Alternative medicine conferences and events - a guide for hotels and conference centres

tl;dr is it a good idea to produce a checklist for hotel event bookers so that they can avoid hosting out and out quackery? What would go in the checklist?

@SLSingh is there much scope for an article in one of the hotel trade magazines about the iffy use of hotel conference facilities?

— Jo Brodie #WouldPreferThatYouBanNazis (@JoBrodie) June 15, 2015

Edit 30 Jan 2018
I could have saved myself writing the post below if I'd remembered these :) Here are two clear guides on things to think about, and things to watch out for, when considering the suitability of a topic or speaker for an event.
A letter to the TEDx community on TEDx and bad science (3 October 2013)
10 Questions To Distinguish Real From Fake Science (8 November 2012)

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Occasionally skeptically-minded people* will learn that a hotel's conference rooms are to be used for a health-related event on a topic that is quackery and which has the potential to be harmful and costly to customers ('patients'). Occasionally such talks take place at universities or on hospital trust grounds too.

Universities and hospitals generally don't want to be associated with quackery, particularly dangerous stuff, and tend to be pretty amenable to cancelling the event or having it moved off-site. That's not always the case with hotels. Many of us would prefer that these events were cancelled completely but as long as the event is legal then there's not much we can do.

Cancer-related alternative health events, however, may be in danger of breaching the Cancer Act 1939 and it may be more appropriate to cancel them. Of course it's entirely possible that someone wants to talk about complementary support for people with cancer with no problematic mentions of stopping their treatment and no advice given about undertaking unevidenced treatments - despite the treatment being quackery it's probably fairly hairmless and I suspect we don't really have much of a valid objection.

This example below though - where a speaker encouraged audience members who had cancer to give up their medication (or avoid taking it in the first place) - that took place at a hotel in Liverpool would seem to be one of the ones that should not have gone ahead. The report, from Michael Marshall of the Good Thinking Society, is a startling read: Cancer ‘Cure’ is Quackers Skeptical Magazine, November 2017, by Michael Marshall

Hotel event bookers might not know that a health-related talk (perhaps badged as a 'wellness' event) is unevidenced quackery or how to tell it apart fom something useful that everyone should know about - and that's where the skeptical-minded community might be able to help.

I wondered if we skeptics might put together a short checklist to help people appraise whether events are likely to cause problems. Does this idea have 'legs' as they say?

Edit 10 January 2018 - one of the topics I wasn't envisaging a university having many problems with, in terms of finding they've unwittingly said yes to room bookings, is conferences by white supremacists on eugenics with a side order of anti-Semitism. Today UCL found itself in this unfortunate position after a story uncovered that such a conference has been hosted at their site for the last four years. UCL has acted quickly to distance themselves from it, suspend future bookings from the staff member involved and are seeking an explanation from them.

• Exposed: London’s eugenics conference and its neo-Nazi links (London Student)
• University probes eugenics conference with links to white supremacists (Jewish Chronicle) The London Conference on Intelligence has connections to a number of controversial racial theorists
• UCL statement on the London Conference on Intelligence (UCL)

For example I might include things like

• if it mentions cancer at all ask them to assure you (the hotel booker) how they will ensure that the content of the presentation and any responses to questions don't breach the Cancer Act 1939 (Trading Standards can veto these events, or bring criminal proceedings against the speaker - I've never heard of venues being prosecuted though, anyone know?)
• if it talks about curing or treating (or 'helping with') any health condition beware - this may fall within misleading advertising (overseen by the Advertising Standards Authority in general, anything relating to the use of medicines would fall under the MHRA [Medicines & Healthcare products Regulatory Authority]
• also be wary of any "that doctors don't want you to know about" hyperbole
• be aware that skeptically-minded people often attend these events for monitoring purposes, and general interest (there is always new quackery to discover)
• the possibility of the whole social media backlash thing, though I think hotels can probably weather that!
• the very real possibility of doing harm to members of the public either by them paying out money for a duff event, or a duff treatment (or them failing to follow better treatment advice) - this is not a good look.
• a list of 'treatment modalities' known to be unevidenced twaddle (eg homeopathy, MMS aka Master Mineral Solution or Miracle Mineral Solution, it goes by other names too)
• a list of treatments for which the evidence is not very good
• how the skeptic-minded community can help beforehand 
• (afterwards is probably a bit late!)
• links to other 'how to spot quackery' checklists including these red flags, or this rough guide to spotting bad science. 

*healthcare professionals, scientists, skeptical activists, concerned members of the public etc
Skepticism-based clearing houses
Any of these organisations would possibly be able to field, or forward on, enquiries from hotels or other event-conference-centres about potentially problematic health events.

• Good Thinking Society
• Nightingale Collaboration
• Sense About Science
• Skeptics in the Pub (various around the UK)

Obviously if your organisation is listed above and you're thinking "hang on, we don't really have the capacity for that!" I can remove you (or amend the listing to clarify the way you might like to be involved, if at all).

• Are there any good skeptic-monitored hashtags? (Beyond #homeopathy and #Burzynski?).
• Do we have examples of successes (from our point of view) where an event has been cancelled or moved?

Example of events not yet cancelled or moved

Hi @ucl Can you say why UCL School of Pharmacy is hosting a homeopathy conference in April 2018? https://t.co/344rKyNyku cc @GoodThinkingSoc  @david_colquhoun @claire6thompson

— (((Alan Henness))) (@zeno001) December 19, 2017

Examples of events being cancelled or moved
Manchester United cancel David Icke show at Old Trafford after backlash (17 November 2017)  The Guardian - the cancellation possibly more to do with alleged antisemitic remarks than quackery per se but an interesting example of social media backlash causing a venue to investigate further.

Homeopathic College Pays Heavy Price for Helping to Screen VAXXED (17 February 2017) Quackometer blog - in this case the screening of the film 'Vaxxed' was not able to be prevented and it was shown at the Centre for Homeopathic Education within Regent's University in London. When it transpired that the university had not been properly informed of the film's contents they cancelled the contract with the Centre (in reality I think they'd hired a few rooms) rendering them homeless. The film was moved from the Curzon Soho screening after it had been cancelled.

A Cinema In London Has Pulled A Documentary By A Disgraced Anti-Vaccine Activist (January 2017) Buzzfeed - Vaxxed, an anti-vaccination film directed by Andrew Wakefield, was to be screened at Curzon Soho but an outcry from scientists and the public stopped that. The film had previously been removed from the Tribeca Film Festival.

UCL cancels homeopathy event by Indian docs after complaints (2 February 2016) The Wire - see background to this story in Andy Lewis' blog Indian Homeopaths come to UK to Lecture on Treating Cancer (comment: “Event cancelled. Booking made by junior sec unaware of issues. Lessons learnt process set up. New instructions on booking in IoN now in place.”)

Cancelled: Man who claims to have cured cancer will not be speaking in Ireland (16 June 2015) The Journal - one event was scheduled to take place at the Clayton Hotel in Galway but was moved to another hotel, which later cancelled once the organisers learned how controversial the speaker's views were, a second event in Dublin was also cancelled. More info at Cork Skeptics' page (they led the campaign).

The fake cancer cure conference the 'healers' tried to keep secret (25 May 2015) - this event (the 'Spirit of Health Congress 2015') went ahead after having been moved twice. Delegates were told to attend a meeting point where they were given train tickets and further instructions, video footage (not shown in link) was obtained of the event.

A cancer-related event, due to take place in June 2014 in Bristol attracted concern from Trading Standard and the organiser of the event first cancelled it then later moved it to Exeter (9 Mar 2014)
[Event initially cancelled][Move to Exeter]

Totnes cancer conference forced underground by Trading Standards (23 March 2012) Josephine Jones' blog - a cancer event was due to take place in Totnes at the Civic Centre. The local MP supported efforts to get the event moved off council property or ideally cancelled and Trading Standards intervened. The event was initially cancelled but later went ahead at a different venue.

