NHS takes up magic magnets cure

[Humphreys]

NHS takes up Cherie's magic magnets cure
Sarah-Kate Templeton, Medical Correspondent

IT COULD be called the Cleopatra Effect. Magnetic therapy, which has held the rich and powerful in thrall from ancient Egypt to modern Downing Street, is about to be made available on the National Health Service.

Continues...

http://www.timesonline.co.uk/article/0,,2087-2058902,00.html

[brettDbass]

"Dr Nyjon Eccles, an NHS GP in north London who carried out the trials, said: “I am not surprised that 4UlcerCare has been accepted since the clinical evidence is very convincing.”

Asolepius is gonna LOVE that :nope:

[Blue Wode]

NHS accountants are so impressed by the cost-effectiveness of a “magnetic leg wrap” called 4UlcerCare that from Wednesday doctors will be allowed to prescribe it to patients.


Does anyone know what studies they used to support that assertion?

[Blue Wode]

Oops.

Just noticed that the article makes mention of a study in the Journal of Wound Care.

It would still be interesting to know if it was scientifically sound.

[drfrank]

You can actually find the description of the trial at http://www.magnopulse.com/study%20reports/UlcerCare_Study.htm.

Possible criticisms (that I can see):

a) very small trial (28 participants, although only 25 finished)

b) ineffective placebo (working out whether you have a magnet attached to your leg or not isn't exactly rocket science)

c) allocation to placebo/magnet treatment may not have been properly randomised, or by chance placed significantly more patients who would naturally heal faster (due to the nature of their ulcer) in the experimental condition.

d) Two patients in the Live group did not complete the study and one patient in the Placebo group died between 8 and 12 weeks after the start of the study. If this was because their condition worsened and they needed more surgery, this could introduce significant bias in such a small sample i.e. if you had 4 people and two got better and two worse, then you discarded the two that got worse, you'd have a 100% success rate ;)

e) median measurement isn't very meaningful with this sample size

f) All the data describing ulcer size and hue were very skewed with a number of outliers. There were also some missing values. Subjective identification of `outliers' by experimenters could lead to bias.

This certainly doesn't constitute anywhere near enough evidence to start using NHS funds on this stuff.

[brodski]

Magnets to be provided on the NHS? Well, isn't that NICE. ;)
are there any physicists on the board that can rebut this claim from the article
"It is not known exactly how magnets work. "
The rest of the paragraph I can do myself. "Adherents believe they improve circulation because they attract the iron in blood towards them and, in doing so, increase the supply of oxygen to the wound. They may also reduce painful acidity in tissue."
When will woo's learn that
1) Blood is not magnetic (well' ok it's not ferromagnetic for all the pedants out there) and
2) Acid does not always mean bad. (Unless its the brown acid, but that's a different story. ;) )

[Nucular]

What the hell is wrong with the NHS? I work in a permatemporary, shared office with one computer and two telephones between three people (including myself, an SHO and a psychologist) with little or no secretarial support and literally no rooms to see patients in, and our collective tax money is to be spent on... magnets.

How can the NHS have such double standards? To withdraw dementia drugs for many people with Alzheimer's disease, to challenge the prescription of herceptin in the courts, and then to suddenly forget how to think, and plough money into fashionable idiocy.

Their "special offer" deal may not sound like a huge amount of money, but consider how many of these magic charms will be prescribed. A 1995 audit (http://www.equip.ac.uk/docs/issues/issue2/leg_ulcer.htm) of one hospital in mid-Essex identified 331 patients treated for leg ulcers in one week. If each of those was given one of these devices, that would have cost £1257.80 just for one week. Per year, that's two or three nurses' salaries. So that hospital could presumably choose between three extra nurses, or this ridiculous placebo.

Meanwhile, here we sit having our ability to do our jobs hampered by third-world conditions, hearing about yet another discredited therapy being repackaged and resold to gormless NHS contracting twerps - the same ones presumably who keep the five homeopathic hospitals running under a healthy NHS budget, whilst real ones close.

The NHS - on the occasions it can be thought to stand for free, state-provided, good quality healthcare for all - is the best invention ever, full stop. But I think we're watching it slowly wither beneath the poisonous fumes of new age fantasy masquerading as 'consumer choice'.

