two theories in play, one of which was in need of modification – the theory of gravity or the theory that the Solar System had only seven planets. Although the majority of astronomers at the time were “betting” on the existence of an eighth planet (which we know as Neptune), there were others (i.e. George Airy, the Astronomer Royal) who felt that the theory of gravity was in need of an overhaul.

The British astronomer John Adams and the French astronomer Urbain Le Verrier began a search for a new planet, using the mathematical basis of the theory of gravity to predict where this new planet might be, based on the irregularities in the orbit of Uranus. In 1845, they both (more or less simultaneously) found the planet – despite resistance, reluctance and a good deal of old-fashioned mule-headedness on the part of their more senior colleagues.

To diagram the process:

a. Hypothesis (Theory, actually): Gravitational attraction is proportional to the product of the masses involved and varies with the inverse square of the distance between them.

b. Problem: The orbit of Uranus is not following the course predicted by the Theory of Gravitation.

c. Possible Explanations: The Theory of Gravitation does not apply at large distances from the Sun OR there is another planet beyond Uranus.

d. Resolution: After calculating where a planet would have to be to cause the observed perturbations of Uranus’ orbit, astronomers found a planet – Neptune – in the expected location. The Theory of Gravitation had survived another test!

The “take-home points” of this example are looking for supporting data (the planet Neptune) before deciding which theory to revise and the fact that they did not automatically assume that one theory was “privileged” and therefore not subject to scrutiny.

[2] When low means high

A few years ago, an unlikely group of researchers – a PhD academic chemist, an MD oncologist and an MBA – embarked on a project to prove that mercury caused autism. Since tests on hair, blood and urine had previously failed to show any significant difference in mercury content between autistic children and “normal” controls, they tested hair specimens that had been collected at the child’s first haircut – the so-called “first baby haircut” – and retained as a keepsake. This, they felt, would be the definitive proof that autistic children had been exposed to a significantly higher mercury levels as infants (as stated by one of the researchers, Dr. Holmes, during the 2000 DAN! Conference).

Unfortunately, the mercury levels in the “first baby haircut” samples from autistic children were significantly lower than those from the “normal” controls. This might have proved to be a difficulty, had not the researchers applied a post hoc correction to their hypothesis. They concluded that, based on their data, autistic children are unable to excrete mercury as effectively as their “normal” peers. They made this conclusion despite numerous studies, many dating back a few decades, that showed mercury was passively taken up by hair rather than excreted.

In addition, a later national study showed that the hair mercury levels that they measured in the autistic children were very close to the national average for children of the age when these hair samples were taken (remember, the hair samples were taken when the children were one to two years old – the analysis was performed many years later). In addition, this same national study – which was not studying autism – showed that the hair mercury levels of the “normal” controls was greater than the national average by over fifteen times!

To diagram the process:

a. Hypothesis: Mercury causes autism (subhypothesis: previous studies have failed to demonstrate high mercury levels in autistic children because the mercury “washes out” by the time of diagnosis some years later).

b. Problem: Hair mercury levels in hair taken at the “first baby haircut” of autistic children are lower than those of “normal” controls.

c. Possible Explanations: Mercury is not related to autism (apparently not considered by the authors) OR mercury protects children from autism (supported by the data, but nonsensical) OR children with autism cannot excrete mercury as well as “normal” controls (consistent with their data but not supported by it – also, not consistent with over forty years of data on how mercury and hair interact) OR the laboratory assays were in error.

d. Resolution: Rather than opt for an explanation that is consistent with known physiology, the authors chose an “explanation” that supported their hypothesis that mercury causes autism at the expense of being almost certainly wrong. In short, either dozens of researchers’ work over the past forty years (and more) is wrong or the authors of this “study” are wrong in their conclusion.

The “take home points” of this example are that a hypothesis (e.g. “autistic children cannot excrete mercury as well as non-autistic children, leading to low hair mercury levels”) which contradicts previous well-established hypotheses or theories (e.g. “mercury is not excreted in the hair – the hair mercury concentration merely reflects the blood concentration at the time the hair was formed”) needs to have data supporting it, not merely the assertions of its authors. Additionally, most of the time, many conclusions can be drawn from the data of a single study – the authors of this study were blinded to those alternative explanations by their single-minded desire to “prove” their hypothesis.

In short, post hoc corrections of a hypothesis are those which “save” the hypothesis at the expense of making it unsupported by data. You can properly “save” a hypothesis that fails to correctly predict reality by either changing the hypothesis so that it predicts reality better (as was done when Neptune was added as the 8th planet). Or you can try to change reality itself by asserting that your hypothesis only predicts reality in your laboratory or in the absence of “negative thought energy”. Or you can take the route of adding another unsupported hypothesis to the mix in order to make the whole thing “work”, as the authors of the “study” in example 2 did. The latter two processes are post hoc corrections and only add more unsupported assertions to a hypothesis that is – by definition – already in trouble.

Coming Up: Conspiracy! (or, Et tu, Brute!)

Prometheus

The 7 Major Thinking Errors of Highly Amusing Pseudoscientists

2006-05-07T14:27:00.000-07:00

In the spirit of the "Seven Habits of Highly Effective..." series of psychobabble books, I have collected the top seven (believe me, there are way more than seven!) thinking errors that I have seen used by quacks and pseudoscientists. These thinking errors are all logical fallacies of one type or another, which leads to a short explanation of what logic is and why it is important.

Logic, despite its rather erudite and ethereal reputation, is not just about scoring points on the Debate Team or sounding like Spock on Star Trek. Logic is about thinking straight. It's about not letting the words we use get in the way of what is being said. Logic is about seeing how people use language to try to fool you - intentionally or inadvertently - in the day-to-day world.

A few of the more passionate pseudoscientists - and their apologists - denounce logic as "mere wordplay" or sophistry. Nothing could be further from the truth. The Sophists developed the use of logical fallacies (the Logic 101 word for "thinking errors") in order to prove anything right or wrong. They were the ancient ancestors of today's "Spinmeisters" and would often engage in "debates" where they would prove both sides of an argument true - or false - just to show off their skills.

Nor is logic just for academics and ivy-covered professors - anyone who listens to an argument, be it a political debate or a television advertisement, can find the logical fallacies in those arguments. It's all about seeing how the other person is trying to fool you into agreeing with them. The fact that they may have also fooled themselves into believing it makes it all the more important to understand how it's done.

Thinking Error 1 - Association is Causation:

Boy, has this one been beaten to death! You can't open a newspaper, turn on the telly or browse the Internet without somebody trying to tell you that, since X is asociated with Y, X causes Y.

A correlation or association merely means that two (or more) things have been found together more often than would be expected by random chance. Their correlation or association might still be due to chance, just as it is possible to get a long string of "heads" or "tails" when flipping coins.

My favorite example of correlation abuse has to be the very strong correlation between reading ability and shoe size seen in every elementary school. Try it - go to your local school and measure the shoe size of any group of children (get the Principal's permission first, or you may have to do a lot of explaining to the police) and compare that to their reading ability. You will be immediately impressed by the correlation - children with larger shoes read better!

Now, does this mean that the way to handle slow readers is to get them larger trainers? Will an oversize pair of Reeboks help a child to advance their reading skills? Well, of course not! As you might have guessed, the children with larger shoes also happened to be (on average) older and older children (on average) tend to have better reading skills.

In this example, the chosen variable (shoe size) was a surrogate for a variable (age) that actually was correlated with reading ability. This is one possiblity for the association. But let's take this one step further.

What about an association that has nothing to do with the outcome? What if we randomly pick people off the street, weigh them and record their eye colour? If our sample is small enough or if random chance intervenes, we could find that a certain eye colour - green, for example - is associated with obesity. Of course, our baloney-meter tells us that eye colour has nothing to do with obesity, but our "random survey" established that very thing.

Or did it?

One way to enhance the possibility that chance will favor our venture (by giving us a correlation we can publish) is to measure a larger number of variables in our study. We can then find those that correlate and publish them. This is what happens in data mining, where huge surveys are done, collecting data on dozens (or hundreds) of variables and then looking for correlations. Some of the results have been quite hilarious (in retrospect).

The problem with data mining is that the people doing it don't "play fair" when they go to analyse the data. They should correct the correlation statistics for the number of variables they studied, but that would lead to the correlations looking like random chance (which they are), and nobody is going to publish that, not even the National Enquirer (headline: "Eye colour associated with obesity by random chance!").

X might cause Y, X and Y might have a common cause, Y might cause X or the result might simply have been the result of a random "clustering" and X and Y might have nothing to do with each other at all. There is no way of knowing without further investigation.

So, when you read about X being said to cause Y because of a "correlation", "association" or even a "strong association", remember to read that as "No causal connection shown between X and Y."

How about the reverse? Does a lack of correlation fail to prove a lack of causation? Sadly, it is not that simple. Which leads us to:

Thinking Error 2 - "A" Cause is "THE" Cause:

This is really an extension of the previous logical error, but it deserves its own listing because it pervades the pseudoscience and quackery communities.

Having established that X causes Y (if that has, in fact, been established) does not mean that X is the only cause for Y. This is a pseudoscience favorite, because it is relatively easy to find well-done studies showing that, for example, mercury impairs the function of a certain enzyme (enzyme "Z"). The quacks and pseudoscientists then proceed to claim (without doing any more research) that finding impaired enzyme Z is a "biomarker" of mercury poisoning.

Unfortunately for them (and the people who believe them), they have established no such thing. There may be one, two or three hundred causes for enzyme Z impairment - many of which may not yet have been investigated - so finding impaired function of enzyme Z "proves" nothing.

Zip, zilch, nil, nada.

However, the ever-confident pseudoscientist will usually not share that little tidbit with the public. The news release will be, "Impaired enzyme Z proof of mercury poisoning!" Doubts rarely make the headlines.

The really annoying part is that the discovered cause - again, one of potentially very many - may not even be the most common cause of the effect. This may lead people to avoid one cause and run - unknowingly - into another.

So, without knowing how many possible causes a certain effect may have, how can you assess whether something is a significant cause of something else?

One simple way is to resort to epidemiology, an admittedly blunt instrument in finding causation, but one that has a particular utility in this instance. By looking at the incidence of - in this example - enzyme Z impairment in a large population and comparing that with the mercury exposure within that population, you can get a pretty good idea of whether or not the hypothesis of causation holds together.

If you find that enzyme Z impairment tracks well with mercury exposure - i.e. the segments of the population with higher mercury exposure have greater impairment of enzyme Z - than you have a piece of supporting data. If, however, the levels of enzyme Z function don't track with increasing exposure, then your hypothesis has a serious problem.

You may have noticed that many of the quacks and pseudoscientists avoid getting to the point of actually having any data like this - data that can test their causation hypothesis. Or, if they have and the data didn't "pan out", they have a ready explanation.

Tune in next time for "Thinking Error 3 - The Post Hoc Correction:"

Prometheus

ABA's Secret to Success

2006-04-30T07:52:00.000-07:00

While reading through some commentary about Applied Behavioral Analysis (ABA) in autism, I began to suspect that I had discovered the "secret" to its reports of "success" in autism.

Part of the "secret" has to do with the way that autism is diagnosed. Even the most well-respected tests of autism rely on external behaviors of the person being tested. As a result, anything that alters those behaviors can alter the results of the test.

ABA is no different - at its core - from all of the other behavioral modification techniques used on humans and other animals. The desired behaviors are rewarded and the undesired behaviors are punished. Now, I'm sure that ABA's supporters will argue that punishment ("negative reinforcement") is no longer a part of ABA. However, the continuous repetition of the command or "physical prompting" (especially to people who are averse to physical contact) has to be considered a punishment.

So, the ABA therapist uses a slight modification of classic conditioning to get an autistic person (usually a child) to either stop doing behaviors that are considered "autistic" or get them to do behaviors that are considered "normal". If ABA manages to get an autistic person to make eye contact, respond to their name or stop flapping, their scores on the various autism rating scales will move toward less autistic (i.e. "improve").

The big question is this - does ABA actually "treat" autism - or just treat the "symptoms"? Does reducing the behaviors unique to autism equate to reducing autism? Or is it just putting on a different coat of paint?

Reducing the automatisms (e.g. "flapping") will generate improvement on standard autism rating scales, so placing the autistic person in a strait jacket should result in a similar "improvement" - right?

Wrong.

A trained psychologist would not be fooled by a strait jacket, but apparently at least a few have been fooled by its behavioral equivalent.

So, what exactly are parents accomplishing by "treating" their children with ABA? Undoubtably, some of the behavioral manifestations of autism that they (the parents, not the child) find most bothersome may be eliminated. This is good for the parents, I suppose, but is there a corresponding benefit to the child?

Not sure about that.

Again, the child may be considered to benefit because the behaviors that mark them as "different" are reduced. However, since these behaviors don't appear to be bothering the child, the "benefits" would seem to be reaped by the other members of the community who are not "disturbed". And, since many autistic children (and adults) report that their "autistic" behaviors (e.g. flapping, avoiding eye contact, etc.) are comforting, the community's "benefit" is realized at a cost to the child.

Bummer.

But, at least ABA improves something about the autistic person's ability to interact with the outside world - right?

Not sure about that.

Let's say I train my goldfish to maintain eye contact with me by only feeding him when he is looking right at me. Has this made him more able to "relate" to people? I doubt it. The same thing applies to ABA and autism. It may alter the behaviors that other people find objectionable, but it is unlikely to change anything fundamental about the autistic person, any more than training me to drool when I hear a bell ring will turn me into a dog.

Woof. Woof, woof!

I suppose that some people will argue that ABA "therapy" (I prefer to call it "training" - that seems more honest) allows autistic people to "get beyond" the obstacles that keep them "locked in" to their autistic world. That's an interesting idea, but completely without any data to support it.

Others will argue that ABA's "successes" are proof enough that it works. Well, let's look at that argument.

The original work by Ivar Lovaas seemed pretty impressive, with nineteen autistic children improved and eight "recovered". However, subsequent studies have failed to reach that level of success. The scenario where early reports (and subsequent reports from the same author or lab) are favorable but other authors (and labs) are unable to demonstrate the same results is depressingly familiar in science. It is usually a solid indicator that the early reports were in error.

Part of the problem is that a lot of the early studies of ABA compared it to doing nothing. Heck, you don't need to be a PhD psychologist to know that spending more time with any child will make them more sociable. As more people (and, especially important, people who did not train under Ivar Lovaas or his graduates) study the results of ABA, I expect that the effects on IQ and speech will continue to diminish.

So, who is benefitting from ABA? Perhaps only the therapists.

Prometheus

Plus ça change, plus c'est la même chose.

2006-04-22T16:30:00.000-07:00

(The more things change, the more they stay the same)

A Heavy Metal Story

In the late 1980's, doctors and public health officials in the UK and the US were struggling to understand why a certain pediatric disorder had been rising dramatically - and alarmingly - over the past decades. Heartbroken parents wanted answers, answers which were not forthcoming from the "medical establishment".

In 1989, a pair of unconventional researchers revealed that they had discovered the cause for this disorder, and that it was related to the use of a particular heavy metal in products intended for infants and small children. Used to prevent one problem, this metal was now blamed for causing a life-altering disorder which was reaching epidemic proprtions in the US, UK and Western Europe.

Realizing the importance of their discovery, these two researchers disdained waiting to publish their results in a peer-reviewed journal and thook their case directly to the public on an television news programme. Needless to say, this caused quite a public uproar and put the scientific and medical "establishments" on the defensive.

Quite soon after the news programme aired, government and academic scientists attempted to reproduce the findings of the two maverick researchers, but were unable to obtain similar findings. These government and academic scientists were accused of attempting a "cover-up".

A panel of scientists convened by the government made a concerted attempt to reproduce the two researchers' findings but were unsuccessful. They concluded that the findings were spurious and that the heavy metal in question was not causing the disorder. This was labeled by many in the public as a "whitewash" and a "cover-up".

A larger panel, led by a major figure in the field, worked for over three years to try to find the truth of the matter. They used more sophisticated tests and larger epidemiologic samples, as well as clinical testing and still were unable to find a connection between the heavy metal and the disorder. Despite the leader's prominence in past efforts to find the cause for this disorder, the results of the panel were alleged to have been "decided beforehand" and dismissed as a "cover-up".

Five years and millions of dollars of fruitless research later, this "explanation" of the disorder has largely receded into the public unconsciousness. A simple change in child care has been at least partially credited with a decline in the incidence of this devastating disorder - a change that had nothing to do with the heavy metal alleged to be the cause. Periodically, an uninformed person (e.g. here, here and here) will "unearth" the hypothesis and have a brief run with it, but the issue is - as far as the scientific and medical communities are concerned - moot. In reality, the two "maverick" researchers had simply failed to eliminate other causes for the results they found.

What was the dread "pediatric disorder"? "Cot death", called "crib death" in the US and later called Sudden Infant Death Syndrome (SIDS).

What was the heavy metal? Antimony, used as a flame retardant in the plastic covers of cot (crib) mattresses.

What does this have to do with anything? Figure it out... Substitute "autism" for "cot death" and "mercury in vaccines" for "antimony in cot mattresses" and it looks like a pretty good fit. Especially the part about the media and non-scientific parent groups taking the lead in promoting an hypothesis that lacks adequate supporting data.

I predict that the end of the mercury-autism story will be similar. The "hard-core" believers will persist unto death in the pathetic faith that their pet hypothesis is correct and the rest of the world will just step around them.

Thanks to John Emsley's book Elements of Murder for making me aware of the elements (pun definitely intended!) of this story.

Prometheus

Autism Parrots

2006-04-17T09:30:00.000-07:00

One of the most irritating aspects of the mercury-causes-autism movement has to be their use of partially-trained parrots to carry on their side of the "debate". I put "debate" in inverted commas because there is no real debate going on - at least not in the sense of an intelligent exchange of viewpoints and arguments. Instead, the mercury-causes-autism proponents simply repeat - ad nauseum - the same tired, threadbare and often contradictory sound bites they have received from the "gurus" of mercurial autism.

