Don’t Take Their Word for It!

About a month ago, I ran into an excellent example of the importance of scepticism. A business card for a local gym was dropped off at my workplace, and they had a “Vibration Training” section on their website. Of course, my interests being as they are, I find myself entirely unable to resist anything involving the word “vibration”, so I took a look.

This page made 2 referenced claims:

the benefits have been well proven to match and surpass conventional forms of training – especially when time is factored in.*

*Roelants, Delecluse, Goris, Veshueren, 2004

A German skin clinic noted that the appearance of cellulite reduced on average 25.68%** with vibration training alone. When combined with conventional cardio exercise this percentage rose to 32.3 % (with a considerable increase in the total time spent exercising).

** Sanderm, 2003

The second claim, in particular, seemed strange to me. I had no idea how cellulite could be measured in a quantifiable way, but even allowing for my lack of knowledge here the figure 25.68% seemed far too specific. Something smelled fishy.

The next step, of course, was to look for the references themselves. Unfortunately, no links were provided on that page. Frustratingly, both references were also misspelled. The name of the first reference’s last author is actually Verschueren, not Veshueren, and the German skin clinic is called Sanaderm, not Sanderm (as far as I can tell, its fully qualified English name is the SANADERM Professional Clinic for Skin Disease and Allergology).

The first study wasn’t too hard to find, being available on PubMed and having been published in the International Journal of Sports Medicine. Here’s a link to the paper – Roelants et al.

The Sanaderm study, however, didn’t seem to be published anywhere. Eventually, however, I managed to find what appeared to be the study in its original German, on the website of another gym offering vibration training – Anti Cellulite Untersuchung.

Unfortunately, I don’t speak a lick of German, so the only way in which I’ve been able to read the study is via Google Translate (here’s a link to the translated study).

The first thing I looked for was how cellulite was measured. To my disbelief, I found that it was not measured in any quantifiable way. Instead, subjects were sorted into 1 of 3 qualitative categories. Here is the relevant passage from the machine translated study:

Defined for this study stages of cellulite

Stage 1
Cellulite is not normally visible. But if the skin Thigh, buttocks or belly with hands is pressed together, dents appear honeycomb.

Stage 2
Cellulite is not pushing together of the skin standing visible.

Stage 3
Cellulite is not pushing together of the skin lying visible.

The word order of the machine translation is unfortunately less than perfect, but I think the meaning is clear enough.

So now my question was how on Earth could they possibly get from a qualitative measurement of cellulite to so precise a measurement as a 25.68% decrease?

Unfortunately, although their results section seems to include all other measurements for each individual subject, the “Cellulite Degree” categorisation is only given for 3 individuals selected (the method of selection is not given) from each of the non-control groups.

Interestingly, one of these example subjects is given a “Cellulite Degree” categorisation of 2.5, despite this being an undefined value. I have not been able to find a justification for this datum anywhere in the study.

The appallingly bad method these researchers have used to compare their groups is to assign arbitrary values (1, 2, and 3) to each of the “Cellulite Degree” categories. It seems these values are associated with the category names of “Stage 1”, “Stage 2”, and “Stage 3”. To illustrate just how inappropriate these values are, I’d like to point out that the categories could easily have been named “A”, “B”, and “C”. There seems to be no justification anywhere in the study for the particular values that have been assigned to each category.

The researchers then added up these values for an entire group, and compared the totals of the first and final tests (omitting the results of the intermediate test that took place halfway through the study).

The sum of these values for the first test of the group that only took part in exercise on the Power Plate vibration machine (Group 1) was 46.50 (why they felt the need to record the result to 2 d.p. is entirely beyond me, and it is not due to the machine translation) and the final result was 37.00. Using these values, which are both almost entirely arbitrary, they seem to have performed the following calculations:

= 9.50


Note that this is absolutely not the calculation that should have been done. By this same calculation, if I start with 1 apple and eat half of it, it has decreased by 100%.

The other calculation, done for Group 2 (the group that participated in a cardio workout routine after the same vibration exercise as Group 1) appears to be of the same form:



The values that they would have gained from the correct calculations would not have been 25.68% and 32.30%, but 20.43% and 24.42%, each of which is massively less. Also recall, of course, that these percentages were still gained using the unjustified values assigned to each qualitative category.

Every single calculation resulting in a percentage change seems to have been performed in the same way, resulting in every case in a result that is wrong and overstated. They also appear to have truncated results instead of employing rounding, although the effect of this mistake is to slightly decrease results (at most by 0.01%, e.g. 1.22% instead of 1.23%).

