Quackwatch

History

Barrett founded the Lehigh Valley Committee Against Health Fraud (LVCAHF) in 1969, and it was incorporated in the state of Pennsylvania in 1970. In 1996, the corporation began the website quackwatch.org, and the organization itself was renamed Quackwatch, Inc. in 1997. The Pennsylvania nonprofit corporation was dissolved after Barrett moved to North Carolina in 2008, but the network's activities continue. Quackwatch is closely affiliated with the National Council Against Health Fraud (NCAHF), of which it was a co-founder.

Mission and scope

Quackwatch is overseen by Barrett, its owner, with input from advisors and help from volunteers, including a number of medical professionals. In 2003, 150 scientific and technical advisors: 67 medical advisors, 12 dental advisors, 13 mental health advisors, 16 nutrition and food science advisors, 3 podiatry advisors, 8 veterinary advisors, and 33 other "scientific and technical advisors" were listed by Quackwatch. Since that time, many more have volunteered, but advisor names are no longer listed. The site has recruited volunteers to report on various topics of questionable health practice. Many credible professionals have agreed to be involved on the site in their fields of expertise.

Quackwatch describes its mission as follows:

... investigating questionable claims, answering inquiries about products and services, advising quackery victims, distributing reliable publications, debunking pseudoscientific claims, reporting illegal marketing, improving the quality of health information on the internet, assisting or generating consumer-protection lawsuits, and attacking misleading advertising on the internet.

Quackwatch states that there are no salaried employees, and a total cost of operating all of Quackwatch's sites is approximately $7,000 per year. It is funded mainly by small individual donations, commissions from sales on other sites to which they refer, profits from the sale of publications, and self-funding by Barrett. The stated income is also derived from usage of sponsored links. The site focuses on combating health-related frauds, myths, fads, and fallacies that is hard to find elsewhere.

Site content

The Quackwatch website contains essays and white papers, written by Barrett and other writers, intended for the non-specialist consumer. The articles discuss health-related products, treatments, enterprises, and providers that Quackwatch deems to be misleading, fraudulent, and/or ineffective. Also included are links to article sources and both internal and external resources for further study.

The site is especially critical of products, services, and theories that it considers questionable, dubious, and/or dangerous, including:

The website also criticizes some practices, such as caloric restriction and the Dean Ornish program, because they are considered to be too difficult for many people to follow, not because they are ineffective; It also argues against resveratrol, which it deems to have inadequate research backing.

The website provides information about specific people who perform, market, and advocate therapies it considers dubious, including in many cases details of convictions for past marketing fraud. It maintains lists of sources, individuals, and groups it considers questionable and non-recommendable. Its lists include two-time Nobel Prize winner Linus Pauling (whose claims about mega-doses of vitamin C are criticized), the National Center for Complementary and Alternative Medicine (NCCAM), and integrative medicine proponent Andrew Weil.

Related and subsidiary sites

The Quackwatch site is part of a network of related sites, including Homeowatch (on homeopathy), Credential Watch (devoted to exposing degree mills), Chirobase (specifically devoted to chiropractic), and MLM Watch (conceived as a skeptic’s guide to multi-level marketing), each devoted to specific topics. Quackwatch.org's articles are reviewed by advisors upon request. The site is developed with the assistance from a worldwide network of volunteers and expert advisors. Many of its articles cite peer-reviewed research and are thoroughly footnoted with several links to references. The site's search engine helps retrieve specific articles. A review in Running & FitNews stated the site "also provides links to hundreds of trusted health sites." Naturowatch is a subsidiary site of Quackwatch which aims to provide information about naturopathy that is "difficult or impossible to find elsewhere", and thereby functions as a skeptical guide to the topic. The site is operated by Barrett and Kimball C. Atwood IV, an anesthesiologist by profession, who has become a vocal critic of alternative medicine.

The site is available in French and Portuguese, and formerly in German, as well as via several mirrors, including www.quack-watch.org and www.quackwatch.com.

Influence

Some sources that mention Stephen Barrett's Quackwatch as a useful source for consumer information include website reviews, government agencies, various journals including an article in The Lancet and some libraries.

Mention in media, reviews, and journals

Quackwatch has been mentioned in the media, reviews and various journals, as well as receiving several awards and honors. It is consistently praised as a top source for screening medical information on the web. In 1998, Quackwatch was recognized by the Journal of the American Medical Association as one of nine "select sites that provide reliable health information and resources." It was also listed as one of three medical sites in U.S. News & World Report's "Best of the Web" in 1999. A website review by Forbes magazine stated:

Dr. Stephen Barrett, a psychiatrist, seeks to expose unproven medical treatments and possible unsafe practices through his homegrown but well-organized site. Mostly attacking alternative medicines, homeopathy and chiropractors, the tone here can be rather harsh. However, the lists of sources of health advice to avoid, including books, specific doctors and organizations, are great for the uninformed. Barrett received an FDA Commissioner's Special Citation Award for fighting nutrition quackery in 1984. BEST: Frequently updated, but also archives of relevant articles that date back at least four years. WORST: Lists some specific doctors and organizations without explaining the reason for their selection.