For example, a typical exchange on this blog and many other venues might go like this:

Mercury-Causes-Autism (MCA): "Our kids aren't autistic, they're mercury-poisoned!"

Skeptic (S): "How do you know this?"

MCA: "Because my kid is getting better on chelation!"

S: "Isn't it possible that he's getting better because of the normal progression of the disorder?"

MCA: "Are you calling me a liar?!?"

S: "No, I'm just suggesting that you might be wrong. How do you know that it's the chelation that's making him better?"

MCA: "Because he's mercury-poisoned, that's why!"

(rinse, repeat)

The sad fact is that most (if not all) of the people arguing that mercury causes autism haven't got a clue what they're talking (shouting? spraying spittle?) about. Even among the "leading lights" of the mercury-causes-autism, there are few who could cogently explain how mercury disrupts protein function, let alone how it could cause autism without also causing the other hallmark signs of mercury poisoning. Of course, nobody can explain the latter - which is why the mercury-causes-autism crowd is now trying to "prove" their case in the courts, including the "court of public opinion".

In his latest newsletter, Uber-Parrot Lenny Schafer admits that the scientific merits of his pet hypothesis is utterly bankrupt. From Kev Leitch's weblog:

"Myself and other autism activists believe there is enough evidence to support a causative relationship between mercury and autism in a court of law, in front of a jury, where standards of evidence are different than that of the narrow focus of scientific findings. And if you can convince a jury, you can convince the public." (italics mine)

So, there you have it: Uber-Parrot Schafer publicly admits that the mercury-causes-autism hypothesis is dead and their only hope is try to win through propaganda and subterfuge what they couldn't prove by data.

Unfortunately, the cause of autism won't be determined by some sort of popularity contest or even an election. Unlike the worlds of business, public relations and venture capital, there are objective truths in science (Paul Feyerabend notwithstanding). If Schafer and Co. manage to "convince" the public that they are right, that mercury causes autism, will that change the facts of the matter? No.

In fact, this attempted end-run by Schafer, Blaxill, Handley and the rest of that sorry crew is likely to have a catastrophic effect on autism research, postponing any real discoveries by decades. After all, once the courts (or the legislatures) have ruled that autism is caused by mercury, then it's a simple matter: pay damages to the families, remove mercury from vaccines and other medications and then file it away under "closed cases".

But, of course, real autism isn't that simple. Only the mercury-causes-autism proponents are that simple.

So, what happens when ten or twenty years go by and there are still autistic children in the 3 - 5 year age range? And this is a certainty, mind you, not just a "what if". Well, it is possible that the mercury-causes-autism people will manage to convince the courts or public opinion or the legislatures that the sky is still falling and that the trace amounts of mercury in the air, food and water are the cause. And, given the abysmally short attention span of the public, this might just work.

However, we would still be no closer to finding out what actually causes autism than we are at this moment - in fact, we would be worse off. After all, having "definitively proven" (in the courts, legislatures and public opinion polls) that mercury causes autism, nobody (except those few real scientists involved in autism research) would care to look any further.

And once we've reduced mercury exposure to the background level (after all, mercury has been in the environment for 4.6 billion years or more), what then? Do we move everybody into orbit - or the moon? And what do we do when autism continues to occur even on our Mars colonies?

Clearly, long before any of this comes to pass, even "the public" will awaken to the fact that they've been bamboozled by the mercury-causes-autism crowd. And then the whole parrot-driven mercury-causes-autism hypothesis will be given a proper burial.

Or we can bury it now. It already smells dead.

Prometheus

ENRON-Style Accounting by the Autism-Mercury Cult

2006-04-14T20:16:00.000-07:00

Once again, the mercury-causes-autism die-hards have demonstrated their ignorance, no their utter disregard of the facts. An ironically-named organization - "Put Children First" (which was "founded by Generation Rescue") put a fact-free full-page ad in USA Today on 6 April, 2006. In this, they made some astounding claims - not the least of which was that there has been a "6,000% increase in autism". Of course, they blame the CDC for this increase.

It's a pity that government agencies can't sue for libel, because this sure meets the criteria - the authors know, or should have known, that what they were writing was false and defamatory. Mind you, this hasn't stopped them before.

"Put Children First", in the context of SafeMinds and Generation Rescue, brings to mind images of innocent children being used as human shields.

Comparing Apples and Orangutans

The "6,000% increase" is nicely demolished by Mike Stanton in his blog, Action for Autism, to which I commend the reader.

What's in a Number?

I would like to take aim at another persistent "mistake" the autism ghouls are pushing - the "1.5 million children with autism" in the US.

According to the US Census Bureau - which I'm sure Generation Rescue sees as just another cog in the giant Conspiracy-to-Hide-the-True-Cause-of-Autism - there were 73,949,950 "children" (defined as persons 17 years of age and younger) as of March, 2006. Even if we take the current worst-case estimate of autism as 1 in 166, that would only yield 445,482 (rounding up) "children" with autism. To get to 1.5 million "children with autism" would require that one child in 50 have autism. Not even the mercury ghouls have tried to push that figure.

So how would they get 1.5 million autistic people in the US?

Again, data from the US Census Bureau reveals that the US population (as of March 2006) was 292,947,437 (I don't know how they get such precision - ask them). An autistic population of 1.5 million would require a prevalence of "only" one in 195 persons - well within the numbers estimated for true autism prevalence.

However, that would also require that the mercury ghouls give up their premise that autism has dramatically risen in recent years. In fact, to keep to their claim that autism "exploded" since the1990's, the bulk of their claimed 1.5 million autistic children would have to be in the age range of 0 to 15 years, which is clearly impossible, as demonstrated above.

Building a Cult on Shifting Paradigms

Thomas Kuhn, a physicist turned philosopher, wrote a great deal on the philosophy of the scientific method. He, you may recall, was the one who coined the ever-popular phrase "paradigm shift". In his writings - which take a rather simplistic view of scientific progress, to be sure - he describes three phases of a scientific "paradigm":

[1] Pre-science, when the theories of the emerging paradigm are in flux and hotly debated.

[2] Normal science, when the theories are taken as a matter-of-fact and most work is on fine-tuning the way the paradigm represents the real world. This is also the time when the "anomalies" of the paradigm - the ways in which it fails to conform to reality - are discovered and accumulate.

[3] Crisis/revolution - where the limitations of the old paradigm result in a relatively small number of scientists in the field adopting a new paradigm, which rapidly becomes the dominant paradigm (after a period of "pre-science" for the new paradigm, while it is being formulated).

According to Kuhn - and the history of science - a steadily decreasing number of scientists will cling to the old paradigm, often using irrational reasoning to support it and/or to refute the new paradigm.

I bring this up because it occurs to me that the mercury-causes-autism groups are entering the crisis/revolution phase of their paradigm. In fact, the mercury-causes-autism paradigm has been a marvelous model for Kuhn's hypotheses - even though there was never much support for the paradigm in the scientific community.

Despite the fact that the mercury-causes-autism hypothesis never made it to "normal science" in the larger scientific community, it still is a useful model of Kuhn's postulates - in much the way that "Sim City" is a model for urban planning. Think of it as an experiment to see if pseudoscience (as modeled by the mercury-causes-autism hypothesis) will follow the same pattern as real science.

In the late 1990's, there was a "pre-scientific" (pre-pseudoscientific?) period in the mercury-causes-autism paradigm, following which a group of largely non-scientists (the few scientists showing little scientific method) published the "normative" article associating the symptoms of mercury poisoning with the almost completely dissimilar symptoms of autism. Of course, since none of the authors had ever seen mercury poisoning, their minds were unencumbered by the data that typically clutters most real scientific thinking.

For a period of time - at least within the pseudoscientific and "alternative medicine" communities - the mercury-causes-autism paradigm was "normal pseudoscience" and "researchers" (pseudoresearchers?) sought - rather than trying to test the hypothesis - to find ways to reconcile it with reality (to the extent they were able to perceive reality beyond their preconceptions).

Now, with a growing body of data refuting the hypothesis (which the pseudoscientists steadfastly try to ignore or marginalize) and with a growing number of self-evident contradictions in the hypothesis (see above) which require more and more elaborate "fixes" to resolve, the paradigm is in crisis. All that remains to be seen is if the pseudoscientific community will act anything like the scientific community would. This is the truly fascinating part of the "experiment".

At this time, it is unclear which path the mercury-causes-autism paradigm will take. It could take the scientific path and be rejected infavor of a new pseudoscientific paradigm or it could even - although this is very unlikely - be replaced by a scientific paradigm. Or it could go down the cult path (e.g. Cold Fusion) and morph into a full-blown faith, where ignorance is enshrined and any data aginst the canon is seen as "the work of the Devil".

Clearly, a number of the Generation Rescue types will head down the "cult" path. Many of them are already at the end of that path, waiting for the rest of their group. The few real scientists who have been sucked into this maelstrom will either have to swallow their pride (for some, it will be too much to swallow) or ride out this paradigm in an eerie imitation of Slim Pickens' final scene in "Dr Strangelove".

We now enter the final phase of the "experiment".

It's a pity Thomas Kuhn isn't alive to see it happen. Or perhaps it's a pity that we are.

Prometheus.

"Epidemic Denial" vs Autism Acceptance

2006-04-06T21:00:00.000-07:00

With the publication in this month's Pediatrics of yet another repudiation of the "autism epidemic", the thimerosal-causes-autism and autism-epidemic groups have gone into yet another collective temper tantrum. And, as usual, their attacks are directed at the author rather than the data. Predictable.

The author, Paul Shattuck (not to be confused with Paul Shattock), seems genuinely suprised by the firestorm around him, especially since he had spent a lot of time and effort working with the Autism Society of America. It must hurt to have those same people turn on him so readily, but I can't say I'm surprised - I've seen it happen too often.

I won't spend the time to dismantle the feeble arguments raised against Dr. Shattuck's work (for that, see Orac and Kevin Leitch). What I would like to do is examine why these groups are so bitterly angry at Dr. Shattuck and others of his ilk who dare to expose the truth behind their lies (excuse me - "misrepresentations").

Denial - so the psychologists say - is not just a river in Egypt, it is a pervasive feature of human existence. A certain amount of denial is normal - I am in a certain amount of denial about getting well into my forties, although it hasn't reached the point where I have altered the birthdate on my driver's license. Denial helps us to minimize the unpleasantness of daily life by covering over the rough parts.

In some ways, you can look at denial as a mental version of spackle (a plaster-like paste used to fill in cracks and holes in walls) - it covers the imperfections of life without actually fixing them. As with spackle, the cracks and holes remain and can spread or reappear, but aren't visible anymore. A relatively small amount of spackle is essentially for good-looking walls, and a relatively small amount of denial is probably also neccesary for a smooth-running life. However, when either spackle or denial are used to excess instead of taking corrective action (e.g. instead of repairing a large crack or dealing with a major life problem), then problems occur.

For major traumatic events - such as finding out that your child has an incurable disability - a short period of denial allows a person to function until they have a chance to assimilate the new information at their own pace. However, this cannot be a permanent solution - or can it?

One way to make denial a permanent solution is to form a support group. Now, well-run support groups are supposed to help people to accept reality, but a growing number of (largely un-managed) support groups - often called "advocacy groups" - seem to exist solely to provide a social network where denial of reality is the accepted norm. Let's examine a few of these in the context of autism:

The "Autism-is-Curable" Groups:

Reality: As far as is currently known, autism is a permanent condition with an extremely variable prognosis. The eventual functional ability of a child with autism cannot be reliably predicted from their initial presentation, although the more severely affected children usually are more severely affected as adults.

Group Fantasy: Autism is curable, but only if the parents commit themselves body and soul to the cure. This includes following advice given by group "leaders", no matter how outlandish and never questioning someone who has "cured" (or "greatly improved") their child. Improvement is seen as the only "proof" needed that "cures" exist.

The fantasy ignores the fact that autistic children always make progress - autism is a syndrome of developmental delay, not developmental stasis. As a result, all children in the group will improve to some extent and some children will improve markedly - regardless of the interventions used. By enshrining these "placebo responders" (in reality, children who were going to improve regardless of the "treatment" used or not used), the group perpetuates the myth and stimulates the other parents to try all the harder in order that their children might be "cured", too.

The "Autism-is-Not-My-Fault" Groups:

Reality: Autism isn't caused by parents - except to the extent that the parents' genetics are involved. Likewise, the overwhelming majority of the data indicates that autism isn't anybody else's fault, either.

Group Fantasy: Autism is caused by the actions or inactions of other people, primarily governmental agencies, doctors, and - of course - that favorite Evil Empire, "Bog Pharma". Parents are only at fault if they fail to do absolutely everything they can do to "cure their children (see above). "Absolutely everything they can do" being determined, of course, by the group leaders.

These groups are the most puzzling, since one of their members, Dr. Bernard Rimland, was instrumental in showing that autism is not the result of "bad parenting". At least these groups aren't saying that autism is caused by a lack of parental warmth and affection. No, this time autism is caused by evil, corrupt and biased governmental agencies that refuse to admit that vaccines (either the MMR or the thimerosal preservative - take your pick) cause autism. The parents are only at fault if they don't try any and all of the proposed "therapies" to rid their children of mercury, poor sulfation, high testosterone, low anti-oxidant levels, hyper- or hypo-active immune systems (or both?) or whatever is current this week.

Many of the people active in these groups are more than willing to assert that parents who fail to enthusiastically embrace their therapeutic insanity are guilty of nothing less than child abuse, not to mention being criminally stupid. And that's just what they're saying in public forums.

So, it's not the parents' fault that their children are autistic - which is a tremendous improvement over Bettleheim and Kanner - but it is their fault if the children stay autistic. "Have you tried chelation? HBOT? Lupron? Injectible gold? If not, you're not trying hard enough!"

I guess that, in the eyes of the "Autism is curable!" and "It's not my fault!" groups, parents aren't "trying hard enough" unless and until their children are either "cured" or dead. And with the increasing lethality of the recommended "therapies" for autism, the latter seems to be getting more and more likely.

So why do parents buy these lines of baloney? Well, one possible reason is that it serves as a distraction. By focusing on how hard they are trying to get their children "well" and how mad they are at the heartless and corrupt government agencies that "poisoned" their children, they can forget - at least for a while - about how these children have not met the parents' expectations.

It may not be "nice" or "gentle", but the hard, cold reality is this: parents of autistic children did not get the child they expected (i.e. a child who was "normal"). This is not the parents' fault, nor is it the fault of the child or - truth be told - the fault of the government, doctors or even "Big Pharma". It just happened.

On the other hand, there is little to be gained - by the parents or their children - from not "dealing with" reality. No matter what fantasies the parents may be encouraged to believe, nothing will change the fact that they have the children that they have. This was a hard lesson to learn about my own child, but it is a lesson that I had to learn. To do otherwise would be to live in a fantasy world.

Acceptance is a simple thing - simple, but often very, very hard to do. Accepting the reality of the world doesn't mean that you have to like it, just that you acknowledge that it is reality. It is hoped that acceptance will lead to a more peaceful coexistence with reality, but that is not a requirement.

So, as long as the members of these so-called "advocacy groups" band together to ignore reality, they will be condemned to go through life being angry, frustrated and exhausted about something they didn't cause and have no power to change. But that's exactly what groups like DAN! and SafeMinds want, because angry, frustrated and exhausted people give them a political clout they would not otherwise have. Imagine how hard it would be for SafeMinds to get a member of Congress to introduce an idiotic bill if they didn't have a number of angry voters (in denial) behind them.

In the end, it's the parents (and their children) who lose in this game.

Prometheus

How to Seek and Not Find

2006-03-31T19:03:00.000-08:00

Dan Olmsted, UPI's Senior Editor for autism-mercury conspiracy, has gone on record (twice) saying that autism is only seen in vaccinated Amish children. He even performed an "exhaustive" search of the Lancaster County Amish communities looking for autistic children. His failure to find any (other than children who had been vaccinated) is further evidence - he claims - that vaccination and, more to the point, the thimerosal in vaccines is responsible for causing autism.

This rather simplistic view of sociology, neurodevelopment and genetics has been heralded, nay, brayed to the world as "proof" that mercury causes autism. Now we are presented with another possible explanation of Mr. Olmsted's amazing findings.

In the 30 March 2006 edition of The New England Journal of Medicine (not up the "standards" of Medical Hypotheses, to be sure, but a solid journal nonetheless), a group of researchers from the Clinic for Special Children in Strasburg, Pennsylvania (which provides services to a large number of Amish and Mennonite children) report a genetic mutation which causes:

"...seizures that progress to autism and retardation" (see here for a nice review of the article)

This mutation is seen in much more often in Amish and Mennonite children, primarily because of their very small gene pool (see here and here for a review). This is not the only genetic disorder seen more frequently in these populations. And this is not to say that this is the same sort of autism generally seen in the general population (it's not).

However, it seems passing strange that Mr. Olmsted, in his extensive canvassing of the Lancaster County Amish communities, did not run across a few of these children. They are, after all, autistic, even if they weren't vaccinated.

Three possibilities leap to mind (there may be others):

[a] Mr. Olmsted didnt look all that carefully for autistic children, having already concluded that there wouldn't be any.

[b] Mr. Olmsted found these autistic children, but didn't count them - either because he (as a trained neurologist and developmental pediatrician) didn't feel that they had real autism or because it conflicted with his forgone conclusion.

[c] The Amish families - being somewhat suspicious of "outsiders" (not without good reason) - didn't confide the details of their family medical issues with Mr. Olmsted.

My money is on [a], with a bit of [c] thrown in for good measure.

One thing my thesis advisor told me early in my education:

"If you don't look for contradictory data, you won't find it. But your critics will."

Prometheus

Miscellaneous Mercury Nonsense

2006-03-26T17:08:00.000-08:00

A few things that aren't big enough for a full posting but are interesting enough.

