Deafness Research UK invites you to take part in the JLA Tinnitus SurveySETTING THE PRIORITIES FOR TINNITUS RESEARCHDespite ongoing research activity in the UK and other countries, there are still so many questions about tinnitus assessment, diagnosis and treatment that remain unanswered. These unanswered questions will form the basis of future research and so it is important that we understand which of those questions to prioritise.This survey is about identifying those priorities for future tinnitus research. The project is being overseen by the James Lind Alliance and led by the British Tinnitus Association and the National Biomedical Research Unit in Hearing (NBRUH). For more information please visit their website: http://www.tinnitus.org.uk/JLA or contact the BTA (details at the end of this message) HOW CAN I GET INVOLVED?You can enter the survey online via Tinnitus SurveyOR you can download the survey at Survey Document We are inviting you to take part in the survey by contributing what you think are the unanswered questions about tinnitus assessment, diagnosis and treatment. You should:
Post: National Biomedical Research Unit in Hearing Ropewalk House 113 The Ropewalk Nottingham NG1 5DU ORJLA tinnitus survey British Tinnitus Association FREEPOST NEA 13451 Sheffield S8 0WF Email:Nottingham AC UK ContactsIf you have any questions about the project please contact The British Tinnitus Association: info@tinnitus.org.uk, Telephone: 0114 250 9933 |
Sunday, 8 January 2012
Treatment Uncertainties in Tinnitus - James Lind Alliance Study
Monday, 22 November 2010
Tinnitus Retraining Therapy and Current Practice
Before the advent of Pavel Jastreboff's Neurophysiological model of Tinnitus it could be said that the treatment of Tinnitus was in quite a poor state. Patients routinely received negative counselling from GP's and ENT Surgeons, e.g. 'There's nothing we can do, you just have to learn to live with it'. Not infrequently any interventions that were tried proved to be unhelpful or even harmful. For example maskers were used in residual inhibitition in an attempt to blast the cochlear (inner ear) with sufficient sound energy to fatigue the system, with the hope that the patient would experience temporary relief, usually in an attempt to get to sleep. Even more dramatic surgeons sometimes agreed to sever the eighth nerve (nerve of hearing) in the mistaken belief that this would stop aberrant firing of damaged hair cells in the cochlear from reaching the brain. What this actually achieved in most cases was highly intractable Tinnitus no longer susceptible to sound enrichment.
Following the publication of Jastreboff's Neurophysiological model and the development of Tinnitus Retraining Therapy by Johnathan Hazel and Jaqui Sheldrake there was a marked shift in attitudes and focus within the Audiological world. Previously Tinnitus patients had been characterised in a lot of departments very negatively and largely dismissed as hopeless causes (sadly this is still the case amongst some reactionary and retrograde Audiologists). Now it appeared that there was something which could be done for these patients and the proponents of TRT were very confident of success. Perhaps it could be argued that there was a tendency to overconfidence which manifested itself in an initial reluctance to heed ‘calls for robust evidence of efficacy’ (Andersson G. et al 2005) and an ongoing insistence that only those trained by its originators are qualified to undertake true TRT. The publication of Hazell and Jastreboff’s TRT – Implementing the Neurophysiological Model and Henry and Jastreboff’s TRT Clinical Guidelines/Patient Counselling Guide in 2004/2007 may represent a softening of this stance.
Currently what takes place in most hospitals is a blending of TRT, the Neurophysiological model, traditional Audiology and sleep/relaxation training. This has been called the Audiological model, however defining what here is actually effective and what is filler can be hard to tell. It appears that a patient centered approach which adjusts the intervention to the patient is considered to be most effective but is this 'holism' the best use of time and resources for both patients and the NHS?
(J Eval Clin Pract. 2010 Nov 19. doi: 10.1111/j.1365-2753.2010.01566.x. [Epub ahead of print]
Management of tinnitus in English NHS audiology departments: an evaluation of current practice.
Hoare DJ, Gander PE, Collins L, Smith S, Hall DA.)
An attempt has been made to simplify the treatment pathway and protocol, but as this relies on naive patients successfully interpreting a poster guiding them to the correct intervention some concerns have been raised about the approach.
Simplified form of tinnitus retraining therapy in adults: a retrospective study.
Aazh H, Moore BC, Glasberg BR.
BMC Ear Nose Throat Disord. 2008 Nov 3;8:7.
