Friday, November 23, 2018

He who lies down with dogs should not smear himself beforehand with peanut butter and meat paste

This post was earlier cross-posted at Leonid Schneider's site, hence the unfrivolous tone. The version there benefits from Leonid's frame-story and e-mail exchanges with some of the principals.

An anonymous contributor to Pubpeer had an odd discovery to report: a 2016 webpage on the Chopra Foundation site, announcing that an advertisement for "an Panchakarma-based Ayurvedic Intervention" had been published in the Nature Salon des Refusés, Scientific Reports. It appears from the paper that changing one's diet brings concomitant changes in one's digestive function... a startling discovery, well-worth paying $1,760 to publicise.


That was not the oddity, however. The authors declared themselves to be free from vested interests in the product they were advertising...



This led to a Corrigendum, when it came to the attention of SciRep's editors that Deepak Chopra (lead author of the paper) is the same Deepak Chopra who pimps the "Perfect Health program" of Ayurvedic Intervention through his Chopra Center, as one of his income streams... but that's not the oddity either. What is of interest here was the enlistment of Steven Steinhubl and Eric Topol to the authorship list... perhaps to bestow a lustre of legitimacy on the paper, and to imply Professor Topol's imprimatur for the claims it made, for he is an intellectual heavyweight. Yet Topol appears nowhere in the paper itself... not, at least, in the version accessible in this reality.

The Chopra Foundation have hastily updated the press release to remove Topol's interpolated name. However, they have not yet amended another Foundation webpage which reiterates the authorship list, and identifies the "Panchakarma-based Ayurvedic intervention" of the advertisement as "the Chopra Center’s Perfect Health program, which prices start at $2865 for a six-day treatment". What is going on?



We must interrupt the flow of exposition here for a book review. Specifically, Topol's review of 'Bad Blood' - an account of Elizabeth Holmes and the Theranos scam. This serves to illustrate Topol's high scholarly expectations.


He recommended the book but wondered how people could be fooled into collaborating with an obvious fraudster like Holmes. How could a business empire be built on pure mendacity, with so little scrutiny of the principal's grandiose assertions?

Now back at last to the Sci.Rep paper and its main author, Deepak Chopra, of the Chopra Foundation and the Chopra Center and many other stepping-stones to the abnegation of ego.

Woos and views[edit]

Deepak Chopra comes from a long line of pseudo-Hindu spiritualists making money off of gullible Americans, but he is one of the first to successfully merge Eastern ayurvedic woo with Western quantum woo and sell it to a mainstream US audience.

Such is his prominence within the New Age and Integrative Medicine landscapes, it might seem that Chopra has always occupied his present position of "Leading New-Age Guru of Eastern Wisdom word-wooze", bestowing vacuous profundities superficialities and dispensing a predigested pabulum of quantum-mechanical and perennial-philosophical buzzwords, but this is not the case. Once Chopra was in the role of Chela - a disciple of Maharishi Mahesh Yogi. Let Andrew Skolnick provide some useful background.

