Chiropractic adjustments can heal your DNA?

The headline above should be good for a laugh, but believe it or not, chiropractors around the world are claiming that they can help your body repair its DNA. All of them cite the same 2005 article as evidence, so I read the article to find out what it was all about.

The article is titled "Surrogate Indication of DNA Repair in Serum After Long Term Chiropractic Intervention – A Retrospective Study," written by Clayton Campbell, Christopher Kent, Arthur Banne, Amir Amiri, and Ronald W. Pero. They published it in 2005 in a chiropractic journal called the Journal of Vertebral Subluxation Research. This journal has many of the trappings of a scientific journal, but it's really all make-believe: it does not appear to be properly peer-reviewed, it is not indexed by standard biomedical databases, and (most damning of all) it is based on a concept, "subluxation," that does not exist. That's right, even the UK's General Chiropractic Council admitted in 2010 that subluxation was a mirage, saying:

"The chiropractic vertebral subluxation complex is an historical concept but it remains a theoretical model. It is not supported by any clinical research evidence that would allow claims to be made that it is the cause of disease or health concerns."

So about that journal article. The claim that chiropractic treatments could somehow improve your body's ability to heal its own DNA seems wildly implausible, but that's what Campbell and colleagues claim. Their press release, which was reproduced verbatim on many chiropractor's websites, said:

"In a landmark study published in the Journal of Vertebral Subluxation Research, chiropractors collaborating with researchers at the University of Lund found that chiropractic care could influence basic physiological processes affecting oxidative stress and DNA repair."

(I can't help remarking that authors don't usually boast that their own work is a "landmark study," but let's move on.)

Unfortunately for Campbell and colleagues, their study has fundamental flaws that completely undermine their claims, as we'll see below. Nonetheless, many chiropractors' websites are touting this amazing "benefit" today, including sites that were updated as recently as a few weeks ago, such as: this one (updated Oct 31 2011), this one, this one, this one in Australia (updated Oct 2011), this one in Australia, and many more.

So what did Campbell et al. actually study? First, they didn't measure DNA repair at all. They measured serum thiol levels, which at best are a very indirect indicator of DNA repair. And they ran a very small study, with just 76 patients, all who came to chiropractic clinics with back pain, whom they divided into 3 groups. The three groups were:

1. No chiropractic treatment, 30 patients
2. 2-12 months of chiropractic, 21 patients
3. 1-6 years of chiropractic, 25 patients

It was not placebo-controlled, blinded, or randomized, which presents major methodological problems regardless of what happened. Before I tell you the results, which group do you think the chiropractors would want to do the best? Bingo! The group that saw chiropractors for many years did the best, as measured by plasma thiols. At least that's what Campbell reported.

But the results were very odd: first, they saw a drop in plasma thiol levels (a drop is a bad outcome, for this study) in patients treated for 2-12 months, from 124 down to 105. But hang on: in the long-term chiropractic treatment group, the average level was 146. So are we supposed to believe that chiropractic is bad for you in the first year, but good for you after that? The problem gets worse, though, when you look at their claim that "there were statistically significant differences in the serum thiol levels of the three groups." None of the serum thiol levels were significantly different: their claim is simply wrong.

[Note: skip the next paragraph if you don't care about the statistics. But the statistics matter.]

Yes, that's right - Campbell et al. got their statistics wrong. Oops! They reported that the 2-12 month group had signficantly lower serum thiol levels, and the 1-6 year group was significantly higher levels, with a p-value of 0.001. From the numbers in their own tables, I was able to compute the true significance values, to determine if their reported value of 146 (plus or minus 60) was significantly higher than the control group's average of 124 (plus or minus 48). It turns out that this difference isn't significant at any level, and certainly not at a p-value of 0.001. A decent journal would never have published this painfully bad analysis.

There are other problems, but this huge error in their central result is devastating. And not surprisingly, no one has replicated these non-results since.

This hasn't deterred Chad Mathey, a chiropractor in Colorado, from posting this comment on his blog just a few weeks ago:

"This [the Campbell et al. study] is an incredible article! This talks about one of the many reasons people do and should stay under regular Chiropractic care. It’s not just for pain and people are starting to finally understand this."

Incredible indeed. As in "not believable" and "not even close to true."

