Stuff that occurs to me

All of my 'how to' posts are tagged here. The most popular posts are about blocking and private accounts on Twitter, also the science communication jobs list. None of the science or medical information I might post to this blog should be taken as medical advice (I'm not medically trained).

Think of this blog as a sort of nursery for my half-baked ideas hence 'stuff that occurs to me'.

Contact: @JoBrodie Email: jo DOT brodie AT gmail DOT com

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Sunday, 24 November 2013

Asking for evidence directly - not sure how well it works: Lyme Regis Reiki

How I heard about Lyme Regis Reiki
I've been taking an occasional glance at the #WDDTY (What Doctors Don't Tell You) hashtag on Twitter, and also seeing exchanges between various people and @_wddty (their Twitter account).

I spotted someone (Lyme Regis Reiki) who'd asked the magazine if they'd published much on reiki then go on to say that they'd had some success in treating someone with epilepsy. They didn't claim that they'd cured epilepsy though, so by itself this isn't much of a big deal.

They also claimed that there was scientific evidence showing that reiki could help with high blood pressure. Again nothing to get too worried about as they are not claiming that *they* can help with this. But I did ask them for their evidence and was pretty much ignored.

Agonies over asking for evidence
I'm not sure what made me ask since I'm of the opinion that it just never comes across well and have written about this before. Whenever you ask someone for evidence, particularly someone that is likely not to take it well, you are putting yourself in a position of (a) aggression and (b) power.

(a) It can't be nice to be on the receiving end of this, particularly if the line of questioning is graceless and sarcastic but it's extremely difficult to couch the question in polite, professional terms without also sounding a bit threatening. (b) If the marketer doesn't agree to your reasonable demands then presumably you're going to have to follow through and report their website / marketing material to the relevant authority - this can never really come across as anything other than "if you don't amend your website I'll report you to the ASA". I'm not fond of confontation or meannness but if someone's making misleading health claims then this makes me a lot less sympathetic to them.

There are also issues of what people understand as 'evidence' (clue: not testimonials, not books unless they have references to the primary research literature) and if you are constantly telling someone, or a group of someones, that their quality of evidence isn't up to scratch it's hardly a recipe for harmony.

But the fact is that making health claims without good evidence can be dangerous. It can lead unwell and vulnerable people to make health decisions that don't help them, may harm them and will likely waste them money too. So I tend to act quite quickly if I see something that concerns me. Since I'd rather not have a fight I generally just get on with reporting the organisation to the ASA or other regulatory authority, depending on the claims made. Probably I should have done that here but I thought I'd give it another go.

Claims on Twitter mostly harmless
So far what they've claimed on Twitter hasn't really fallen within the remit of the Advertising Standards Authority's (ASA) remit - they've not claimed that they are doing any of this through their service. However they are tweeting about reiki and have a link in their Twitter bio to the website for their commercial practice so being cautious is no bad idea.

The only tweet I've received in reply confirmed that the evidence exists if only I do my own research for it. I've seen this type of statement before and I don't understand it - if evidence clearly exists why not point enquirers towards it? Another person also asked them for evidence and was sent a link to a book. To be fair the book might do a very good job of putting the research evidence in context but what I certainly wanted and what the other enquirer wanted was links to the primary research publication. Perhaps we'll remain disappointed.

Claims on website of concern
Meanwhile, I am disappointed in some of the content of this person's website which has a bulleted list of health conditions whose symptoms they say can be helped by reiki.

lymeregisreiki.vpweb.co.uk/ [clickable version]
Reiki can help improve the symptoms of many illnesses including:

*Depression
*Anxiety
*Insomnia
*Grief
*Pain
*Chronic Fatigue Syndrome and M.E.
*Fybromyalgia
*High blood pressure
*Infertility
*Low self esteem
What the ASA and CAP allow reiki sellers to claim, and what they don't
Unfortunately this type of marketing information isn't permitted by the ASA who are following the guidelines from CAP (Committee of Advertising Practice) on reiki, which say that marketers need robust evidence to claim any physical healing effect, which is basically what you're doing if you claim that reiki can help with symptoms.
"To date, neither CAP nor the ASA has seen evidence to support claims that Reiki can have a physical healing effect on the body.  If marketers claim that it does, they should hold robust evidence (Rule 12.1)."
The ASA is also concerned when marketers list a bunch of quite serious health conditions that need appropriate medical supervision - if the reiki clinic doesn't have an appropriately qualified doctor or similar on staff then they need to be particularly careful how they refer to conditions that need medical supervision.
"Marketers should not discourage essential medical treatment for conditions which should be supervised under a suitably qualified healthcare professional (Rule 12.2)."
Although a half-arsed medical disclaimer doesn't usually wash with the ASA there doesn't appear to be anything encouraging people to check with a proper doctor first on this page.

