Saturday, April 7, 2012

Quack Diagnostic Criteria (QDC)

This document represent an unfinished attempt to collect criteria for the diagnose of quacks. I had most of it done a couple of weeks ago, but I don't have the energy to properly finish it. So here it is, unfinished work in progress, to be refined over time:

The Quack Diagnostic Criteria (QDC)

As a simple definition, a quack is someone:
  • who practices medicine (tries to treat diseases/illnesses/ailments/etc.)
  • and postulates disease theories and treatment mechanisms which are not rooted in reality
  • and does provide no actual evidence for his disease concepts
To differentiate, someone postulating a hypothesis to be tested – while making clear that it is only a unproven hypothesis – is not a quack.

As well, someone treating people while aware of the insufficiency of the available information, and communicating this fact clearly, is not a quack either.

And, for our definition, a quack shall not be someone who provides knowingly faulty evidence for disease theories and treatment mechanisms, because, in contrast to a quack, someone providing knowingly faulty evidence is a fraud. However not all frauds know that they lie: some frauds delude themselves and think – just like quacks – that they are right. The distinction between a fraud and a quack is a difficult one, as we can't look into someones head.

And someone providing unknowingly faulty evidence (e.g. gathered by other people) is a fool (at best), but might be a quack as well.

Please note: Not every unscientific doctor is a quack! A quite distinct subgroup of unscientific doctors can be well characterized as "psychiatrist" or "psychologists". Same as in the quack discipline of Ostheopathy there are tendencies for reformation and adherence to scientific principles (cf. Evolutionary Psychology), but until today these are far from sufficent.

The typical quack is a loner. He or she is in most cases only loosely associated with a few select other quacks, unlike the organized quackeries of psychiatry, chiropractic "medicine" and (the unreformed) Ostheopathy. Yet conversely, most of the people a quack associates with are quacks as well.

One problem in diagnosing quacks is that they tend to "borrow" terms form proper medicine for their purposes. They may seemingly talk about "allergies" or "toxins", yet when quacks use terms like these they remain vague with their assertions. So one doctor says "allergy" and means an concrete pathological process, which can be tested for with proper tests – and another doctor says "allergy" and means this and that, and uses tests that are not worth the postage paid for them (if doctor does test at all).

Another problem is that an – otherwise reasonable – doctor may fall victim to the trends of our time and include one or two methods that should be avoided. The difference between a reasonable doctor and an quack usually is the amount of BS, woo and quackery included. An otherwise reasonable doctor may for example resort to acupuncture, because he does not know better. If a doctor however prominently advertises woo – e.g. the holy trinity of quackery: homoeopathy, acupuncture and holistic naturopathy – he usually is an quack.

And as a corollary, the quality of the total argument by the doctor should help to differentiate quacks from proper medical doctors.

Following are four areas, where one can rate someone if he/she is a quack.

What a Quack says about his/her field:
Add a point for each one applicable, add additional points for each asterisk (*).

Dislikes "Western" Medicine
Tries to "integrate" BS into Medicine *
Never talks about Evidence Based Medicine
Or, tries to give medicine based on actual evidence a bad name (What's the alternative? "Believe Based Medicine"?)
Adherent of "Traditional" Medicine (Chinese, Indian, Whatever) **
Adherent of Ayurveda **
Adherent of "Alternative" Medicine **
Adherent of "Complementary" Medicine **
Adherent of "Integrative" Medicine **
Adherent of "Naturopathic" Medicine **
Adherent of "Functional" Medicine **
Adherent of "Holistic" Medicine (whatever that is) *
Adherent of "Environmental" Medicine
Adherent of "Nutritional" Medicine *
Adherent of Herbalism **
Adherent of "Neuro-Immune" Medicine *
Adherent of mind-body dualism **
Adherent of Chiropractic "Medicine" **
Adherent of Osteopathic "Medicine" **
Adherent of Aromatherapy *
Talks about "Allopathic Medicine" **
Seeks the company of other quacks **
Sees drug companies as the root of all evil
Others are doing it for the money! (while ignoring his/her own financial interests)
Sees "The Establishment" as the root of all evil

The method a quack uses:
These are the methods used (or not used) by the individual to be tested for quack tendencies.