This is another illustration of how pseudoscientists use the trappings of science to do make-believe science, and then advertise their "findings" to the world, just as Dr. Oz did in his recent apple juice and arsenic experiment. Dr. Oz didn't even publish his findings - he just announced them on his show. Campbell and colleagues used a pseudoscience journal. After all, who's gonna know?

The anthrax vaccine boondoggle

The anthrax vaccine is a truly bad idea. The U.S. has wasted billions of dollars on it, and it just seems to go from bad to worse. Now a government panel has recommended that we test the vaccine on children, which raises a whole new array of ethical questions.

Don't get me wrong: vaccines are the greatest boon to public health of the last 200 years. We eradicated smallpox, we're close to eradicating polio, and childhood deaths from infectious diseases are far, far lower thanks to the vaccines we give our children. These are truly wondrous advances.

But the anthrax vaccine is different, from start to finish.

For starters, anthrax is not infectious. This might come as a surprise to those who've only heard about this through the media. An anthrax "outbreak" is impossible, because the B. anthracis bacterium cannot spread from person to person. Vaccines against diseases such as measles, mumps, and influenza protect millions of people each year, because these are common infectious diseases that spread easily between people.

Anthrax was never a public health threat, and it isn't one now. We don't need an anthrax vaccine. And by developing and then promoting one, the government is abusing the good will that the public has towards vaccines, possibly endangering the public health further by playing into the hands of the anti-vaccine movement.

The Centers for Disease Control (CDC) does not recommend that children be vaccinated against anthrax. In fact, it doesn't recommend that anyone get routine vaccinations against anthrax:

"Vaccination is recommended only for those at high risk, such as workers in research laboratories that handle anthrax bacteria routinely."

The CDC recommendation makes sense. Therefore I was stunned to learn this week that the National Biodefense Science Board (NBSB) recommended that we launch an anthrax vaccine testing program in children (see page 37 of their report).

The NBSB report admits that

"Currently, U.S. children are not at immediate risk from anthrax and would not benefit directly from pre-event AVA [anthrax vaccine] administration."

It also states that

"There is no known benefit to vaccinating children in the absence of an imminent threat from exposure to B. anthracis other than potential future benefit."

Case closed, right? We can't conduct vaccine trials in children if there's no benefit.

Somehow, though, even after these statements in their own report, the NBSB managed to recommend testing the vaccine in children. As justification, they present this claim:

"Preparation for a national and potentially global threat from the use of B. anthracis spores by terrorists is a major priority for U.S. national security."

This is a massive overstatement. A national and global threat? Anthrax is not infectious, as the NBSB knows. The only people affected in an attack would be those directly exposed to the bacterium, likely only a handful of people. We don't vaccinate millions of people just to protect a hypothetical few: this is an abuse of the public trust in vaccines.

So why are we wasting billions of dollars to develop, test, and administer a vaccine against something that hardly infects anyone? The anthrax vaccine development project was on its way to being cancelled by the U.S. before the 2001 anthrax attacks. In an ironic twist, the likely perpetrator of the attacks, Bruce Ivins, was allegedly motivated by his interest in reviving the anthrax vaccine program. If so, then he succeeded in a big way: in 2004, the government announced Project Bioshield, which dedicated $5.6 billion to biodefense, much of that going to anthrax vaccine research.

I'm not surprised that if the government dedicates billions of dollars to biodefense, and distributes it to companies and universities who then become dependent on these funds, then advisory panels such as the NBSB will recommend an ever-increasing number of security measures. After all, some of the members of that committee are funded by biodefense dollars, and if we cut the funding, their own livelihoods might suffer.

Speaking to the Washington Post, panel member Ruth Berkelman said:

“We need to know more about the safety and immunogenicity of the vaccine as we develop plans to use the vaccine on a large number of children in the event of a bioterrorist’s attack.”

No, we don't. We don't need to know about the safety of the vaccine in children because it would be unethical to test it on them. And if there is an attack, we shouldn't respond by vaccinating "a large number of children," because anthrax doesn't spread from person to person. This is one vaccine we can do without.

[Note: I was a member of the research group that sequenced the DNA of the B. anthracis used in the 2001 attacks. We published our findings in two papers, one in 2002 and the second, after the investigation concluded, in 2011.]