As I recently said at a talk to the RNID in Northern Ireland any service offering positive and accurate advice is better than no service at all. It has been suggested many times that the greatest benefit inherent in TRT was the 'counselling', or educative component rather than the attempt to subconsciously de-condition a response which has been criticized as a mis-reading of conditioning theory.
http://www2.cochrane.org/reviews/en/ab007330.html
There is a good deal of work remaining to be done on the Audiological model. One of the greatest challenges will be attempting to bring some order to the range of approaches on offer so that it becomes more amenable to research and meta-analysis. What I would offer up is that practitioners of alternative treatments are content that they have an answer to the problem that is correct without testing. Science based practitioners on the other hand take more take more care to test, develop and refine their treatments to ensure they are achieving the best outcomes possible based on the latest evidence.
Sadly this can make the scientific approach appear less certain and unwilling to guarantee specific outcomes – the CAM person knows, the clinician advocates the most compelling lines of evidence. At my recent RNID talk I was dismayed to see patient information leaflets produced by them advocating and signposting access to CAM treatments instead of evidence based ones. There remains a job of work to be done to educate the public that the distinction is vital.
Following the publication of Jastreboff's Neurophysiological model and the development of Tinnitus Retraining Therapy by Johnathan Hazel and Jaqui Sheldrake there was a marked shift in attitudes and focus within the Audiological world. Previously Tinnitus patients had been characterised in a lot of departments very negatively and largely dismissed as hopeless causes (sadly this is still the case amongst some reactionary and retrograde Audiologists). Now it appeared that there was something which could be done for these patients and the proponents of TRT were very confident of success. Perhaps it could be argued that there was a tendency to overconfidence which manifested itself in an initial reluctance to heed ‘calls for robust evidence of efficacy’ (Andersson G. et al 2005) and an ongoing insistence that only those trained by its originators are qualified to undertake true TRT. The publication of Hazell and Jastreboff’s TRT – Implementing the Neurophysiological Model and Henry and Jastreboff’s TRT Clinical Guidelines/Patient Counselling Guide in 2004/2007 may represent a softening of this stance.
Currently what takes place in most hospitals is a blending of TRT, the Neurophysiological model, traditional Audiology and sleep/relaxation training. This has been called the Audiological model, however defining what here is actually effective and what is filler can be hard to tell. It appears that a patient centered approach which adjusts the intervention to the patient is considered to be most effective but is this 'holism' the best use of time and resources for both patients and the NHS?
(J Eval Clin Pract. 2010 Nov 19. doi: 10.1111/j.1365-2753.2010.01566.x. [Epub ahead of print]
Management of tinnitus in English NHS audiology departments: an evaluation of current practice.
Hoare DJ, Gander PE, Collins L, Smith S, Hall DA.)
An attempt has been made to simplify the treatment pathway and protocol, but as this relies on naive patients successfully interpreting a poster guiding them to the correct intervention some concerns have been raised about the approach.
Simplified form of tinnitus retraining therapy in adults: a retrospective study.
Aazh H, Moore BC, Glasberg BR.
BMC Ear Nose Throat Disord. 2008 Nov 3;8:7.
As I recently said at a talk to the RNID in Northern Ireland any service offering positive and accurate advice is better than no service at all. It has been suggested many times that the greatest benefit inherent in TRT was the 'counselling', or educative component rather than the attempt to subconsciously de-condition a response which has been criticized as a mis-reading of conditioning theory.
http://www2.cochrane.org/reviews/en/ab007330.html
There is a good deal of work remaining to be done on the Audiological model. One of the greatest challenges will be attempting to bring some order to the range of approaches on offer so that it becomes more amenable to research and meta-analysis. What I would offer up is that practitioners of alternative treatments are content that they have an answer to the problem that is correct without testing. Science based practitioners on the other hand take more take more care to test, develop and refine their treatments to ensure they are achieving the best outcomes possible based on the latest evidence.
Sadly this can make the scientific approach appear less certain and unwilling to guarantee specific outcomes – the CAM person knows, the clinician advocates the most compelling lines of evidence. At my recent RNID talk I was dismayed to see patient information leaflets produced by them advocating and signposting access to CAM treatments instead of evidence based ones. There remains a job of work to be done to educate the public that the distinction is vital.
Bad Tinnitus Forum
You may or may not have noticed that the forum is gone. This is mainly because I have no time to administer it, but also because it was mostly populated by spam, despite frequent weeding.