The supramolecular chemistry of the homeopathic remedy (1 October 2010) - amazingly this event was scheduled to take place at the University of Cambridge (!) but people managed to get it cancelled by mid-September.


Other responses to quackery

In response to recent tour by anti-vas activists promoting Vaxxed movie @LightForRiley donated 50,000 vaccinations to UNESCO #skepticon

— Irma Gherd (@maureenchuck1) November 18, 2017

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Sandra Hermann-Courtney's strange behaviour...
The homeopathy enthusiast Sandra Hermann-Courtney (@BrownBagPantry and @OnFluff on Twitter) is not happy at all about my post above. She stole its entire content and republished it on her own blog, with no attribution. After I tried several attempts at getting her to add commentary ('fair use') or remove the post she finally took it down. Then she replaced it with her own post bleating about this one and complaining that I'd threatened her with a DMCA takedown notice. Mmm, not quite but you can enjoy seeing how duplicitious she's been here.

She has form on using people's content without permission and also behaving abominably to someone who lost a child to sepsis (it started badly when she suggested they might have saved the child if they'd tried homeopathy, and somehow managed to get worse). This blog post above isn't 'against' homeopathy per se, it's against misleading promotions or wrong health advice. Non-misleading homeopaths etc are probably perfectly nice people, I've no argument with them :)

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Homeopathy clinging to NHS by its fingertips, not far to fall

Every year the UK Government's Department of Health publishes (through the Health and Social Care Information Centre, HSCIC) the latest figures for money spent on prescriptions in the NHS in England. This is known as prescription cost analysis data and this year it was published on 7 April.


The data include the number of prescription items and the cost of those items. In many cases, and partiularly in the case of long term conditions like diabetes, numbers of prescription items tend to increase each year.

But not for homeopathy prescription items (which, anachronistically, are still permitted on the NHS where doctors (presumably?) want to give patients 'a pill' without actually giving them a pill)...

The graphs below (prepared by the Nightingale Collaboration) show the number of homeopathy items prescribed and the overall costs associated with prescribing them. As you can see homeopathy is plummeting on the NHS and has been for some time. That's quite a ski slope there.

The peak number of prescribed items was in 1996 at about 170,000 items. By 2005 this had roughly halved to about 80,000 and, rather dramatically, had halved again two years later in 2007. In 2015 the number dips below 10,000 items, to 8,894.

Graphs made by and stolen from Nightingale Collaboration, click to enlarge

With fewer items being prescribed overall costs are dropping too though the relative cost per item has doubled in 20 years (the cost per item was £4.97 in 1995 and in 2015 was £10.60, thus allowing me to make the joke that homeopathy is most certainly not cost-effective* on the NHS).

You can find a summary of the original data on page 381 of this 711 page PDF ;)

Click to enlarge image.

It's World Homeopathy Awareness week from 10 to 16 April 2016 but it looks like the UK at least is wise to the nonsense of homeopathy. If you plan to share one homeopathy-related article during the week please make it the Nightingale Collaboration's careful analysis of homeopathy's plummetous drop on the NHS which you can find and enjoy here - Homeopathy on the NHS: at death's door http://www.nightingale-collaboration.org/news/183-homeopathy-on-the-nhs-at-death-s-door.html

*technically cost-effectiveness-ness for drugs would weigh the effectiveness of the medication (for homeopathy that's zero) against the cost (anything other than free is a waste of money) but here I am mean-spiritedly demonstrating that even compared against itself it's useless. Ha!

Version for homeopaths
Well done homeopaths! You started the year with zero prescribed homeopathic items and ended it with nearly 9,000 - a massive increase, great work everyone :) 

PubMed is not for beginners... well, OK, maybe. Making sense of medical research.

Recently I've seen this image (from BasicBiologyBabe on Facebook) crop up a fair bit on 'skeptic Twitter' (of which I'm a member). We are the people who argue with those who claim that [X] can diagnose or cure [Y] despite no good evidence that it can. We also report misleading advertising to Advertising Standards Authority or Trading Standards etc and sometimes get claims removed and dodgy websites closed. As skeptic blogger Guy Chapman once put it we're at the intersection between science advocacy and consumer protection.

While I do try to be polite to people whose opinion differs from mine I find it pretty difficult not to be terse with people who are putting others' health at risk with their bad advice!

Transcript: "PUBMED IS NOT FOR BEGINNERS. Browsing abstracts on PubMed does not take the place of a university education in a scientific field. Experience and knowledge of context are essential to comprehension as well as reading the WHOLE GODDAMNED PAPER. Stop being dicks. - Scientists Everywhere [fb.com/BasicBiologyBabe]"

Clearly there's a big element of truth to this 'PubMed is not for beginners' idea,  but I'm not sure that this sort of advice will convince the people who might need to be convinced.

People who are promoting dangerous or ridiculous treatments or diagnostic tests (think antivaxxers, homeopathy shills, live blood analysis, tuning fork therapy etc) occasionally cherry-pick a PubMed abstract and promote the idea that it supports their favoured treatment or test. I've collected a few examples in this Storify, some are pretty funny but it's sad to think people are being so badly misled. They seem a lost cause to be honest ;)

But what about non-specialist people who have a health condition, or care for someone who does, who want to find out more? 

I'm hoping to go to an event on 'Communicating risk in health information' (London, Tue 26 Jan) which is for the subgroup of science communicator types who communicate health information. This is partly about helping non-specialist people to make sense of statistical information by helping those communicating it to express it more clearly.

A straightforward translation of 'science' to 'plain English' for an abstract (even for a whole article) will never be sufficient because an abstract or article cannot be read in isolation. Readers need to consider how it fits in with what's already known on a topic and also to know what conclusions can reasonably be drawn from a particular type of study design (how many people were involved, were they randomised etc) and just knowing lots about 'biology', for example, isn't enough. In fact it might give people a false impression of knowing / understanding.

A 2011/12 project, 'Patients Participate!', looked at ways in which patients could be more involved with health information providers (for example, medical research charities) and found that patients and the public wanted the following, which are all very reasonable -

• To find out about the latest medical research and how it relates to their health
• Accessible, plain English, searchable summaries of research articles that clearly communicate the implications and limitations of the research findings
• Information they can trust (credible, reliable and unbiased)
• To engage with researchers and research funders
• To be involved
• To learn more about research because theyare interested and they want to be better informed about the latest developments
• To help researchers be better communicators

It's hard enough to provide a dedicated abstract translation service, let alone one that takes all this into account and I don't think we've comprehensively solved that problem sustainably, though different health charities do this in their own ways.

Here's a comment I left under the picture on Facebook in response to people asking 'well OK, but where can we find this info then?' -

"Where possible I'd suggest, for medical articles, asking reputable health charities for their take on a study. Many of them have dedicated science communicators (of varying job titles) whose job it is to (a) explain the content of new studies AND (b) put it in context with other information known about the topic, as well as highlighting what conclusions can reasonably drawn from a particular study design etc.

There are certainly many efforts made to 'translate' scientific abstracts into plain English but by itself this might not be very useful, as there is usually a requirement for some background information needed, in order to know how much weight to give to some new finding."

 To which I'd add this patient-facing resource (there are other suggestions in this PDF (also linked above))

NHS Choices' Behind the Headlines - stories covered in the press might be spot on but often the end result can be that the study is a bit overhyped. The text of the newspaper article can be very good and clear, but let down by a dramatic headline. While we might all hope that everyone ignores the headline and reads the entire article I think we'd agree that's unlikely. Behind the Headlines considers the context of the story and explains the science for a non-specialist audience. It's fab.