Don't take your vitamins

We've known for a long time that vitamins are good for you. Perhaps the best example is vitamin C, which completely cures scurvy, a disease that has plagued mankind for millenia. (It was described by Hippocrates some 2400 years ago.) Scottish doctor James Lind described how to cure scurvy with citrus fruit back in 1753, but it wasn't until 1932 that scientists Albert Szent-Gyorgyi and Charles Glen King identified vitamin C as the essential nutrient behind the cure for scurvy. (Szent-Gyorgi gave vitamin C the name ascorbic acid because of its anti-scurvy properties.)

Many other vitamins and micronutrients are required for good health, such as vitamins B and D, iron, folic acid, calcium, and potassium. Deficiencies in these vitamins cause all sorts of diseases, some of them very serious.

So it seems intuitively obvious that if a little bit of these nutrients is good for you, then a lot should be even better. Right? This intuition is the basis for the a huge and powerful nutritional supplements industry, which makes billions of dollars each year selling multi-vitamins and high-dose supplements in a bewildering variety.

The problem is, our intuition is wrong. Two separate studies published this past week, involving tens of thousands of subjects, showed that high doses of vitamins and supplements, rather than being helpful, can sometimes kill you.

In the first study, Jaakko Mursu and colleagues have been following 38,772 older women since 1986. The women in the study, whose average age was 62 back in 1986, have reported their use of multivitamins and supplements for the past 25 years. The news was not good: the risk of death INCREASED with long term use of multivitamins, vitamin B6, folic acid, iron, magnesium, zinc, and copper. The risk of death only decreased with the use of calcium. They also noted that in other studies, calcium had the opposite effect.

The authors concluded that there's

"little justification for the general and widespread use of dietary supplements,"

and the story was widely reported as showing that supplements are risky (Wall St. Journal) and unnecessary (New Zealand Herald).

In the second study, Eric Klein and colleagues studied 35,533 men over the past 10 years, looking at whether vitamin E or selenium would decrease the risk of prostate cancer. Both supplements have been claimed to have benefits, so the researchers randomly divided the subjects into four groups, giving them daily doses of (1) vitamin E only, (2) selenium only, (3) vitamin E and selenium, and (4) nothing (in the form of placebo pills).

The result: the risk of cancer INCREASED for the men taking vitamin E, selenium, or both. Although the increased risk is small, it is abundantly clear that neither of these supplements is helpful against prostate cancer.

Not surprisingly, the supplements industry hasn't taken this news lying down. The Council for Responsible Nutrition is an industry lobbying group representing the supplements industry (don't be fooled by the name). They released a statement by their vice president, Duffy MacKay (a naturopath, which is a form of quackery I'll have to treat separately in the future), grasping at the fact that, in the study, the increased risk of cancer from vitamin E plus selenium wasn't quite as big as the increase from vitamin E alone.

"This reinforces the theory that vitamins work synergistically," said MacKay.

Aha! So if I take even more supplements, perhaps my risk of cancer will go up only an eensy-teensy bit?

The Council released a second statement about the study on multivitamins, saying

"CRN maintains that nutrients may be robbed of their beneficial effects when viewed as if they were pharmaceutical agents, with scientists looking to isolate those effects, good or bad."

I see... so the benefits of supplements will disappear if we treat them as drugs: wouldn't that include taking vitamins and supplements as pills?

The supplements industry (Big Supp?), which is largely unregulated, has a darker side too: countless hucksters, many operating primarily through the Internet, who are making a fortune selling overpriced supplements (and advice on how to use them) that they claim will cure cancer, diabetes, and a host of other diseases. These include internet quack Mike Adams, who posted a response to this week's studies on his Nature News website, claiming:

"Recent attack on vitamins a fabricated scare campaign."

In Adams' response, he starts by arguing that the American Medical Association"has a long and sordid history of openly attacking vitamins and nutrition," a bizarre claim that has nothing to do with the study results even if it were true (it's not). He goes on to claim that the

"study data were ALTERED!"

(the all-caps is his) and

"voodoo statistics [were] used to alter the outcome."

I looked at the numbers he extracted from the paper to support these claims, and he failed - badly - to understand the data. Apparently for Mike Adams, statistics that he doesn't understand are just "voodoo."

