The Quackery Index

Take the measure of your favorite quack, and compare him/her to other quacks.

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This is a simple method for rating potentially revolutionary contributions to medicine, either relating to psoriasis or not. This modified version of The Crackpot Index appears here with the gracious permission of John Baez, the original author and copyright holder (1998).

So, select a theory, therapy, or product you’re interested in (“they,” in the sections that follow, will typically refer to the advocates, proponents, manufacturers, distributors, etc. of that theory, therapy, or product, be it one person or several). Start with zero points, and then:

Subtract


5 points for generosity.

1 point for every test done of that specific theory, therapy, or product which reported positive results (case studies of individual patients do not count).

5 points for every formal clinical trial run to test that specific theory, therapy, or product which reported positive results.

5 points for each known possible side effect of that therapy or product which is published or otherwise acknowledged by its proponents.

10 points for every double-blind clinical trial run to test that specific theory, therapy, or product which reported positive results and was published in a peer-reviewed mainstream medical journal.

Now Add


1 point for every statement they make that is widely agreed on to be false.

2 points for every statement that is clearly vacuous.

3 points for every statement that is logically inconsistent.

5 points for each such statement that is adhered to despite careful correction.

5 points for every assumption they use which contradicts some part of the current body of scientific medical knowledge.

5 points for each word in all capital letters (except for those with defective keyboards).

5 points for every formal clinical trial run to test the specific theory, therapy, or product which reported negative or inconclusive results.

5 points if they assume that the age of a practice has any bearing on whether or not it is valid medicine. For example: “The Chinese have been using acupuncture for over 4,000 years, so there must be something to it.”

5 points if they assume that because the theory, therapy, or product worked for them, some friend(s), family member(s), or patient(s), it will work for everyone (or almost everyone, or even a simple majority of users).

5 points if they suggest that because the symptoms of two diseases look similar, they might be caused by (or cured by) similar therapies or products. 10 points if “might” is “probably.”

5 points for every time they mention a “healing crisis” or “Herxheimer reaction” (the latter only applicable when talking about diseases not known, scientifically, to be caused by microorganisms).

5 points for each published testimonial for, or anecdote about, the theory, therapy, or product, without a corresponding clinical trial report published in a peer-reviewed medical journal.

5 points for every illness or condition which they claim the theory, therapy, or product can rectify to some extent (the first five get no points, they’re “freebies”).

10 points for each instance where they fail to publish, or otherwise acknowledge, a known side effect of the therapy or product. 15 extra points for claims that there are no known side effects, while in the same article, message or advertisement, they refer to clinical trials which demonstrated side effects to a significant degree. An additional 25 points if they advocate the use of any substance which, at the dosage(s) suggested, is known to be dangerous.

10 points for every double-blind clinical trial run to test the specific theory, therapy, or product which reported negative or inconclusive results.

10 points for every claim that modern medicine is fundamentally misguided (without good evidence). 10 extra points if the claim specifically refers to “Western medicine.”

10 points if they point out that they have gone to school, as if this were evidence of sanity. 10 extra points for every instance in which they ignore or ridicule a person who makes a valid objection to their claims because, they say, that person does not have as high a degree as their own (or as many diplomas, published articles, etc.).

10 points if they begin the description of the theory, therapy, or product by saying how long they have been working on it.

10 points if they have mailed a description of the theory, therapy, or product to someone they don’t know personally and asked that person not to tell anyone else about it, for fear that the ideas will be stolen.

10 points if they refuse to divulge the ingredients of the product to potential customers. 10 extra points for refusing to do so because “it’s not patentable.”

10 points for offering prize money to anyone who proves and/or finds any flaws in the theory.

10 points for each statement along the lines of “I’m no doctor, but my theory is conceptually right, so all I need is for some people (guinea pigs) to try this therapy (or product) and see that it works.”

10 points for each attempt to recruit guinea pigs on any Usenet group or by email. 10 extra points for trying to recruit guinea pigs by telling people that there’s no risk, or by repetitively insisting that it won’t cost a dime. 15 more points if they ask for testimonials or before-and-after photos from any guinea pigs they do manage to recruit.

10 points for arguing that a current well-established theory is “only a theory,” as if this were somehow a point against it.

10 points if they defend their theory, therapy, or product by stating, “modern medicine doesn’t have all the answers, either.”

10 points for arguing that while a current well-established theory predicts biological phenomena correctly, it doesn’t explain “why” they occur, or fails to provide a “mechanism.”

10 points for each claim that the germ theory of disease is fundamentally misguided (without good evidence).

10 points for each claim, explicit or implicit, that since substance X has certain pharmaceutical properties, then substance Y, which has a close chemical or molecular resemblance to substance X, will have those same properties (without good evidence).

10 points if they claim that their work is on the cutting edge of a “paradigm shift.”

10 points if they make the barest hint of a suggestion that because a substance is “natural” it must be safe. 20 extra points if such a claim is stated explicitly.

10 points if they claim that their product is “all-natural” when it’s clear that it is not. Similarly, 10 points for each suggestion that practices like colon hydrotherapy, the use of therapeutic magnets, or the like are “natural” acts.

10 points for any product sold through multi-level marketing (or network marketing, or whatever the latest term is). 5 extra points for each use of the phrase “share the opportunity” on their web site, in their messages, or in their advertising. Double all points if they’re just a distributor, repeating the hype with which they were taken in.

10 points if they advocate “alternative medicine” on the basis of “a patient’s right to choose.”

10 points if they’ve developed their theory, therapy, or product based on claims made in popular-press books, magazines, newspapers, or web sites.

10 points if they’ve got a money-back guarantee.

20 points if they suggest that they deserve a Nobel prize.