I've no idea which Raspberry Ketones weight loss products can legally be sold in the UK

Short version: (1) Bottles of pills containing raspberry ketones may be being sold illegally in the UK because they are an unauthorised novel food whose safety hasn't been assessed properly. (2) Raspberry ketones are a waste of money as a weight loss supplement (no good evidence they work, any weight lost is solely due to changes in diet / exercise.

Full post: A couple of weeks ago I learned from BBC1's Watchdog that it might actually be illegal for companies to sell Raspberry Ketone products in the UK (if you've bought some online with a credit or debit card you may be able to get your money back - there's no evidence they help with weight loss), and tweeted the following:

It's illegal for Raspberry Ketones to be sold in the UK as a diet supplement (hence sales from abroad). Use chargeback to recover any money.
— Jo Brodie (@JoBrodie) July 2, 2014

Were I sending that tweet now I'd probably add a couple of caveats: (1) I don't know what sort of crime it is (unfair trading? mislabelling?) or what the punishment would be (fine more likely than jail I'd think) and (2) it seems to depend on the type of product on sale.

In October last year the Food Standards Agency (FSA) opened up a consultation with people who sell raspberry ketone products and asked for information about the products. One thing the FSA were keen to find was evidence that these products had been widely consumed in the UK since before 1997.

Under Regulation (EC) 258/97, novel foods and food ingredients may only be marketed if they have been evaluated and authorised under the procedures defined in the regulation. A novel food or ingredient is defined as one that was not consumed to a significant degree in the European Community before 15 May 1997. Raspberry ketones have not been authorised under this regulation.

The Agency is not aware of any evidence for a history of consumption of raspberry ketones anywhere in the EU before May 1997 and we are therefore minded to view it to be a novel food, which cannot be sold legally until it has been formally authorised. As such, any companies who wish to market foods containing raspberry ketones in the EU will need to apply for an authorisation under Regulation (EC) 258/97. Such an authorisation would require the submission of a dossier to one of the 28 EU Member States, demonstrating that the ingredient (a) does not present a risk to the consumer; (b) does not mislead the consumer; and (c) is not nutritionally disadvantageous compared with other foods that it might replace in the diet.
Source: Request for information from businesses: Raspberry ketones FSA 24 October 2013 [emphasis added by me]

In March they published their findings and I have to say I'm still a bit confused. Very reasonably the FSA makes a distinction between different types of raspberry ketone products noting that some can be sold without problem, but that some need to have some sort of authorisation.

Some raspberry ketones are fine...

"We received and reviewed information from a small number of interested parties. We have confirmed that some raspberry fruit extracts, which may or not be marketed as “raspberry ketones”, are outside the definition of a novel food, based on conclusions reached in other EU Member States. This is limited to extracts prepared using water or 20% ethanol (1:4 ethanol:water). These extracts therefore do not require authorisation as novel foods."
Source: Raspberry ketones (letter to interested parties) FSA 12 March 2014 [emphasis added by me]

but some are not...

"We have not received any other information that provides evidence of a history of significant consumption of raspberry ketones prior to 15 May 1997. We therefore remain of the view that raspberry ketones, other than the extracts mentioned above, are novel and fall within the scope of the EU legislation on novel foods. 

Under Regulation (EC) 258/97, novel foods and food ingredients may only be legally marketed in the EU if they have been evaluated and authorised under the procedures defined in the regulation, raspberry ketones have not undergone this process. Any companies who wish to market a novel food in the EU will need to gain an EU authorisation under Regulation (EC) 258/97. Such an authorisation would require the submission of a dossier to one of the 28 EU member states, demonstrating that the product a) does not present a risk to the consumer; b) does not mislead the consumer; and c) is not nutritionally disadvantageous compared with other foods that it might replace in the diet." Source: as above, 12 March 2014 [emphasis added by me]

But wait...

"This advice does not apply to the use of the chemical substance “Raspberry ketone” (4-(p-hydroxyphenyl)butan-2-one) as a flavouring. This compound is a permitted flavouring substance in the EU and small amounts of raspberry ketone can be used as a flavouring, in compliance with the EU Flavourings Regulation (1334/2008/EC). If used for any other purpose it would have to comply with the novel foods regulation." Source: as above, 12 March 2014 [emphasis added by me]

There seem to be three different classes of raspberry ketones
(1) Those that are a particular kind of water / ethanol extract
(2) Naughty raspberry ketones that can't be sold without authorisation
(3) The butan-2-one chemical compound

If you're buying raspberry ketones online or from Holland & Barrett (really, really don't bother, try and get your money back, there's no evidence that they can do anything for weight loss) then how do consumers know whether the product is being sold legally (though uselessly), or illegally as a novel food of unknown safety (also uselessly).

I had a look at the online Holland and Barrett shop page for Raspberry Ketones and didn't find any information about EU authorisation.

Similarly I've no idea if the raspberry ketones on offer from Groupon are being marketed legally or not. I've asked them to clarify.

Groupon selling raspberry ketones. Is that allowed? CC @_JosephineJones @JoBrodie pic.twitter.com/cpVLtJJMN0
— NurtureMyBaby (@NurtureMyBaby) July 27, 2014

Personally I don't think anyone should be wasting money on these products at all but if you do want to, how do you know which ones are "OK" to buy? There seems to be insufficient information for consumers.

Video purportedly showing a cure of motor neurone disease, with #homeopathy - nope

A couple of weeks ago I rather lost my temper with the discussions on the #homeopathy hashtag when someone implied that homeopathy could cure Motor Neurone Disease (MND) and that there was video evidence for this. This is flat out untrue. Homeopathy pills are made in such a way (diluting, then a special kind of shaking called 'succussion', the more more diluting and so on) to the point that there's no, or negligible levels of, active ingredient in the end product. People might certainly feel better and reassured after talking to a friendly homeopath, or taking their pills - but they cannot cure any diseases.

"Case of MND Restored to Healthy State with Homeopathy By Prof Dr A K Gupta" - below I go through each of the segments, struggling to make much sense of it.



It's difficult to follow what's being said. Someone is definitely speaking some English words but the rest is spoken in an Indian language and I think there is also a translator, and the sound is not good.

At no point is any evidence offered that the patient has or ever had a correct diagnosis of motor neurone disease. We are presented with a man who is unwell (coughing, difficulty speaking) and we all seem to be accepting that he has MND. Perhaps he does but this video doesn't bother to offer any robust confirmation.

We first see the patient on 10 July 2010 and the screen titles notes that he is experiencing "Coughing with difficulty in speaking, falls back when sitting". I cannot understand what is being said but the doctor (presumably) is asking a series of questions and the patient answers them through coughing.

We next see the patient on 11 August 2010 where his "Coughing, Fasciculations* (and) Muscle Pain (are apparently) Reduced", though he seems to me to be in more discomfort. *involuntary muscle twitching which can be of the harmless eye-twitch variety if you're a bit tired to twitching that's associated with a variety of more serious conditions.

Then on 15 December 2010 his "Speech (is) slightly better, Fasciculations much better" - the clip is too short to see how he's really changed but he seems fairly similar to the video from his first clip. Of course it's impossible for me (who doesn't speak the language) to know what's going on but it looks very much like the poor man is anxious and appears to be looking at someone else for support - if that was what he was after I hope he was getting it.

11 March 2011 "Speech nasal but much better, Choking Better, No More Falling Back" - the man's speech seems worse if anything but he looks happier at least.

We're now 2m 35s into an 8 minute video and there's been NO CONFIRMATION about what condition he may have or have had.

10 September 2011 "Swallowing improved, overall symptoms are better, patient feels stable" - I keep hearing the word 'fasciculation' and wonder if the doctor is just asking him if his fasciculations are better. While I agree that patients should be asked about their symptoms it would seem that fasciculations produce signs that are fairly obvious.