So I'm afraid the news boils down to this: eat lots of fruit and vegetables, and a balanced diet, and you'll get all the micronutrients and vitamins you need. Supplements are only needed if you have a demonstrable deficiency. For most people, multivitamins and other supplements are a waste of money, and they might even be harmful. But hey, apples are in season right now, and spinach can be kind of tasty if you prepare it properly.

Is the government hiding something about the next flu pandemic?

Remember the flu pandemic? The one that swept the world just two years ago? You might be forgiven if this has slipped your mind - after all, it doesn't seem like such a big deal now. That's because we got lucky: despite many dire warnings about the danger of another 1918 "Spanish flu", when the 2009 pandemic arrived, it was far milder than previous pandemics. Hundreds of millions of people got the flu in 2009, but for most of them, it wasn't so bad. In fact, the new flu is less severe the old flu - the strain that was circulating before the new pandemic hit.

Now we have two flus circulating: the "old" H3N2, and the 2009 pandemic flu, called H1N1. (And the vaccine protects against both of them, so get your flu shot! Your friends, neighbors, and co-workers will all benefit.)

We really dodged a bullet in 2009. Despite our best efforts, it took 7 months (April to November) before a new vaccine was ready. Before we realized how mild it was, people were desperately snapping up stores of Tamiflu, an anti-viral medicine that only barely helps to treat the flu. If it had been like 1918, Tamiflu wouldn't have helped much, and tens of millions would have died.

The 2009 pandemic originated in pig farms in Mexico. We don't know precisely where it made the first leap into humans, but it appears that two different strains joined together in a pig somewhere to create the new H1N1. The flu has a nasty habit of jumping the species barrier, hopping to humans from both pigs and chickens.

So now that we know all this, next time will be different, right? The world's influenza scientists are monitoring pigs and chickens closely now, keeping a close eye on any new flu strains. Right? RIGHT???

Er, no. Not exactly. For one thing, surveillance in pigs appears to be nonexistent. I checked to see how many flu sequences from pigs in Mexican have been desposited in the public archive at GenBank since 2009 (using this terrific database). The result? One, in 2009. Nothing from 2010 or 2011. Hello, is anyone awake at the CDC and the WHO?

This despite the fact that scientists have serious concerns that the deadly H5N1 avian flu (the "bird flu") could combine its genes with H1N1 and create a really nasty new flu strain. And scientists have long had concerns that pigs could be the mixing vessels for new flu outbreaks - exactly what happened in 2009.

But wait… maybe they are monitoring the flu, but they're just not telling us. That would feed into all the fringe government conspiracy groups that claimed the 2009 pandemic was an intentionally engineered government-funded enterprise (see this BMJ article for more). I don't believe any of those conspiracy theories - most of them are just nuts - but read on.

Sharing data about flu viruses has been a touchy subject with the WHO and the CDC for years. As reported by the University of Minnesota's CIDRAP,

"In late 2006, virus sharing became an international flash point when Indonesia broke a long tradition of free international sharing of flu virus specimens by withholding its H5N1 virus samples as a protest against the high cost of commercial vaccines derived from such samples. The controversy has drawn attention to the problem of equitably distributing vaccines in the event of a pandemic."

A few months ago, the WHO finally agreed on a new set of principles on data sharing, which states that

"The WHO GISRS laboratories [which includes the CDC] will submit genetic sequences data to GISAID and Genbank or similar databases in a timely manner."

Excellent! If they do it.

As every biomedical scientist knows, GenBank is a free, public database of genetic sequence data that contains millions of sequences, from humans, bacteria, viruses, you name it. But GISAID is another database, in Switzerland - one that I initially supported - just for flu data. The original mission of GISAID was that data deposited there would go to GenBank as well, with little or no delay. But in a classic bait-and-switch move, the GISAID board changed that policy after the database was up and running, and now they can sit on data as long as they want.

OK, you say, but it's a private database, so they can do what they want. True enough. But here's the surprising bit: the CDC deposits most of its flu sequences ONLY in GISAID, where they can milk them for scientific results for years without sharing them with others. As one of GISAID's original supporters, I have an account there, and here's what I found.

So far, the CDC has deposited sequences from 6,801 flu isolates in GISAID, of which only a tiny handful are in GenBank. 3201 of these originated in the U.S., so there can't be any foreign government insisting that they be kept secret. These provide critical data that could help scientists predict what is coming in the next flu season. But you can't get these sequences without a GISAID account. And even if you have a GISAID account, as I do, you have to agree not to release the data as a condition of getting a look.