Geiers' Testosterone-Mercury Binding Model Full of Sheet:

My fond compliments to the University librarians who located and delivered to my desk the article that is the sole published report of a complex forming between testosterone and mercury:

Cooper A, Gopalakrishna EM, Norton DA. The crystal structure and absolute configuration of the 2:1 complex between testosterone and mercuric chloride. Acta Crystallogr B. 1968 Jul 15;24(7):935-41.

My favorite part of the article has to be the authors description of how the crystal was made:

"...by dissolving equimolar amounts of testosterone and mercuric chloride in minimal hot benzene."

For those not facile with chemistry-speak, the authors took equal numbers of molecules of testosterone and mercuric chloride and dissolved the mixture in the minimal amount of hot benzene that it took to dissolve the mixture.

This is not a condition even remotely similar to anything found in living tissue - of any vertebrate species. In other words, it isn't likely to happen in autistic children unless you dissolve them in hot benzene.

The Geiers' Seek Data Post Hoc to Support Recent Assertions made about Autism Statistics:

Apparently, the recent JPandS article by the dynamic duo has been "outed" by none other than Joseph of "Autism - Natural Variation" . It seems that G&G didn't check to be sure that their data was what they thought it was but just went ahead and fit it to their hypothesis anyway.

Now that they've been "outed" (again), they are frantically seeking new data from the California DDS to shore up their foundering conclusions. Joseph, who has been in contact with the editors of JPandS, feels that a retraction is in the offing. Personally, I think that the chances of JPandS asking the Geiers for a retraction is slim, at best - it's not their style. However, stranger things have happened.

Legitimate Clinical Laboratory Provides Reference Range for Lead after "Provocation" with DMSA or EDTA:

LabCorp, a legitimate clinical laboratory company headquartered in Burlington, North Carolina, has extensive experience in occupational testing. They are no fly-by-night company, having over 1000 testing facilities nationwide and 35 primary laboratories. Their reference values for urinary lead just happen to include values for people after taking DMSA or EDTA for chelation. Unfortunately, they do not have similar values for mercury, but a quick look at the lead values may give some idea of what those might be.

LabCorp's reference values for "environmental exposure" to lead is 0 - 50 mcg/day, which is a bit higher than most labs. Their reference range for testing done after chelation with EDTA (1 gram IV) or DMSA (2 grams PO) is 0 - 600 mcg/day. Now, since DMSA is a much better chelator for mercury than it is for lead, even if we stick to the 1:12 ratio that LabCorp has found for lead, we should still be erring well on the side of calling someone "mercury- toxic" when they are not.

So, if 0 - 15 mcg/day is within the "normal" range for urine mercury without chelating, then the upper limit of the reference range after chelation should no less than 180 mcg/day. Most likely, the upper limit after chelation will be significantly higher than that, given the amounts of mercury DMSA pushes out of the kidneys (and DMPS is even better at getting mercury out of the kidneys).

I'd be interested in hearing from anyone who has had themselves or their children tested for mercury after DMSA or DMPS (don't tell me if you've given your children EDTA, I'd just have to call Child Protective Services). No names, please! But urine mercury values would be most welcome.

Prometheus

Mercurial Laboratories

2006-03-23T10:56:00.000-08:00

One of the recurrent themes in the mercury-causes-autism propaganda is use of a certain, select group of laboratories to make the "diagnosis" of "mercury toxicity". Easily the most prominent of this "select" group is Doctor's Data, Inc of St. Charles, Illinois.

It may not seem fair to pick on Doctor’s Data (DDI), since they are probably no worse (and no better) than any of their mail-order lab competitors. But Doctor’s Data has been the “lab of choice” for a number of mercury-autism “studies”, so its reliability has more bearing on the validity of the “research” supporting the mercury-autism connection.

Well, the first thing that pops up on a careful examination of the DDI website is that their reference ranges (sometimes called “normal ranges”) are different (lower) than those used by the more standard clinical laboratories (0 – 5 mcg/day vs 0 – 15 mcg/day). Now, I’ve heard it argued that their assays are more “sensitive”, and so a lower reference range is appropriate, but this doesn’t hold up to careful scrutiny.

To begin with, DDI is using the exact same equipment that the clinical lab at the local University hospital is using, and also the same as used by nationwide clinical laboratories (where clinics and smaller hospitals send their urine mercury samples). Besides, a greater sensitivity only lowers the minimum detectable level; it doesn’t affect the value.

Some of you are probably asking yourselves, “What does it matter? Mercury is bad, so any amount is bad…right?”

Wrong.

Mercury is a ubiquitous element – it is found everywhere on the planet, even in pristine alpine lakes. It is in the air you breathe, the food you eat and the water you drink. It comes from burning fossil fuels, industrial processes, broken fluorescent tubes (less with the newer ones) volcanic eruptions and deep sea hydrothermal vents. In short, everybody has mercury in their bodies from the time they are conceived until (and after) they die.

As a result, it is expected that any urine sample (or blood or hair or…) from any person will have some amount of mercury in it. Analyses that fail to show mercury are simply not sensitive enough – it’s there, they just aren’t seeing it. And none of this has any impact on DDI’s decision to use an upper limit of “normal” that is one third of the generally accepted value.

I suppose we ought to first talk a bit about how these “normal ranges” are determined. To begin with, they are not simply “agreed upon” or “generally accepted” values (unlike some of the EPA and OSHA limits). The “normal” or reference range is determined by measuring the values of at least one thousand “healthy, normal” volunteers. I put “healthy” and “normal” inside quotation marks because there is some debate about how these characteristics are defined and determined. The general practice is to use college students, often athletes, who report no health problems. For tests which may show age related changes (e.g. testosterone), volunteers of the appropriate age (and/or sex) are recruited. This is called “normalization” or “norming”.

In the end, all of the values for the thousand or more “healthy, normal” volunteers are collated and the “normal” or reference range is set to include 95% of the values obtained. This leaves 5% of the presumably “healthy, normal” population outside of the “normal” range, which is why I put “normal” in quotes and why the preferred term is “reference range”.

One of the conundrums in clinical laboratory medicine is this 5% of the “normal” population that – by definition – is outside of the reference range. This is particularly problematic when you are running a battery or “panel” of tests, since each one of them has a reference range that excludes 5% of the “healthy, normal” population. It is a relatively simple exercise in probability to find how many tests you have to do to reach the point where there is a greater than 50% chance that one of the results will be “abnormal” (i.e. outside the reference range) in a person who is “healthy” and “normal”[Answer: 14].

Good, responsible clinicians are aware of this fact and guide their interventions accordingly. Less responsible clinicians may see this as an opportunity. After all, if you order a “panel” of 30 tests, there is a 78.5% chance that a “healthy, normal” person will have at least one abnormality. And this applies when the tests have been properly normalized (tested with over one thousand “healthy, normal” volunteers) and have the appropriate reference ranges used. What happens if you change those assumptions?

Let’s start with proper normalization. One technique used by labs when they are performing a laboratory test that has never had a formal normalization process is to use a much smaller group of “healthy, normal” volunteers (up to one hundred) and create a provisional normalization. Because of the potential for errors and random variation with such a small test group, such tests are usually marked as “experimental”, “provisional” or other such verbiage – to warn the unwary that these tests should not be given too much credence.

Another, less valid approach (often used by mail-order or “do-it-yourself” labs) is to use the specimens provided as a source of the values for the normalization process. This is fraught with errors, since the specimens are usually being sent because the client suspects that they have a health problem. Although, for the mail-order or “do-it-yourself” laboratories, this may be less of a problem, since they seem to cater to the “worried well” segment of the population.

One rather less savory technique seen at some laboratories (of the mail-order or “do-it-yourself” variety, exclusively) is to set the reference range of a test as the mean (“average”) of the “normal” values (see above), plus and minus one standard deviation. For those not familiar with the standard deviation, it is a measure of the variation within a group – the bigger the number, the wider the range of values around the mean. A handy feature of the standard deviation is that – for a population with a “normal” (this time, “normal” means “bell shaped distribution curve”) distribution – the mean plus and minus two standard deviations encompasses about 95% of the population (95.5%). Plus and minus one standard deviation from the mean only encompasses 68.3% of the population, which would leave 31.7% of the ”healthy, normal” population outside of the reference range.

Now, if you use the +/- one standard deviation stratagem, it takes a lot fewer tests to get an abnormal result from a “healthy, normal” person. In fact, the chance of having one “abnormal” result is over 50% after only two tests. A meager panel of five tests raises the chance to over 85%. This can be a real boon to those looking for an abnormal result – any abnormal result – to show their worried-well patients.

This brings us back to DDI and their…”individualistic” reference ranges. Let’s see if we can estimate how changing the reference range might impact their reports.

Looking at urine mercury, DDI advertises that they use ICP-MS (inductively-coupled plasma – mass spectroscopy) for their analysis. Perkin-Elmer, a manufacturer of those machines, lists the limit of detection (LOD – the lowest concentration it can detect) of its ICP-MS as 0.1 ppb (parts per billion, or mcg/liter), which works out to around 0.2 mcg/day, given average urine output. Compared to DDI’s upper limit of 5 mcg/day, this is close enough to zero to make no significant difference, and that assumption will give DDI a bit more leeway.

Now, the distribution of urine mercury values – even in the “healthy, normal” population – is not going to be a normal distribution (the nice “bell-shaped curve” of basic statistics). The values will be clustered nearer zero, as has been shown by a number of studies. In fact, the distribution can be modeled as a normal distribution (“bell-shaped curve”) folded in half at the mean (the peak of the curve). This assumption greatly simplifies the math and, in the process, gives DDI yet another break, since it places the mean at zero and thus broadens the standard deviation (mathematical tricks – don’t try this at home, or on your homework).

If we do this, and assume that the reference range used by the grand majority of clinical laboratories is two standard deviations from the mean, this gives us the following:

Mean: 0 mcg/day (yes, I know this is unrealistic, but it gives the advantage to DDI)
Standard deviation: 7.5 mcg/day

In a two-tailed normal curve, the mean plus and minus two standard deviations encompasses 95.5% of the population. In this “folded”, one-tailed distribution, the mean (0 mcg/day) plus two standard deviations (no minus, since that would lead to negative numbers, which would be really ridiculous) will encompass 95.5% of the population and should define the reference range.

With these assumptions, which clearly give the advantage to DDI, the upper reference range used by DDI (5 mcg/day), is the mean plus 2/3 of a standard deviation. This range only encompasses 49.5% of the “healthy, normal” range, so you reach the 50% probability of a “false positive” (abnormal result in the absence of any disease) with a single test.

Remember, the assumptions used to construct this simple model were grossly biased in favor of showing DDI in a good light, so it is likely that their reference range is even worse than the model shows.

To be fair, DDI’s reference ranges are close to or identical to the “standards” on some of their tests (cadmium, for instance). However, their reference ranges for arsenic and antimony were three times higher than the standard ranges used by most clinical labs. As my son would say, “Go figure.”

DDI steps “over the line” again with their lead reference range, which is given as 0 – 20 mcg/day, against 0 – 31 mcg/day for the other laboratories. Using the same model as above, we get a pretty similar answer – DDI’s reference range only encompasses 81.8% of the “healthy, normal” population.

If DDI had stuck strictly to the established reference ranges for its DDI’s “Urine Toxic Metals” panel (15 metals, from aluminum/aluminium to uranium), there would be a 53.7% chance of a single false positive result (an abnormal result in the absence of disease). By changing the reference ranges on just mercury and lead (two “hot topics” in autism, by the way), and even giving them credit for raising the reference ranges on antimony and arsenic (assuming that these tests now have a 2% false positive rate), the overall risk of a single false positive goes to over 75% [77.9%].

Let me say that out again. By reducing the reference range on lead and mercury – even if we can assume that they are using valid reference ranges for the others (such as tin, platinum and thallium, for which large normative studies have not been done), the chance that a perfectly healthy, normal person would get back one abnormal test result goes to over 75%. And that abnormal result is most likely to be either mercury or lead.

Is it any wonder that DDI is the “lab of choice” for people trying to find a connection between mercury and autism?

Prometheus.

Armchair Science vs Real Science

2006-03-12T08:18:00.000-08:00

In American football, there is a term for those who sit in front of the telly and pontificate on what they would have done if they had been in charge of the game. They are called "Armchair Quarterbacks". As I understand it, it is not meant to be a compliment.

In the world of pseudoscience and quackery - and especially in the world of "alternative" autism therapies - there are a group of people who sit in front of television cameras and pontificate on what "might" cause autism and what "might" treat it. I think the term "Armchair Scientist" fits these people well.

As with "Armchair Quarterback", "Armchair Scientist" is not a flattering term.

An Armchair Scientist gets to sit and speculate about what might be without ever having to do the hard work of actually doing any research to find out what is. The average Armchair Scientist doesn't even bother to review the published literature - they just make it up from what people have told them, what they've read on the Internet and what comes to them in their dreams.

However, the more pernicious of the Armchair Scientists have a pasing familiarity with the literature and cite it to their benefit. Several good examples of Armchair Scientists can be found on the FAIR Autism Media website. My personal favorites from this site are the dynamic (definitely sarcasm - see the video) duo of Geier and Geier (pere et fils).

In their video clip from the FAIR site, Geier and Geier expound at length (in a performance that can only be described as "petrified" - it's too stiff to be "wooden") about how they "discovered" that testosterone is the linchpin to explaining:

[1] How thimerosal invaccines causes autism (their bread and butter - literally).
[2] How the myriad of disparate and illogical autism treatments "work".
[3] Why more boys than girls are autistic.

It's a masterful piece of work, to be sure, and it would be a magnificent addition to the corpus of medical knowledge except for one small problem...

They don't have any data.

They begin with a stirring description of how they "found" that mercury inhibited a key enzyme in the pathway (more properly, the web of interlocking synthesis pathways) from cholesterol to testosterone and how this discovery led them to the belief (unsupported, as yet, by any data) that this was the key to the autism puzzle. Their "discovery" was from a paper by Ryan RA and Carrol J, Studies on a 3beta-hydroxysteroid sulphotransferase from rat liver (1976).

In this paper, Ryan and Carrol describe that the enzyme 3beta-hydroxysteroid sulphotransferase (EC 2.8.2.2) was, "...inhibited by p-chloromercuribenzoate and HgCl2". However, if you do a search of Medline for that enzyme, you will find that it is regulated, stimulated and inhibited by a wide variety of substances besides mercury.

So, let's look for a moment at some of the other claims they make on this video.

They cite a "study" by Boyd Haley, PhD who reportedly exposed neurons in cell culture and found that testonsterone enhanced the toxicity of mercury. This would be interesting - if not earth-shattering - news, except that it hasn't been published anywhere. Boyd Haley has a long list of publications and his name alone was able to get unadulterated twaddle published in an otherwise respectable journal, so I doubt the lack of publication is due to the infamous "conspiracy of silence".

A possible explanation for this absence of publication is that Boyd Haley doesn't feel confident enough of his results to embarrass himself in front of his peers. It's one thing to show video of neurons "unraveling" to a group of credulous parents - it's another thing entirely to show the same piece of work to people who know the "tricks".

That said, there are several studies that have looked at the role of testosterone in mercury poisoning (which should never be confused with autism - the symptoms and signs are completely different). A study by Barregard, Lindstedt, Schutz and Sallsten, Endocrine function in mercury exposed chloralkali workers (1994), showed that "Serum total testosterone, but not free testosterone, was positively correlated with cumulative Hg exposure."

Another study by Tanaka, Naganuma, Miura and Imura, Role of testosterone in gamma-glutamyltranspeptidase-dependent renal methylmercury uptake in mice (1992), showed that "Renal mercury content in 4-week-old male mice was twofold higher than that of females and increased with age, but remained constant in females." and "Seven days after castration of 4-week-old male mice, both renal mercury content and gamma-GTP activity were decreased to the levels in females."

On the other hand, a study by Mohamed, Burbacher (a familiar name) and Mottet, Effects of methyl mercury on testicular functions in Macaca fascicularis monkeys (1987), showed "The MeHg-induced increase in semen abnormalities was not accompanied by any significant changes in serum levels of testosterone."

Even more interesting is a study by Hirayama,Yasutake and Inoue, Effect of sex hormones on the fate of methylmercury and on glutathione metabolism in mice (1987), which found:

"Twenty-four hours after oral administration of MeHg, urinary Hg levels were significantly higher in males than in females. Tissue Hg levels of males were higher in the kidney, but lower in the brain, liver and plasma than those of females. The fate of injected MeHg in castrated males was similar to that in normal females except for its brain levels. This feminization of the mercurial behavior in the castrated males was restored by treating with testosterone propionate (TP). When control mice were treated with TP, urinary excretion of Hg increased in both sexes, whereas renal Hg level increased only in females. Administration of estradiol benzoate (EB) to males decreased the renal accumulation and urinary excretion of Hg, whereas its hepatic levels
increased."

In short, Hirayama et al [thanks Clone3G, for the reference!] found that testosterone protected the brain and increased mercury excretion. And that estrogen made the mice more susceptible to mercury poisoning. Quite the opposite of what Geier and Geier speculate might be happening in autistic children!

So, the connection between mercury and elevated testosterone - which seems so solid to the Geiers - is not clear at all, even at overtly toxic levels. Nor does the idea that testosterone impairs mercury excretion or increases mercury toxicity seem to be holding water.

The real laugh in the show was when the Geiers described how mercury "coordinated" the binding of testosterone into large "sheets" and "matrices" that were resistant to breakdown by enzymes. They based this - so they said - on crystallographic data. Since there is only one report of co-crystallization of testosterone and mercury [Cooper A, Gopalakrishna EM, Norton DA, The crystal structure and absolute configuration of the 2:1 complex between testosterone and mercuric chloride (1968)], it seems that is the source of this datum.