Briefly: in 1991, at the start of his career, Chopra co-authored a piece for JAMA about 'Ayurveda' (this was a time when JAMA's policy was to report on non-Western Healing Modalities, to signal the editors' open-mindedness and their acceptance of alternative ways of knowing making money).
Maharishi Ayur-Veda: Modern Insights Into Ancient Medicine
AYUR-VEDA is the oldest existing medical system, having its heritage in ancient India. It is recognized by the World Health Organization and is still widely practiced.1 The All India Ayur-Veda Congress (representing Ayurvedic physicians) has a membership of over 300 000, and 108 Ayurvedic colleges in India grant a degree after a 5-year program. Yet, until recently, Ayur-Veda has been virtually unknown in the West. Current interest in disease prevention and health promotion has led to its investigation by a growing number of Western physicians who are finding it to add valuable knowledge that is complementary to modern allopathic medicine.
It soon emerged that the "Maharishi Ayur-Veda" praised in this paper had little to do with Ayurveda as commonly understood. Some might say that Ayurveda in India is an inchoate jumble of medieval superstitions and traditional quack remedies ranging from cow dung to toxic metals, with a centuries-long tradition of shortening Indian lifespans while benefiting Indian charlatans; loosely analogous to Traditional Chinese Medicine, or the Renaissance medicinal milieu of trichobezoars and antimony... but I shall not speculate here. The point is that the Modality advertised in Chopra's article is roughly as 'ancient' as New Coke, being a proprietary life-style accoutrement dreamed up by Maharishi Mahesh Yogi to scam gullible Western suckers... just another brand within his business empire, along with Transcendental Meditation and Yogic Flying. The attempt to equate it with the Ayurveda of antiquity was, bluntly, a lie.
"Chopra sells Ayurvedic medicine, which is traditional Indian medicine filtered through the Maharishi Mahesh Yogi and mixed with "physics" in order to treat the dangerously low levels of money in Chopra's wallet.[citation NOT needed]"
This economy with the truth attracted some opprobrium. Or possibly odium (I am unsure on the exact distinction between the two). More odium / opprobrium ensued from Chopra's failure to mention his conflicts of interest when he reported on the Maharishi's products - i.e. his personal profits from their sale, as part of Maharishi Marketing. This is something of a recurring theme.

Chopra was inspired by Skolnick's article to sue his critics. The case was thrown out of court, though this left Chopra and his lawyer unfazed; they cheerfully lied to the media that Skolnick had admitted fault in a negotiated settlement. I don't know where I'm going with this, except to note that (1) Deepak Chopra has no shame, and his own unique perspective on facts; and (2) he hires lawyers when people ridicule him for obvious fabrications, so govern yourself accordingly.

Now Chopra's advent on the scene happened to coincide with the rise of Integrative Medicine within the American health-care economy, and its adoption by major medical centres. The details of Integrative (Complementary) Medicine can be hard to pin down, but the general notion is that more money can be extracted from patients customers if in addition to treatment that works, they are also paying for placebos to make them feel good (and placebos are more effective when adorned with the patina of 'tradition'). It empowers customers with the responsibility for treatment that doesn't work (for failing to maintain a sufficiently positive consciousness). This Weltangeist or Zeitschauung proved to be the ideal environment for Chopra, and we find him in symbiotic relationships with the medical centres.


Much more could be said about Chopra and the rest of his remunerative career, but it will suffice to outsource this to RationalWiki, Orac at Respectful Insolence, and Scævola. There is no point in preaching to the choir (also, Deepak Chopra hires lawyers). Moreover, it would distract us from the original question: Why was Eric Topol's name co-opted for the Ayurveda paper?

The Sci.Rep paper was one outcome of an especially Chopralific venture called the SBTI, a.k.a. the Self-Directed Biological Transformation Initiative Initiative [sic] - an unabashed advertisement and validation for the Chopra Centre health-spa / holiday retreat, expressed through the medium of a Clinical Trial. The SBTI is best understood as an exercise in confounders. The ~70 participants received the full panoply of Chopra Resort services (vegan diet, meditation lessons, purgative herbs, mantras, yoga, saunas, massage and possibly scented candles), in exchange for providing data of various forms selected to show a beneficial change (state-of-mind questionnaires, blood tests, heart and breath monitors, microbiome, optional aura readings). A Prospectus provides further detail.

I note in passing that Chopra's great-souled altruism does not extend as far as paying for advertisements for his products, and he set up an IndiGoGo account to raise funds for the expenses. It is not clear whether participants paid to take part in the 'study'. One paper says they didn't, but according to the prospectus, test subjects and controls alike were charged $2875 (a reduced rate) for the week at his Health Spa.
There is NOT a direct cost to participate in this study, however there is a program enrollment fee for Perfect Health. The enrollment fee has been offered at a discounted rate due to study requirements/responsibilities taking place during the Perfect Health program.
According to the Clinical Trial database and to Deepak's website, a constellation of luminaries were signed up as PIs on facets of the study. Topol and Steinhubl were to analyse the body-function readouts; Nobel Laureate Margaret Blackburn would examine telomere length. From Chopra's perspective, that makes them his paid staff.