There's a risk, with self-reported improvements, that the doctor hears what they want to hear... the coughing seems better but the speech doesn't.

31st October 2011 "Better in general, speech affected due to Pollution of crackers during Diwali" - er, what? The crackers were polluted, or eating crackers polluted treatment? No indication given. I'm none the wiser.

7.1.12 "Choking & Suffociation completely cured" - I'm glad to hear it but at no point in this video (we're 5m 21s in) has there been any evidence offered that the man has ever been correctly diagnosed with any particular health condition, let alone MND.

No information is given about his other treatment (is he under the care of a neurologist?), none about the natural course of whatever condition he might have (does it progress relentlessly or are there periods of remission). Is it possible that he has been misdiagnosed and has another condition that is resolving by itself (so far I've not seen much evidence of dramatic improvement overall, and of course I am probably being led to look for things by the intertitles telling me how he's improving in certain aspects).

With the benefit of the doubt I'm going to assume that it's not fake (ie not an actor portraying symptoms) but of course that can't be ruled out as literally no evidence is offered for what's going on in the video. It's just a man talking to another man in an office in a language I don't understand. This is emphatically NOT evidence for homeopathy. If you're using this as evidence for homeopathy I recommend not doing that as it doesn't prove anything and the video is incomprehensible enough to be working against you.

At this point in the video I'm struggling to see much improvement in his speech, though it is slightly better - to be honest I didn't know what his speech was like previously.

At 6m 33s the intertitles state "Wife thanks homeopathy and Dr A K Gupta in restoring her husband's almost bed ridden condition & inability to eat / drink", then "Lost voice, choking, fasciculations back to near NORMAL HEALTHY STATE. Now he does not has (sic) to write to communicate."

We then see the man's wife (presumed) sitting in front of a calendar from Dr Reckeweg (seller of homeopathic tissue salts, though possibly not in the UK) who then (apparently) reads something from a cue card (she's looking away from the camera unless a question is asked, though perhaps she's just sitting opposite her husband and is looking at him). As I don't understand the language I don't know what she's saying.

Having now watched the full video at the request of a homeopathy supporter I have to assume I'm being expertly trolled and have been bested by their quick-thinking mockery. Well done homeopathy supporters and I think we can all agree that this video offers zero evidence in favour of (or against, it literally offers no evidence of any kind) homeopathy.

The Motor Neurone Disease Association were also tagged in the tweet sent to me with the video link so I had a look at their pages to see what they say about homeopathy. Sadly they don't say "it's a load of nonsense" but they do at least make it clear that you need to be talking to your doctor:

"Homeopathy
The objective of homeopathy is to alleviate illness or conditions by stimulating the body’s own natural healing processes. Homeopathy can be applied to the symptoms of many illnesses, as well as causes. As people can present varying symptoms, separate remedies may used for the same condition or illness for different individuals.

It is essential that a qualified homeopath be consulted, as their first task is to identify which remedies may work for the individual involved.

Note: it is important that you consult your doctor before taking any homeopathic remedy to ensure there is no conflict with any other medication you may be taking."

See also
Motor Neurone Disease Association website
The Homeopathy Awareness Week website on why people should be very, very aware of homeopathy.

Comments on this post
I am no longer adding further examples of these almost-identical generic comments despite receiving between three and five a day of them as I think their purpose (which is to help people be aware that they're spam comments in case they come across them elsewhere) is served already. Anyone trying to leave a comment of that nature here, with promises of miracle cures and whatnot, has been pre-cursed by me and will experience dreadful pains before a lingering death. It's only what you deserve ;) Mwahahaha.

It seems the magazine 'What Doctors Don't Tell You' doesn't like me

I was surprised to discover this afternoon that I've now made it into yet another* Facebook rant from the people behind What Doctors Don't Tell You (there have been many rants though this is my first inclusion). They've been escalating their rants about skeptic activists (while unironically noting how few of us there are) ever since Tesco decided to stop stocking their magazine. The reason Tesco gave was that the magazine wasn't selling^ - I've no idea if this is true or if Tesco really did listen to the complaints against the magazine's content (or possibly they just read it and drew the relevant conclusions themselves).

*https://www.facebook.com/WDDTY/posts/770960436257904
^https://www.facebook.com/photo.php?fbid=10152543438997767&set=p.10152543438997767&type=1&theater - this link might take you to a picture shared on WDDTY's public page, it's a screenshot of an email from Tesco saying that they'd removed it in response to feedback.

Anyway, What Doctors Don't Tell You is now blaming skeptics for the withdrawal of the magazine and is now reduced to publicising personal and work information about us. To me this is very telling. Each of us has blogs where we've criticised the magazine's content or the framing of its content. If they think we're wrong it would be better to point out where we've missed something. The fact that the chosen tactic relies on personal attacks speaks volumes.

Remember that a number of the advertisers in the magazine have been found to be in breach of the advertising standards guidelines and in one particularly amusing case, someone whose research was written about in the magazine pointed out that the author had got it wrong.

Here's what WDDTY would like you to know about me... or at least someone whose name rhymes with mine (I have spelled it as Jo Brodie for... ooh, forever).

The bits that are accurate are fine. The bits that are inaccurate are quite wrong (surprise!) and it ropes in another Jo Brodie who might be a bit miffed to find herself (himself? Jo can be a man's name too) connected with this, so my post here is published to clarify my own 'involvement' in the list of skeptical activists. At the end of this post I'm including links to any other relevant blog posts that clarify the misinformation in the WDDTY Facebook post.

My work / volunteering
I do indeed work two days a week (2.5) for the CHI+MED project, yes. It's funded by the EPSRC (one of seven research councils) which are funded by the taxpayer. We are not paid by the pharmaceutical industry or, for that matter, the medical devices industry. We do work with medical device companies - we're trying to reduce the harm that can happen when complicated devices are used under stressful conditions.

My job is partly to update the website and expand the project's online presence - fair enough. I also give talks about our research, in particular the work we've done on public (& stakeholder) engagement and science communication.

For the rest of the week I do not work at Diabetes UK and haven't done since June 2012. Diabetes UK made the entire Science Information Team redundant then (5 people affected) but I'm on friendly terms with them, they do good stuff and I learned a lot while there.

I have never worked for Prof Wharton and until today had never heard of him. If you google his name and add mine you'll find that he does have a secretary with my name (spelled -ie not -y) but it isn't me. There are a surprising number of people called Jo Brodie who aren't me in fact. Prof Wharton's based in Sheffield, I'm in London. I'm sure I'd do quite a good job if I did work for him though as I have a Masters degree in Neuroscience and he seems to work in that sort of area.

For the rest of the week I actually work (1.5 days) on the Teaching London Computing project - supporting computing teachers who'll be delivering the new subject / curriculum. I also volunteer one day a week (1d) at JDRF (the Juvenile Diabetes Research Foundation) so that I can put my diabetes statistics knowledge to good use.

"I'm not medically trained"
The reason I freely admit that I'm not medically trained is because it's true and some of the things I post here touch on health and medical topics. I think it's important to state this so that people aren't misled - I am not qualified to give advice, in much the same way that this magazine isn't qualified to give medical advice. To be honest even if I was medically qualified I'd still not be acting appropriately in giving advice because I don't have access to your medical records and might give advice that isn't relevant to you.

This concept was made very clear to me while working at Diabetes UK. We took calls from the public, explained that we were science information officers and then hopefully did a competent job of explaining complex topics simply. Quite a few people referred to us as 'doctor' (of course we corrected them) and many callers maintained the belief that we were medically trained, some were surprisingly quite deferential. That bothered me because we were trying to signpost them to information, not give them medical advice, and we certainly didn't want to misrepresent ourselves. I hope to make it clear from the outset (in the blog bio bit at the top) that I'm not medically qualified and I also re-mention it in relevant posts too.