Apart from the fact that the processes used to crystallize testosterone (or most any other biological molecule) for X-ray crystallography are not happening in the body, there are some flaws in this "reasoning":

[1] If the mercury is complexed into a matrix of testosterone and mercury, it is not available to cause problems. It would seem that these "sheets" of testosterone would be an ideal way to sequester mercury away from delicate brain tissue, which would leave open the question of why the Geiers want to reduce testosterone.

[2] Mercury doesn't complex with carbon, oxygen or hydrogen very well - it "prefers" sulfur, but will complex with phosphorus or nitrogen in a pinch. below are the structures of several compounds related to testosterone (including testosterone itself). For those unfamiliar with the notation, the lines have a carbon atom at each end unless a letter is present.

Clearly, there is no high-affinity spot for mercury to attach.

[3] How is mercury - a brainless atom that cannot read structure diagrams - to know that it should attach to testosterone and not one of the several "look-alike" molecules? How many of the intelligent life-forms reading this blog can spot the testosterone molecule?

Here's the "key" for the above test:

So, we have no data to support the idea that testosterone binds preferentially to mercury, that mercury bound to testosterone (if it were possible) would be bioavailable (capable of doing harm). We also have no data that mercury causes an increase in DHEA (as proposed by Geier and Geier) or that testosterone impairs excretion of mercury. What's left?

Prometheus

Undead Bad Science

2006-03-07T21:12:00.000-08:00

One nasty thing about peudoscience - it doesn't die quietly.

The dreadfully inept "study" of mercury in the hair of autistic children - saved as momentos of their first haircut - by Holmes, Blaxill and Haley (2003) continues to spread misinformation and confusion. A quick check on "Web of Science" revealed that it had been cited in other papers fifteen times! Of course, it should come as no surprise that at least six of those citations were in articles by the dynamic duo of pseudoscience, Geier and Geier (see here and here, also here, here, here and here).

In a nutshell, the Holmes et al "study" compared the mercury in the "first baby haircut" hair of 94 autistic children and 45 "neurotypical" controls. Disregarding so many procedural, technical and analytical flaws that they almost defy counting, the "data" they came up were these:

Autistic children's hair mercury levels: 0.47 ppm (+/- 0.28 ppm)
Control children's hair mercury levels: 3.63 ppm (+/- 3.65 ppm)

Now, Holmes (a radiation oncologist who was in "alternative" medical practice at the time), Blaxill (an MBA) and Haley (a somewhat conflicted PhD chemist) concluded that, since the autstic children had lower hair mercury than the controls, that autistic children were unable to excrete mercury.

Huh?!?

Mind you, they offered no data to support that startling (if not ridiculous) conclusion, nor does anything known about mercury "excretion" in hair support that line of "reasoning". As far as I can tell, they just made it up rather than face what the data (such as it was) told them - that mercury had nothing to do with autism (actually, the data suggest that mercury might protect children from autism - another unlikely possibility).

Now, come along with me for a minute as we take a look at another study of hair mercury. This study, published in 2004, was part of the National Health and Nutrition Examination Survey of 1999-2000 and looked at the hair mercury levels of 838 "normal" children ages 1 - 5. This is roughly the same age range of the hair samples Holmes et al examined. The NHANES results, however, were different:

Children's hair mercury levels: 0.22 ppm (+/- 0.04 ppm)

This puts the Holmes et al conclusions in a different light, doesn't it? The autistic children in the Holmes et al study had over twice the mean hair mercury level of the NHANES group (of 838 children) and the Holmes et al controls had hair mercury levels of over sixteen times the NHANES level.

What are they feeding those kids?

Well, the only conclusion that you can draw from that data is that the Holmes et al study is garbage. My suspicion is that their laboratory - Doctor's Data - is the cause of the outrageously high levels of mercury found in the children - especially the control children.

So, I hope that this stake through the heart will help this abysmal study finally rest in the obscurity that it so richly deserves.

I doubt it, though - the undead always rise again.

Prometheus

Below Junk Science

2006-03-04T16:50:00.000-08:00

The junk science team of Geier and Geier (father and son) has outdone themselves this time.

Once, they were content to mine the contaminated VAERS database (also see here) to find the data that they or their clients had planted there. It was a simple thing, really. They knew that groups like “Defeat Autism Now!” had been encouraging their members to report to the VAERS database that their autistic children (and their family members’ children and their neighbors’ children and…) had been injured by vaccines.

It should be no surprise that when they looked at the VAERS database, the Geiers found those reports. This “data” does not support the “mercury-causes-autism hypothesis” any more than finding Easter eggs at an Easter egg hunt would prove the existence of the Easter Bunny

But now, they have begun to step away from bad “epidemiology” and move into a new realm. In 2005, they announced their new business – Fairy Tale Science - in the "journal" Medical Hypotheses (the National Inquirer of medical journals - see here). In their introduction, Geier and Geier trot out all of the “usual suspects” in the autism-mercury world – including the article by Redwood, Bernard and Brown that predicts autistic children will have higher hair mercury levels than non-autistic peers and the article by Holmes, Blaxill and Haley that shows that autistic children have lower hair mercury than non-autistic controls.

[Note: the autistic children in the Holmes et al article had hair mercury levels about twice the average for their age range found in the NHANES study of over eight hundred children – the “normal” controls had hair mercury levels over fifteen times higher than the NHANES average. This highlights the danger of ignoring data that doesn’t fit your preferred hypothesis - and the dangers of using a lab like "Doctor's Data".]

After this attempt to muddy the waters by bringing in contradictions, irrelevancies and poor research – including “research” that involves absolutely no data – the Geiers spin their “Just So” story about how mercury raises testosterone levels and thereby causes autism. Drawing on a single 1976 publication showing that the enzyme that converts DHEA to DHEA-S is inhibited by mercury (actually, any enzyme that transfers a sulfur would probably be adversely affected by mercury), they assert that this is the piece of the puzzle that explains how most of the autism “therapies” work. Of course, they omit the possibility that the apparent effectiveness of these autism “therapies” may be an artifact of poor research (“no research” being a subset of “poor research”).

Their article provides a number of poorly designed flow charts that purport to show how inhibition of this one enzyme greatly increases testosterone in both autistic boys and girls – never explaining how a “buildup” of DHEA would not lead to elevated estrogen in girls. Actually, this is just a small part of the unexplained features of this “hypothesis”. Here are some others:

[1] Studies are cited that show elevated testosterone in autistic subjects, yet no data is given to show how these elevated levels could cause autism. Certainly, elevated testosterone is linked with aggression, but not (yet) to autism. Causation is not shown, only an association.

[2] No data is given to suggest that DHEA is elevated in autism – this would have been a relatively simple test to do.

[3] No data is given to suggest that the enzyme converting DHEA to DHEA-S is impaired in autistic subjects, or that inhibiting this enzyme would raise testosterone levels. This is especially true for females, who it seems would be as likely to develop elevated estrogen.

[4] No data is given to suggest that the enzyme converting DHEA to DHEA-S is significantly impaired at mercury levels seen in autistic children. While you can argue that retained mercury could cause continued brain impairment, it is hard to imagine that there is no turnover of this enzyme in the years since these children were born. And it also hard to imagine that – given the extensive homeostatic regulation in larger eukaryotes (like humans) – that no increase in enzyme synthesis would occur as a result of a buildup of DHEA.

So, starting with two pieces of real data ([a] some autistic children have elevated testosterone levels and [b] mercury can impair the function of one enzyme related to testosterone production), the Geiers have spun a tale of how mercury can cause autism, how various unrelated autism “therapies” are working through this common pathway, and how giving autistic children drugs to reduce testosterone can make them “all better”.

Is anyone else seeing the holes that I do? There is no data to support what they are saying, beyond the rather thin threads mentioned above. Now, if they were advocating the use of a water-soluble vitamins and absorption-limited “minerals” (ala Rimland), that would be one thing. The risks of that sort of “therapy” are low and the costs are likewise low. However, Lupron (the drug they are advocating on their “snake-oil circuit”, if not the only drug mentioned in their article) is potentially very dangerous and it is very expensive.

A few minutes on the phone with the local wholesale pharmacy revealed that the cost of an average dose of Lupron is about $1200 (US). After several more minutes on the phone with Blue Cross (a health insurance company), I discovered that the “patient contribution” for this drug – if the drug was indicated - would be about $240 (they were rather vague about the number) a dose.

Now, from the chatter on the Internet, it appears that Geier and Geier have been saying that reducing testosterone will help remove mercury from autistic children. Apparently G&G have been saying that mercury combines with testosterone to form “sheets” and that reducing testosterone levels “frees” the mercury.

This – whether it comes from G&G or not – is pure fantasy. There is nothing about testosterone that would make it have a greater affinity for mercury than its parent molecule, cholesterol. And there is whole lot more cholesterol in the body – even a pubescent male body – than testosterone. So, if mercury could form “sheets” with testosterone, it would be even more likely to do so with cholesterol, which is so much more prevalent. Let’s not even mention estrogen, progesterone, DHEA, cortisol and all the other steroid hormones – all of which are equally likely (or, more precisely, equally unlikely) to bind with mercury.

Geier and Geier, in their Medical Hypotheses article and their advocacy of Lupron “therapy” for autism are setting new lows for their “research” standards. This stuff isn’t even up to the standard of “Junk Science”.

Prometheus.

A Field Guide to Quackery and Pseudoscience – Part Five

2006-02-25T17:04:00.000-08:00

Quantum Noise

From time to time, certain words and phrases are lifted out of their native environment and placed into everyday language. When this happens, the original meaning of the word or phrase is often altered or lost entirely. Such is the case with the word “quantum”.

The idea that energy might come in small, indivisible “quanta” was the result of the photoelectric effect, the solution of which was what led to Albert Einstein’s Nobel Prize in Physics. Later, it was discovered that not only energy, but space and even time are “granular”.

When quantum mechanics reached the public consciousness (several decades after it was developed), one of the first colloquial terms introduced was “quantum leap”, meaning a large, revolutionary (and presumably progressive) change. This is ironic, since a “quantum” (plural “quanta”) is the smallest possible change in energy, space or time.

It was once said that only a handful of people truly understood quantum mechanics, and looking on the Internet, you might be forgiven for believing that it is true today. This is not to say that quantum mechanics is not discussed on the Internet – quite the contrary! A search for the word “quantum” will reveal thousands of websites offering “quantum” products and services, along with large number of sites offering to explain how quantum mechanics can explain a dizzying amount of pseudoscientific (or quack) nonsense.

Easily the largest numbers of these quantum nonsense sites are those about “quantum healing”. Starting with the undisputed king of quantum nonsense, Deepak Chopra, and moving down to websites that offer to cure you – using the mysterious quanta – over the telephone (you don’t even need to stay on the line!).

Let’s look at some of the ways these people think they are using the “mysterious quantum”:

From Deepak Chopra:

"Quantum healing is healing the bodymind from a quantum level. That means from a level which is not manifest at a sensory level. Our bodies ultimately are fields of information, intelligence and energy. Quantum healing involves a shift in the fields of energy information, so as to bring about a correction in an idea that has gone wrong. So quantum healing involves healing one mode of consciousness, mind, to bring about changes in another mode of consciousness, body."

From a Quantum Healing Center:

"Further, quantum physics discovered in the last decades that every particle of matter is associated with interaction and resonance quanta (parcels of energy) at a ratio of about 1 nucleon to 1 billion quanta. The quanta exhibit specific patterns and are susceptible to resonance. These subtle energetic configurations (bodies) can be disturbed causing unwellness and pain. Therefore, the body is a quantum mechanical device and Quantum Healing is healing the bodymind from a quantum level. That means from a level, which is not manifest at a sensory level. Quantum Depth Healing involves a shift in the areas of energy information, so as to bring about a reconstruction in an idea that has gone wrong. "

A testimonial from a nurse anesthetist who believes that she is a “quantum healer”:

"This is one of the latest of my adventures. I was giving a fellow anesthetist a break recently, and the surgeon was 2 hours into trying to fix a tibial fracture that would not reduce. The OR nurses know first hand of my abilities, and smiled when I went into my 'voodoo' mode. Doing a vector anaysis, I noted that the femur was also affected by the tibial fracture. By utilizing Quantum-Touch , the tibia realigned itself under fluoroscopic visualization to the amazement of the surgeon and the radiology technician. The returning anesthetist just smiled and nicknamed me 'Dr. Bombay' after the character in Bewitched."

From a person who believes that quantum mechanics means we can create our own reality:

"You probably know of the increases in awareness and consciousness on the planet. Just think what it could mean for your life to find out about the reality of the unseen world, and how it responds to the holographic images you create with your mind!

Choose to take part in rejuvenating the entire planet while also Creating What You Want!"

What all these people have in common is that they really don’t understand quantum mechanics at all.

Quantum “consciousness”:

There are two underlying features that most of the “quantum misunderstandings” have in common. The first is the idea that “consciousness” can influence reality directly – as opposed to acting through the actions of the organism with the “consciousness”. Many of these “quantum promoters” assert that we can change our reality – our health, our wealth, and even our future – simply by thinking the right thoughts.

Now, this is what practitioners of Cognitive Behavioral Therapy (CBT) have argued for decades, but the “quantum promoters” are not talking about changing your life though a better attitude – they’re claiming that your thoughts can actually influence the elementary particles that make up our world.

Where did they get this idea? Well, when quantum mechanics was still new, many of the leading lights in physics were bothered by its apparent paradoxes. In physics, paradoxes are almost always a sign that the theory is wrong. Einstein and Schrodinger believed that these paradoxes indicated that quantum mechanics was an incomplete theory of reality.

One of the apparent paradoxes of the quantum world is the behavior of photons and electrons. Depending on how you look at them, they are “either” waves or particles. To many physicists in the early days of quantum mechanics, the way that photons and electrons showed wave properties when the experimenter was looking for waves and showed particle properties when they were looking for particles suggested that it was human consciousness –a “conscious observer” – that caused the “collapse of the wave function” into either a particle or a wave. Prior to this intervention of human consciousness, the photon or electron was supposedly in a “superposition of states” – neither particle nor wave - waiting for a conscious observer to “cause” it to choose one or the other.

Schroedinger went so far as to propose a “thought experiment” in which a cat was placed in a box containing a device that would release a poison if a radioactive atom decayed (this would never get by modern animal experimentation rules). Since radioactive decay is a quantum event (and random – which bothered Einstein and Schrodinger), it could be assumed that it would also be influenced by a conscious observer. As a result, the fate of the cat would not be determined until someone opened the box. Until then, the cat would be in a superposition of states – neither alive nor dead – a situation that is (as Schrodinger clearly intended it to be) completely ridiculous.

The modern resolution of this “paradox” of quantum “particles” (e.g. photons, electrons, etc.) is simple. The “paradox” results because of the false dilemma – particle or wave – rather than any limitation or “magical” nature of quantum theory. Photons and electrons (and all other elementary particles) are neither particles nor waves – they are something that we have no analogy for in our macroscopic world.

As a result, there is nothing about our consciousness that influences quantum particles or – sad to say – the world outside of ourselves. If we want to use our consciousness to influence the world, we will have to work through our muscles – by talking, typing or doing.

Entaglement:

Many of the “quantum promoters” use “entanglement” as an explanation of how everything in the universe is “connected”. This supposedly explains how we can influence objects and “draw energy” from them. This is about as far from real quantum entanglement as it could possibly be.

Quantum entanglement occurs when two particles (usually photons) are emitted from an atom in a singlet (or neutral) state. Because of the conservation laws, the photons (for instance) will have the same polarization [the identical polarizations cancel out because the photons are heading in opposite directions – for a much better explanation, see Victor Stenger’s “The Unconscious Quantum”]. No matter how far they travel, these two photons will have the same polarization – they are considered to be “entangled”.

What entangled photons have to do with “quantum healing” or “remote viewing” or anything of that sort is unclear – and probably imaginary. The basic problem is that the “interesting” quantum effects average out as you get more and more particles together. This is referred to as “decoherence” and explains why we don’t see footballs (“soccer” balls, to those raised in the US) changing into waves during the World Cup.

Uncertainty:

Of all things, Heisenberg’s Uncertainty Principle is occasionally used to explain New Age Nonsense. For those who don’t know it, the Uncertainty Principle states that it is not possible to know a particle’s position and momentum with complete accuracy. This is usually expressed as:

DpDx > h

where: Dp = uncertainty in momentum, Dx = uncertainty in position and h = Planck’s constant.

There is some uncertainty (pun intended) about what this means. At one level, it is expressing a physical limitation of our ability to measure very small objects. While I can know with very good precision the exact position and momentum of a football during a game, that is because the particles I am using to “measure” its position and momentum (photons) are infinitesimal compared to the object I am measuring.

At the level of measuring photons or electrons, the particles used in measuring are nearly as massive (or equally as massive) as the object being measured. It is if I had to track the location and momentum of the football by bombarding the field with footballs and watching to see footballs taking an odd bounce. Clearly, once one of the “measuring” footballs collided with the “target” football, the “target’s” position and momentum would be changed.

However, there is data suggesting that another interpretation of the Uncertainty Principle is also valid – that position and momentum are complementary properties and that knowing one of them more precisely means that the other property can only be known with less precision. Alternately, momentum and position may be properties that are linked in such a way that constraining (measuring) one forces the other to become less precise (less “real”).

As with all of the other quantum effects, uncertainty becomes less of an issue in the macroscopic world we human inhabit. In our world, it is possible to know both position and momentum with a high degree of precision, given the proper tools.

Conclusion:

Quantum mechanics is a fascinating subject that is filled with apparent mysteries and paradoxes – effects that are unfamiliar or even counter-intuitive for beings that inhabit our scale level. Despite its bizarre aspects, quantum mechanics is not magic. And magic is exactly what the “quantum promoters” are trying to claim.

Mind reading, distant viewing, therapeutic touch, etc. all make use of jargon that includes liberal use of the word “quantum”. This does not mean that they are quantum effects any more than repeatedly saying a cat is a dog will turn it into a Labrador Retriever. What they are describing is not quantum physics but magic, and magic does not exist outside of storybooks.