I'm pleased to say that I've heard the British Tinnitus Association will shortly be launching a forum of its own with expert moderation. I've been moaning to the RNID for a while now that there discussion board is quite an unhealthy place for new people with Tinnitus, but they have seemed unwilling to address it. Hopefully this will become a joint venture and the RNID can let their current message board go.
Apologies then to anyone who was actually using the forum but I think it time to let the big boys try to get it right.
Tim
I'm pleased to say that I've heard the British Tinnitus Association will shortly be launching a forum of its own with expert moderation. I've been moaning to the RNID for a while now that there discussion board is quite an unhealthy place for new people with Tinnitus, but they have seemed unwilling to address it. Hopefully this will become a joint venture and the RNID can let their current message board go.
Apologies then to anyone who was actually using the forum but I think it time to let the big boys try to get it right.
Tim
Monday, 13 September 2010
Ear Woo in the NHS
It has been quite a while since I managed to find time to blog sadly. Too many irons in too many fires. But this particular event is worth a bit of a chuckle.
As an NHS Audiologist specialising in Tinnitus and a Skeptic I don't take too kindly to nonsensical exploitative treatments wherever I find them (low level laser therapy, I'm looking at you...). But I have never had to deal with them in my own workplace, until now that is.
While sitting down to a quick sarny and some admin one of my colleagues rushed in to my office waving a leaflet. She had found this, along with dozens of its fellows, scattered around the staff canteen. This was advertising a very long list of woo, all being delivered by the same individual through the offices of our Occupational Health Department. One of the treatments on offer was Ear Candling, which I have looked at before on here 'Hopi' Ear Candles, but in brief - pointless and dangerous.
I called up the OH department and they confirmed that this was indeed advertised through their office.
This brought up a number of questions in my mind.
1) How DO these individuals manage to gain specialities in multiple treatment modalities?
2) What evidence base is being employed to permit this treatment on NHS staff?
3) Who was getting a kick back from this?
Number one is easily addressed by looking on the internet. Given sufficient spare time and cash it would be quite simple to become an expert in:
Homeopathy
Reiki
Reflexology
Candleology
Aromatherapy
Stone Massage
Aura Manipulation
etc etc.
Indeed if you tried hard enough you could paper a reasonable sized office in official looking certificates of complementary treatment modalities.
For number 2 there was no evidence base suggesting efficacy or safety of treatment, they were completely unaware of any potential harm.
Having identified who I was and my speciality (Chief Audiologist and Hearing Therapist) I explained in detail why it was that I was deeply unhappy with such a moronic and dangerous practice being offered in my Trust. I also provided (via email) all the research literature I have examining the claims & harm of ear candling (Ernst, Seeley, etc). The person I was speaking to clearly came from a woo sympathiser perspective but was suitably swayed by my talk of 'employing evidence based medicine' and my willingness to take it further if necessary. As it happened the practitioner was in the hospital that day and agreed to withdraw ear candling from her list of offered therapies
I failed to receive a satisfactory answer to number three and will continue to pursue this. I would hope that the trust is at least receiving some benefit from this therapists direct access to staff and accommodation.
What do you think, is it ok for a health service that demands evidence based practice from all it's Doctors, Nurses and Allied Health Professionals to simultaneously advertise treatments that have a implausible mechanism of action and strong evidence of active harm?
As an NHS Audiologist specialising in Tinnitus and a Skeptic I don't take too kindly to nonsensical exploitative treatments wherever I find them (low level laser therapy, I'm looking at you...). But I have never had to deal with them in my own workplace, until now that is.
While sitting down to a quick sarny and some admin one of my colleagues rushed in to my office waving a leaflet. She had found this, along with dozens of its fellows, scattered around the staff canteen. This was advertising a very long list of woo, all being delivered by the same individual through the offices of our Occupational Health Department. One of the treatments on offer was Ear Candling, which I have looked at before on here 'Hopi' Ear Candles, but in brief - pointless and dangerous.
I called up the OH department and they confirmed that this was indeed advertised through their office.
This brought up a number of questions in my mind.
1) How DO these individuals manage to gain specialities in multiple treatment modalities?
2) What evidence base is being employed to permit this treatment on NHS staff?
3) Who was getting a kick back from this?
Number one is easily addressed by looking on the internet. Given sufficient spare time and cash it would be quite simple to become an expert in:
Homeopathy
Reiki
Reflexology
Candleology
Aromatherapy
Stone Massage
Aura Manipulation
etc etc.