Qualifications and competence
The post mentions several other people, largely to try and imply that we're a bunch of un-medically-qualified folk who are not fit to assess the content in the magazine. By contrast, their own advisors include:

"seven medical doctors on its editorial panel, plus several PhDs and highly qualified practitioners of a number of alternative disciplines. Thousands of doctors and health practitioners of every persuasion regularly read WDDTY and comment enthusiastically. The two editors of our magazine have been medical science writers for 25 years, and every word in our pages is checked by a science editor with a an extensive history of writing and editing medical studies for the pharmaceutical industry."

You might be interested in the background of these doctors...

I'm amused by the bit pointing out that a fact checker worked for the pharmaceutical industry - the magazine often criticises Pharma for distorting evidence so I'm not sure what to make of that. Also if the magazine is called What Doctors Don't Tell You it seems odd to tout the fact that you're taking editorial advice from them.

While I am not a medical science writer I've done a fair bit of it (only 8 years, so I can see immediately how my qualifications fall dramatically short of theirs) and am not too bad at critical appraisal. Really, anyone who's been trained as a scientist is reasonably competent to critically appraise scientific or medical information - and we can all improve with practice.

WDDTY's message is that we're not qualified to comment on their magazine. While I maintain that anyone who can make sense of evidence is qualified to do this, it's not at all clear who WDDTY would accept as suitable:

• Not the eight of us because we're not medically trained
• Not doctors because they are medically trained...
• ... except some doctors who agree with them.

In addition to my sciencey qualifications I actually think that my most relevant-to-WDDTY one is that most of the complaints I put in to the ASA result in upheld adjudications or are informally resolved. I can think of only two that were rejected outright - one because the ASA disagreed with me and thought the advert wasn't misleading, the other one (recently) was because the complaint didn't actually fall within their remit.

Others have shared the Facebook status, taking WDDTY's message that we're not qualified to comment -

Personally I think the first line should read "This important magazine is being written by people who have no credentials whatsoever to give opinions on medical issues..."  my criticism is not about anyone's qualifications but based on the evidence of the magazine's published output. 

I'm a little bit miffed about the last line of course because my qualifications and experience are all about the health and medical field, just not as a doctor.

They end with:

"...write to Tesco today and ask them to re-stock What Doctors Don’t Tell You. And tell them a bit more about the people who fire off ‘complaints’ – that they are neither true customers nor people with either the training or experience to evaluate the information in our pages: customer.service@tesco.co.uk"

Unfortunately for WDDTY I (and the others mentioned) have both the training and experience to evaluate the information in their pages, and that's why they're a bit mean about us.

Others' take on being included in the list (will add as more are written)
Skepticat aka Maria
http://forum.thinkhumanism.com/viewtopic.php?f=76&t=6604

Guy Chapman's blahg
WDDTY goes "the full Errol"

WWDDTYDTY (What What Doctors Don't Tell You Don't Tell You)
Meet the people who would dictate your health care

The campaign against WDDTY continues, apparently

Lynne McTaggart has published a post [http://www.lynnemctaggart.com/blog/272-the-campaign-against-what-doctors-dont-tell-you-continues] suggesting that skeptics (we're in 'quotes' for some reason) have managed to convince Tesco that customers have been complaining about the magazine ​What Doctors Don't Tell You​ . I don't think this is quite right - any complaints I've sent to Tesco either by email or Twitter haven't focused on my customer status, only why I think the medical information in the magazine isn't up to scratch.

Ms McTaggart also suggests that we've "harrassed dozens of [WDDTY's] advertisers by reporting them to the ASA" - well I'd say the advertisers have made misleading advertising claims and the expected response to that would be to report it to the ASA. From what I can tell the ASA agreed that the ads were misleading and adjudicated against quite a few of them for breaching the advertising guidelines that all marketer are meant to follow.

Then things get a bit odder - she says that various skeptic organisations "sent their foot soldiers to hide our magazines on the shelves of stores and attempted to destroy our Google ranking."
True enough several people hid magazines, but framing this as 'foot soldiers' is a bit daft. A couple of people tweeted about doing it on the #wddty hashtag, it amused some others and they did it too. Not really a command from on high.

Regarding the Google ranking - this seems to relate to a persistent misunderstanding of how 'Do Not Link' works. When a website links to another website it is effectively implying to Google's webcrawlers that it values that website. By using tools like Do Not Link we're telling Google to ignore this implication - but we're not worsening the Google ranking, we're just not increasing it.
The sentence "One of our websites was even mysteriously hacked into" seems to suggest that "skeptics did it" but websites are hacked all the time and I suspect it's more likely a coincidence. Of course it is possible that there are rogue skeptics doing this but I doubt it.

"Simon Singh is busy these days tweeting his supporters to write Tesco to thank them for not stocking us." - yep, I followed this suggestion as it seemed a good one. I was quick enough to write to them when they were selling it, no bad idea to thank them for (eventually) listening to my concerns.

I've thanked Tesco for taking #WDDTY off its shelves

The magazine What Doctors Don't Tell You is available to purchase from their website and various other outlets throughout the UK and even abroad. It's an extremely easy magazine to get hold of, though I'm not sure why you'd want to once you understand what's in it.

It's written in an engaging narrative style and suggests that there's information out there that can help you with your health, but that doctors are keeping quiet about it - either because they don't understand it or are deliberately hiding it so that they can make more money from mainstream treatments. There's a whiff of  conspiracy theory about it but what particularly annoys me is the way it handles evidence and information.

If, when working as a science info officer at a medical charity, I'd taken the same attitude to evidence that some of the magazine's content has done I'd expect colleagues and my boss to have had a quiet word. It's all too easy to come across Medline abstracts that agree with your ideas but "in science we have to count the misses as well as the hits"⁽¹⁾ and you need to consider a wider range of evidence and put things in context.

It's extremely unusual that all the information you need to make sense of a study / paper can be found from just reading it (even in full) - you may need some prior knowledge about the health condition, or study design, to know how much weight to give it. You may need to read other documents to find out more, and ask people for their thoughts (you might have missed something). Critical appraisal can be a fun and collaborative thing.

There have been a number of things in the magazine that seem to be very wrong (and on one notable occasion the author of at least one study⁽²⁾ has stated that the magazine has drawn incorrect conclusions about the work). We all make mistakes and since I work in the area of human error (@chi_med) I can't be too snooty about that, however there seems to be an absence of 'errata'⁽³⁾ (the bit where publishers print what was previously wrong and what the corrected version should say).

Following a long exchange of emails and tweets asking several supermarkets to stop selling it Tesco has apparently soft-announced (by contacting complainants rather than press releasing anything, I believe) that it will no longer be stocking the magazine. Hooray.

I was quick enough to bleat so have sent them a thank you note, which is below.

----

Good evening

I'm delighted to learn that you've decided to stop stocking the magazine What Doctors Don't Tell You. It's full of silly ideas mixed in with some sensible stuff (in my opinion this makes it all the worse as it cloaks itself by having just enough sense in it not to trigger too much amazement) but sadly the silly ideas are also potentially rather dangerous.

Implying that sunbathing can help manage diabetes (through increases in Vitamin D in the skin when exposed to the sun) is an odd take on the relationship between Vitamin D and glucose levels. Suggesting that homeopathy can help treat cancer is really quite bonkers.

Had they stuck to vague advice about eating your greens and made their medical disclaimer a bit more obvious I might not have taken against the magazine but a few of us have looked at it in some depth and have serious concerns with its content.