20 points if they’ve written and published a popular-press book about their theories or therapy, instead of subjecting the ideas to rigorous clinical trials and peer review. 20 extra points if their book is self-published.

20 points for each claim that the use of antibiotics is fundamentally misguided (without good evidence).

20 points for every use of science fiction works, myths, or religious texts as if they were fact.

20 points if they claim, after clincal or scientific testing has failed to validate their theory, therapy, or product, that “there are other ways of knowing it works.”

20 points if they defend themselves by bringing up (real or imagined) ridicule accorded to their past (or current) theories. 20 extra points if they suggest that their theories, therapy, or products will eventually be “vindicated.” 25 more points if they mention a story along the lines of H. pylorii and ulcers, or (even though it’s not medical) plate tectonics. And another 30 points if they also quote Schopenhauer.

20 points for each use of the phrase “knee-jerk reaction,” “drug-company apologist,” or the like.

20 points for each use of the phrase “self-appointed defender of the orthodoxy.”

20 points for each claim that their theory, therapy, or product has been successfully tested, without citing any supporting documentation.

20 points for each claim that an abstract from a medical research paper implies something which it clearly does not. 10 extra points if they’ve read the entire article, but still maintain it means something other than what the author(s) concluded.

20 points for each mention of “cleansing” or “detoxifying.”

30 points if they claim that all objections to their theories are “nitpicking,” and/or that people should be looking, instead, at the “big picture.”

30 points if they suggest that anyone who objects to their theories, therapies, or products is doing so only in order to protect their own financial well-being.

30 points for each claim that the use of vaccines is fundamentally misguided (without good evidence). 20 extra points for suggesting that vaccines do more harm than good.

30 points for each instance of “fear mongering” with regard to an established medical practice (for example, calling for an end to flouridation and amalgam fillings by pointing out that flouride and mercury are highly toxic). Or, 50 points for a blanket condemnation of modern pharmaceuticals as “poisons.” 20 extra points for talking about patient deaths in general. 30 more points on top of that if they refer to the Institute of Medicine report while obviously not understanding it (or 40 points if they haven’t read it, but refer to newspaper articles about it).

30 points for each mention, as if it were legitimate, of a thoroughly discredited “method of healing,” such as homeopathy, aromatherapy, or acupuncture (hardly a comprehensive list).

30 points for each positive mention of Andrew Weil, Deepak Chopra, Edgar Cayce, Linus Pauling (if not a discussion of chemistry), or similar figures.

30 points if they mention how much money they’ve invested in researching their theory, therapy, or product. 10 extra points for using that as sole justification for putting a fee (no matter how small) on nothing more than information about the theory or therapy (an email “pamphlet,” for example). 20 more points if they argue that the fee is tiny compared to the “thousands of dollars people spend on drugs which don’t work.” Another 25 more points for if they admit that such a fee is their only source of income, since they’re unemployed at the moment.

30 points for any suggestion that modern medicine is just now beginning to understand the ideas they advocate. 30 extra points if they also claim that modern medicine is “proving” those ideas (without good evidence).

30 points if they claim that their theories were developed by an extraterrestrial civilization (without good evidence), or by studying some long-lost tribe which few people have heard of, the population of which “hardly ever gets sick,” or has an incredibly long average lifespan, or something else along those lines (also without good evidence). 50 points if they claim that their theories were developed by studying such a long-lost tribe which was visited by extraterrestrials.

30 points if they allude to delays in their work while they spent time in an asylum, or references to the psychiatrist who tried to talk them out of their theory.

30 points if they claim that their product is FDA approved, but fail to mention that the ingredients are not approved for their specific intended use.

30 points if they claim that there is a conspiracy between the “drug companies” and the FDA (without good evidence).

30 points if they are legally obligated to add the statement “These statements have not been evaluated by the Food and Drug Administration” to their packaging and advertising.

30 points for each claim that their theory, therapy, or product “gets at the underlying cause” of disease, or “treats the disease instead of the symptoms.” 30 extra points if modern medical science has not yet demonstrated knowledge of what, precisely, causes the disease(s) in question. An additional 40 points if they point this out in the same paragraph in which they claim their theory, therapy, or product will treat the “underlying cause.”

40 points if they use a questionnaire to “diagnose” you.

40 points if they claim that the “scientific establishment” is engaged in a “conspiracy” to prevent their work, specifically, from gaining its well-deserved fame, or suchlike. 30 extra points if, when you object to some part of what they claim, they then assert that you must be part of the conspiracy.

40 points if they state that their therapy or product can “cure cancer” (along with whatever else it can supposedly do).

40 points if they compare themselves to Galileo, suggesting that a modern-day Inquisition is hard at work on their case, and so on.

40 points if they assume that, because the feedback they receive is “overwhelmingly positive,” or because few people have asked for their money back, their theory, therapy, or product “works.”

40 points if they compare those who argue against their ideas to Nazis, stormtroopers, or brownshirts, or if they say anything along the lines of “I hope you’re happy with your disease.”

40 points if they claim that when their theory is finally appreciated, present-day medicine will be seen for the sham it truly is. (30 extra points if they publicly fantasize about show trials in which scientists who mocked their theories will be forced to recant.)

40 points if they claim that “doctors” and/or “pharmaceutical giants” aren’t interested in curing anyone — that they want us to remain sick so they can afford to keep their yachts and/or go on long ski or golf vacations. 40 extra points if they suggest that doctors and/or drug companies are trying to kill us.

50 points if they claim they have a revolutionary medical treatment but refuse to describe it because “nobody else understands it,” because they’re “tired of all the abuse,” or any other similar excuse.

100 points if the product is an honest-to-goodness Pyramid Hat.