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Myth or Medicine
Bruce Barbour - May 2019I have just watched Myth or Medicine on SBS (8:30pm, 20th May 2019). The premise of the program is that people come in front of three medical experts and present treatment methods which are "alternative" to the accepted Western medical approach. If the experts are suitably impressed and think that the treatment is amenable to testing they arrange for the testing. The results are then reported back towards the end of the show. The show will run over a number of episodes. This article is about the first episode.
A lot of the program was interesting, informative and entertaining. Good presenters dealing with interesting material. However I have a problem with the way they tested one of the treatments. That treatment was the use of Sauerkraut as a topical treatment for acne. This was proposed by Beata (sorry I don't know her second name) who said that she got immediate improvement after one treatment of Sauerkraut and 100% cure after 6 months of usage. The panelists agreed that it was worth doing scientific testing on.
This was all great to this stage. However it all went downhill from there. The testing that they proposed was that the test participants would use the Sauerkraut as a topical treatment for 10 minutes a day, two times a week for two weeks. That is a total of only four treatments, each three or four days apart. Where the heck did they come up with the idea that that treatment regime was suitable or adequate? What other topical treatment in medicine would work under such a treatment regime, especially on a condition as intractable as acne can be. I know when I had acne in my teenage years and into my twenties I went through many tubes of chemist store bought acne treatments, applying them twice a day or more, for seemingly months, with only moderate alleviation, if any. Certainly not a cure. Yet they proposed that the Sauerkraut treatment be used for only four applications, each three or four days apart. Beata herself said that she used the treatment daily for a period of up to 6 months to get a complete cure. Now I can understand that a television program may not be able to wait for 6 months for a full treatment cycle but they could have at least done a treatment each day for two weeks minimum or preferably for a month or longer, depending on television program restrictions. While Beata did not mention the period of time for the daily application, it wouldn't have surprised me if it was longer than 10 minutes at a time.
The other issue I noticed from the pictures on the show is that each test participant seem to be using a different brand of what looked like store bought Sauerkraut. This is from my observation of the bottles the participants took from their refrigerators - they all had different labels. It is possible they were all the same Sauerkraut - just the bottles different. Beata stated that her treatment was done with the use of homemade Sauerkraut. She did not mention it being store bought. While I don't know the specifics of the brands of Sauerkraut used I do know that some of the store bought brands are pasteurised, that is all the living bacteria in the product has been killed (by heat treatment - which may have impacted nutrient levels as well). I recognised one of the brands and it is definitely pasteurised. Beata used homemade Sauerkraut, which would have live bacteria in it. Even the panelists in their discussions thought that the bacteria in the Sauerkraut might be active, and therefore important, in the treatment of the acne. If the store bought Sauerkraut was pasteurised it is quite likely to be a less effective than non pasteurised.
The test participant's means of application also seems to vary - using different types and sizes of application bags. They also applied the treatment to different parts of the body.
So what test results did they get? Apparently 37% reported improvement, 26% a decrease in redness and 37% no improvement. That is over 60% of test participants with a positive improvement - either a decrease in spots or a decrease in redness. Those results are remarkable for only four treatments, on a condition that is hard to treat as acne, on test participants that would have had the condition for a long period of time and for whom other Western medical treatments must have failed, and under a flawed test regime. How much better could the results have been for a better test regime and a longer test period? Beata, while she thought the result was good for such a short test period, said she thought it would have been a lot better under a longer trial. While she hid it she was clearly unhappy with the level of testing done.
I am not a scientist but even I know that when setting up a test procedure minimising the variables as much as possible is important. The application process and the position on the body should have been standardised. The brand of Sauerkraut used should have been standardised. It should have had live bacteria, rather than being pasteurised. While it may have introduced a variable into the testing I would have asked Beata to make and provide the Sauerkraut for the testing. They should have also consulted with Beata on other aspects of the test regime - such as number of treatments and application times.
There was a number of other ways the testing varied from medical testing orthodoxy or may have been inadequate:
- they did not seem to use a control group, which in this case would be a comparable size group with acne that was given an known inert product that would be applied on the same schedule as the test group and monitored in the same way. The control group is there to control for the placebo effect of a treatment process and for people getting better over time without treatment;
- while it is not a 100% certain the results that the program did report seem to come from the participants self reporting on whether their acne had improved or not, rather than being assessed by one of the test team - by for example taking before and after photos or the counting of spots - just a more objective assessment than self reporting. Self reporting could lead to a bias in the results because the participants may want a positive result and unconsciously adjust their assessment accordingly; and
- While they did not tell us the number of participants it is likely that the number was low, too low to be able to assign real significance to the results.
They also did not try to determine why the treatment was successful - the active ingredients - which they did do on one of the other treatments tested.
The premise for the show is great - the scientific testing of selected alternative therapies. But if they are going to do testing which they can claim as medically valid, they must do it properly. How can the presenters, all reputable members of the medical profession, allow their names to be associated with test processes which are not up to acceptable standards.
I will give the program an "A" for a great idea, and "F" for carrying it through - at least for this acne treatment.
I will continue to watch the latter programs of this series. I am hoping for better. Do it right guys - or don't bother.