Thank you for taking it off your shelves. Now, is there any chance you might give the Daily Mail the heave-ho while you're at it ;-) They're usually OK on science but often pretty dire on health stuff.

Best wishes,
Jo

@JoBrodie----

(1) I'm sure loads of people have said it but I associate it with an amusing talk by Michael Shermer.
(2) Ctrl+F / search for Sun et al
(3) Well gosh! They've only gone and corrected something. Apparently the recipe was meant to say tomahto but ended up saying tomayto so they've addressed that serious problem ;)

Uh oh! I hope this doesn't become a habit: a correction in the latest issue of #WDDTY pic.twitter.com/GS4sdMoUzE
— Alan Henness (@zeno001) June 27, 2014

Note for the hard of thinking: asking a major supermarket to stop stocking a magazine has nothing at all to do with the freedom to publish or say something, which is what is generally understood by the phrase 'freedom of speech'. Or at least that's how I understand it but you're welcome to correct me, but ill-thought through comments will be deleted :)

Misleading health claims around the world - going global

A few years ago I learned, by accident, that the UK's Advertising Standards Authority (ASA) would handle complaints made about organisations based outside the UK. My complaint was against an organisation claiming it could reverse Type 2 diabetes - their ad had appeared on my Facebook page (I was working at Diabetes UK at the time so the algorithms probably brought up a lot more diabetes stuff than they do now), so I took a screenshot and reported it.

The organisation turned out to be based in Spain but through the ASA's cross-border agreement it was passed to the Spanish ASA equivalent to handle the complaint, who investigated, and an adjudication was upheld against the organisation.

Given that UK people will see adverts from all over the world it makes sense that we can report them to the relevant authorities if they're misleading. More recently I've been looking into the list of countries that the ASA will liaise with, both European (Austria, Belgium, Bulgaria, Czech Republic, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Lithuania, Luxembourg, The Netherlands, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, Switzerland and Turkey) and non European (Australia, Brazil, Canada, Chile, India, New Zealand and South Africa) and began to wonder what can be done about misleading claims from the US.

Yesterday I found out that the US' Federal Trade Commission (FTC) will apparently take complaints about US adverts from UK citizens, though I've not yet tested it, so we'll see.

@FTC Will you accept consumer complaints from complainants in the UK? (Marketer complained about is based in the US). Thanks :)
— Jo Brodie (@JoBrodie) May 8, 2014

@FTC It's someone making misleading health claims on their website. Complaints straightforward in UK but not sure of how to do a US one yet.
— Jo Brodie (@JoBrodie) May 8, 2014

@JoBrodie Hi Jo, you can file complaints with the FTC at http://t.co/g3okfpjGWW. Thank you.
— FTC (@FTC) May 9, 2014

The FTC has recently taken some quite firm action on people making misleading claims about diabetes, which is great to see - FTC Obtains $2.2 Million Judgment against Supplement Marketer that Made Phony Claims for Treating and Preventing Diabetes (7 March 2014) - FTC's press release.

There's no guarantee though that they'll process a complaint in the way that the ASA does (the ASA publishes an adjudication on its website) particularly as they let complainants know that:

"Your complaint may help us and our law enforcement partners detect patterns of fraud and abuse, which may lead to investigations and eliminate unfair business practices. Complaints are entered in our secure online database, which is used by many local, state, federal, and international law enforcement agencies. The FTC cannot resolve individual complaints, but we can provide information about what next steps to take."

So I'll put a complaint in to the FTC, though I may well never hear of it again :)

Complaining via the ASA (Advertising Standards Authority) or European ASA about a non-UK advert

by @JoBrodie

You can complain about adverts appearing in other countries (eg on non-UK websites).

The UK's Advertising Standards Authority is a member of the European Advertising Standards Alliance (EASA) along with 23 other European countries. If an advert appears in another country you can report it to the ASA and they'll pass it on to the EASA while liaising with you, thanks to their cross-border complaints arrangement, or you can also complain directly through the EASA.

I discovered this by accident when complaining about an advert for a diabetes clinic that appeared on Facebook - even though it was based in another country I reported it as it was clearly targeting a UK audience (and making misleading claims). I wasn't sure if there was much that could be done, but there was. The ASA told me they were passing it on to the regulator in that country and they kept me informed throughout - and my complaint was upheld.

The 23 European countries other than the UK are:

Austria, Belgium, Bulgaria, Czech Republic, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Lithuania, Luxembourg, The Netherlands, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, Switzerland and Turkey.

There are also 7 non-European countries that have regulatory links:

Australia, Brazil, Canada, Chile, India, New Zealand and South Africa.

Some examples of adjudications appearing on the ASA's website where the trading address isn't in the UK.

• A brochure distributed at a timeshare meeting (2011, Spain)
• A diabetes clinic (this one isn't my complaint, though same organisation) (2011, Spain)
• A magnetic 'fuel saver' (2011, France)
• Airliner claiming ecofriendliness (2010, Finland)

South Africa
Consumer code | Complaint form
If advertisers don't play fair then the ASASA will take out an ad-alert.

Wasted money buying weight loss pills online? Try and get your money back and report to Action Fraud

This post is modified from one that appeared as part of an earlier post and is aimed at people in the UK.

Weight loss pills and supplements are advertised in newspapers (though I think some of them are cottoning on to the fact that they don't really work), magazines, television programmes and adverts, dedicated websites, pop-ups on other people's websites, sites like Instagram, Twitter and on YouTube. If you've bought some and wish you hadn't (check your credit card / debit card bill as there may be ongoing charges added) then here are some suggestions for what you might be able to do.

1. Try and get your money back
If you've bought pills (or anything online) with a debit or credit card then you may be able to get your money back. Have a look at the information on Section 75 and Chargeback at Martin Lewis' Money Saving Expert page on Visa, Mastercard & Amex Chargeback: protection for debit card purchases. I think it only works if the cost was over £100 though but worth checking.

2a. Report the website to the Advertising Standards Authority (ASA)
How to complain about misleading marketing / advertising (as of 2011 websites are included) - http://asa.org.uk/Consumers/How-to-complain.aspx

Have a look at what the Committee of Advertising Practice (they produce the guidelines that the ASA uses to determine if marketing material on websites or leaflets is OK) has to say about various types of weight loss advertising too.

• Weight control: Herbalife and similar weight management products
• Weight control: Food and Food Supplements
• Weight control: Pills, medicines and patches - note that "claims such as “decrease appetite”, “burn fat” and “speed up metabolism” are likely to be medicinal and should not be made for unauthorised products."

See also UK Government information on the Advertising Standards Authority 


2b. Report to Trading Standards 
From Trading Standards' website - Trading Standards tips for successful New Year's resolutions: 

• The New Year may seem like a perfect time to get back into those skinny jeans. Trading Standards is warning consumers to be sceptical of fad diets, misleading statements and exaggerated promises made by companiespromising to have a “miracle cure”. Not only will they fail to lighten anything but your wallet, many products may be untested and could be extremely unsafe.
• Trading Standards warns consumers to be wary of internet sellers or small ads offering weight loss supplements such as herbal remedies which promise an easy route to weightloss.
•  Consumers have reported falling foul of internet sites where they thought they were subscribingto a free slimming pill trial only to discover they were tied into expensive contracts.

The first port of call was previously Consumer Direct however Citizen's Advice took over this role in April 2012, see their Advice Guide.

If you know the operating address of the company then contact the relevant local Trading Standards office, you can do this from the UK Government's Trading Standards web portal. Note that the UK office address may not be the company's actual address (might be outside of the UK).

There's some good background advice in this This is Money article (note that it's from 2009 so some of the links won't work and Consumer Direct aren't involved anymore) - "Help! I've been caught by diet pills scam".

See also "Warning issued over illegal 'fat burning' chemical" (September 2013) from the Trading Standards Institute.