So why does the CDC deposit sequences in GISAID? I think it's precisely because of the restrictions. CDC's scientists don't want others to look at "their" data, because they're afraid someone else might discover something important and publish it before them.

The CDC, of course, is part of the U.S. government, and all its work is funded by the public. But it seems that the CDC flu scientists have forgotten their public health mission - or at least, they appear to be more concerned about their own careers (and the papers they might publish) than about making sure the world is ready for the next pandemic.

And by the way, even these sequences don't seem to include anything from pigs in Mexico. Hello, CDC? You are looking at swine flu now, aren't you?

Perhaps I'm being a bit harsh. I love the CDC: they do a terrific job most of the time, providing vital services to protect the public from infectious diseases. But their internal scientists sometimes seem to operate within a cocoon, and I'm afraid that's happening here. This culture of secrecy has got to stop, and I suspect that will only happen under pressure from the outside. The CDC Director, Thomas Frieden, needs to tell his flu people to start sharing what they know with the rest of the world. And they can start by putting their data in GenBank.

Dr. Oz tries to do science

TV doc Mehmet Oz, who hosts a very popular daily television show, tried to conduct a scientific experiment this week. He wanted to test whether apple juice from some of the most popular juice makers in the U.S. contained toxic levels of arsenic. For some reason - perhaps he was feeling guilty about all the unscientific claims he has been pushing on his show - he decided he would try to prove this scientifically.

With all the resources of his TV network behind him, he was able to put on a pretty good show. But Dr. Oz is no scientist, as he made very clear when he presented his "discoveries." His pretend-science act - and that's what it was - was a disaster. I'd have to give him an "F" for his experiment, where he claimed that he had found dangerous levels of arsenic in five popular brands of apple juice: Minute Maid, Apple & Eve, Motts, Gerbers, and Juicy Juice.

His website proudly displays these results, claiming that the arsenic is from pesticides used in China. After his "extensive national investigation" he concluded:

"American apple juice is made from apple concentrate, 60% of which is imported from China. Other countries may use pesticides that contain arsenic, a heavy metal known to cause cancer. After testing dozens of samples from three different cities in America, Dr. Oz discovered that some of the nation's best known brands of apple juice contain arsenic."

There are many problems with this study, but the biggest one is that its conclusions are false. The reasons include:

1. Oz asked a lab to test for total arsenic, but there are two forms of arsenic, commonly known as organic and inorganic. Organic arsenic is everywhere, and it's mostly harmless. As the FDA explained in its first warning letter to Oz:

"As we have previously advised you, the results from total arsenic tests CANNOT be used to determine whether a food is unsafe because of its arsenic content. We have explained to you that arsenic occurs naturally in many foods in both inorganic and organic forms and that only the inorganic forms of arsenic are toxic, depending on the amount. We have advised you that the test for total arsenic DOES NOT distinguish inorganic arsenic from organic arsenic."

2. Oz didn't try to replicate his own results, and didn't even think to question the numbers he got from the lab he hired. Here's a hint, Dr. Oz: if you come up with a surprising result, then you must try to replicate it yourself to see if you get the same answer. And you should be your own greatest skeptic. Not Dr. Oz: he had all his samples tested at a single lab, which the FDA warned him was giving erroneously high results. The FDA re-tested samples from the same lot for one of the juice makers (Gerber), and sent Oz another letter on Sept 13, telling him the results, as follows:

FDA Sample Total Arsenic Result (Average)
Sample 659595 Lot #1157515791 2.0 ppb
Sample 659596 Lot #1125515762 4.0 ppb
Sample 659597 Lot #1125515761 6.0 ppb
Sample 710623 Lot #1059515761 5.0 ppb
Sample 710624 Lot #1059515762 5.0 ppb
Sample 710625 Lot #1157515761 2.0 ppb
Sample 710626 Lot #1157515762 3.0 ppb

The lab that Oz hired had reported far higher total arsenic levels: 36 ppb. The highest result that the FDA found was six times lower. This would be very, very worrisome to any good scientist. The FDA also warned in this letter that

"it would be irresponsible and misleading for the Dr. Oz Show to suggest that apple juice is unsafe based on tests for total arsenic."