Displays displeasure towards the scientific method *
Never talks about "regression toward the mean"
Does studies that are not reproducible *
Likes non-blinded studies **
Likes studies without proper control groups
Likes studies with very small sample sizes
Likes case studies *
Loves anecdotes *
Loves tests without diagnostic value **
Loves speculation without evidence **
Ignores studies that contradict his speculations *
Likes weasel-words *

What a quack says about disease causes or mechanisms:

Speculates about disease mechanisms without evidence *
Speculates about undetectable persistent pathogens *
It is unmeasurable "chronic low grade" or "persistent" infections! **
It's an allergy!
It's the mitochondria!
It's vaccines! **
It's Lyme! **
It's XMRV! **
It's HIV-negative AIDS! **
It's mold! **
It's candida/yeast! **
It's heavy metals! **
It's mercury! ***
It's "toxins"! (Generally unspecified "toxins") *
It's pesticides!
It's radiation/electrosmog/microwaves! *
It's electromagnetic field (EMF) hypersensitivity (EHS)! *
It's inflammation!
It's free radicals!
It's oxidative stress!
It's the amygdala! **
It's the hypothalamus! **
It's the neuro-transmitters! *
It's the endocrine system / hormones!
It's the adrenals! *
It's the thyroid! *
It's thyroid hormone resistance! **
It's metabolism blockage! *
It's Th1/Th2 immune imbalance! **
It's the acid/base balance! It's too much / too little acid! It's too much / too little bases! **
It's energy blockage! **
It's (bio-)energy! **
It's vibrations! **
It's malabsorption!
It's the gut!
It's an leaky gut!
It's the subconscious! *
It's qi! **
It's "balance" (or lack thereof)! **
It's "harmony" (or lack thereof)! **
It's "dysfunction"! **
It's some other newfound fancy mumbo-jumbo! (e.g. Gene Instability)

What a quack prescribes:

Again, add a point for each. Add another point for each asterisk (*).

Recommends vitamin supplements
Recommends mineral supplements
Recommends magnesium supplements
Recommends trace element supplements
Recommends enzyme supplements
Recommends protein supplements
Recommends probiotic supplements
Recommends micronutrient supplements
Recommends anti-oxidant supplements
Recommends daily intake of OTC drugs like aspirin or NAC
Recommends "natural" remedies *
Recommends herbs and plant extracts *
Recommends homeopathy **
Recommends acupuncture **
Recommends reflexology **
Recommends fire cupping **
Recommends reiki ***
Recommends biofeedback/neurofeedback ***
Recommends neuro-linguistic programming (NLP) ***
Recommends hypnotherapy
Recommends "emotional healing" **
Recommends oxygen (e.g. hyperbaric oxygen therapy HBOT)
Recommends "desensitisation"
Recommends long-term anti-biotics **
Recommends GcMAF
Recommends "detoxification" **
Recommends "chelation" **
Recommends something with a "Detox Reaction" ***
Recommends something with "Die-off or Herx/Herxheimer reactions" ***
Recommends expensive tests not covered by insurance, available only at special labs *
Has an proprietary treatment "protocol" **
Has an "one size fits all" treatment protocol **
The treatment "protocol" is an erratic collection of woo**
Has an extensive treatment protocol were he/she throws everything but the kitchen sink at a patient
Call his protocol "individualized" medicine despite his/her "one size fits all" approach **
Claims to have a better cancer treatment than evidence based medicine **
Claims to cure cancer **
Claims to cure autism **
Talks about "healing" outside the context of flesh wounds
Talks about "mobilizing the body's healing capacity" or some such
Sells any of the above **
Can't be bothered to recommend something that has been tested, because testing if something actually helps (or harms) people would be "too expensive"

Closing remarks

The higher the score, the more likely you are dealing with a quack – again, some of these talking points might be used by real medical doctors. The score-values for each area will have to be determined empirically. If someone's talking points are more than 80% from this QDC, you can be certain to have a quack.

And unfortunately, if someone is not a quack, that does not make him/her necessarily an good medical doctor…

1 comment:

  1. Spam removed for thebestraspberryketone.com raspberry ketone for men.

    (What quack bullshit is this?)

    ReplyDelete

Comments are most welcome! But please:

- No SPAM whatsoever, no supplements, no pharmaceuticals, no herbs or any other advertisements

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- Be critical if you want to, but try to be coherent

Comments are moderated, because I am tired of Gerwyn-V99-The-Idiot and his moronic sockpuppets, and tired of the story of the two dogs, but I will try to publish everything else.

If you are not Gerwyn (and want to tell me something other than the story of the two dogs), then relax and write something! :-)

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