2c. Report it to Action Fraud
If you have lost money in buying unevidenced weight loss pills you can report this to Action Fraud, who have this to say on Miracle Health Scams:

"Miracle health scams can include fake ‘miracle’ cures and weight loss products as well as bogus online pharmacies.

It is unlikely that such products have been properly tested or that there is any proof that they are medically effective. Some of these products may even be harmful.

Advertising for miracle health cures often include fake testimonials from apparently satisfied customers, have unproven claims about the product’s effectiveness, make false claims about clinical tests and have worthless ‘money back’ guarantees."

---

Tis the season of weight loss pills, and other online pills, for which there is generally not very good evidence. 

Most are probably fairly harmless and just ineffective (waste of money, and a hassle to get a refund), but some aren't harmless and the sorts of risks can include:

• the pills do contain the ingredients listed but the pills should really only be used under medical supervision
• the pills don't contain the ingredients listed but some other (possibly prescription-only) medicine, perhaps one that has been taken off the market

To be fair, very few are actually lethal. Do watch out for the fat burning one above though.

Fairly often the pills will contain a variety of herbal ingredients and minerals but no evidence is given that the pills have been tested as a combination of those ingredients. If evidence is offered only for the individual ingredients (often small studies in animals or humans) then be wary as things can behave quite differently in combination - and if the pills haven't been tested in the format that they're being sold in then the company cannot reasonably make any claims about them.

I've written previously about the tactics of review sites* and the concept of article spinning** and this means that I sometimes get blog comments from people who are annoyed at having paid money for online pills - hope this updated post helps.


*they're often not actually review sites but provide a link to a merchant site from which you can buy the product, while giving the review site a small percentage of the sale - this is perfectly legal by the way, and often used to really good effect by some charitable organisations (eg with selling books through Amazon) it's just helpful to be aware of it.

**taking a block of text, changing a few words, and publishing this in the hope of fooling Google that it's a fresh new website - this has let people 'flood' the internet with similar websites all promoting the same product, though Google has begun penalising some of the sites.

WDDTY 'exposes' the ASA but slightly misses the point I think

Since I've been blocked from the "What Doctors Don't Tell You" Facebook page I can't comment there and I doubt they'd publish a letter from me so I'm posting it here. I'm still smarting a little bit from the ban to be honest as I don't think I could have been any more polite while disagreeing with someone - I pointed out that people who are critical of WDDTY might not be 'Big Pharma shills' (after all, I'm not).

Of course my blog is indexed in Google (nothing unique to me, most blogs are and Blogger is owned by Google) so this text may well show up when people search for WDDTY-related material in a way it probably wouldn't if I'd posted it on Facebook. So swings and roundabouts.

I've had a look at the December edition of this magazine and was disappointed though not surprised by the WDDTY Opinion Piece on the Advertising Standards Authority. I think bits of it are wrong, but bits of it are also encouraging people to focus on the wrong battle. In addition to the ASA there's a lot that a knowledgeable, motivated, collaborative and snarky bunch of bloggers can do and have done to try and tackle misleading advertising claims.

If you spot any mistakes in my arguments below please let me know, thanks.

---

Dear WDDTY

There seems to be some confusion in your opinion piece on the ASA (Advertising Standards Authority) and its role. Since the pharmaceutical industry is not allowed to advertise directly to the public in the UK the ASA does not rule on any of its marketing material. The PMCPA (Prescription Medicines Code of Practice Authority) is the body that makes sure that pharma companies are operating within the ABPI's (Association of the British Pharmaceutical Industry) code - if drug advertising (found in the medical not general literature) is misleading then the PMCPA can take action against it. The ASA instead ensures that marketing material is compliant with the CAP (Committee of Advertising Practice) code.

In both cases the two agencies are paid for by the industries that they regulate, so I don't think the ASA is paid for by pharma companies. Undoubtedly some pharma companies have a non-prescription only medicine wing that they might advertise to the public so I'll accept that there might be some money from them.

I am more concerned that the tone of the article suggests to readers that the ASA is getting a bit above itself and can be ignored. I'm not sure that this is helpful to any of your readers who are making health claims without robust evidence because they may not realise what happens if someone reports them to the ASA.

I've probably reported only around 30 adverts or marketing items to the ASA. In one or two cases the ASA disagreed with me and felt there was no case to answer, a few more have been resolved informally but rather a lot have resulted in an adjudication in 'my' favour. To be honest I'd have preferred that the organisations involved just amended their pages when first asked, and saved themselves and the ASA the bother.

Within this relatively small, compared with other skeptic bloggers, number of complaints I have had a pretty high success* rate and this is what I've learned from going through the process several times.

*I think it's important to say that my definition of success is a misleading claim being removed or modified and not just someone getting told off. I'd be lying though if I said I hadn't also enjoyed some of the worst cases being told off.

A complaint is made to the ASA
Initially the ASA will probably contact the organisation / marketer and ask them to amend any misleading claims. Even if they do so promptly the ASA will still list this on their website as an 'informally resolved' case - i.e. the mere act of me reporting a website tends to result in their trading name being listed on the ASA (this is why I'd prefer to have a quiet word with the marketer first but this rarely goes well).

Marketer decides to defend their claims
If they decide to challenge the ASA by providing evidence then the ASA will deliberate further and make an adjudication. Either it will go in the marketer's favour (not upheld) or it won't (upheld) but again in either scenario the case will be listed on the ASA's website on its own separate page and will likely be tweeted.

Marketer told to amend claims, marketer doesn't
If, after an adjudication is upheld, the marketer still doesn't amend the claims then the ASA may add them to its list of non-compliant online advertisers. It can also work with search engines to remove paid-for advertising and take out an advert itself about the misleading claims. In parallel with this there's a high chance that it will be tweeted and blogged about and may even make it to the mainstream press. The ASA has recently (as of 21 November 2013) strengthened its relationship with Trading Standards and if the claims are still problematic then the ASA can refer the marketer to Trading Standards. At that point things could well become rather serious as Trading Standards can bring a case against them to court which is likely to result in a fine or (rarely) a prison sentence.

Bloggers and newspapers might publicise this further
Again, in parallel, there will probably be some blogging and possibly mainstream news articles about this which can damage search results (when people look for information or a company website they will find information pointing out that the company has been making misleading claims).

'Using' the ASA
To say that Simon Singh and the Nightingale Collaboration 'use' the ASA is a bit silly, since that is the body that deals specifically with misleading consumer advertising. Though on a much smaller scale you could also say that I 'use' the ASA to persuade marketers to make their claims more reasonable.

In some cases I report people to Trading Standards, sometimes to the Medicines and Healthcare Regulatory Authority. More recently I have reported some marketers to the CHNC (Complementary and Natural Healthcare Council) for misleading claims, where that marketer is registered with that professional body. The CHNC has suggested that its members should follow ASA / CAP guidelines.

Credit where it's due
Simon Perry devised the Fishbarrel tool which is a plugin for Chrome. However if readers of the Nightingale Collaboration's newsletter want to take part in a particular claim they rarely submit complaints to the ASA precisely for the reason of not swamping them. The Nightingale Collaboration usually asks readers to share relevant examples with them, and then they submit a master complaint - this is more efficient.

Don't get bogged down with just evidence - medical governance is important too
The ASA isn't just interested in evidence (robust evidence please, not these feeble little studies that show a small positive effect) but also what types of conditions people are talking about. There are a number of serious conditions that require the care of appropriately qualified doctors and if a website or leaflet is claiming to treat people with those conditions, but doesn't have a doctor on-site, then this is problematic - irrespective of the quality of any evidence.