Indeed if you tried hard enough you could paper a reasonable sized office in official looking certificates of complementary treatment modalities.
For number 2 there was no evidence base suggesting efficacy or safety of treatment, they were completely unaware of any potential harm.
Having identified who I was and my speciality (Chief Audiologist and Hearing Therapist) I explained in detail why it was that I was deeply unhappy with such a moronic and dangerous practice being offered in my Trust. I also provided (via email) all the research literature I have examining the claims & harm of ear candling (Ernst, Seeley, etc). The person I was speaking to clearly came from a woo sympathiser perspective but was suitably swayed by my talk of 'employing evidence based medicine' and my willingness to take it further if necessary. As it happened the practitioner was in the hospital that day and agreed to withdraw ear candling from her list of offered therapies
I failed to receive a satisfactory answer to number three and will continue to pursue this. I would hope that the trust is at least receiving some benefit from this therapists direct access to staff and accommodation.
What do you think, is it ok for a health service that demands evidence based practice from all it's Doctors, Nurses and Allied Health Professionals to simultaneously advertise treatments that have a implausible mechanism of action and strong evidence of active harm?
Friday, 16 April 2010
BCA gives up case against Simon Singh
So here is his original article in full.
The fight for libel reform is not over, please sign the petition found here:
http://www.libelreform.org/
Simon Singh
The Guardian, Saturday 19 April 2008
Article history
This is Chiropractic Awareness Week. So let's be aware. How about some awareness that may prevent harm and help you make truly informed choices? First, you might be surprised to know that the founder of chiropractic therapy, Daniel David Palmer, wrote that, "99% of all diseases are caused by displaced vertebrae". In the 1860s, Palmer began to develop his theory that the spine was involved in almost every illness because the spinal cord connects the brain to the rest of the body. Therefore any misalignment could cause a problem in distant parts of the body.
In fact, Palmer's first chiropractic intervention supposedly cured a man who had been profoundly deaf for 17 years. His second treatment was equally strange, because he claimed that he treated a patient with heart trouble by correcting a displaced vertebra.
You might think that modern chiropractors restrict themselves to treating back problems, but in fact they still possess some quite wacky ideas. The fundamentalists argue that they can cure anything. And even the more moderate chiropractors have ideas above their station. The British Chiropractic Association claims that their members can help treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying, even though there is not a jot of evidence. This organisation is the respectable face of the chiropractic profession and yet it happily promotes bogus treatments.
I can confidently label these treatments as bogus because I have co-authored a book about alternative medicine with the world's first professor of complementary medicine, Edzard Ernst. He learned chiropractic techniques himself and used them as a doctor. This is when he began to see the need for some critical evaluation. Among other projects, he examined the evidence from 70 trials exploring the benefits of chiropractic therapy in conditions unrelated to the back. He found no evidence to suggest that chiropractors could treat any such conditions.
But what about chiropractic in the context of treating back problems? Manipulating the spine can cure some problems, but results are mixed. To be fair, conventional approaches, such as physiotherapy, also struggle to treat back problems with any consistency. Nevertheless, conventional therapy is still preferable because of the serious dangers associated with chiropractic.
In 2001, a systematic review of five studies revealed that roughly half of all chiropractic patients experience temporary adverse effects, such as pain, numbness, stiffness, dizziness and headaches. These are relatively minor effects, but the frequency is very high, and this has to be weighed against the limited benefit offered by chiropractors.
More worryingly, the hallmark technique of the chiropractor, known as high-velocity, low-amplitude thrust, carries much more significant risks. This involves pushing joints beyond their natural range of motion by applying a short, sharp force. Although this is a safe procedure for most patients, others can suffer dislocations and fractures.
Worse still, manipulation of the neck can damage the vertebral arteries, which supply blood to the brain. So-called vertebral dissection can ultimately cut off the blood supply, which in turn can lead to a stroke and even death. Because there is usually a delay between the vertebral dissection and the blockage of blood to the brain, the link between chiropractic and strokes went unnoticed for many years. Recently, however, it has been possible to identify cases where spinal manipulation has certainly been the cause of vertebral dissection.