[Pragmatist]

Magnets to be provided on the NHS? Well, isn't that NICE. ;)
are there any physicists on the board that can rebut this claim from the article
"It is not known exactly how magnets work. "
The rest of the paragraph I can do myself. "Adherents believe they improve circulation because they attract the iron in blood towards them and, in doing so, increase the supply of oxygen to the wound. They may also reduce painful acidity in tissue."
When will woo's learn that
1) Blood is not magnetic (well' ok it's not ferromagnetic for all the pedants out there) and
2) Acid does not always mean bad. (Unless its the brown acid, but that's a different story. ;) )

I already debunked the garbage of Dr Nyjon Eccles in the old Bioelectromagnetic thread ages ago. See this post: http://forums.randi.org/showthread.php?postid=652459#post652459 and the following one. It looks like he's still spouting the same old nonsense.

[Lothian]

People, you are being overly critical of magnet therapy. Do you not realise that magnets are Class 1 Medical devices under directive 93/42/EEC (http://www.conformance.co.uk/resources/99D0390.pdf). This has been pointed out to me on more than one occasion.

This prestigious honour means that means that they have been rigorously tested and are proven to have
· a general requirement for safe design
· the minimisation of risks from contamination
· compatibility with materials with which they are likely to come into contact
· the minimisation of hazards of infection and microbial contamination
· provision of sufficient accuracy (for devices with a measuring function)
· protection against radiation
· adequate product marking
· adequate user instructions
Ok not a single scrap of evidence that they work but Class 1 Medical Device wow.

[Pragmatist]

From the magnopulse study quoted by drfrank above (my emphasis):

Twenty-eight patients with chronic leg ulcers entered the study (20 male). All trial patients had received evidence based ulcer care throughout the study period. Patients were allocated to Placebo (sham, 12 subjects) or Live (real, 16 subjects) magnet treatment.

In other words, the patients were given proper medical treatment while they were being "treated" with magnets. And the reason they got better had to be solely due to the magnets... I also note that they admit that "magnet therapy" isn't evidence based.

This is identical in form to Eccles earlier "study" (see Bioelectromagnetics thread) in which he concluded that 29.4% of patients experienced pain relief from magnets - of course this had nothing to do with the fact that 29.4% of the patients just happened to be taking pain killers at the same time!

How in heck can anybody call this "science"?

[Pragmatist]

People, you are being overly critical of magnet therapy. Do you not realise that magnets are Class 1 Medical devices under directive 93/42/EEC (http://www.conformance.co.uk/resources/99D0390.pdf). This has been pointed out to me on more than one occasion.

This prestigious honour means that means that they have been rigorously tested and are proven to have
· a general requirement for safe design
· the minimisation of risks from contamination
· compatibility with materials with which they are likely to come into contact
· the minimisation of hazards of infection and microbial contamination
· provision of sufficient accuracy (for devices with a measuring function)
· protection against radiation
· adequate product marking
· adequate user instructions
Ok not a single scrap of evidence that they work but Class 1 Medical Device wow.

Exactly. I also covered that one in the Bioelectromagnetics thread: http://forums.randi.org/showthread.php?postid=623001#post623001

[brodski]

People, you are being overly critical of magnet therapy. Do you not realise that magnets are Class 1 Medical devices under directive 93/42/EEC (http://www.conformance.co.uk/resources/99D0390.pdf). This has been pointed out to me on more than one occasion.

This prestigious honour means that means that they have been rigorously tested and are proven to have
· a general requirement for safe design
· the minimisation of risks from contamination
· compatibility with materials with which they are likely to come into contact
· the minimisation of hazards of infection and microbial contamination
· provision of sufficient accuracy (for devices with a measuring function)
· protection against radiation
· adequate product marking
· adequate user instructions
Ok not a single scrap of evidence that they work but Class 1 Medical Device wow.
Um, one minor point, as I understand it, conformity assessment for 93/42/eec is reactive, not proactive.
What this means is that the manufacturing, or importing, company issues a notice of conformity to the local conformity enforcement body, which states that the product meets the requirements of 93/42/eec, conformity is generally only assessed if there is a complaint.
Unless the product is actually dangerous when used as directed by a competent person, the no action can be taken.
All in all the status of a class 1 medical device is about as prestigious as Gillian McKeiths PHD.

[Ririon]

But shouldn't industrially manufactured magnets be bad for you? Product idea for anybody with questionable ethics reading this: Iron ore is usually magnetic, right? And since you can find it nature, it's "natural". Obviously much better for you... ;)

[brodski]

But shouldn't industrially manufactured magnets be bad for you? Product idea for anybody with questionable ethics reading this: Iron ore is usually magnetic, right? And since you can find it nature, it's "natural". Obviously much better for you... ;)
No, no, no!
What you want are "rare earth" magnets.
Anything that is "rare" must be worth a bit, "rare" things are special, and so must be better than normal magnets, and they are "earth" magnets, so that means that they're "natural", and therefore good. Lets face it, anything with "earth" in it's name is practically an incarnation of Gaia herself. ;)

[Lothian]

No, no, no!
What you want are "rare earth" magnets.
Anything that is "rare" must be worth a bit, "rare" things are special, and so must be better than normal magnets, and they are "earth" magnets, so that means that they're "natural", and therefore good. Lets face it, anything with "earth" in it's name is practically an incarnation of Gaia herself. ;)
But are they organic ?