Prometheus

Opinions are like......; everybody's got one.

2006-02-21T23:00:00.000-08:00

Just a quick mid-week post today.

I've been noticing lately how many people in the blogosphere are under the (mistaken) impression that their ability to form an opinion means that their opinion is somehow valid. This is generally true on the Internet, but especially true in one particular corner of the Web...

Examples:

From a lawyer with no training, experience or education in biology, medicine or chemistry:

"Autism is mercury poisoning!"

From a venture capitalist with no training, experience or education in biology, medicine or chemistry:

"Autism is mercury poisoning!"

From a marketing consultant with no training, experience or education in biology, medicine or chemistry:

"Autism is mercury poisoning!"

What would these same people say if I, a humble molecular biologist with no training in law, investing or marketing presumed to tell them that they were dead wrong about something in their fields? I imagine that laughter would be the nicest thing I could expect - and it would be well deserved! After all, who am I to think that my uneducated opinion about those matters amounts to anything?

Yet, strangely enough, they seem to think that - despite their lack of training, experience or education in biology, medicine or chemistry, they have mastered all of the subtleties of the issues surrounding autism.

Yes, life is stranger than fiction!

Let's dispose of the "elephant in the living room" at the outset. These people (and many more just like them) have no idea what they're talking about - they are just repeating what they've been told. For the most part, they have no more comprehension of the biology of autism than my goldfish does.

These same people, who wax eloquent on the "devastation" that mercury has wreaked on the immune system, couldn't describe the functions of B-cells and T-cells to save their lives. Likewise, they dismiss out of hand any suggestion of a genetic contribution to autism without the slightest understanding of genetics. In fact, I would be willing to bet that most of them don't even know how many chromosomes they have (answer: 46).

What they do have is someone that they "trust", who has told them what they want to hear, namely:

[1] "I know exactly what caused your child's autism." (as opposed to what an honest doctor would tell them, namely that nobody really knows what causes autism yet)

[2] "Your child's autism is not your fault." (probably true, but again, without knowing the cause, who can say?)

[3] "Someone else caused your child's autism." (a nice way to focus anger externally and keep from dealing with the feelings of loss and grief - not true, however, since nobody really knows what causes autism)

[4] "I know how to make your child better." (I suspect that most actually believe this - it still doesn't make them right, and they most likely are not)

These answers contrast sharply with the truths (added parenthetically above), which are neither comforting nor satisfying, but have the advantage of being true. However, given the choice between a pleasant fairy tale and an unpleasant truth, most people opt for the fairy tale. It's just human nature.

At some point, most (but certainly not all) of the people who take the fairy tale option will come to realize the truth - that they have bought in to a version of the world that is not "in synch" with reality. When that happens, most will simply drop out of the "support groups", rallies, e-mail lists and blogs and go back to quietly living their lives in the real world.

Fortunately, more and more of these people are coming forward to tell their stories to the world, to talk about how they bought the fairy tale and were led down the garden path. Most are not angry with those who misled them or out to "put things right". The ones I have corresponded with simply want to put their stories in front of parents - to let them make up their own minds.

Contrast this with the strident and angry tones of the autism-mercury Crusaders, who do everything in their power to silence all dissent and squash all skepticism.

So, what can you learn from all this?

The calm, quiet parents have been there...and back.
The angry ones are still living in the fairy tale.

Prometheus

Why Anecdotes aren't Data

2006-02-20T11:00:00.000-08:00

A reader pointed me to a wonderful example of how people's impression of reality does not always match with reality itself - and a perfect example of why scientists spend so much time and effort trying to make sure that they aren't fooling themselves.

This reader pointed me towards the "Parent Ratings of Behavioral Effects of Biomedical Treatments" on the Autism Research Institute's website. For those of you who are not familiar with the work of the Autism Research Institute (ARI), it is - at least at present - primarily involved in finding and promoting "biomedical" treatments for autism, which apparently means the same as "alternative medicine". I say this because they reject - quite vigorously - several "biomedical" treatments that are well inside the mainstream of medical therapy.

Anyway, my helpful reader was trying to convince me that chelation has a significant positive effect on autism, as evidenced by the reports of parents who filled out the questionnaire (available on-line). Leaving until later any discussion about the validity of opinion polls used to judge medical therapies, let's look at what they have found.

On the list, chelation is placed under the heading of "Biomedical/Non-Drug/Supplements" and is included in the group "Detox. (Chelation)". Now, this is a very interesting place to put chelation - and shows the bias of the website quite nicely - since all chelating agents recommended by DAN! doctors (the practitioners recommended by ARI) are, sad to say, drugs (e.g. EDTA, DMSA, DMPS).

But, leaving that aside, the ARI opinion poll shows the following for "Detox. (Chelation)":

Got Worse - 2%
No Effect - 22%
Got Better - 76%

At this point, the pollster adds an odd mathematical twist - they divide the percent who "Got Better" by the percent who "Got Worse" and comes up with a 35:1 "Better:Worse" ratio. This is an interesting trick, since it ignores the 22% who experienced no effect and - it could be argued - are "worse" because they were exposed to the cost, effort and risk of chelation (or Detox. - whatever that might be) without experiencing any benefit. Including these people gives a less impressive - but still positive-sounding - 3:1 "Improvement:No Improvement" ratio.

Note also that the original survey data has six "effectiveness" levels (Definitely Helped; Moderate Improvement; Possibly Helped; No Definite Effect; Little Worse; Much Worse) with three "improved" ratings and only two "worsened".

But how likely is this to represent reality?

Taking a look further up the list (in the "Drugs" section, appropriately), we come to "Secretin" (both IV and Transdermal). The "scores" for these treatments are as follows:

Secretin IV:

Got Worse - 7%
No Effect - 44%
Got Better - 48%

Secretin Transdermal:

Got Worse - 10%
No Effect - 49%
Got Better - 41%

So how does this compare with double-blinded studies? According to the ARI parent survey, IV secretin was 48% effective (a little less than half). The studies done by Repligen (which had a strong motive to find a positive effect) showed that IV secretin was no better than placebo.

So, does this mean that chelation is likely to be better, since it has a better win:loss ration?

Sadly, no.

Chelation is still "topical", it has a lot of people "talking it up" at the moment and, as a result, will rate higher. As parents experience the inevitable "treatment failures" and see the cycles of the disorder coming around again, they will become disenchanted with chelation and it will gradually fall from favor.

If we could go back and see the poll numbers for secretin during its heyday, we would see - I suspect - much the same result. High "effectiveness" numbers when everyone was talking about how secretin was going to "cure" autistic children, followed by a slide from grace as the studies after study showed no effect.

In a way, the chelation promoters have learned a valuable lesson from secretin - you'll notice that they are not encouraging real scientists to study chelation for autism in a blinded fashion. I suspect that they are none too happy with Dr James Adams, who is about to show just how effective chelation is for treating autism.

As they say...stay tuned!

Now, what about the idea - so popular with "alternative" medicine promoters - that the patient (or parent, in this case) is the best judge of whether a treatment works? And the corollary of that hypothesis, that opinion polls are an acceptable means of collecting efficacy "data"? Well, decades of scientific study have shown us that people are not very good judges of whether or not a treatment is working. Else, why would practitioners - and patients! - have been so willing to pursue purging, bleeding, cupping (making a comeback in "traditional" medicine), amulets, potions and general shamanism? Because - in their opinion - it appeared to work!

If you want to know how this could happen, go back to my "Field Guide to Pseudoscience and Quackery: Part 4" and read the last part:

"...the quackeries appear to “work” for the following reasons:

[1] The natural course of the disease: Fully 95% of the ailments for which people seek medical attention are self-limited – meaning that they will get better without treatment. The classic example is the “common cold”, for which there have been quack remedies since the dawn of human history. Left untreated, the average “cold” will resolve in about seven days. Vigorously treated by either quack remedies or real medicine (antibiotics, steroids, etc.), the average “cold” will resolve in about a week.

Also, some disorders are more severe at the outset than they are later - a good example being stroke. Quack practitioners have been making a living for years by treating recent stroke victims with vitamins, herbs, hyperbaric oxygen and the like and then taking credit for their improvement. Of course, even if you don't do anything, most stroke victims are much better a month or two after their stroke than they are the day it happens. The same is true of certain childhood developmental disorders, where quacks eagerly take credit for the natural progression of the disorder as the child gets older.

It's a wonder that someone hasn't promoted giving typical kids mega-vitamins, minerals or chelation in order to improve their verbal skills, coordination and social interaction. After all, if you give high-dose vitamin B6 to one year-olds, they'll have better language, social and physical skills when they're five. Of course, so will the kids that don't get the treatment. It's the natural progression of childhood - even in developmentally delayed children. Developmental delay does not mean developmental stasis.

[2] Regression to the mean: Most chronic or long-term ailments have a cyclic or fluctuating course – getting worse and then getting better and then repeating the cycle. Generally, people will seek medical attention for these ailments when they are at or near their worst. As a result, any treatment given – even an ineffective one – will usually be followed by improvement as the natural course of the disease takes it toward milder symptoms, potentially fooling the patient into believing that the remedy “worked”.

[3] Self-fulfilling Prophesy: Often called the “placebo effect”, which is a gross misnomer. The placebo is not having an effect – it is, in fact, completely inert. What is happening is that the patient, having been examined, given a diagnosis and prescribed a treatment, is expecting to get better. This expectation will cause them to unconsciously emphasize any feeling that their symptoms are improving and ignore or minimize any feeling that the symptoms are staying the same or worsening. In fact, since worry and feeling helpless have repeatedly been shown to increase pain, it is not surprising that a sense of hope – even false hope – will improve bothersome symptoms.

[4] Sense of Empowerment: The one thing that quackeries do that real medicine would do well to emulate is the way they involve the patient in the treatment. Modern medicine has largely tried to cut the patient “out of the loop” as much as possible – with implanted devices, long-acting medications, transdermal patches, etc. – because patient compliance is a huge variable in any treatment regimen. By eliminating this variable as much as possible, real medicine manages to attain more predictable and uniform results. This is all well and good, but it has the undesired effect of making the patient feel like a passive recipient of treatment, rather than an active participant. By giving the patient complex, arcane rituals to perform, the quack gives their patient a sense of control over this aspect of their life."

Bottom line - opinion polls are not a substitute for data. They aren't even a good first approximation of data. In fact, they have only a 50:50 chance of pointing in the same general direction that real data might point. And before someone says it, let me point out that none of this involves "lying" - just fooling ourselves.

Prometheus

Inadvertent Irony in Islamdom

2006-02-11T10:30:00.000-08:00

My article about Quantum Noise is rapidly growing into a smallish book. While I work at trimming it down to blog-friendly size, I wanted to comment on another variety of irrationality in the world.

No doubt you have all seen the pictures, on the telly or in the newspapers, of Islamic outrage over a cartoon initially published on September 30, 2005, in the Danish newspaper "Jyllands Posten". It wasn't until the cartoons were re-published in the French newspaper "France Soir" and the German "Die Welt" - and others - a few weeks ago that the "Islamic World" exploded in paroxysms of violence. Apparently, "Jyllands Posten" doesn't have a wide circulation among Muslims - and I can't find it at my local newsstand, either.

Here's the ironic part:

In response to cartoons that portray the Prophet Mohammed and Islam in general as promoting violence, destruction and murder, Muslims all over the world have exploded in an orgy of violence, destruction and murder.

I think that pretty much proves the point, don't you?

Images of Muslims rioting, burning embassies (usually the Danish Embassy, but they aren't too particular), screaming hate and invective while holding the Koran and burning home-made Danish flags (I suppose the local Angry Mob Supply shops don't stock flags other than US and British these days) has certainly driven home the point that Islam does not promote or even condone violence, destruction and murder. Right?

As my son would say - "Not!"

Let me make doubly sure that everyone is getting the point - people are dying and property is being destroyed because of a newspaper editorial cartoon.

A cartoon is killing people.

Seriously - I'm not making this up!

Those involved - at least, those who can calm down enough to talk to the ubiquitous reporters - claim that they are avenging an insult to the Prophet Mohammed. Apparently, destruction and murder in the name of the Prophet is not nearly as insulting to his memory as a cartoon. Am I missing something?

To be sure, not all Muslims are involved - not even a majority. However, the number of "prominent Muslims" (e.g. Imams and other Islamic religious leaders) who have condemned the violence has been...underwhelming. And I don't see any of them out in front of the mobs saying "Stop!"

Certainly the cartoons were in marginally poor taste - so are many political cartoons. And I have seen cartoons disrespectful of other religious icons on numerous occasions and have failed to note an explosion of rage and violence from Christians, Jews and Buddhists. So what has happened to the "Islamic World's" sense of proportion? These cartoons were worth a stern rebuke and a flurry of letters to the editor - perhaps even a boycott of "Jyllands Posten". But rioting, burning and killing?

Most of you - at least those who weren't out burning Danish flags and spewing spittle all over your Koran - are probably thinking, "There's got to be more to this than just a cartoon." And you're right - the "Islamic World" has a serious axe to grind with the West, and it all goes back to something that happened outside Vienna.

I can hear you say to yourself, "Vienna? What happened outside Vienna? What about Western exploitation, support of Middle Eastern dictatorships and support of Zionism?"

No, the problem actually started outside the city gates of Vienna when Jan Sobieski and a small force of Polish cavalry (Hussars) routed a Muslim army of over 300,000 (if you believe contemporary accounts, which may have inflated the numbers a bit) led by Grand Vizier Kara Mustafa. This was the high-water mark of the armies of Islam. From that moment on, they were on the defensive and were gradually pushed completely out of Europe. If it hadn't been for Jan Sobieski's gallant attack, Europe would now be Islamic and world events would have unfolded in a completely different fashion. Maybe better, maybe worse, but certainly different.

How do I know that this is what the Islamic world is really upset about? Let me tell you the date of Sobieski's attack:

September 11, 1683

How's that for a non-coincidence?

So, the next time someone in the Western world asks "Why do they hate us?" (and they will, you can bet), you can tell them to blame Jan Sobieski and those gallant and colorful Polish Hussars.

Prometheus

The Captain has turned off the Comment Moderation light - you are free to post comments again, with caution.

2006-02-06T14:15:00.000-08:00

Dear Readers,

After an unplanned Internet outage (and telephone outage and cable TV outage... ahhhh, it was bliss!), I returned to find that certain people (you know who you are!) had posted comments that were on (or over) the edge of my tolerance. I will quote from the most egregious of them:

"You will jump at any chance to knock those of us who help our kids with chelation because you are terrified we are right which would confirm you as a child abuser for refusing to help your daughter and allowing her to rot in the abyss of autism."

Now, I have no problems with people disagreeing - even disagreeing emphatically (or vehemently) and I am certainly no stranger to sarcasm (yet another of my New Year's Resolutions trashed before February) and even ridicule. However, I will not tolerate abuse of innocents on this blog - and I consider dragging someone's children into the argument abuse of innocents.

If you want to call each other names (within reason - nothing they won't allow on television, which limits you very little), cast aspersions or even make fun of each other (or me), that's OK. But keep it to the people involved in the discussion!

Just to make it clear - calling children names or saying that they are going to "...rot in the abyss of autism." brings out the enraged mother bear in me. Don't do it if you don't want to get mauled.

They say that a word to the wise is sufficient. Now we get to see who's wise.

'Nuff said?

I think so.

You may resume normal commenting.

Proemtheus.

27th Skeptic's Circle

2006-02-02T00:01:00.000-08:00

Welcome to the 27th Skeptic's Circle! I hope you enjoy your visit! Now, pull up box and listen to the story...

There were still traces of the sunset visible on the western horizon as Prometheus slouched into the command tent. He paused outside to savor the cool night air before pulling aside the canvas flap and stepping in. He gestured to the staff to keep their seats as he pulled up a camp chair and collapsed into it.

Taking a moment to gather his thoughts, he could hear the sound of artillery in the distance – mostly outgoing, but a few scattered explosions could be heard in front and behind their lines.

"You’d have thought they’d have either gotten the range or stopped shooting." he muttered to his artillery staff officer.

"You’d think so, sir, but they haven’t. It’s mostly falling short or long – we haven’t been hit but the local towns and farms are taking a pounding."

The artillery officer glanced at a sheaf of papers. "Their artillery is too weak to range us, but they overload the powder charge to try and make up for it. They can’t hit the broad side of a barn and they’ve blown up or shot out most of their pieces."

Just then, a shell passed overhead making a horrific shriek, landing with a dull thud far behind them. A few of the staff members flinched, but most didn’t even seem to notice.

"That was one from the Generation Rescue Brigade, sir. It makes a hell of a noise, but they haven’t hit anything yet – and they’re mostly duds. Even if you did get hit, I wouldn’t take it personally – they probably weren’t aiming at you." He took a quick look at his briefing papers. "Their guns are small-caliber and their rifling is shot-out – only effective for scaring the civilians…and occasionally killing a few of them."

Prometheus stretched to see the situation map. "Is there any way we could move our lines so that the civilians wouldn’t catch it so badly?" The operations officer looked up from updating a map and said, "Sir, no matter where we’ve moved, the civilians keep getting pounded – I think they’re targeting them deliberately because they can’t do us any real damage."

Just then, Orac swept into the tent, whacking his cavalry Stetson against his thigh to knock off the road dust. "Orac, you old horse-blanket! Good to see you!" shouted Prometheus, clapping him on the shoulder and raising another cloud of pale dust. "I see that your brigade has been raising Hell all over the front – even got in a few good raids behind their lines. Great work!"

Orac shrugged with characteristic modesty. "We’ve been keeping busy, keeping them off-balance. Just doing our bit."

"And getting a price on your head for your efforts, I see." said Prometheus. They were interrupted by the dramatic entrance of Autism Diva. "I hope I’m not late." she said, brushing dust from her cloak.