Aside from all this, it’s also worth noting that a control group of 5 is abysmally small. On top of that, the average initial cellulite categorisation (which I realise is arbitrary, but it’s the only indication available to me of each group’s cellulite) for the control group is lower than for the other 2 groups.

The average initial value for the control group is 1.5. My first calculations for the average initial values for Groups 1 and 2 resulted in 1.94 and 1.39, respectively, but then I realised that the results tables listed “Number of volunteers” as though no participants had dropped out.

From earlier in the results section I could find that 1 participant from Group 1 and 6 participants from Group 2 dropped out. Taking these data into account, the actual average initial values for Groups 1 and 2 were 2.02 and 1.72, respectively.

It’s hard to compare these values due to their arbitrary nature, but I feel it’s worth noting that they are both significantly above the average value of 1.5 for the control group.

This study, in particular its value of 25.68%, seems to be quoted practically everywhere the product used (Power Plate) is advertised. Here are some examples I found (this list is far from exhaustive, you’ll be able to find many more by searching for such things as “25.68% vibration”):

I’d also like to mention that the participants in this study were all females aged 25-45, yet none of the places where I saw it referenced recognised that its conclusions should not be applied to males or to females outside of that age range.

Also, as far as I can tell from the machine translation, the control group underwent no training, so the difference attributable to the Power Plate vibration equipment cannot be assessed from this study. Instead of comparing exercise to exercise+vibration, they have compared no exercise to exercise+vibration.

And, of course, I have not “debunked” or “disproven” the type of training done in this study. All I have done is criticise a particularly bad study.

Hopefully the title and contents of this post are enough to make the conclusions that you should draw quite clear. Just in case they’re not, though, let me state them explicitly:

Don’t Take Their Word for It!

You should not trust others to tell good science from bad. You should especially not trust people who are trying to sell you something.

Remember the importance of scepticism, and remember what it means to be sceptical. Ask questions. Investigate. Criticise. Don’t take their word for it.

Misusing the Term “Doctor” in New Zealand Advertising

Earlier this year, I saw an infomercial on TV for “Dr Ho’s decompression belt”. This was only a few days after I’d encountered this post on Science-Based Medicine, which mentioned “decompression therapy” in a post entitled “Chiropractic Gimmickry”, so my alarm bells were ringing and I wrote down as much detail about the ad I could in one of my pocket notebooks.

Later, when I was able to look the product up online, it seemed that the only official claims made of it were related to pain relief. As far as I could tell, that seemed consistent with the evidence, so I decided not to pursue that avenue. However, I did find that so-called “Dr Ho” is not a medical doctor, but instead a “Doctor of Chiropractic and Acupuncture”.

For quite some time now, I’ve had a link in my bookmarks to an article published in 2008 in the New Zealand Medical Journal entitled Use of inappropriate titles by New Zealand practitioners of acupuncture, chiropractic, and osteopathy, and this situation reminded me very strongly of that article. To sum it up, “Doctor” is not a protected term in New Zealand, but there are laws that prevent it from being used in such a way as to imply that a person is a medical doctor when, in fact, they are not. That study outlines the law and shows roughly how common such misrepresentation appears to be (spoiler: very common). The law in question is in the Health Practitioners Competence Assurance Act 2003.

In response to this, I wrote in to the ASA (Advertising Standards Authority), asking if anyone there could clarify for me when it is and isn’t appropriate to use the term “Doctor” in advertising. I’ve inserted this original message at the bottom of this post.

After about a month and a half, during which I’d received a couple of notifications to let me know that they were looking into it, I received an email to let me know that the matter has been settled. About a week after that, I was sent this ruling.

It seems that the people responsible for the advertisement have altered it to clarify that Dr Ho is a chiropractor, and not an MD as was previously implied. I’m sure the distinction will be lost on most viewers, but I’m happy to consider this a victory. Even though ads tend to have short lifetimes, the fact that a precedent has been set makes me optimistic.

I would encourage other people living in New Zealand (and elsewhere, of course, but the law may differ in other countries) to make similar complaints when they observe this behaviour. If you do so, it would probably be useful to refer to this complaint and, if appropriate, the relevant provisions listed in the ruling:

Principles 2 and 3, and Part B2 Requirement 3 of the Therapeutic Products Advertising Code.