Laurie Mathiason was a 20-year-old Canadian waitress who visited a chiropractor 21 times between 1997 and 1998 to relieve her low-back pain. On her penultimate visit she complained of stiffness in her neck. That evening she began dropping plates at the restaurant, so she returned to the chiropractor. As the chiropractor manipulated her neck, Mathiason began to cry, her eyes started to roll, she foamed at the mouth and her body began to convulse. She was rushed to hospital, slipped into a coma and died three days later. At the inquest, the coroner declared: "Laurie died of a ruptured vertebral artery, which occurred in association with a chiropractic manipulation of the neck."
This case is not unique. In Canada alone there have been several other women who have died after receiving chiropractic therapy, and Professor Ernst has identified about 700 cases of serious complications among the medical literature. This should be a major concern for health officials, particularly as under-reporting will mean that the actual number of cases is much higher.
Bearing all of this in mind, I will leave you with one message for Chiropractic Awareness Week - if spinal manipulation were a drug with such serious adverse effects and so little demonstrable benefit, then it would almost certainly have been taken off the market.
• This article was taken down in June 2008 following a legal complaint from the British Chiropractic Association (BCA) but was reinstated on 15 April 2010 after the BCA discontinued its libel action against Simon Singh
-- Post From My iPhone
The fight for libel reform is not over, please sign the petition found here:
http://www.libelreform.org/
Simon Singh
The Guardian, Saturday 19 April 2008
Article history
This is Chiropractic Awareness Week. So let's be aware. How about some awareness that may prevent harm and help you make truly informed choices? First, you might be surprised to know that the founder of chiropractic therapy, Daniel David Palmer, wrote that, "99% of all diseases are caused by displaced vertebrae". In the 1860s, Palmer began to develop his theory that the spine was involved in almost every illness because the spinal cord connects the brain to the rest of the body. Therefore any misalignment could cause a problem in distant parts of the body.
In fact, Palmer's first chiropractic intervention supposedly cured a man who had been profoundly deaf for 17 years. His second treatment was equally strange, because he claimed that he treated a patient with heart trouble by correcting a displaced vertebra.
You might think that modern chiropractors restrict themselves to treating back problems, but in fact they still possess some quite wacky ideas. The fundamentalists argue that they can cure anything. And even the more moderate chiropractors have ideas above their station. The British Chiropractic Association claims that their members can help treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying, even though there is not a jot of evidence. This organisation is the respectable face of the chiropractic profession and yet it happily promotes bogus treatments.
I can confidently label these treatments as bogus because I have co-authored a book about alternative medicine with the world's first professor of complementary medicine, Edzard Ernst. He learned chiropractic techniques himself and used them as a doctor. This is when he began to see the need for some critical evaluation. Among other projects, he examined the evidence from 70 trials exploring the benefits of chiropractic therapy in conditions unrelated to the back. He found no evidence to suggest that chiropractors could treat any such conditions.
But what about chiropractic in the context of treating back problems? Manipulating the spine can cure some problems, but results are mixed. To be fair, conventional approaches, such as physiotherapy, also struggle to treat back problems with any consistency. Nevertheless, conventional therapy is still preferable because of the serious dangers associated with chiropractic.
In 2001, a systematic review of five studies revealed that roughly half of all chiropractic patients experience temporary adverse effects, such as pain, numbness, stiffness, dizziness and headaches. These are relatively minor effects, but the frequency is very high, and this has to be weighed against the limited benefit offered by chiropractors.
More worryingly, the hallmark technique of the chiropractor, known as high-velocity, low-amplitude thrust, carries much more significant risks. This involves pushing joints beyond their natural range of motion by applying a short, sharp force. Although this is a safe procedure for most patients, others can suffer dislocations and fractures.
Worse still, manipulation of the neck can damage the vertebral arteries, which supply blood to the brain. So-called vertebral dissection can ultimately cut off the blood supply, which in turn can lead to a stroke and even death. Because there is usually a delay between the vertebral dissection and the blockage of blood to the brain, the link between chiropractic and strokes went unnoticed for many years. Recently, however, it has been possible to identify cases where spinal manipulation has certainly been the cause of vertebral dissection.
Laurie Mathiason was a 20-year-old Canadian waitress who visited a chiropractor 21 times between 1997 and 1998 to relieve her low-back pain. On her penultimate visit she complained of stiffness in her neck. That evening she began dropping plates at the restaurant, so she returned to the chiropractor. As the chiropractor manipulated her neck, Mathiason began to cry, her eyes started to roll, she foamed at the mouth and her body began to convulse. She was rushed to hospital, slipped into a coma and died three days later. At the inquest, the coroner declared: "Laurie died of a ruptured vertebral artery, which occurred in association with a chiropractic manipulation of the neck."