[brodski]

But are they organic ?
No, but they are free range.

[Tirdun]

Now, I would probably pay to see an organic magnet.

Crap, a google search came up with one:
US DOE (http://www.er.doe.gov/sub/accomplishments/decades_discovery/16.html) Blasted science!

[Soapy Sam]

http://www.timesonline.co.uk/article/0,,2087-2058902,00.html

I draw your attention to the young lady in the "Free Download" photo.

She must be very ill, given what she has clamped to her ears.

[bridgy]

Derek Price, the MD of Magnopulse was interviewed on BBC Radio 5 Live's news program "Drive" last night. The interview started something like this:
DEREK PRICE: "They've been shown to work in a double blind placebo controlled trial".
PRESENTER: "Well the NHS are convinced, so they must work".

To be fair the presenter did go on to (gently) query their effectiveness a little more but the general impression from the interview was that they were clearly and fully proven to work - and I don't remember him asking how they worked at all. (The female presenter ended by jokingly asking if they could make them to relieve pain during childbirth - to which Derek Price said they were actually working on that!!)

The fact is that any treatment endorsed or provided by the NHS is naturally assumed to have been proven to work by most of the general public - a view that I think is regularly reinforced by the media.

[drfrank]

From the magnopulse study quoted by drfrank above (my emphasis):

In other words, the patients were given proper medical treatment while they were being "treated" with magnets. And the reason they got better had to be solely due to the magnets... I also note that they admit that "magnet therapy" isn't evidence based.

This is identical in form to Eccles earlier "study" (see Bioelectromagnetics thread) in which he concluded that 29.4% of patients experienced pain relief from magnets - of course this had nothing to do with the fact that 29.4% of the patients just happened to be taking pain killers at the same time!

How in heck can anybody call this "science"?
Although I don't believe in this baloney, the results of this experimental methodology could theoretically still be meaningful.

Of course, looking at absolute changes is meaningless, as this may just be directly attributed to the proper medical treatment given or natural healing. However, all other things being equal (which they almost certainly weren't), if the experimental group showed significant improvement over the control then that would indicate some efficacy to the magnetic treatment.

It really does disgust me that the NHS have snapped up this stuff with public money based on a single tiny trial with a number of very significant flaws, though :mad:

[David Colquhoun]

I have also tried to dig out something on Nyjon Eccles (at http://www.ucl.ac.uk/Pharmacology/dc-bits/quack.html#mag1 ).

On the Badscience site (http://www.badscience.net/?p=220) a posting appeared from a a Michael King, who appears to be from the Prescription Pricing Authority (the perpetrators of the approval of magnets). He seems to me to have been hoist by his own petard, but has not, so far, responded to my challenge to explain what he means, as posted at http://www.ucl.ac.uk/Pharmacology/dc-bits/quack.html#mag2.

[David Colquhoun]

Well I am making slow progress in trying to find out from the PPA how it is that they can judge cost-effectiveness, without knowing whether the magnets are effective or not.

Michael King of the PPA has replied to my question be email, and has been helpful on the phone.

I’ve posted what I learned so far at http://www.ucl.ac.uk/Pharmacology/dc-bits/quack.html#mag2

Thus far, it does not look good for the PPA.

[David Colquhoun]

The whole magnet saga is as good an example as any of double standards in the NHS.

No form of CAM has ever been referred to NICE, they tell me. The best chance of getting something done might be a NICE assessment. The decision of whether or not to recommend anything to NICE rests, unfortunately, with the Department of Health, BUT anyone can suggest a topic.

I have just suggested that homeopathy as a whole be referred to NICE. The objection is likely to be that there is not a suffciently good evidence base for NICE to deal with it. That, of course, is exactly why NICE should deliver a verdict. To say otherwise is to perpetuate the existing double-standard. I tried to counter this argument in the comment section.

The best chance of success is probably for them to get a flood of requests. I suggest you all go to http://www.nice.org.uk/page.aspx?o=topicsuggest and suggest homeopathy, and get all you friends to do the same.

