Straight Dope on Quackwatch

Just checking with the expert minds here: are Dr. Stephen Barrett and quackwatch.com legit?

The only people I’ve seen who are critical of it have been practitioners of alternative medicine.

Okay, just looking for cites and stuff. Just about the only info I could find about him was from the angry alt people.

Any neutral web bios on him?

His Wiki article has an impressive number of references that might be of help.

Why would that devalue the criticisms?
This issue is likely more of a debate than a question, so my opinion is thus:

Barrett (from what I know of him) is more of a pseudoskeptic than a skeptic. A skeptic examines the evidence wherever it takes him/her. A pseudoskeptic examines an issue with a preconcieved conclusion (all XYZ is good or all XYZ is bad) and then finds evidence to support that conclusion. Everyone does both at various times (uses evidence to find conclusions vs using conclusions to find evidence).

However as an example on this page:

http://www.quackwatch.com/01QuackeryRelatedTopics/ortho.html

He claims there is no evidence nutritional medicine works for psychiatric disorders. However that isn’t the case, many studies have been done.

Minerals for depression.

Alternative therapies for schizophrenia.

http://www.schizophrenia.com/treatments.php

So again this isn’t a general question, but my view is that Barrett is not a true skeptic. True skeptics just follow the evidence to whatever conclusion it takes them to. Pseudoskeptics start with the conclusion and then find evidence to support it.

That isn’t to say everything he says is suspect or untrue. However you are only getting info that supports a pre-concieved notion with people like Barrett and I’d take his info about as seriously as I would studies funded by companies trying to sell you a product. You pretty much know what his conclusions are going to be before he even begins writing because his goal doesn’t seem to be science for sciences sake, but science to support a pre-concieved conclusion (non-mainstream medicine is bad).

At least from what I can tell of him.

I’m just pointing out that they’re not disinterested. (Certainly, it’s possible that Barrett isn’t either, but I don’t think anyone’s ever shown that he’s taking money from Big Pharma or any such).

I think you’re overstating what he wrote. He’s not addressing nutritional therapy in general, he’s writing about megavitamin use (over and above the body’s needs). He notes that there are a few limited uses where it is proven effective, but mostly it has not been shown to be effective. He mentions that it has been specifically studied as to schizophrenia and found ineffective, which your schizophrenia link concurs with. Based on this background, he’s concluding that practitioners who prescribe megavitamins “to all or most of the patients who consult them” are quacks.

I don’t disagree with your other links at all, but they look like they’re addressing instances of vitamin deficiency, rather than megavitamin use. IANAD, though, so I may indeed be misunderstanding something.

Wesley Clark has it right. Barrett may have started out with the idea of debunking “alternative” medicine by pointing out that these treatments hadn’t been subject to strict clinical trials, but somewhere along the line he decided that anything alternative was automatically bad and phony.

A good example is his treatment of Glucosamine in threatment of joint pain and arthritis. Glucosamine Sulfate is a commonly prescribed treatment for joint pain in humans and animals. I have had it recommended to me by a couple of regular general practitioners, both M.D.'s, and neither proponents of alternative therapies. Glucosamine Hydrochloride and Chondroitin Sulfate are cheaper materials and are often included or entirely replace the GS in formulations.

If you look at the Dr. Barrett’s page on Glucosamine, you’ll see that he references the word “Glucosamine” readily, but whenever he gets specific, he is really talking about GHcl. He references the “largest and best-designed clinical trial”

Note that Glucosamine Sulfate was not used. He deliberately avoids discussion of GS when all of the positive trials used GS instead of GHCl.

Here is a link to an abstract of a randomized, double-blind, placebo controlled trial of Glucosamine Sulfate showing positive results.

Bottom line, much of what he posts is true, but it isn’t all that difficult to debunk homeopathy and magnet therapy. When it comes to things like accupuncture and Glucosamine Sulfate, he obfuscates and throws around a lot of misinformation. Here is an example from his page on accupuncture:

WTF?

Asiatic Black Bears are being hunted at unsustainable levels due to the market for their gall-bladders and paws by practitioners of tradtional Chinese Medicine.

Seems to be a problem for a lot of species, actually. Not sure what your objection to Barret mentioning it is.

Because the link on his homepage is simply labelled “Accupuncture.” His article is mostly a criticism of other aspects of Traditional Chinese Medicine. It is classic bait and switch, and a perfect example of the kinds of things he does.