But of course Oz wasn't going to go back and check his results. That would be too scientific! Instead, he aired a show in which he wildly overstated the results and the possible risks. He didn't express even the slightest uncertainty about his findings. He interviewed audience members who dramatically confessed that they hadn't realized they were poisoning their own children. The horror!

To their credit, the mainstream media didn't buy this one. ABC in particular, featured an interview on Good Morning America with both Oz and Dr. Richard Besser, ABC's medical editor, who called Oz's show "extremely irresponsible" to his face. Oz danced around the accusations but never once admitted he might have made a mistake. Besser really lays it on the line in this smackdown (click to watch the video):

Among other things, Besser said that Oz's hyperbolic, poorly-supported claims are like " yelling fire in a movie theater". Bravo for Dr. Besser.

I'm not sure if Mehmet Oz was always the way he is now, but he seems to use his show to sell products (and to sell himself!) rather than to inform the public about medical issues, as one of my fellow Forbes bloggers, Alice Walton, has noted. Dr. Oz has embraced complete quacks, too, notably Joseph Mercola, whom he has had on the show more than once.

Maybe Oz was trying to show his science-y side by doing what he thought was a real study, actually measuring arsenic levels in samples of apple juice. But he botched it so badly that he just demonstrated his own lack of serious science cred.

Dr. Oz ought retract his erroneous claims about arsenic and apologize for his scaremongering and his sloppy science. But he's showing no signs of that: on his website he is sticking by his claims, and he challenges the FDA and the food companies to come on his show. He's also claiming that the source of the arsenic is pesticide sprayed on apples imported from China, although he presents no evidence at all for that. This is not how science is done, Dr. Oz. You made a claim, and others pointed out major problems with it. It's incumbent on you to come up with better evidence. But somehow I suspect that will be too much trouble for you. Real science can be such a pain that way.

The black death is dead

Evolution tells us a lot about death. Of course it's about life too, but it's really about survival, which involves both life and death.

As most people know, the Black Death was a horrible plague that swept through Europe, Asia, and Africa in the 1300's, killing tens of millions of people at a time when there weren't so many people to begin with. The world's population prior to the plague, about 450 million, dropped to 350 million. About one-third of the entire population of Europe, and half the population of China, may have died. Centuries earlier, the Plague of Justinian in 541-542 C.E. may have killed even more, up to half of Europe and untold millions elsewhere around the world. In ancient and medieval times, people thought the plague was caused by rats, but the true cause wasn't discovered until 1894, when Alexandre Yersin of France and Kitasato Shibasaburo of Japan finally traced it to a bacterium now called Yersinia pestis, which is transmitted by fleas, which in turn are carried around by rats.

The plague kills all of its hosts, even the fleas:

"The bacteria multiply inside the flea, sticking together to form a plug that blocks its stomach and causes it to starve. The flea then bites a host and continues to feed, even though it cannot quell its hunger, and consequently the flea vomits blood tainted with the bacteria back into the bite wound. The bubonic plague bacterium then infects a new victim, and the flea eventually dies from starvation. " Source: Wikipedia

Gross, I know. But the original plague, the Black Death, has never returned. Why not? A study last year and another one published just this week provide the answer.

Last year, Barbara Bramanti and colleagues collected DNA from mass graves dating to the Black Death, and showed conclusively that the victims were infected with Yersinia pestis. Until this study, some scientists were uncertain about whether Yersinia pestis was the true cause, but Bramanti's research should settle that question once and for all. They also showed that at least two distinct strains of plague bacteria infected Europe, each arriving via a different route.

Further evidence appears in a remarkable new study published this week by Hendrik Poinar and colleagues. They exhumed over 100 skeletal remains from victims of the Black Death, collected from a ancient London cemetery, East Smithfield, which has been conclusively dated to the plague years, 1348-1350. Using the latest DNA sequencing methods, they identified Yersinia pestis DNA in 20 of the 109 victims.

Both studies collected enough DNA to show that the strain of Yersinia pestis from 1350 C.E. is unlike any modern strain. In other words, the original plague died out, probably long ago. The likely explanation is just this: the Black Death was simply too deadly to persist. Evolutionary theory tells us that a pathogen that kills all its victims will eventually run out of victims, leading to its own extinction. The plague bacteria needed to evolve into something less virulent, and that seems to be what happened. A bug that doesn't kill its host is far more successful evolutionarily. (Just look at the common cold, which we can't seem to get rid of.)