BLOOD-BASED MARKERS OF CELLULAR AGING
Team Leaders
Nobel Laureate Dr. Elizabeth Blackburn, Elissa Epel, Ph.D., and Paul J. Mills, PhD
Will be studying:
 Telomerase and Telomere Length
 Oxidative Stress
 Inflammation, Cardiovascular Disease and Stress Biomarkers
 Mitochondrial DNA Health
GENERAL PHYSICAL AND HEART HEALTH
Team Leaders
Eric J. Topol, MD and
Steven R. Steinhubl, MD
Will be studying:
 Single lead ECG/ heart rate
 Heart Rate Variability
 Physical Activity
 Sleep Quality
 Respiratory Rate and Depth
 Photoplethysmogram
Of course the whole Everything-at-Once approach makes it impossible to link any potential benefit to one specific intervention, destroying any value of the exercise as science, though that was never the point. Orac predicted this back in 2014. So years after the trial finished in February 2015, the only publications are the Metabolomics paper and two bits of fluff on self-assessed spirituality / non-duality, and hilarity ensued. Fortunately there was also a series of favorable puff-pieces in Huffington Post, in which the Chopra Corporation takes greater pride.


But wait, there's more! Can you handle the excitement? For a third version of the Sci.Rep authorship list exists... this time, including Dr Blackburn! This version is presumably authoritative, for it comes directly from the UCSD Press Office, co-signed by "Director of Media Relations" and "Senior Public Information Officer" (though the fawningly Chopra-centric nature of the text inspires a cynical suspicion that it was actually written by one of his lickspittles and sent to UCSD to be churnalised).
"Co-authors include: Arthur M. Moseley, Joseph Lucas, Lisa St John Williams and P. Murali Doraiswamy, Duke University; Elizabeth H. Blackburn, and Elissa E. Epel, UC San Francisco; Sheila Patel, and Valencia Porter, UC San Diego and The Chopra Center for Wellbeing; Scott N. Peterson, Sanford Burnham Prebys Medical Discovery Institute; Eric E. Schadt, Steven R. Steinhubl, and Eric J. Topol, Scripps Translational Science Institute; and Rudolph E. Tanzi, Harvard University."
Nevertheless, I am advised that Dr Blackburn was never involved in the paper, and thus never retracted authorship, and has no intention of ever publishing on the telomere facet of the SBTI. In fact, contra the Clinical Trials entry, she did not collaborate in the SBTI after all.

Topol, I am further informed, has no plans to publish on the heart/breathing facet of the SBTI. In contrast, Steinhubl is enthusiastic about a paper in preparation based on that data, and I look forward to seeing how he resolves all the confounded interventions.

Blackburn has published research on the effects of meditation, recruiting subjects through Chopra's therapeutic regime, but that lacked his co-authorship and fell outside the SBTI.¹ We should also note Topol and Steinhubl's 2015 paper, in Frontiers of Human Neuroscience, on the topic of "Cardiovascular and nervous system changes during meditation". Chopra was a co-author there (though relegated to penultimate position in the authorship list: a loss of prestige that may have rankled and cried out for redress).


It may be that Topol was unaware of the calibre of his collaborators, or of the risk they would later feel free to steal his reputation. Now I have no reason to doubt the integrity or the value of the measurements of body functions reported in the Frontiers advertisement paper. And of course Topol has the right to choose collaborators, and to acknowledge them with co-authorship if they have assisted with recruiting subjects. I am just remembering the 'Bad Blood' review, and pondering on the irony.

1. 'Orac' was mistaken on that point in his critical review of Epel et al. (2016).

4 comments:

H. Rumbold, Master Barber said...

+1 for Chopralific

Smut Clyde said...

"Chopralitic" would also have been accepted.

H. Rumbold, Master Barber said...

not to give anyone ideas, but there are suckers out there who would pay for faecal microbiota transplant/probiotics with fossilized dino dung- i.e."chopralithic" therapy

Smut Clyde said...

Idea duly given!