The random thoughts of a sceptical activist.

Advertising Standards Authority (ASA)

Bronfort on: Ear Infections

Time to take a closer look at some of the conclusions of the Bronfort report.

Otitis Media is, to the average parent, an ear infection — of the middle ear, to be precise. This can affect children and can be very painful and disturbing to both infant and parents. About one in five chiropractors I complained about made claims about ear or similar infections. It was also one of the childhood ailments that Simon Singh mentioned in the Guardian article the BCA had a hissy fit about.

Because of my complaints and because there appeared to be no definitive list (other than the ASA’s list of acceptable claims, of course) of what conditions were backed by robust evidence, the GCC commissioned five US chiropractic researchers to review the good evidence for all the conditions I complained about. I’ve already said something about the kinds of evidence Bronfort et al. decided should be included in the report: they were interested in only relying on quality evidence.

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All change!

The GCC’s Bronfort report is starting to have an effect. And not before time.

The British Chiropractic Association removed their Happy Families leaflet from their website last year, but it is still on the websites of some chiropractors (for example Weston Chiropractic Clinic here (cached).

Over the intervening months, various chiropractors have removed loads of claims from their websites, with one of them even asking Skeptic Barista if he could check they had made the appropriate changes!

As part of the ongoing complaint process, I have received observations on my complaints from 290 chiropractors (so far) and some have included ‘before and after’ screenshots of their websites, showing what they have removed or changed. (Don’t worry, I intend to write about what’s been happening and what the current position of my complaints is very soon.)

Now, presumably as a result of the Bronfort report, the BCA have removed various statements from their website over the last few days.

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Curbing the quacks & protecting the public

In November last year, there was speculation that the ASA’s remit might be extended to cover claims on advertisers’ own websites, rather than just third-party online adverts (the so-called digital remit).

In launching their new Code of Advertising Practice today (which comes into force on 1 September 2010), the ASA/CAP have given more details:

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Talking the talk

The first few pages of Bronfort et al. certainly talk the right talk:

EBH [Evidence-Based Healthcare] is about doing the right things for the right people at the right time. It does so by promoting the examination of best available clinical research evidence as the preferred process of decision making where higher quality evidence is available. This reduces the emphasis on unsystematic clinical experience and pathophysiological rationale alone while increasing the likelihood of improving clinical outcomes. The fact that randomized clinical trial (RCT) derived evidence of potentially effective interventions in population studies may not be translated in a straight forward manner to the management of individual cases is widely recognized. However, RCTs comprise the body of information best able to meet existing standards for claims of benefit from care delivery. The evidence provided by RCTs constitutes the first line of recommended action for patients and contributes, along with informed patient preference, in guiding care. (page 4)

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Spot the difference

The first photo was taken in East Kilbride shopping centre on 16 August 2009. The second was taken this morning.

Spot the difference:

Answer: Today’s advert has the claims for “Children with colic & ear infections” covered up.

The removal of these claims may have been due to the GCC’s recently released Bronfort report, or perhaps they’ve now read the ASA guidance they’re supposed to follow. Who knows.

The claims left are for: “headaches and migraines, neck, back and shoulder pains, sciatica or disc injuries, sports or accident injuries, pins and needles in arms and legs”.

A step in the right direction, but a long way to go yet.

What’s Polish for ‘chiropractor’?

Czego mogę się spodziewać podczas wizyty u kręgarza?

If your Polish isn’t up to scratch, this roughly translates as: What can I expect when visiting a chiropractor?

Ah! I hear you say. Is it just a coincidence that this is suspiciously close to What can I expect when I see a chiropractor?

No, of course it isn’t. That was the title of the GCC’s leaflet that Simon Perry (Adventures in Nonsense, Leicester Skeptics in the Pub and skeptical columnist for the Leicester Mercury) complained to the Advertising Standards Authority about last year. Continue reading

Discover Chiropractic

No. I’ve not been converted and I’m not urging you all to realise that the future of humanity and an end to all pain, suffering and diseases known to man lies in the chiropractic way.

It’s the name of a chiropractic clinic in Edinburgh. They wanted to spread the word about the benefits of chiropractic and decided to advertise.

Oops! You’d have thought… No. I won’t say it again.

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The trouble with babies

When it comes to supplying the Advertising Standards Authority with evidence that backs up claims you’ve made in an advert, it’s a good idea to make sure it does actually back up the claims you’ve made. Common sense, really. Saves a lot of hassle. And an adverse adjudication. And adverse publicity.

It’s a fallacy of personal incredulity I know, but I’d have thought that Philips Electronics UK Ltd — part of giant Royal Philips Electronics of The Netherlands — would have been circumspect when it came to ensuring they have the appropriate evidence for claims they were making.

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Washing dirty linen in public

The General Chiropractic Council publishes annual Fitness to Practice reports, which contain summaries of all complaints dealt with over the year and useful advice and guidance for chiropractors on topics like:

1. Professional boundaries
2. Abuse of trust or exploitation of lack of knowledge
3. Communication with patients and obtaining consent
4. Record keeping
5. Management and care: initial examination and review of treatment
6. Use of X-rays
7. Local complaints procedure
8. Treatment prescribed by another health professional
9. Protecting patients and colleagues from risk of harm
10. Honesty, integrity and trustworthiness
11. Politeness and consideration towards patients
12. Respecting confidentiality

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Shedding more light on acceptable evidence

Pharmacies are in the news again this week. Not Boots this time, but that other well-known high street chemist, Lloyds Pharmacy.

An ASA adjudication, published today, upheld a complaint against a TV advert about their ‘light therapy device‘.  The advert claimed:

Hay fever seasons [sic] here again.  But heres [sic] something you might not have tried before, the Lloyds Pharmacy hay fever reliever.  Its [sic] been shown to help reduce symptoms like your runny nose and itchy eyes … Just pop it up your nose for a couple of minutes two or three times a day and start making the most of your summer.

Although I wouldn’t be entirely keen on sticking anything up my nose, I don’t suffer from hay fever. However, I do know it can be a miserable condition and anything that might help would be worth a try. But you’d want something for which there was good evidence for efficacy before you splashed out your hard-earned cash, wouldn’t you? And you’d want the seller to be able to provide that good evidence when asked?

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Je suis Charlie

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