This case is not unique. In Canada alone there have been several other women who have died after receiving chiropractic therapy, and Professor Ernst has identified about 700 cases of serious complications among the medical literature. This should be a major concern for health officials, particularly as under-reporting will mean that the actual number of cases is much higher.
Bearing all of this in mind, I will leave you with one message for Chiropractic Awareness Week - if spinal manipulation were a drug with such serious adverse effects and so little demonstrable benefit, then it would almost certainly have been taken off the market.
• This article was taken down in June 2008 following a legal complaint from the British Chiropractic Association (BCA) but was reinstated on 15 April 2010 after the BCA discontinued its libel action against Simon Singh
-- Post From My iPhone
Friday, 2 April 2010
Current Workload
I'm currently working on:
1 article for BAA magazine for the BSA
1 of series of articles for the BTA magazine 'Quiet' on CAM treatments
Re-writing the Tinnitus Update for Audiologists for the BTA
Developing the national Quality Evaluation Tool for Advanced Adult Rehabilitation
Two lectures for the European Tinnitus Course
Research programme for DEFRA
Developing www.sheffieldindustrialhearing.co.uk
Seeing patients privately at www.hearingtherapy.net
NHS workload.
Feel tired just looking at it!
Also just filmed a segment on Tinnitus for The One Show which should be coming out on week of 19th April.
If you have tried or have heard of a CAM treatment for Tinnitus that you're curious about I'd love to hear from you,
-- Post From My iPhone
1 article for BAA magazine for the BSA
1 of series of articles for the BTA magazine 'Quiet' on CAM treatments
Re-writing the Tinnitus Update for Audiologists for the BTA
Developing the national Quality Evaluation Tool for Advanced Adult Rehabilitation
Two lectures for the European Tinnitus Course
Research programme for DEFRA
Developing www.sheffieldindustrialhearing.co.uk
Seeing patients privately at www.hearingtherapy.net
NHS workload.
Feel tired just looking at it!
Also just filmed a segment on Tinnitus for The One Show which should be coming out on week of 19th April.
If you have tried or have heard of a CAM treatment for Tinnitus that you're curious about I'd love to hear from you,
-- Post From My iPhone
Thursday, 1 April 2010
Simon Singh wins his Bogus Adventure vs the BCA
In a wonderful decision delivered at 9.30 this morning the three most senior judges in the country have overturned the previous ruling on meaning in the case of Simon Singh vs the British Chiropractic Association.
Mr Justice Eady had ruled that Simon's use of the word 'bogus' was a statement of fact and inferred that the BCA was knowingly promoting ineffective treatments. Today it has been decided that he 'erred in his approach' and that it was clearly an opinion piece supported by evidence. This allows Simon to use the far more reasonable 'fair comment' defence rather than having to prove that the BCA were knowingly dishonest. The BCA have already produced a statement available from their website. It remains to be seen whether or not they have any appetite to persue their case when faced with such a defence.
I certainly know of chiropracters who claim to cure Tinnitus, as well as practitioners of traditional Chinese medicine. Whilst I'd love to see their evidence I'd rather not go through a libel case. I may well look into a literature review in the future with CAREFUL commentary....
Of course this is only the beginning of the reform of our frankly ridiculous UK libel laws but there are apparently strong hints within today's ruling that change may be starting to happen.
Congratulations to Simon on this historic victory for science and common sense.
-- Post From My iPhone
Mr Justice Eady had ruled that Simon's use of the word 'bogus' was a statement of fact and inferred that the BCA was knowingly promoting ineffective treatments. Today it has been decided that he 'erred in his approach' and that it was clearly an opinion piece supported by evidence. This allows Simon to use the far more reasonable 'fair comment' defence rather than having to prove that the BCA were knowingly dishonest. The BCA have already produced a statement available from their website. It remains to be seen whether or not they have any appetite to persue their case when faced with such a defence.
I certainly know of chiropracters who claim to cure Tinnitus, as well as practitioners of traditional Chinese medicine. Whilst I'd love to see their evidence I'd rather not go through a libel case. I may well look into a literature review in the future with CAREFUL commentary....
Of course this is only the beginning of the reform of our frankly ridiculous UK libel laws but there are apparently strong hints within today's ruling that change may be starting to happen.
Congratulations to Simon on this historic victory for science and common sense.
-- Post From My iPhone
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