Here’s the original email I sent:

To whom it may concern,

I saw an infomercial on TV last Sunday evening (19/08/2012, around 7:30-7:45 on Prime) for “Dr. Ho’s decompression belt”. This advertisement raised my suspicions as, a couple of days earlier, I’d read an article on the highly reputable website Science-Based Medicine that described “decompression therapy” as something which is commonly recommended by chiropractors for dubious reasons.

As far as I’ve been able to tell, the only claims made for this product (that it can relieve back pain) don’t seem illegitimate, and although I’ve found numerous references to the product having been “clinically tested” and “scientifically proven” without any corroborating references I’m not sure if official promotions have made such claims. However, in my search I discovered that “Dr. Ho”, as he described himself in the infomercial where he authoritatively promoted the product, is not a medical doctor. Instead, he is a “Doctor of Chiropractic and Acupuncture”.

The Health Practitioners Competence Assurance Act 2003 states that “a person may only use names, words, titles, initials, abbreviations, or descriptions stating or implying that the person is a health practitioner of a particular kind if the person is registered, and is qualified to be registered, as a health practitioner of that kind”. I was under the impression, from the use of the term “Doctor” in this advertisement, that “Dr. Ho” was a licensed medical doctor and therefore actually had the authority with which he promoted his product.

My conclusion that this use of the term “Doctor” can be seen as misleading, and therefore violate the Health Practitioners Competence Assurance Act 2003, when used in such a context by non-medical doctors is corroborated by this article from the New Zealand Medical Journal.

I’d very much appreciate it if someone with authority on the matter could clarify for me just what is and isn’t acceptable when it comes to referring to oneself as “Doctor” in a medical context within advertising. Can such behaviour be considered a breach of advertising standards, or is it considered acceptable? If it is considered acceptable, is there a list of qualifications which allow one to call themselves “Doctor”, or would no qualifications be necessary?

Thank you in advance,

Mark Hanna

Anti-Life vs. Anti-Choice

In every abortion debate, the opposing sides invariably label themselves positively as either “pro-life” or “pro-choice”. This reflects the fact that the different sides typically disagree on what the important philosophical issues to consider should be.

“Pro-life” activists tend to support the point of view that neither pregnant women nor their physicians have the right to kill a fetus, as would be required to abort a pregnancy. In contrast, “pro-choice” activists typically argue that the rights of the pregnant woman should override those of the fetus, which requires the use of her body to survive, such that she has the right to have it killed.

I consider myself “pro-choice”. However, it would be bizarre and wrong to describe me as “anti-life”, as might be expected for a person opposing a movement that calls itself “pro-life”.

I would certainly say that, everything else being equal, it would be better to carry a fetus to term. In this way, I am 100% pro-life. However, everything else is not equal. There is often a physiological and psychological toll involved with carrying a fetus to term, just as there is with an abortion.

Despite this, the goal of the “pro-life” side is typically to make abortions illegal. Whereas it would be bizarre to characterise a “pro-choice” person such as me as “anti-life”, it would be entirely appropriate to brand the “pro-life” movement as “anti-choice”.

I feel as though it shouldn’t be necessary to discuss the more complex issues of this debate, such as making abortions illegal resulting in a higher number of unsafe illegal abortions and scenarios such as rape- or incest-induced pregnancies or pregnancies that threaten the health of the prospective mother, such as some ectopic pregnancies. While I feel as though these scenarios illustrate the importance of keeping this medical procedure legal and accessible, I do not think discussing them should be required in order to conclude that it would be the right choice.

Perhaps the most useful way to see this is that yes, it is a complex issue. Yes, it is a question of morality and yes, like most complex moral issues, the line dividing “right” from “wrong” is very fuzzy. What makes anyone qualified to decide that the answer should be the same in every case? Surely the more moral thing to do is to defer the choice to the people affected most by it.

Problems with the Argument from a Comprehensible Universe

At the debate where I heard the cosmological argument I talk about in my last post, I also heard an argument from a member of the audience that I don’t think was responded to adequately. The structure of their argument went something like this:

  1. The Universe is comprehensible.
  2. Everything that is comprehensible was designed.
  3. Everything that was designed had a designer.
  4. The Universe has a designer.
  5. The designer of the Universe is God.

Of course, the latter 2 of the 3 problems I talk about in my last post also apply to this argument – that the premises (in this case, mainly premise 2) are baseless and that even if the argument proved the existence of a designer of the Universe we could say nothing else about that designer than that they designed the Universe. Those aren’t the problems I want to talk about here though.