[brettDbass]

I suggest you all go to http://www.nice.org.uk/page.aspx?o=topicsuggest and suggest homeopathy, and get all you friends to do the same.
Done and done.

[Nucular]

I've a mind actually to suggest magnetherapy to them.

I wonder actually whether it might be best to pick the application of homeopathy for which the evidence seems to be the ‘best’ – e.g. homeopathy for eczema, or something, any ideas? – and get as many people as possible to suggest it.

The suggestion system (and NICE as a whole) seems more geared up for investigating treatments for individual disorders. This doesn’t rule out an ‘individualised’ system like homeopathy, but does mean, I think, that unless we conform to that rule and specify the disorder, they’ll never pick it up. Impractical as it may seem, a ‘death by a thousand cuts’ (a cut for each disorder it is claimed homeopathy can be used for) might be the only way if NICE is involved.

But the trouble is with that approach, that even if NICE did pick it up for each disorder (which they probably wouldn’t), the circular logic for homeopathy proponents would be “well okay, it doesn’t work for condition X, but it does work for the others, so there’s no reason to think it won’t work for condition X too”. Plus there’s next to no research for individual disorders (it’s hard enough for the reviewers and meta-analysers to get enough to write a report on as a whole), so NICE would probably say they have nothing to work with; and if they didn’t, CAM fans would say they’ve done it on flimsy evidence, there’s not enough research because of funding problems, evil drug companies, et cetera ad nauseam.

So whilst I wish NICE would investigate homeopathy, and I’m happy to join in any campaign to try to make them, I can’t see it happening like that. I completely agree that the main point here is that NHS tax money shouldn't be spent on treatments with zero evidence, let alone keeping 5 hospitals running for the sole purpose of delivering these treatments; but if it's the remit of NICE to evaluate existing evidence rather than take note of a lack of it, then we're barking up the wrong organisation, or we should be asking them to change their remit first.

But the magnets, on the other hand, are a discrete treatment (magnets) for a discrete disorder (leg ulcers), and so I think have a much better chance of getting picked up by NICE. IMHO.

[Deetee]

http://www.timesonline.co.uk/article/0,,2087-2058902,00.html



Apropos this link, you should also see this (http://www.timesonline.co.uk/article/0,,1060-2063313,00.html).

[Nucular]

e.g. homeopathy for eczema, or something, any ideas?
...or e.g. asthma, as per this new Cochrane review (http://www.cochrane.org/reviews/en/ab000353.html) which shows, astoundingly, a plethora of poor designs from which emerges zero evidence anyway.

[Nucular]

This was discussed on BBC Breakfast News this morning, though I missed the first bit.

They had a very strange woman come in who spoke absolute nonsense about magnets, sellotaped some to her neck to cure her sore throat, and sells them at £40 a pop. She brought with her a woman she's 'treated' who came across as more sensible (though had paid the £40 anyway) and seemed to think the magnets had cured her migraines.

The therapist woman talked about the iron in the blood being attracted to magnets (but only just enough to aid healing, not so much that your skin will go red), changing acid to alkali to aid the healing process, and observed that, as a magnet is an external energy source, it will heal the body without depleting the body's own energy.

Thankfully, the Breakfast News 'resident GP' was on - it would have been nice to see her demolish the quack's nonsense, but she did introduce a healthy scepticism, whilst acknowledging a 'shred' of evidence, which requires further investigation. She also called into question the NHS policy-making process in terms of buying in new technologies such as the magnets, and said it needed looking at closely, which was great.

Then the magnet woman made everyone go "erm..." by saying "well what's often missed is that the NHS has already been using magnets for years. In MRI machines. They're just big magnets". When it was carefully explained to her that the MRI machine is for scanning, not treating, she speculated that it might help anyway. :rolleyes:

She also mentioned "150 studies" which support magnetherapy, and added "and they can't all be wrong", thereby describing of course the very basis of scientific epistemology.

[antihippy]

Oh dear ...

It wouldn't be the first time that I've complained about BBC Breakfast so they are probably glad that I had left for work when that article was on. I've searched BBC news archives looking for a mention of this and cannot find anything about today's lunacy.

I wonder if their researcher even bothered to search the BBC News site?

http://news.bbc.co.uk/1/hi/health/4582282.stm

In any case; for those that did see this, and can comment, don't forget to pursue a complaint against the BBC. I think we really need a well organised science lobbying group to really start knocking heads together. I'm rapidly losing patience with the UK and considering moving elsewhere.