That’s actually why I like quack-watch. It does something more then just go after the obvious and easy targets.

The name of the article is "Be Wary of Acupuncture, Qigong, and “Chinese Medicine”. The links to “Acupuncture”, “Chinese Medicine” and “Quigon” all go there. I hardly see how that’s a bait-and-switch. Just because he didn’t write a separate article for each topic?

Barrett
[quotes]
(http://www.quackwatch.org/01QuackeryRelatedTopics/DSH/glucosamine.html) that study’s researchers, who said, “If patients choose to take dietary supplements to control their symptoms, they should be advised to take glucosamine sulfate rather than glucosamine hydrochloride and, for those with severe pain, that taking chondroitin sulfate with glucosamine sulfate may have an additive effect.” (emphasis added)

Also, one of Barrett’s conclusions states “If you decide to try glucosamine anyway, have a knowledgeable physician guide how you do it.”

Oh, come on. That is an overwhelmingly negative article about a very commonly prescribed therapy with a very high rate of sucess, if you take the right formulation. If you had osteoarthritis and he were your doctor, you would miss out on a safer and more effective therapy and instead be taking NSAID’s that can cause liver damage. All because some chiropractors recommend their patients take it.

I’m just saying that he does acknowledge a possible difference between GS and GHCl. And while he’s negative about it, he ends by saying that the evidence about glucosamine is “conflicting” (i.e., not automatically bad) and recommends that you talk to your doctor about it. Glucosamine is an odd duck; the Europeans have approved it as a drug and the FDA hasn’t. “Conflicting” may not be a bad term for that situation.

You know what they call alternative therapies that are proven to work? Therapies.

My dad (who takes an interest in things related to health and weight-loss for professional reasons) submitted an article to Quackwatch, and was impressed with Barrett’s accessability. Its my understanding that Barrett tends to make a lot of enemies (among, naturally, those who promulgate “alternative medicine”), so this makes it hard to find unbiased information about him and his stuff.

My impression: his stuff is legit, but he needs (badly) someone to organize his site(s). It’s terribly all-over-the-place.

Also, heh, the fact that this thread has quickly branched off into nitpicking debates on specific therapies pretty much sums up the response to Barrett’s stuff: since he tends to paint with a broad brush, I have little doubt that he’s wrong on various things. His overall skepticism, however, is definitely warranted.

Cite?

But acupuncture is bullshit. Until recently, every part of China had a different set of “traditional” acupuncture points. Tests of acupuncture don’t correlate with the proscribed points. Acupuncture is based on Qi which has not been demonstrated to exist, and traditional Chinese doctors diagnose using the pulse which has no medical basis.

Just because it’s your favorite BS doesn’t mean it’s not BS.

You overstate the evidence for this therapy. A Cochrane Collaboration review in 2000 of multiple studies found that glucosamine had some benefits in osteoarthritis over placebo; however a review article in an American Association of Family Practice publication noted the following:

“The (Cochrane) update, which included only the higher quality studies and eight new studies (2,570 patients), showed less consistent and somewhat less favorable results regarding improvement in pain and function with use of glucosamine sulfate for two to three months.”

Also, it seems that only one of the many glucosamine/chondroitin preparations on the market has any proven efficacy in treating arthritis.

Anyone can cherry-pick a study here and there to show an alleged benefit for a treatment. What alt med advocates do (when they’re not slamming all clinical research as being a tool of Big Pharma) is to tout some small/poorly controlled study in an alt med journal as proving that their treatment works - but large well-conducted trials fail to bear this out the vast majority of the time. Barrett and Quackwatch do a good job summarizing the best quality evidence.

Barrett has been subjected to an immense amount of personal attack from people whose feel their beliefs (and in the case of quacks, livelihoods) are threatened by his articles and attempts to promote quality evidence-based medicine (one of the favorite gambits is to intimate that his medical license was taken away, when it’s actually on inactive status as is common with retired physicians). His overall view on alternative medicine is a bit more jaundiced than mine, but then he’s seen a lot more quackery come down the pike. He has my respect.

i think that acupuncture has been used as an anesthetic for both humans and animals.

things can be found to be real and be beyond the explanation of a culture. it is still real and the people might be skilled at using it yet their explanation might be lacking. in ancient Greece magnetism was thought to be caused by little screws in the materials.