"Not exactly regulation headgear, is that?" said Prometheus, pointing to her tiara. "It is in my brigade.", retorted the Diva. "Now that must be an interesting sight." muttered Orac under his breath.

"What were you saying about headgear?" said Bartholomew Cubbins from the tent flap as he removed one of his several hats. "I’m sure that I have one here that will satisfy whatever regulation you care to quote."

One by one and in small groups, the other Allied commanders filed into the tent. They exchanged greetings, got coffee and gradually settled into seats in front of the large map set up at one end of the tent.

Once they were all gathered, Prometheus stood up in front of the map and said, "Thank you all from taking time from the war to meet here tonight for our weekly conference. We’re a long way from final victory, but because of your efforts, we are closer to it this week than we were last week." He took a look around the room. "Now, I’d like to start off with a short report on the enemy order of battle. If you look at these charts here, here, here and here, you’ll see what we are up against." as he tapped each chart with his pointer.

"Our enemy is aggressive, committed and utterly ruthless – they will not hesitate to use any tactic that they think will aid them. They are not bound by the Rules of Science as we are, and they use that to their advantage. However, they are fighting on the side of ignorance and superstition, and so they will ultimately fail. Our job is to hasten that defeat and to minimize civilian casualties and suffering. The general population may not always understand that we are fighting for them, but we must never forget that."

As Prometheus sat down, Orac stood and strode to the map. Whacking his riding crop against it, he said, "My brigade has been hitting them wherever we see an opportunity. Last week, we did a deep penetration raid on Enthnoscience, causing heavy damage. Reconnaissance photos indicate that it will take them months to become combat effective again."

Striking another part of the map, he continued, "We also detected unexpected activity in the Alternative Medicine Spam sector and launched a spoiling attack. It looks like we set them back a bit." After pausing to answer a few questions, Orac sat down again, propping his dusty riding boots on an empty chair.

Next, Autism Diva stood and walked to the map. "My brigade has been concentrating our attacks on the Autism sector, punching holes in the Autism-Mercury Brigade and rolling up their flanks. We’ve cut off a number of their subordinate units and expect to have them mopped up directly. It will be hard, bloody fighting, but we’re confident that we will succeed." Her face took on a grim expression.

"However, what I wanted to talk about tonight is the grave potential for civilian casualties in our sector. We’ve already discovered the casual slaughter of a young child, for which the Autism-Mercury Brigade bears direct responsibility. Of course, they claim that he was a 'casualty of war' and have even tried to blame us for his death. Beware – these people are absolutely without conscience and will stop at nothing." She sat down without another word.

Walking to the map in the somber silence that followed Autism Diva’s announcement, Bartholomew Cubbins bowed his head for a moment before proceding. "My scouting units have been analyzing intercepts from the various units in the Autism Army Group East and have found a number of weaknesses in their plans." He proceeded with a detailed analysis of the myriad weaknesses of the "mercury-causes-autism hypothesis.

As he was moving to sit down, the air was ripped by the howl of a multi-engine jet bomber flying at tent-top level. It flew directly overhead, bathing them all in noise and the smell of burned kerosene, before turning away to the front lines. Shortly afterward, a rippling series of explosions could be heard far in the distance. Although a few of the staff officers had dived under tables, the Allied commanders sat or stood immobile, a look of stunned surprise on their faces.

"What was that!?" shouted Orac.

"Oh, that was the Bolen Bomber.", said Prometheus. "He comes over every night about this time. Comes in low and fast and makes a Hell of a racket, but he never hits anything. That is, he never hits us - half of the time he drops his bomb-load on his own side. That’s why our anti-aircraft guns don’t shoot at him – he’s doing our job for us."

Gathering his scattered notes Dr. RW, stepped to the podium and gave his briefing on the latest maneuvers in "alternative medicine." He was followed by Xenophile, who gave a run-down on cell-phone cancer scares.

After a short break to refill coffee cups, Paige's Page gave a brief tear=down on sports teams and their version of the old "Gott mit uns." fallacy. From the Rachel had a masterful analysis of Red Rain episodes that have had the anti-skeptics twisting in the wind and Ahistorically followed with an insightful demonstration of lying with statistics (and graphs)

The Second Sight detailed an punishing attack on Homeopathy, one of the oldest brigades in the enemy's order of battle and one that has been reconstituted more times than Florida orange juice. Moment of Science gave a stirring description of how he has dealt with Monsters and Creationists and The Incredible Hallq outlined his hand-to-hand battle with hypnosis.

Lord Runolfr gave a critical briefing on the roles given to science in the movies and was followed by Skeptico, who gave back-to-back briefings on Quantum Chopra and the media and their softball approach to "alternative medicine" .

Kevin Leitch detailed how the autism alties still don't understand the basics about science and Be Lambic or Green wrapped up the conference with a humorous tale of a psychic whose second sight needs glasses.

The eastern horizon was showing the first pale glimmers of daybreak as the Allied commanders said their farewells and mounted their steeds, helicopters, jeeps or APC's for the long trip back their commands. As he watched them go, Prometheus turned to his XO and, with a catch in his voice and a trace of moisture in his eyes, said "With allies like that, we can't help but win!"

Thank you one and all for your contributions, your support and, above all, your efforts in our common fight against ignorance and superstition.

Prometheus

A Field Guide to Quackery and Pseudoscience – Part Four

2006-01-31T08:35:00.000-08:00

Psychics:

Psychics are an interesting breed, especially since it is clear that they are either consciously deceiving their “clients” or are frankly delusional. Their claims to “see” the future, to “see” into other people’s minds or to “see” hidden objects or events are not simple misinterpretations of the data before them, as is the case with most “well-meaning” pseudoscientists and quacks.

People claiming to be psychics either do or do not “see” what they claim to see. If they do not, then they are simply charlatans making a buck off of a gullible populace, no better or worse than thousands of other frauds. If, on the other hand, they do “see” what they claim, then they need to explain their extremely low accuracy. Given an accuracy of less than one “correct” prediction per thousand “wrong” predictions, a rational person would conclude that they are no better than guesses. A psychic who truly believes that their one “hit” among thousands of “misses” constitutes a unique ability is either incapable or unwilling to face reality.

Psychic “abilities” come in three general types:

[a] The ability to see what is hidden in the future.
[b] The ability to see what is hidden in the present or past.
[c] The ability to cause physical actions by direct action of the mind (i.e. not through the action of muscles).

The last of these – “c” – is the basis of claims like Uri Geller’s – who claims to be able to deform silverware with his mind – as well as those who claim to be able to heal with mind power (e.g. “Therapeutic Touch”, “Thought-field therapy”, etc.). Those who claim to do “psychic healing” - in any of its incarnations – may be simply misinterpreting data before them, as many quacks do (see below). The rest of the psychics are either deluded or lying.

Among the dozens of people claiming to have psychokinetic abilities, few have submitted their claims to rigorous testing. Those that have submitted their “powers” to legitimate testing have all failed, although they usually claim that “skeptical vibrations” (or other similar maladies) have interfered with their powers. The James Randi million dollar prize remains unclaimed – the best proof that psychokinesis is bunk.

But back to the predictive arm of “psychic abilities”. These range from predicting the future to “remote viewing” to finding abducted children and missing objects – all of which are eagerly promoted by a largely uncritical mass media. Witness the burgeoning number of television programs featuring “psychic detectives” – all evidence of our collective fascination with the idea of “mind powers”.

Left out of most of the media frenzy over “mind powers” are those mind powers that we know exist, one of which gives us the ability – if we use it – to see that “psychic abilities” are baloney. I refer, of course, to our rational intellect.

“Predictive” psychics are basically detectives. Using purely normal (i.e. not “paranormal”) powers of observation – powers possessed by most, if not all, humans, they assess their “target” and make some purely normal (vide supra) predictions about them. For the fraudulent variety of psychic, these observations may be “augmented” by more deliberate detective work, even something as simple as having a “chat” with the target prior to the “reading” – just to “put them at ease”, of course. Details uncovered during these investigations will then be put to use “proving” the psychic’s abilities.

It is a bit ironic that psychics universally begin their “routine”, not by revealing what we don’t know, but by “revealing” what we do. By this I mean the sometimes casual “dropping” of personal details that the target thought the psychic did not know. Once they have convinced their target that they truly have “psychic abilities”, they are then free to employ their imagination to tell the target what they want to hear.

The detective game that psychics play is amazing to watch. The best way to see it is to view an uncut videotape of a session – something most psychics absolutely refuse to allow, usually claiming that it “disrupts the ether”, “introduces skeptic energy”, blah, blah, blah. What it really does is provide unimpeachable documentation of their inability to get the right answers from their “psychic abilities”.

If you dispassionately watch a psychic at work, you will see the strategies they use. They usually begin with general statements, which are voiced as questions but phrased as statements, to get “hits” and fool the target into giving them more information. These will be broad, ambiguous characteristics that could apply to a number of people.

For example, if the target is interested in contacting someone who is “no longer with us”, the psychic might start out with, “I get the sense that your loved one died without completing something important.” (who doesn’t?), to which the target is supposed to reply (and usually does), “Oh yes! Fred always wanted to learn to play the piano, but he died before he got the chance.” Believe it or not, this will be counted as a “hit” by the psychic and their supporters.

Now, the psychic knows the name of the person the target wants to “contact” and some details about him. The probing will continue in a general fashion for a while; “I sense that Fred was a happy man, who loved children.” – and the target may reply, “Well, he loved to tease children, and he was happy doing that, so I suppose that’s right.” Another “hit”.

This will go on for a period of time, with “hits” being followed up and “misses” being explained away; “When I said that Fred loved the sea, I meant that he loved your Aunt May, who was lost at sea.” Once the psychic gets the sense that the target (and other members of the audience, if there is one) are convinced of their “powers”, then the baloney gets sliced a lot thicker. “Fred says that he’s sorry about teasing all of you as kids and wants you to know that he’s happy where he is.” Of course, it is extremely unlikely that Fred will be contradicting the psychic, unless “where he is” happens to be Pennsylvania.

The key to making it as a psychic is to emphasize the “hits” and explain away (or, better yet, ignore) the “misses”. The big-time psychics are the ones who have mastered this art. Sylvia Brown(e), for instance, was not the slightest bit ruffled when the coal miners she had confidently predicted to be alive (just hours after all major news outlets had announced the same news, by the way) turned out to be dead (she was right about one of the twelve, so that should count as 1/12^th of a “hit”). Her other predictions have been no more accurate than that one.

Now, psychics and their defenders will often claim that any “inaccuracies” (like predicting someone will have a long and successful career the week before they die) are due to the inherent difficulties of translating their “visions” into concrete predictions. Or, they might claim that an event was of insufficient gravitas to create a psychic “impression”. All of which fail to explain why no psychic was able to predict the terrorist attacks of 11 September, 2001. Of course, several of them later claimed to have “felt” it coming, but you don’t have to be a psychic to predict the past.

The same process of emphasizing “hits” and minimizing (or ignoring) “misses” is at work when psychics descend on a crime scene or appear during the search for a missing person. No psychic has ever given an unambiguous answer in a crime or missing person case. Their “information” is either dead wrong or so vague as to be useless. It is little help to say that a missing person (or body) is “near a lake” in rural Minnesota (“Land of 10,000 Lakes!”) or “in the desert” in Nevada, but that’s the sort of “clues” psychics will claim as “hits”.

One final note about psychic predictions. Any claim to be able to “see the future” has to address the issues of quantum physics, chaos theory and foreordination. The quantum physics problem is that certain events – such as radioactive decay – are purely random, an idea that even Einstein struggled with. Now, while quantum randomness is usually “smoothed out” at the macroscopic level (where we live), chaos theory tells us that there are certain physical phenomena – the weather, for instance – that are exquisitely sensitive to the starting conditions and may be affected significantly by quantum randomness.This means that psychic “predictions” – if they are real – should get less accurate the further they project into the future, just like weather predictions. In fact, we find that psychic “predictions” are just as inaccurate for tomorrow as they are for a decade from now – which is to say, very inaccurate.

The foreordination question, however, is the thorniest for the psychic “future-tellers”. Simply stated, if psychics were able to predict the future, that would imply that the future is already – to at least some extent – already fixed. To some extent, the future of most matter is foreordained, since it is primarily under the control of gravity. However, in the realm of human events – which is where the psychics concentrate – there is a great deal of randomness and unpredictability introduced by human “free will”. So, if the psychics are right and they can predict the future – however dimly – that would imply that human free will is an illusion and that we are “fated” to do whatever we do.

And if we are unable to alter our actions, if the future has already been set, then what is the purpose of having a psychic “predict” the future? We couldn’t alter it. We couldn’t even prepare ourselves for it because whatever we did – even going to a psychic – was already foreordained. If the future is set, then there is no reason to predict it.

Quacks:

Quacks come in a dizzying variety, almost too many to count. And they are certainly propagating too quickly to count. So, rather than give an exhaustive (and exhausting) list of the types and varieties of quack, I will try to acquaint you with the Family of Quack.

The major division in the Quack Family is between deliberate and inattentive quacks. Deliberate quacks are aware that they are peddling nonsense and don’t care – inattentive quacks think that their remedies actually work and don’t care to find out the truth. As a result, this division is largely a cosmetic one, since the effects and actions of the two groups are largely the same. It can therefor be nearly impossible to differentiate between the two groups in the field, since the distinguishing characteristic is intent, rather than action.

Curiously, both groups react similarly when presented with incontrovertible evidence that their remedies are useless. Both respond with vigorous denial and claims of bias, corruption and incompetence against those who would attempt to introduce facts into their fantasy-based world.

This brings us to one of the key features of the Quack Family – fantasy. Real medicine, like real science, aspires to base its practices on data and rational analysis. And like real science, real medicine often falls short of perfection in this goal. However, quackery never truly aspires to be reality-based, since its founding principles are purely fantasy-oriented:

[1] It is possible to know the “truth” without testing the hypotheses.
[2] All evidence contrary to the “truth” is the result of lies or incompetence.
[3] The Quack practitioner is the recipient of “special” knowledge, powers or intellectual abilities.
[4] All “cures” are solely due to the skill of the Quack practitioner.
[5] All failures are solely the fault of the Patient.

You will notice that [1] and [2] form a logical tautology of sorts: the “truth” is knowable without data and any data contradicting the “truth” is – by definition – false. This logical loop forms the core of most large-scale quackeries, one of the latest being the “mercury-causes-autism” tautology. This fantasy loop was launched by the assertion that children with autism are the result of mercury poisoning from vaccines. Since about 95 – 99% of children in the US prior to 2000 had received at least one mercury-containing vaccine, it was predictable that almost all autistic children would have, as well.

Continuing the loop, data showing that some of the features of mercury poisoning are described using the same words as some of the features of autism was taken as further “proof” – data that the major features of mercury poisoning and autism were completely different was ignored. Highly inaccurate “epidemiological” data from education and social service departments was used to show autism prevalence rising, while the fact that the amount of mercury-containing vaccinations had been steady for years (decades, in the UK and Denmark) during that rise was ignored or denounced as heretical (“biased”, “corrupted”, “flawed”).

Similar scenarios have played out in other quackeries – only the names change.

Continuing in the fantasy-based mode, many sub-types of the Quack Family have taken to accusing their detractors – who are often practitioners of real medicine – of having base, commercial motives. In short, they claim that real medicine is only interested in keeping people sick, in giving them expensive medicines, etc. etc… and that quackeries are an economic threat to real medicine.

On a purely commercial basis, quackeries are a boon to real medicine. People who take their imaginary ailments to quack practitioners are doing doctors a favor – all the real medicine practitioners I have spoken to have no interest in trying to cure the “worried well”, as they call these people. And people who take real ailments to practitioners of imaginary medicine will either get better on their own or will eventually show up to be treated by practitioners of real medicine – in the office, the emergency room or the morgue. With real, non-self-limited ailments, you can either see the doctor now or you can see them later. Either way, you end up getting real medicine eventually. If you are lucky, it won’t be too late.

So why do so many doctors (MD/DO) practice quackery, encourage it or condone it? The reasons are varied and complex. Those who practice quackery have often found that it is less stressful than real medicine. Quackery isn’t covered by insurance plans (or most government health programs), so the paperwork and reimbursement hassles associated with insurance disappear. And quackery is generally a more restful, non-confrontational practice than real medicine. People who visit the quack are generally more motivated to try what the doctor recommends – no matter how silly it may seem. Finally, quackery is a way for an otherwise undistinguished doctor – perhaps one who just isn’t that good at diagnosis and treatment – to find a niche where they can make a name for themselves and not have to bother with the tedium of actually finding out what is wrong with their patients.

The final question, and one that the quacks often use in their own defense, is “Why do people keep going to quacks if the treatments don’t work?” This is really quite simple. People go to quacks because they have “lost faith” in real medicine. It may be that real medicine doesn’t have a good treatment for their ailment – which is especially true if that ailment isn’t real. Or it may be that the available treatments are unpleasant, uncomfortable, or frightening. Or they may be one of the “worried well” who are convinced that the aches and pains of mortal life are signs of some dread ailment. And, in many cases, the quackeries appear to “work” for the following reasons:

[1] The natural course of the disease: Fully 95% of the ailments for which people seek medical attention are self-limited – meaning that they will get better without treatment. The classic example is the “common cold”, for which there have been quack remedies since the dawn of human history. Left untreated, the average “cold” will resolve in about seven days. Vigorously treated by either quack remedies or real medicine (antibiotics, steroids, etc.), the average “cold” will resolve in about a week.

Also, some disorders are more severe at the outset than they are later - a good example being stroke. Quack practitioners have been making a living for years by treating recent stroke victims with vitamins, herbs, hyperbaric oxygen and the like and then taking credit for their improvement. Of course, even if you don't do anything, most stroke victims are much better a month or two after their stroke than they are the day it happens. The same is true of certain childhood developmental disorders, where quacks eagerly take credit for the natural progression of the disorder as the child gets older.