The biggest problem I have with this argument is that, as far as I can tell, it is incompatible with any form of theism other than deism. For those of you who are unfamiliar with this term, here is a definition of deist with which I agree, from Princeton University:

a person who believes that God created the universe and then abandoned it

Essentially, deism is the belief in a god who created the Universe but does not interact with the Universe; a god that does not perform miracles. Again, just so we’re on the same page, here is a definition of “miracle” that I think is accurate in this context, again from Princeton University:

a marvellous event manifesting a supernatural act of a divine agent

The important part of that definition is supernatural act. Miracles are, by definition, supernatural. This means that they break the “laws of nature”, which are the physical laws that govern our Universe. This makes miracles inherently unpredictable – if they follow no knowable law then it is impossible to predict or understand them. They are incomprehensible.

So, if it is possible for miracles to take place, then the Universe cannot be said to be comprehensible. If it’s possible for miracles to take place, then there is no method by which we can determine that a particular event was not a miracle. In essence, we could not be sure that God isn’t just messing with us.

If miracles could be understood, then presumably that would mean they were subject to some physical law similar to those with which we are already familiar. However, if this were the case, then there would be no reason to call them supernatural. They would simply be another aspect of nature, and therefore not miraculous. If this were the case, then it would seem to me that a god would not be necessary to explain them.

So, to sum up:

  1. The argument made by the audience member stands upon the premise that the Universe is comprehensible.
  2. A Universe in which miracles are possible would not be comprehensible.
  3. If this argument were correct, it would preclude a god that can perform miracles.
  4. This conclusion is very likely inconsistent with the beliefs of the person making the argument.

I would actually go further to say that this means it is never okay to conclude that a particular event was a miracle, but that’s also a discussion for another post.

Problems with the “First Cause” Argument

There is a common argument for theism that I have seen many times online, but I only heard it for the first time earlier today. It basically goes like this:

  1. Everything that exists had a beginning
  2. Everything that begins to exist has a cause
  3. The Universe exists
  4. Therefore the Universe had a beginning
  5. Therefore the Universe had a cause
  6. I call this cause, the creator of the Universe, God

The argument typically also states or implies that this god exists and has no creator itself. I just quickly want to go over 3 problems with this argument.

Special Pleading

The premise on which this argument rests is essentially “Everything that begins had a cause”. However, the “solution” to the problem of the Universe’s existence posited in this argument is that a god exists, which both exists and has no cause. God is created as a special exception to that universal rule. This is a logical fallacy known as “special pleading”. In this case, at least, it basically means that the conclusion of the argument is inconsistent with its premises.

Baseless Premises

The premise that “Everything that exists had a cause” seems intuitive. After all, causality is pretty well-established as a fundamental law of the Universe. However, it is far from unproven. Not only that, but no evidence has been put forward in order to support it. In fact, if this law were to be applied in totality, then you would end up with an infinite regression.

For example, let’s say one thing exists – let’s call it A. Because A exists, it must have had a creator. It can’t be its own creator, though, because the law of causality means the thing that caused it must have been from before it existed. So, a separate object – let’s call it B – must also exist in order to be the creator of A. However, the same logic that we just applied to A also applies to B; something else must exist in order to be the creator of B. So long as the law that “Everything that exists had a cause” holds, this continues ad infinitum.

The solution to this problem put forth in this argument is an eternal creator that is exempt to this law. Remember that, because the solution is exempt to the law that created the problem in the first place, this is special pleading. However, this is not the only possible solution. The solution that I think is most likely to be true is simply that this law, that “Everything that exists had a cause”, is false. This view is, as far as I am aware, backed up by the latest science in cosmology. For example, see the excellent lecture by Lawrence Krauss on YouTube, A Universe from Nothing.

Says Nothing About Any God

Even if, for the sake of argument, I agree that this absolutely proves that the Universe had a creator, so what? There is nothing, aside from the fact that it apparently created the universe, that we could say about the creator. Even if I also agreed that, for example, a Jewish man that lived 2000 years ago rose from the dead, and even if I agreed that he had magical powers that enabled him to perform such magic as multiplying bread and fish, and turning water into wine, so what? There is still absolutely no evidence that this Jew is in any way the same thing that created the Universe.

The same logic applies to any other supposed God. There is no reasonable method by which we could assign extra attributes to this hypothetical thing that created the universe. There are no observations, no data at all. Remember, this thing hasn’t been observed, but (for the sake of argument only) proven via logic. You’d need a whole other (very good) argument in order to be able to reasonably say that this thing that created the Universe is also this thing that made the burning bush speak.