Be careful what you wish for
Dismantling the ASA will not stop bloggers from reporting misleading trading claims to Trading Standards or other regulatory agencies. It also won't stop them writing about misleading claims, and in terms of search engine results that may be the bigger problem for those who rely on online reputation. I certainly can't imagine things would be much better for sellers of alternative medicine if the government began regulating it directly.

If you've received an #askforevidence tweet or email from me it might mean the following

Hello

You might have received a message from me asking for some evidence for a claim you've made in your marketing material. My request might have taken you by surprise and you might be rather annoyed to be challenged in this way. I expect I would be a bit surprised if someone contacted me too, so I've written this post to try and explain what it is that I'm trying to do.

I regularly report what I believe to be misleading marketing claims to the Advertising Standards Authority. Many (by no means all) have resulted in an adjudication being upheld against the marketer with the details listed on the ASA's website. In fact even if the case doesn't get as far as an adjudication (usually because the marketer agrees to the ASA's request to amend the claims) the marketer's trading name will still appear on the ASA's pages in the 'informally resolved' section.

It seemed like a good idea, in terms of saving time and effort and avoiding names being listed, for me to try asking people if they will amend their claims before reporting them to the ASA. If claims are amended then there's nothing to report to the ASA. It may not work of course but I thought I'd give it a go.

The reason I'm asking is that I'm not convinced by the claim(s) that you've made on Twitter or on your website (or leaflet). The claims are possibly in breach of the Advertising Standards Authority's (ASA) and Committe for Advertising Practice's (CAP) advertising codes and it may be advisable for you to think about changing your wording.

Please have a look at the CAP's AdviceOnline database or browse the Advice Index to search for your treatment to find out what you can say about it in your advertising material. You can also browse this alphabetic list of therapies for information.

Don't forget that the ASA aren't just interested in evidence for your claims. If you mention serious conditions or diseases (the sort that anyone would expect to be under the care of a doctor) and you don't have a doctor at your clinic or place of treatment then the ASA may want to know more about this. From previous adjudications they tend to take a dim view of people or companies claiming that they can treat a long 'shopping list' of diseases and they have frequently mentioned their concerns about a website failing to encourage people to visit a doctor for essential treatment. A medical disclaimer is not sufficient to get around this and it is generally inadvisable to say anything that could be understood as you offering to diagnose, treat or cure any disease - unless you have robust evidence.

You may very well think that I am wrong or that your treatment is fantastic, and of course I am easy enough to ignore. But if the evidence doesn't satisfy CAP's requirements for 'robust evidence' then the ASA may well ask you to amend claims made on your website.

If you decide not to amend your advert (and a number of people are standing their ground and defying the ASA) then a number of potentially annoying things can happen -

1. Listed on ASA's informally resolved page
Even if you do amend your ad I think your company will probably still be listed on the 'informally resolved' section of their website. That is what has happened in the past (and precisely why I thought "wouldn't it be great to avoid this by asking people to change their claims before getting the ASA involved?").

2. ASA investigations and adjudications
The ASA might undertake a more formal investigation which can result in an adjudication. These are listed on individual pages on the ASA's website, tweeted by the ASA and usually a few others and occasionally picked up by mainstream media, more frequently by science / skeptic bloggers. The adjudication may be upheld (against you) or not upheld (that is, it's actually in your favour) but either way it's on their website.

3. ASA's list of non-compliant advertisers
If an adjudication is upheld and you still do not amend your website then the ASA may add you to its list of noncompliant online advertisers. These events are tweeted by the ASA and by a number of other people. To be honest it doesn't look good to people who are searching online for information about your company, though some people seem to treat these citations as a sort of 'badge of honour', and as proof that the ASA is oppressing them in some way.

There's also quite a high chance that bloggers will write about the listing and a low to medium chance that it will be picked up by the mainstream press. The ASA also do proactive press work, speaking on radio as well as being invited to comment in written pieces too.

The ASA can take further action against you though. They can take out an advert that is critical of your marketing claims, they can also work with search engines to remove your paid-for advertising. Their adjudications seem to feature prominently in search results too.

Although the ASA has no legal sanction over you itself (that I'm aware of) their activities and the follow-on results of those (including blogging), might damage your reputation online.

4. Trading Standards, courts, fines, trading restrictions
The most annoying thing that the ASA can do though is refer you to Trading Standards. Because there are trading laws and acts in place Trading Standards can use the power of a court to stop you trading, or fine you for continuing to make misleading claims (ie trading unfairly). If you are making claims about curing cancer then you are probably also in breach of the Cancer Act of 1939. It is likely that you will get a fine and nothing more, though if you continue I think the next fine will be larger and I believe that after that (certainly in the case of the Cancer Act) you may be looking at a prison sentence. These are definitely picked up by the mainstream press, bloggers etc.

The ASA recently announced that they'd strengthened the processes involved in working with Trading Standards: Trading Standards becomes ASA’s legal backstop power (21 November 2013).

See also

• Asking for evidence when companies make misleading claims - but whom should we ask? #askforevidence  (22 September 2013)
  This post is basically me deciding not to ask people first, because it's never gone down well in the past! However on reflection while there are certainly cases that I'll just report directly I still want to try out a bit of negotiation first.
  
  Here's a bit of what I wrote there -
  
  "A question for fellow skeptic bloggers / activists... and perhaps for 'quacks'
  I've always thought that it would seem to be a kindness to give a company an opportunity to avoid a citation on the ASA's website by seeing if it's possible to resolve the misleading claims before snitching on them.
  
  However I'm yet to find the right way to do this - and wondered if anyone had any ideas or if we've all agreed to just get on and report it. I wonder if people who are (let's charitably assume they're doing it unwittingly) making misleading claims would rather skeptics 'had a quiet word' before bringing things to the ASA's attention.
  
  I've tried face to face, telephone conversations and emails but unfortunately there doesn't seem to be a way of communicating to someone that their advert is misleading without getting their hackles up. Or if there is I've not managed it (and I'm always Britishly polite about it even if they aren't).
  
  Worse, I feel that I do have to tell them that if they don't change the advert I'm going to report it to the ASA and that just sounds threatening. So, much as I'd like to, I'm afraid I don't bother with the preliminaries and just report the misleading claims."

Disclaimer
It's a bit tedious when people assume that anyone who reports misleading health claims is a secret member of some group of people paid by 'Big Pharma', rather than someone who is simply a bit annoyed to see potentially dangerous claims made on the back of poor quality evidence. However I am happy to state that I do not receive any money or other benefits from the pharmaceutical industry either directly or indirectly, nor do I have any stocks and shares in any of the pharmaceutical industries.

I am not a member of the Nightingale Collaboration (no-one is, they do not have members, though I do read their newsletter and am supportive of their aims and sometimes their campaigns). I am not a member of Sense About Science (don't think they have members either) but I have donated money to them and will happily do so again - not large amounts of money either.

My interest in taking action on misleading claims arose from reading Ben Goldacre's Bad Science Guardian column, his blog and the forum he created and coincided with hearing about crazy adverts for diabetes cures when I used to work at the health charity Diabetes UK. As part of my (then) job I received a number of enquiries from people who'd come across miracle cures and wanted to know more about them. I wanted to know how it was possible that such claims could be made, discovered that they couldn't and began reporting them.

You might also argue that there are more important things to worry about, however I might well be worried about them too, or I might not - it's not actually relevant. I do worry that the pharmaceutical industry has not been transparent about the effects of drugs and I have signed the #AllTrials petition to make it harder for them to keep hidden what they want to keep hidden. It would be great if you did the same. The petition comes from Sense About Science, Ben Goldacre and others that you might not approve of - however the aim of the petition is to make Big Pharma publish ALL of its clinical trial data and not just the bits they like. I think we'd all agree that that's a good idea even if you don't like who's calling for it to happen. Hope so.