It's a wonder that someone hasn't promoted giving typical kids mega-vitamins, minerals or chelation in order to improve their verbal skills, coordination and social interaction. After all, if you give high-dose vitamin B6 to one year-olds, they'll have better language, social and physical skills when they're five. Of course, so will the kids that don't get the treatment. It's the natural progression of childhood - even in developmentally delayed children. Developmental delay does not mean developmental stasis.

[2] Regression to the mean: Most chronic or long-term ailments have a cyclic or fluctuating course – getting worse and then getting better and then repeating the cycle. Generally, people will seek medical attention for these ailments when they are at or near their worst. As a result, any treatment given – even an ineffective one – will usually be followed by improvement as the natural course of the disease takes it toward milder symptoms, potentially fooling the patient into believing that the remedy “worked”.

[3] Self-fulfilling Prophesy: Often called the “placebo effect”, which is a gross misnomer. The placebo is not having an effect – it is, in fact, completely inert. What is happening is that the patient, having been examined, given a diagnosis and prescribed a treatment, is expecting to get better. This expectation will cause them to unconsciously emphasize any feeling that their symptoms are improving and ignore or minimize any feeling that the symptoms are staying the same or worsening. In fact, since worry and feeling helpless have repeatedly been shown to increase pain, it is not surprising that a sense of hope – even false hope – will improve bothersome symptoms.

[4] Sense of Empowerment: The one thing that quackeries do that real medicine would do well to emulate is the way they involve the patient in the treatment. Modern medicine has largely tried to cut the patient “out of the loop” as much as possible – with implanted devices, long-acting medications, transdermal patches, etc. – because patient compliance is a huge variable in any treatment regimen. By eliminating this variable as much as possible, real medicine manages to attain more predictable and uniform results. This is all well and good, but it has the undesired effect of making the patient feel like a passive recipient of treatment, rather than an active participant. By giving the patient complex, arcane rituals to perform, the quack gives their patient a sense of control over this aspect of their life.

Well, that’s all for now. Next time: Quantum Noise

Prometheus.

A Field Guide to Quackery and Pseudoscience – Part Three

2006-01-22T21:23:00.000-08:00

Life Extension:

One of the constants of life, so we are told, is death. While there are people (and possibly other animals) who long for death, the studious avoidance of death is also fairly universal among living organisms. Enter the quacks and pseudoscientists.

The “field” of life extension has been around so long that its origins are lost in the mists of pre-history. For most of human history, life extension “techniques” were magical – as are most of those today. Then, starting in the late Seventeenth Century, science began to show us real ways to extend human lifespan. First with sanitation (e.g. clean drinking water) and then with a progressively more accurate understanding of how diseases occurred, we began to see a real improvement in human life expectancy. The average lifespan, which started at 30 years in the early 17th Century (primarily due to high infant mortality), is now up to the mid- to late 70’s in the Western world, with some countries pushing on into the early 80’s.

The problem with success is that once you achieve the impossible, it becomes part of your job description.

Not realizing the fundamental biological limitations of the human body, many people see the remarkable progress in longevity and expect that people will continue to live longer and longer lives as the technology improves. In truth, some people will live longer, but most won’t.

If you look at a survivorship curve of modern humans (see below), you will see a number of interesting points. One is that there are stages of life when mortality is relatively high. Early infancy is still a period of (relatively) high mortality, due (in the West) primarily to congenital disorders, although the growing reluctance to vaccinate children may change that. The next period of high mortality – especially for males – comes in the late teens and early twenties. Anyone who has lived through that period of life should understand why this is so.

After passing through the twenties, the mortality rates remain relatively stable (deaths due to trauma decrease, deaths due to disease increase) until (in 2002) about age 45, when the mortality rate begins to accelerate. In the 2002 figures, this curve continues to grow steeper until about age 100, when it flattens out. However, at this point, the percent surviving is about zero. About, but not quite.

It is these few, these happy (we hope) few, that capture the attention of those who are interested in living longer. In its November 2005 edition, National Geographic interviewed a number of healthy elderly people in a vain attempt to find out their “secret” for a long, healthy life. I call this a vain attempt because, like so many people before them, the editors of National Geographic are looking at the wrong people. Instead of looking at the people who are living longer, we should be looking at those who aren’t.

From the 10 November 2004 issue of the National Vital Statistics Reports:

“Life expectancy was 74.5 years for males [in 2002], increasing by 0.1 year from 74.4 years in 2001. Life expectancy for females in 2002 was 79.9 years, increasing by 0.1 year from 79.8 years in 2001. The increase in life expectancy between 2001 and 2002 for females was primarily the result of decreases in mortality from heart disease, cancer, homicide, cerebrovascular disease, and chronic lower respiratory disease. The increase in life expectancy could have been greater if not for the offsetting effect of increases in mortality from accidents, Alzheimer’s disease, pneumonia, perinatal conditions and septicemia. For males, life expectancy increased primarily because of decreases in mortality from heart disease, homicide, cancer, cerebrovascular disease, and HIV disease. The increase in life expectancy for males could have been greater were it not for the offsetting increases in mortality from accidents, diabetes, septicemia, perinatal conditions and Alzheimer’s disease.” [italics mine]

So, despite the doom and gloom from various “alternative” medicine promoters, life expectancy in the United States, at least, continues to increase despite our lack of attention to them. Interestingly, despite much ballyhooing of increasing cancer deaths, cancer doesn’t seem to have had an impact on longevity. In fact, the report specifically mentions that cancer mortality is decreasing.

And what were the factors holding back even greater increases in longevity for both men and women?

[1] Accidents
[2] Perinatal conditions (a vague term encompassing deaths in early infancy)
[3] Alzheimer’s disease
[4] Septicemia

None of the currently popular nostrums or programs for life extension address either accidents or perinatal conditions (since most, if not all, are aimed at aging Baby Boomers who have – by definition – successfully avoided “perinatal conditions”). Septicemia is addressed, at best tangentially, by those remedies that promise to “enhance the immune system”, although that may also have the effect of increasing mortality from autoimmune disorders.

Alzheimer’s disease, the new horror of the Baby Boomers, is prominently mentioned in several life extension programmes, but no real data is offered to support their claims. Considering that it may take decades for Alzheimer’s disease to fully manifest, it is a safe promise to make. Besides, how many people (or their families) would bother to ask for their money back if they did develop Alzheimer’s disease?

Nutritional “supplements”, crystals, meditation, “antioxidants”, hyperbaric oxygen, the list goes on. The details of the “treatment” are myriad, as are the ways in which these “secrets” of life extension were discovered. Two features are consistent, however:

[1] The purveyors of these “treatments” continue to age at a normal rate.
[2] None of these “treatments” have been shown to work.

Since it would take decades to show if the “treatments” worked, the purveyors will have a long time to spend their proceeds before a customer (or their surviving relatives) comes to collect a refund.

A closer look at the survivorship curve (see below) shows the fundamental problem. Comparing curves from 1900 to 2002, you can see that improvements in medicine and sanitation have significantly reduced mortality in early and middle life. However, in the 1900 curve, the proportion of people living to 100 years was only slightly less than there are today. The difference is in the number of people living to 80, 90 and even 95 years, which is significantly different between 1900 and 2002.

This would suggest that there is a longevity “wall” somewhere around 100 years. Biology tells us that there may be many reasons for this – telomere shortening being one of them. Certain tissues have a “pre-programmed” limit on the number of cell divisions they can undergo, after which they die from loss of genetic material. These tissues do not normally divide rapidly, so this may function as a “fail-safe”, preventing uncontrolled cell division – or cancer.

So, are any of the longevity “secrets” likely to work? No. People have been trying to find the “secret” to longer life for all of recorded history, and none have found it yet. Even careful examination of people who have lived over 100 years fails to reveal any consistent “secret” except one:

Have long-lived parents.

I can’t see how anyone can change that.

Prometheus.

Coming up: Psychics

27th Skeptic's Circle Coming Up!

2006-01-20T09:45:00.000-08:00

It is a rare honor, indeed, but this humble blog has been selected to host the 27th Skeptic's Circle (2 February 2006). All wishing to submit material for consideration please send it to:

photoninthedarkness@yahoo.com

Thank you,

Prometheus

A Field Guide to Quackery and Pseudoscience – Part Two

2006-01-15T15:00:00.000-08:00

Thanks to some helpful readers for pointing out that I missed a few "Generally Shared Characteristics" of pseudoscience and quackery. Here they are, along with some others I found:

Straw Man: - Not a character in “The Wizard of Oz”, but another logical fallacy. A “straw man” argument is one that doesn’t address what the opponent said, but rather a position that is easier to argue against. This is a popular strategy by pseudoscientists and quacks because they have no actual data to argue with. The basic strategy goes something like this:

In my…”discussions” with various supporters of the mercury-causes-autism movement, I have often had people say to me, “Why do you find it acceptable to put poison [i.e. mercury] in children’s vaccines?” when I say that the data does not support the hypothesis that mercury causes autism. This is a classic straw man.

Rather than address my argument that mercury does not cause autism, they have tried to make it seem that I am arguing in favor of putting mercury in vaccines. This would be much easier to argue against, except that I never said it.

Inversion of Proof: - In the real scientific world, the people who propose a new hypothesis are the ones who are responsible for “proving” it. The pseudoscientists and quacks prefer to take an easier route – they ask you to prove them wrong! This is a great time-saving (and money-saving) technique. As an interesting twist, as more people have become aware of who is responsible for providing the data, the pseudoscientists have taken to claiming that saying their pet “theory” is wrong is the assertion that requires proving!

Special Pleading: - When all else fails, quacks and pseudoscientists fall back on their final line of defense: special pleading. They argue that the reason that scientific studies of their claims fail to find any evidence of it is that “regular” science is incapable of detecting the effect they claim. It may be that the energy field they claim cannot be measured by current techniques, or that standard double-blind studies are “incompatible” with their “theory”. Whatever the excuse, it all boils down to claiming that the reason science finds no evidence of their claim is because of a failure of science, not because their claim is wrong.

Now, it is entirely possible that there are forms of energy that we cannot now detect, just as Isaac Newton had no way of detecting radio waves. However, Newton did not make any claims about radio. And for energy forms that we can detect, it is unlikely that amounts below the current level of detection can have any significant effect at the macroscopic level. Likewise, clinical effects that grow smaller and smaller as more patients are studied are likely to be non-existent. It’s not the science that fails – it’s the pseudoscience.

False Dilemma: - A popular trick in pseudoscientific and quackery “debates” is to creat a false dilemma – the claim that there are only two (or possibly three or four) alternatives when, in fact, there are many more. The classic example is the statement, “You’re either with us or against us.” While this may have a certain resonance in political situations, it has no place in science.

A more typical example of the false dilemma in pseudoscience is to state that since one possible explanation of a certain phenomenon is what they claim, that their hypothesis is the only explanation. This, of course, is rarely the way things are. A good example of this is seen in the assertion (by a certain mail-order lab favored by autism “alternative” practitioners) that finding a certain organic acid in the urine is a “marker” for “yeast overgrowth”. They say this because it is not seen in (the small number of) normal subjects (that they tested) and is seen in people with “yeast overgrowth” or “dysbiosis” (how this was determined is not clear).

Even if we grant them the presence of this organic acid in “dysbiosis” or “yeast overgrowth”, there are many more choices than the one we are given: organic acid = yeast overgrowth. Other possibilities that readily come to mind are yeast colonization (without “disease”) and eating yeast-containing foods. They haven’t even shown that the absence of this organic acid indicates that there is no yeast overgrowth. They are stuck on the horns of their own false dilemma.

Types of Pseudoscience and Quackery

Clearly, no mere book or blog could ever hope to give an exhaustive – or even extensive – listing of all the myriad types of pseudoscience and quackery. The best that I can hope to do is provide descriptions of the major groups, the equivalent of Families in organismal systematics. Still, this should suffice to allow identification of these groups in the field. Further refinement of identification can wait until the specimen is back in the laboratory.

Scientific Creationism/Intelligent Design: - This is a pseudoscience that actually precedes the development of what we now call science, so it seems fitting to list it first. Despite the name, it’s not good science – it’s not even bad science – it’s just religion dressed up in a lab coat trying to look like science. Fortunately, recent legal challenges have ended with the judge agreeing on this point. Once you strip away the jargon and double-talk, Scientific Creationism and Intelligent Design (ID) are both reduced to the following:

God did it.

Although this may be a comforting thought to people who like to believe in that sort of thing, it fails utterly as a scientific hypothesis. For one thing, scientific hypotheses need to be falsifiable - this means that there should be a test that can be performed that could potentially show that the hypothesis is wrong. That’s how real science works: you make a hypothesis – a model of how you think the world (or a small part of it) works – and then think up ways to test that model.

If the hypothesis “passes” the test, then you keep testing it in different ways until you have satisfied the doubts of your scientific peers. If the hypothesis “fails” the test, then it has to be either modified or discarded. There is no room for sentimentality.

The problem with a supernatural explanation of natural phenomena – and attributing the diversity of life on Earth to God or a “Designer” is definitely supernatural – is that there is no way to test it. There is no test that could ever show that a supernatural being that cannot be seen, felt, heard, smelled, touched, weighed or measured doesn’t exist. As a result, supernatural explanations are outside of science.

Both types of creationist pseudoscience rely heavily on the False Dilemma fallacy. What they do is emphasize the areas of evolution that are incomplete or controversial and pretend that those “flaws” mean that evolution is not valid. This, of course, ignores the mountains of data that support evolution, but that’s how pseudoscience works.

Having – in their own minds – demolished evolution as a theory (or as “only a theory”), the creationists then assert that the only other option is Creationism – or Intelligent Design, as it now calls itself. This is the false dilemma – the claim that there are only two choices: evolution or creationism. Leaving aside for a moment the claim that they have “refuted evolution” by finding “flaws” in it, the idea that creationism would be the only remaining choice is ludicrous. This makes as much sense as saying that, having proven that I don’t drive a Chevrolet, that my car must be a Toyota.

Another part of their faulty reasoning is the idea (usually unstated, but implied) that because evolution can’t explain everything, it can’t explain anything. A variation on this sorry theme, often stated by its chief pseudoscientists, is that since they can’t understand how evolution could explain the complexity of life on this planet, that it can’t. This last one is less a failure of evolution as a theory than it is a failure of their imagination or understanding.

Demonstrating that they don’t understand physics any better than biology, many supporters of ID have argued that evolution is a violation of the Second Law of Thermodynamics. For those whose recollection of the Law may be a bit fuzzy, the Second Law states that the entropy (degree of disorder) of an isolated system can only increase. This is a law proven every day by my desk and lab bench. But, more to the point, ID supporters have argued that life couldn’t have evolved from “simpler” forms, since that would have resulted in less disorder.

True enough, a cat has more “order” than a bacteria, due to its greater complexity (primarily in the form of tissues, organs, organ systems). The reason that this does not violate the Second Law is that a cat (or a bacterium) is not an isolated system. Biological organisms reduce entropy within their bodies by taking in less complex food and converting it into more complex tissues. However, the overall entropy of the system (in this case, the solar system) increases. We biological organisms create a local decrease in entropy by greatly increasing the overall entropy of the larger system – primarily by degrading high energy foods into lower energy waste products.

Finally, in their most recent court struggles, the creationists (now known as Supporters of Intelligent Design) have resorted to a unique form of special pleading. Rather than just say that science can’t be used to understand “Intelligent Design” – which would have seriously undermined their effort to get ID taught in science classes – they tried to get the “official” (i.e. legal) definition of science broadened to include ID.

Of course, by the time they got the door open wide enough to squeeze ID into science, it would have been wide enough to fit just about anything (including religion, of course) into the “broadened” definition of science. It didn’t work as a legal ploy, but it certainly made for good theater as a pseudoscientists with legitimate scientific credentials said – with a straight face – that astrology should be considered science.

Something for Nothing – Free Energy and Perpetual Motion Machines: - One of the great truths of life is “There’s no such thing as a free lunch”, often abbreviated as TANSTAAFL. This is especially true in physics, where this truth has been codified as the Second Law of Thermodynamics (already briefly discussed above). However, one of the invariable truths of human nature is that wherever there is a law, someone will try to break it.

You’ll note that I said try to break it – physical laws are not only self-enforcing, they are, in fact, unbreakable. Try violating the Law of Gravity – step out of a second-story window and see how long you can break it. The ground will act as the law enforcement agency for that particular law. Still, human nature being what it is, there are people who are convinced that they can “beat” the Second Law – and they’re usually looking for investors to help them do it. A group of people investing in a scheme to break a human law would be committing “racketeering” – a group investing in a scheme to break physical laws are “losing their money”.

The number and variety of schemes to get “free” energy is amazing – the US Patent Office probably has wastebaskets full of them (see: USPTO Models, Exhibits and Specimens). Although the details vary, the fundamental facts remain disappointingly similar – these “machines” are supposed to generate more energy than is put into them. This goes by a variety of names – “over unity” (efficiency great than 1.0 or 100%), “perpetual motion”, “free energy”, etc. Not one has ever been successfully tested, but millions have been sold.

But you don’t have to wait for the test results to come in to know that these “free energy” machines won’t work. They can’t. You just can’t get more energy out of a system than it contains. That’s the common-sense explanation.

A slick variant of the “free energy” pseudoscience are those devices that claim to “help your car burn gasoline more efficiently” or, even better, “run your car on water”. Current internal combustion engines are pretty close to their best efficiency the design is capable of, so even a major redesign of your engine will not appreciable improve its efficiency. Certainly, “lining up the molecules” of the gasoline in the fuel line will not measurably improve efficiency, even if the hardware store magnets used in the device could actually do that. The same goes for devices on the carburetor or special air or fuel filters. The best way to improve your car’s fuel efficiency (apart from buying a more fuel-efficient car) is to keep it in good repair.