The same thing happened to the "Spanish" flu virus, the one that cause the terrible 1918 flu pandemic. It too evolved into a milder pathogen, and it is still with us today - the 2009 influenza pandemic was caused by a direct descendant of the 1918 virus.

The Black Death was so widespread that it even affected human evolution. In 1998, Stephen O'Brien and colleagues showed that a mutation that confers resistance to HIV first appeared in the human population in the 1300's. They concluded that this mutation can best be explained by "a widespread fatal epidemic"; in other words, the Black Death. I should be careful to explain that the plague didn't actually cause the mutation: the mutation occurred naturally. The Black Death selectively killed more people without the mutation, leaving us with a population of humans that tended to have the mutation.

In light of these new results about evolution, I can't help pointing out that, finally, that evolution has been in the news recently for another reason. Several U.S. politicians, some campaigning for President, have been attacking evolution, saying that it has "got some gaps in it" and even supporting the teaching of creationism. Scientific facts aren't affected by political statements, of course, but the future of the U.S. is. Politicians who attack evolution, whether from ignorance or from some political or religious agenda, only hurt our future potential as a technology leader. I can only hope that the public won't support these anti-science positions.

The $350,000 questionnaire from NIH

Let's see: if you could get $350,000 from the government to develop a questionnaire, does that seem like a good deal? What if the questionnaire was designed mostly to ask people if their "qi" was balanced, or their "prana" was improving? Apparently, we don't have enough surveys of patients asking them these vital questions, but never fear: NIH's National Center for Complementary and Alternative Medicine (NCCAM) has money to burn.

To be specific, NCCAM has given $354,341 to Cheryl Ritenbaugh at the University of Arizona (grant number R01-AT003314) to develop a questionnaire designed specifically to address "CAM" outcomes, "especially those therapies that have an energetic or spiritual component" which includes homeopathy, energy healing, and acupuncture. According to the grant's abstract, CAM therapies

"focus on vital force, qi, prana, or similar concepts. This contrasts with biomedicine, where the focus is on specific diseases, organs, symptoms, or mechanisms."

Let's see if I understand this statement. Biomedicine tries to understand and cure diseases. CAM, according to Dr. Ritenbaugh, focuses on magical fairy dust - oops, I mean vital force and qi. And alas, laments Ritenbaugh,

"CAM researchers have not had tools to measure outcomes that are based on CAM clients experiencing whole person outcomes or transformative experiences."

Clearly, we need a questionnaire designed to ask people about their qi.

To be fair, Ritenbaugh isn't merely going to develop a questionnaire. She also proposes

"to rigorously evaluate this tool in appropriate populations chosen for ethnic diversity and CAM experiences."

Phew, that's a relief. We have to be sure the questionnaire works.

NIH's website lists the published results reported for all of its grants, and so far this one has nothing to report, despite being in its third year. In another NIH institute, this would be an embarrassing failure. But in any other institute, a proposal asking for $350,000 to create a questionnaire about imaginary life forces would have no chance of being funded in the first place.

But wait, it gets better! Last year, NCCAM awarded Dr. Ritenbaugh an additional $120,000 for this project, part of the federal government's stimulus funding. So it's really a $470,000 questionnaire.

As a long-time reviewer on NIH review panels, I can only imagine what the NCCAM reviewers discuss. They must inhabit an alternate reality, where magical forces flow through and around the body, and magical, pseudoscientific treatments like acupuncture, healing touch, magnet therapy, and homeopathy somehow really work. The mind boggles.

I tried unsuccessfully to find Ritenbaugh's $470,000 questionnaire, even a piece of it. Perhaps when she finishes the project, she'll publish it. I think she owes it to the public - after all, we paid for it.

(An aside: the University of Arizona is one of NCCAM's biggest recipients of grant funds. UA's Iris Bell has received multiple NCCAM grants over the years, which I've written about before, including a ridiculous proposal to study how often you need to shake a homeopathic remedy while you're diluting it to nothing. Ritenbaugh is currently sharing a grant with Bell on a large training grant from NCCAM to Arizona, which will train "junior investigators preparing for a career in whole systems of CAM research." Good thing they're training more pseudoscientists; must keep the work going.)