How can the government, through the NHS, justify allowing this? Recent reports suggest that the NHS (specifically in England and Wales - Scotland has its own problems) has plunged significantly into the red. This has forced the NHS chief to resign; whether he was pushed is under debate. I want to see more nurses, more doctors - more health professionals - not New Age snake oil sellers in the NHS.

[Nucular]

If anyone saw it and wants to complain, here's the place to do it: http://news.bbc.co.uk/newswatch/ukfs/hi/newsid_4000000/newsid_4008200/4008215.stm

I'm not sure if I will, I'm thinking - because although the madwoman was on, I think she probably did her cause no favours; the GP did show overt scepticism, though perhaps not having the time to refute every bit of nonsense; and in fact it was one of the interviewers, Sian (?), who pointed out that a MRI machine scans, rather than treats.

But browsing their website, I can see not a single mention of this portion of the programme - weird.

[Dcdrac]

I have jsut read in the telegraph that NHS staff are going to be made redundant, and yet the NHS wastes money on this rubbish. I would close that complememnntary medicine centre too and redirect the cash to known scientifically proved cures.

[JimTheBrit]

This was discussed on BBC Breakfast News this morning, though I missed the first bit.

Nucular, can you recall what time the item was on and approximately how long it lasted? I can probably track down a copy.

Edit: On ITV1 news now: Fitness scams - quack claims at the gym. Coming up: Kate Moss & acupuncture. Yeesh.

Further edit: If anyone sees any similar items on quack claims/products/services in the future, please let me know by posting in the UK TV thread or via PM. I collect 'em for reference and research purposes and can get hold of them even after broadcast, even regional items. Ta.

[Spiro]

The issue of NHS double standards goes beyond therapy. A couple of years ago I wrote to the President of the Royal College of which I'm a Fellow (Pathology) and asked why, if the NHS is so supportive of alternative medicine, the College doesn't accept that I can diagnose carcinomas with a pendulum and infections by feeling a patient's aura. His response expressed concern but was essentially palliative.

The NHS is the main UK employer of doctors who belong to the various Royal Colleges. The Colleges maintain very tough criteria for admission and prescribe high standards of practice for their specialist fields. Yet they stand by silently, refusing to endorse anything woo within their own domains, but making no criticism of a Health Service that panders to patient gullibility.

I guess the underlying reason is right there in the title: they are Royal colleges, therefore patronized by a genetically selected bunch of people who lack the acumen to understand the issues properly and make all their judgements by instinct and gut feeling.

[Nucular]

Nucular, can you recall what time the item was on and approximately how long it lasted? I can probably track down a copy.
It was around 9.00, ±15 mins? I caught about 5 minutes of it, but I don't know how much there was before that as I wasn't in the room. BBC1, obviously.

[Blue Wode]

The NHS is the main UK employer of doctors who belong to the various Royal Colleges. The Colleges maintain very tough criteria for admission and prescribe high standards of practice for their specialist fields. Yet they stand by silently, refusing to endorse anything woo within their own domains, but making no criticism of a Health Service that panders to patient gullibility.

With regard to those various Royal colleges that stand by silently, refusing to endorse anything woo within their own domains, would this include the Royal College of General Practitioners?

According to NHS Direct, over 40% of GPs (presumably employed by the NHS) provide access to CAM:

If you would like alternative therapy through the NHS, you will need to be referred by a doctor, usually your GP. At present, over 40% of GPs provide access to alternative or complementary therapies.

http://www.nhsdirect.nhs.uk/en.aspx?articleID=482

Isn't providing access to alternative and complementary therapies through the NHS an endorsement of woo?

[Spiro]

The Royal College of General Practitioners sits mainly on the rational side of the fence, despite the popularity of CAM among UK GPs. They have issued perfectly responsible warnings to GPs about checking for possible interactions between such things as herbal medicines and drugs such as warfarin. They emphasize the need for scientifically acceptable proof of efficacy of CAM.

It would be nice to think the Colleges could combine forces to press for the same standards of evidence for CAM as are applied to "orthodox" treatments. But with a supposedly educated public under a daily barrage of horoscopes, asinine health scares, wildly pro-CAM anecdotes (even in "responsible" newpapers and TV channels) and science journalists/celebrities who don't seem to be able to differentiate a hypothesis from a superstitious belief, the Colleges probably take the line of least resistance and say next to nothing at all.

[Blue Wode]

Bump.

You'll find an update on this over at the UK-Skeptics’ forum where David Colquhoun has just posted details of his brush-off from the PPA.

http://www.skeptics.org.uk/forum/index.php?topic=28.0