As for running your car on water, that isn’t going to happen. Internal combustion engines work by changing higher energy chemical bonds into lower energy bonds. They take carbon-hydrogen bonds and carbon-carbon bonds and turn them into the lower energy carbon-oxygen and hydrogen-oxygen bonds. The excess energy is released as heat – and heat is what runs the engine. Water has hydrogen-oxygen bonds, which are lower-energy and thus stable. Mixing water with air – which is what your car’s engine does with its fuel – does not give any options for forming lower energy bonds. Air is made up of nitrogen, oxygen, a little carbon dioxide and argon. No opportunities for lower energy bonds with that lot.

So, if someone offers you the “investment deal of a lifetime” involving “free energy” (or one of its variants), just remember this: you would have a better chance of making money playing the lottery.

That’s all for now. In the next installment I’ll cover “life extension” and “psychics”.

‘Til then.

Prometheus.

A Field Guide to Quackery and Pseudoscience – Part One

2006-01-06T17:29:00.000-08:00

Introduction:

Quackery and pseudoscience are not, strictly speaking, biological organisms, but they show many of the traits of organisms. Like some viruses, they rapidly mutate and evolve to resist host defenses and ecological change. Like many bacteria, they are found worldwide and often pick up or exchange new characteristics (genes?) in a fashion eerily reminiscent of horizontal gene transfer. And like any number of invasive species worldwide, they threaten to overgrow their adopted habitat and successfully resist all efforts to limit or exterminate them.

Since quackery and pseudoscience do not fit into stable “species”, the usual field manual format of giving the defining characteristics and range will not fit too well. Some have been around long enough to have developed a stable set of characteristics (although, as with many biological organisms, a certain amount of variability is noted) and others are so new (or so mutable) that they practically defy description.

The approach this manual will take is to follow the format of the great descriptive texts of the late 18th century, where some organisms are described in detail and others – those less well characterized – are given short descriptions or fragmentary reports. In addition, a short section of the generally shared characteristics of quackery and pseudosciences will begin the manual.

Note: quackery and pseudoscience are not mutually exclusive – quackery can be considered a subset of pseudoscience dealing with medical treatments. However, some quackeries are so far from even the appearance of science that it seems proper to list it as a separate category.

General Shared Characteristics:

A priori - (knowable independent of experience) – One of the hallmarks of quackery and pseudoscience is that their proponents operate from the assumption that their “hypothesis” is correct and look for “data” to support it – to the extent that they look for any data at all! For reference, the corresponding scientific method is to design tests (or look for data) that would prove the hypothesis false. In short, the scientific process is to challenge a hypothesis until it breaks, and then build a better one!

By only looking for data supporting their hypothesis, the proponents of quackery and pseudoscience can ignore the masses of data that show their hypothesis to be false and can concentrate only on the data (often of poor quality or only tangentially relevant) that seems to support it. This is a sure-fire method to keep oneself in everlasting ignorance, as proven by the many promoters of pseudoscience and quackery.

Conspiracy – Promoters of quackery and pseudoscience often claim to be the victims of conspiracies to suppress the “truth” of their claims. Even those that do not make an explicit claim of conspiracy will usually claim that their hypothesis is not given the "proper attention" by other scientists/doctors.

The details of these conspiracies may be vague (“They don’t want you to know about this…”) or specific (“The oil companies bought the patent on a car that will run on water and locked it up.”). In any case, these conspiracies inevitably entail involvement of such a large number of people that credulity is strained (at least).

Claims of conspiracy simply serve as a “smokescreen” to keep their intended audience (victims?) from asking why their “hypothesis” isn’t more widely accepted.

Jargon - Now, to be fair, every branch of science has its own jargon. The difference between true scientific jargon and pseudoscientific jargon (or quackery jargon) is that scientific jargon has a specific definition.

Let me illustrate: when I go to a meeting and someone says that they did a Northern blot and probed with P32-labeled p53 cDNA, I know precisely what they did (see below).

“Northern blot” – more properly called “Northern hybridization”; performed a gel electrophoresis of RNA and then transferred that RNA to a nylon or nitrocellulose membrane.

“probed” – incubated a solution of labeled DNA or RNA that is complementary to one or more of the RNA molecules that have been transferred to the membrane by Northern blotting.

“P32-labeled p53 cDNA” – DNA labeled with radioactive phosphorus (P32) made by performing reverse transcription of the p53 RNA and then amplifying the resulting complementary DNA (cDNA) with the polymerase chain reaction using nucleotides that incorporate radioative phosphorus.

The purpose of scientific jargon (and almost all “real” technical jargon) is to allow people familiar with the field to communicate ideas in an efficient manner. The purpose of pseudoscientific (or quackery) jargon is to obscure meaning and cover a lack of definition.

To illustrate – what, precisely, is meant by the quack term “detoxification”? What is being detoxified, from where and how? The same applies to various “field” and "energy" references in pseudoscience. What are they, how are they generated and how can they be measured?

Pseudoscience (and quackery) jargon serves to allow the promoter to sound scientific without actually having to define their terms or be scientific. They use scientific-sounding words to confuse and distract their audience , whereas the “real” scientific and technical jargon serves to inform and improve communication efficiency. By using terms that are unclear or foreign to their audience, the pseudoscientist or quack is sending the message, “This is too technical for you to understand, but it’s real science – trust me!”

Most of the jargon used in quackery and pseudoscience has roots in real science, so the audience – which is usually no more scientifically literate than the general population (which is to say, not very) - will understand only that they are technical terms. It is unlikely that many members of the audience will understand what the terms actually mean and even less likely that someone will realize that they are being used in a nonsensical fashion.

Deepak Chopra is the master of obfuscation with scientific jargon, as he repeatedly uses terms from quantum physics in ways that show (to anyone who understands quantum physics – an admittedly small cohort) that he has little or no grasp of the subject. But his audience eats it up because the jargon keeps them from seeing that the Emperor has no clothes! They don’t realize that his “insights” make as much sense as saying that the square root of orange is purple or that the differential of watermelon is apple.

Ad hominem - "Attacking the messenger” is a time-honored tactic in pseudoscience and quackery. This is not the same as calling names, although it is often described as such. Ad hominem is a logical fallacy only if the personal attack is the major (or only) support of your argument. For example, when pseudoscientists or quacks defend their claims by asserting that those who disagree with them are “baised” or “incompetent”, they are engaged in a logical fallacy, since there is no support for their argument in the failings (real or imagined) of others.

However, simply pointing to someone’s moral, intellectual or other failings (again, real or imagined) is not an ad hominem fallacy if it is not used as a major (or sole) support for an argument. For example, if I state that a certain pseudoscientist’s arguments are false because of this data and that study and these flaws in his arguments AND I claim that he never bathes below the collar line, that would not be an ad hominem fallacy because the assertion of personal flaws (i.e. his poor personal hygiene) is not a major support of the argument. It might be unkind, impolite or even untrue, but it’s not an ad hominem fallacy.

Like jargon, the ad hominem attack (or fallacy) is a smokescreen. It is used to distract attention from the real issue – whether what the person has said is true or not – and redirects it to a spurious claim that may or may not have any bearing on the issue. Whether or not I bathe regularly or work for a pharmaceutical company or vote Republican has no bearing on the validity of my arguments. The facts (should) speak for themselves.

False Analogy - Pardon me if this section is beginning to look like the syllabus for Logic 101, but the claims and counterclaims of the pseudoscientists and quacks routinely use logical fallacies. Logical fallacies are ways of confusing people and hiding a weak argument. Since pseudoscience and quackery are made up entirely of weak arguments, logical fallacies are the only way to keep them from being exposed.

The classic form of the pseudoscience and quackery false analogy is as follows:

“Since X does Y to A, then X should do Y to [fill in the blank – you , your water pipes, etc.].”

One that I recently came across was the claim that since a certain fungus caused flower bulbs to become dormant (and thereby live longer in marginal environments), applying that fungus to your skin would make it age slower. Clearly, this is a false analogy on several levels. One, your skin is not a flower bulb – you are an animal, not a plant. Secondly, making skin cells dormant would not necessarily be a good thing, since skin cells turn over at a very rapid rate.

You’ll note that the heart of the false analogy is that there is no data presented that the process happens in the way suggested (i.e. no data that the fungus either makes skin cells dormant or slows skin “aging”). This makes as much sense as asserting that, since fertilizer makes flowers grow bigger and faster, it will make your child grow bigger and faster.

False analogies are often more subtle – and thereby more insidious. The question to ask when confronted with one is, “Have they shown the effect they propose, or is it just by analogy?”

Post hoc, ergo propter hoc - “After this, therefore because of this” - This fallacy, extensively used in quackery, is to assign causation when none is actually demonstrated. The classic example is to claim that beneficial effects seen after giving a particular nostrum were caused by said nostrum. This fallacy may be used in pseudoscience, as well, but it is the principle tool of the quacks.

Since many biological and physical phenomena have random or cyclic fluctuations, it is a simple matter to apply a putative “treatment” and then wait for the desired effect to occur naturally. Whether it is zinc lozenges to speed recovery from a cold (14 days with the lozenges, two weeks without) or “ion injection” to cause rain, the “practitioner” need only wait for the inevitable and then take credit for it.

With quackery, this is even more pronounced because of the effect of expectation. People who expect to get relief of their symptoms will often feel better after “treatment” simply because they believe they are. This often goes by the erroneous name of “the placebo effect”. A more accurate term would be “the wishful thinking effect”, since the placebo (or useless nostrum) had no role except to trigger the wishful thinking.

Appeal to Authority - Because of their lack of data (pseudoscience and quackery would be real science and real medicine if they had data to support their claims), all pseudoscience and quackery eventually distills down to an appeal to an authority. “I told you so, that’s why!” is an argument that should fail to satisfy people much past their 13th birthday, but it works all too well in some situations.

The variants of Appeal to Authority most often seen in pseudoscience and quackery are usually from the “In my experience” group, although the occasional “…used in traditional Chinese/Native American/etc. medicine for thousands of years…” specimen is seen in quackery. It is rare to see an appeal to a living outside authority in pseudoscience or quackery, although Linus Pauling (and other Nobel Prize laureates suffering from "Post-Nobel encephalopathy") has gotten extensive use. Dead authorities (especially long dead, anonymous “traditional” authorities) cannot contradict claims.

Well, that’s all for now. Stay tuned for further episodes!

Prometheus.

What should they have known and when should they have known it?

2005-12-22T19:07:00.000-08:00

One of the recurring themes in the wacky world of "alternative" medicine (and "alternative" biology) is the use of "authorities" as unimpeachable sources of information. As far as I can tell, the irony of their behavior is completely lost on the "alternative" medicine crowd, most of whom will rant long and loud about not trusting doctors, scientists, "the government", "Big Pharma", the AMA, the CDC, the FDA.... you get the picture.

Yet, despite this stated (and restated and restated...) aversion to "authorities", they seem perfectly willing to suspend their suspicions and disbelief when someone in a position of authority on their side (e.g. a journalist, like David Kirby) tells them something. Granted, many of these "authorities" are telling them not to trust doctors, scientists, "the government", etc., which is exactly what many of the "alternative" medicine crowd already fervently believe.

Where it all gets a little strange is when the "authority" is a doctor - the "real" MD/DO kind, not one of physician wanna-bes, like chiropractors, naturopaths, homeopaths and whateveropaths. These people are trusted - I assume - because they have broken from the herd, turned their back on "entrenched dogma" (a phrase I borrowed from a Post-Modernist lecture I attended) and have joined the forces of enlightenment and....well, you get the idea.

Seeing how some people have turned these "renegade" physicians (e.g. Joseph Mercola [also see here], Jeff Bradstreet, Andrew Wakefield, Rashid Buttar, Andrew Weil and Deepak Chopra) into saints (occasionally martyrs), gurus and even saviours has left me wondering. Clearly, these physicians have tapped into a unmet need in the people they....... I suppose the polite term would be "treat". This is fascinating in its own right, but should be dealt with by someone with greater knowledge of the human psyche. What I'm interested in is the following:

These people have all had a scientific education - with at least a passing familiarity with scientific method - and should know that what they are saying is, at best, untested and, at worst, known to be false.

So, we come to the title of this posting. There is, I am told, a provision in law that holds a person liable for false statements if they knew or should have known that the statement is false. Now, I'm not a lawyer and I have no pretensions about my legal knowledge, but it seems to me - humble biologist that I am - that there is at least a moral responsibility (if not a legal liability) for making authoritative, emphatic statements that you either know or should know - because of your education and training - aren't well supported (or are, in fact, disproven) by the data.

One of the reasons that "alternative" medicine and "pseudoscience" appeal to the "average person" (i.e. people with little or no formal education in the sciences) is that they offer simple (some might say simplistic) answers to difficult and complex questions. People who find science intimidating and impenetrable (i.e. most of the population) want a simple answer to their questions. They don't like long, complicated answers riddled with probabilities and conflicting or ambiguous data. And they especially don't want to be told that nobody knows the answer yet. Regretably, most simple answers to complex questions are also wrong.

If you ask one of these "renegades" how to slow (or even stop!) aging, what causes autism or how to "cure what ails ye", they almost always have very concrete, definite anwers. Many of them will also sell you the goods you need to carry out their advice. What they won't tell you is that they have no data - other than their own "clinical experience" - to support what they say.

If what these "renegades" were doing (or advising you to do) was the "norm" in the medical community, then you would be at least no worse off for following advice that had not been scientifically tested. Quite a bit of medicine - even today - is based on the collective "clinical experience" of thousands of physicians. Periodically, one of these practices gets picked off by a scientific study, in which case the medical community adopts a new "norm".

However, if your physician is one of the "renegades", you have no such reassurance. Occasionally, the lone maverick who stands alone and refuses to follow the herd is the vanguard of a new breakthrough in medicine (or science). Most often, however, they are simply wandering aimlessly off the trail and into the wilderness. Taking you with them.

However, if asked, most (if not all) of these "renegade" physicians will tell you that the treatments they recommend are both safe and effective - they have seen them work on dozens/hundreds/thousands of patients. If pressed, they will often offer up pages of glowing testimonials. They may even be able to tell you about a well-respected physician in New York/Europe/Asia who has done a large study showing how well it works - although they usually can't cite a literature reference. These sorts of studies are often (lamentably) unpublished, owing to the dastardly machination of "Big Pharma" and the AMA.

Yet, at some level, these physicians must know that they are working outside of the realm of science. Some of them - Weil and Chopra spring to mind - don't care. Others - such as Bradstreet - have apparently convinced themselves that their own clinical experience is a sufficient substitute. But they all should know better.

Prometheus

Note: Prometheus will be spending the next week communing with the waves and absorbing photons. Feel free to post comments, but don't expect a quick response - this will be a decidedly low-tech trip.

Lost on the Moral Compass Course

2005-12-19T17:21:00.000-08:00

After finishing my last post ("Collective Amnesia"), I spent a little time contemplating the issue of "conflict of interest".

Conflict of interest is something that the supporters of various "alternative" autism hypotheses throw around a lot. They use it to explain why studies fail to show a connection between thimerosal and autism. They use it to explain why we should pay no attention to the dozens of excellent scientists and doctors who say that there is no connection. They use it to explain why nobody is doing research that finds a connection between mercury and autism.

But they don't use it to explain why many of the people on their "side" are doing what they do.

While looking through the material for my last post, I stumbled across the fact that Dr. Bernard Rimland was one of the people who patented the use of secretin in any form to treat autism. That patent was then sold to the Repligen Corporation, which then began testing (recombinant) secretin as a treatment for autism. Dr. Rimland (and the other owner of the patent) donated the Repligen stock to the Autism Research Institute (ARI) - which is run by Dr. Rimland.

When Repligen decided - in January of 2004 - to stop the secretin study because of unfavorable preliminary results, Dr. Rimland published a letter to the CEO of Repligen in the ARI newsletter, Autism Research Review International. This letter included the following statement:

"We have gotten, and continue to get, communications from upset parents and physicians, many of whom are Repligen stockholders."

The following graph of Repligen's stock price may help illuminate at least some of the cause of the upset: (stock chart). The stock price had gone over $8 in October of 2003 but was down to around $4 in late December. The precipitous drop (to about $2.50) in January 2004 was probably linked to the news that their promised blockbuster was a non-starter.

Now, I'm sure that Dr. Rimland had many other reasons besides stock values to be upset about the end of the study, but don't you think that it would have been ethical to at least mention that ARI was a major stockholder in the company? That might have informed readers that there was a potential conflict of interest involved in Dr. Rimland's letter and editorial.

Instead, Dr. Rimland mentioned that many of the parents and physicians who had communicated with him were stockholders and completely ommitted any mention of ARI's role as a major stockholder.

Other conflicts of interest abound in the "alternative" autism world.

Geier and Geier - famous for their ability to glean definitive information from a corrupted database - make their money doing "expert witness" work for parents suing (or trying to sue) over alleged vaccine injury. Besides other ethical issues that they might have (see here), it is clear that they have a financial stake (i.e. a conflict of interest) in finding that vaccines - or a component of vaccines - cause autism (or other disorders that one can sue over).

The "alternative" autism conferences are filled with people who are providing "infomercials" about the "therapy" they are selling without explicitly disclosing this fact to the parents at these conferences.

For example - Boyd Haley lectures on how mercury causes autism and - coincidentally - is founder of a company that sells some "advanced" dental diagnostics and also promotes the idea that mercury (from dental amalgams and/or vaccines) causes a number of chronic conditions, including autism.

Given the incredible conflicts of interest seen among the "scientists" supporting both the autism-mercury and autism-vaccine hypotheses (granted, there is a significant overlap), I find it almost laughable that they accuse other people of conflict of interest. Almost, but not quite.

Clearly, the conflict of interest issue is just a red herring, since the very people making the accusation are untroubled by gross conflist of interest among people on "their" side. In fact, it seems more like a case of projection, where they accuse others of the very transgression that they, themselves, are repeatedly committing.

So, it seems that the leaders and "researchers" of the autism-mercury group have lost their moral compass (if, indeed, some of them ever had one).

Prometheus.