In one of their rulings the ASA is very clear on what can be said about blood pressure:
"We considered that the serious medical conditions referred to in the ad - high blood pressure, stroke and addictions - and the references to the benefit and help provided by Reiki in treating those conditions, could discourage readers from seeking essential treatment for serious medical conditions from a qualified medical practitioner. "

Next steps
I'll check in a day or so, if the list of conditions is removed (I've asked them to do this) then that's the end of it as far as I'm concerned. If not, I'll report the site to ASA. I'm aware of at least two other people who are also looking into this, they may well just report anyway.

There's no guarantee the ASA will do anything about this as they've recently dealt with a large number of reiki and websites promoting related therapies through a master-complaint put in by the Nightingale Collaboration (and I wrote about my contribution here). And let's face it there are far worse examples of misleading advertising, but telling someone you can help with depression and high blood pressure without good evidence is not great in my book.

In the last week the ASA has reported on its strengthened relationship with Trading Standards to ensure that misleading advertisers are aware of their legal responsibilities. While the ASA cannot fine or imprison anyone (all they can really do I suppose is embarrass them or cause negative PR to appear on search engine results pages) Trading Standards can take action to stop a company from trading as well as work within the Court system (fine for a first offence and so on) under various trading laws and acts.

ASA rulings against specific reiki sellers
Comments
Please don't be boring. If you are going to come here and tell me how I have misunderstood reiki then please include links to real good quality evidence, the sort that would stand up in an ASA investigation. If you do not have this and are just convinced and believe that reiki's great then bad luck because I'm convinced and believe that reiki is just pleasant hand-waving. People who like that sort of thing will undoubtedly feel better after a session of hand-waving, that's not in doubt. But if you want to claim that it can help with serious medical conditions, show me the (good quality) evidence. Testimonials will be ignored, thanks. 




3 comments:

  1. I wonder if the statement that "the evidence exists if only I do my own research for it" is partly an attempt to disrupt positioning in terms of power and authority? It's a common enough teaching strategy (I want students to be able to search the research literature themselves so, while I'll give them some starting points, I would typically be expecting them to do most of their literature search themselves), so maybe your correspondent is trying to position themselves as someone who knows about their intervention?

    Being pedantic, testimonials are evidence and can sometimes be appropriate evidence to guide treatment choices (e.g. if I found several well-evidenced testimonials of how a hospital amputated the wrong limb from patients, I'd be asking lots of questions before going there for an amputation!) Clearly, though, they're not appropriate evidence for lots of things.

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    Replies
    1. Thanks Jon - good points :)

      The ASA does actually permit testimonial use in limited cases - more here http://www.cap.org.uk/Advice-Training-on-the-rules/Advice-Online-Database/Testimonials-and-endorsements.aspx - though not to 'prove' efficacy of a product or treatment if it hasn't been shown to work in other ways. I'd certainly agree with your assessment of how testimonials can be used to give further information.

      I'm all for doing some reference-hunting legwork myself but strongly feel that if claims are being made then the person making them should be able to back them up. I was disappointed to be ignored and disappointed to see someone else sent a link to a book.

      My biggest concerns are not being a total arse to someone who may genuinely believe in their treatment and think they're doing a good and kindly thing, while also making it clear that they might be breaking the law. I also want to do something useful to help vulnerable customers. Given the success that doctors, scientists and skeptic bloggers, as well as members of the public, have had in getting ASA adjudications upheld for all sorts of complementary treatments it seems that it would be quicker and wiser for marketers to take enquiries about evidence much more seriously.

      The chance of an adjudication is probably quite high, even if it's informally resolved they'll still get a listing on the ASA's website - and all this is avoidable.

      I just wish there was a way to talk to therapists without getting their backs up... it would just save a lot of time and effort.

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    2. I wonder if the (not uncontroversial) idea of symmetry might be helpful here http://www.theguardian.com/science/the-h-word/2013/mar/07/how-to-argue-with-sceptics-and-deniers I don't think there's any easy answer, though.

      Delete

Comment policy: I enthusiastically welcome corrections and I entertain polite disagreement ;) Because of the nature of this blog it attracts a LOT - 5 a day at the moment - of spam comments (I write about spam practices,misleading marketing and unevidenced quackery) and so I'm more likely to post a pasted version of your comment, removing any hyperlinks.

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