Citations by journalists

Quackwatch has also been cited or mentioned by journalists in reports on therapeutic touch, Vitamin O, Almon Glenn Braswell's baldness treatments, dietary supplements, Robert Barefoot's coral calcium claims, William C. Rader's "stem cell" therapy, noni juice, shark cartilage, and infomercials. The site's opinion on a US government report on complementary medicine was mentioned in a news report in the Journal of the National Cancer Institute. Sources that mention quackwatch.org as a resource for consumer information include the United States Department of Agriculture, the American Journal of Pharmaceutical Education, The Lancet, the Journal of Marketing Education, the Medical Journal of Australia, the Journal of the American Dietetic Association, the U.S. Department of Health & Human Services, the U.S. National Institutes of Health, the Skeptic’s Dictionary, and the Diet Channel. Websites of libraries across the United States of America, include links to Quackwatch as a source for consumer information. In addition, several nutrition associations link to Quackwatch. An article in PC World listed it as one of three websites for finding the truth about Internet rumors, and WebMD listed it as one of eight organizations to contact with questions about a product. In a Washington Post review of alternative medicine websites, the introduction rated Quackwatch as offering "better truth-squadding than the Food and Drug Administration or the National Center for Complementary and Alternative Medicine."

American Cancer Society

The American Cancer Society lists Quackwatch as one of ten reputable sources of information about alternative and complementary therapies in their book Cancer Medicine, and includes it in a list of sources for information about alternative and complementary therapies in an article about on-line cancer information and support. In a long series of articles on various alternative medicine methods, it uses Quackwatch as a reference and includes criticisms of the methods.

Health On the Net Foundation (HONcode)

The Health On the Net Foundation, which confers the HONcode "Code of Conduct" certification to reliable sources of health information in cyberspace, directly recommends Quackwatch, and has stated about Quackwatch:

On the positive side, “four web sites stand out” from the rest for the exemplary quality of their information and treatments: quackwatch.org, ebandolier.com, cis.nci.nih.gov and rosenthal.hs.columbia.edu. Three sites, quackwatch.org, rosenthal.hs.columbia.edu/ and cis.nci.nih.gov are HONcode certified by the Health On the Net Foundation.

Their website also uses Quackwatch extensively as a recommended source on various health-related topics. It also advises Internet users to alert Quackwatch:

If you come across a healthcare Web site that you believe is either possibly or blatantly fraudulent and does NOT display the HONcode, please alert Quackwatch. Of course, if such a site DOES display the HONcode, alert us immediately.

Gold standard in 2007 feasibility study

In a 2007 feasibility study on a method for identifying web pages that make unproven claims, the authors wrote:

Our gold standard relied on selected unproven cancer treatments identified by experts at http://www.quackwatch.org. The website is maintained by a 36 year old nonprofit organization whose mission is to “combat health related frauds, myths, fads, fallacies, and misconduct.” The group employs a 152 person scientific and technical advisory board composed of academic and private physicians, dentists, mental health advisors, registered dietitians, podiatrists, veterinarians, and other experts whom review health related claims. By using unproven treatments identified by an oversight organization, we capitalized on an existing high quality review.

Site reviews

The Good Web Guide said Quackwatch "is without doubt an important and useful information resource and injects a healthy dose of scepticism into reviewing popular health information". Cunningham and Marcason in the Journal of the American Dietetic Association described Quackwatch as "useful", while Wallace and Kimball, in the Medical Journal of Australia, described the site as "objective". The Rough Guide To The Internet writes "don't buy anything until you've looked it up on Quackwatch, a good place to separate the docs from the ducks."

Ned Vankevitch, associate professor of communications at Trinity Western University, places Barrett in a historical tradition of anti-quackery, embracing such figures as Morris Fishbein and Abraham Flexner, which has been part of American medical culture since the early-twentieth century. Acknowledging that Quackwatch's "exposé of dangerous and fraudulent health products represents an important social and ethical response to deception and exploitation", Vankevitch criticizes Barrett for attempting to limit "medical diversity", employing "denigrating terminology", categorizing all complementary and alternative medicine as a species of medical hucksterism, failing to condemn shortcomings within conventional biomedicine, and for promoting an exclusionary model of medical scientism and health that serves hegemonic interests and does not fully address patient needs.

Donna Ladd, a journalist with The Village Voice, says Barrett relies heavily on negative research in which alternative therapies are shown to not work. Barrett said to Ladd that most positive case studies are unreliable. Ladd wrote that Barrett says that most alternative therapies simply should be disregarded without further research: "A lot of things don't need to be tested [because] they simply don't make any sense," he says, pointing to homeopathy, chiropractic, and acupuncture as examples of alternative treatments with no plausible mechanism of action.

Waltraud Ernst, professor of the history of medicine at Oxford Brookes University, commenting on Vankevitch's observations, agrees that attempts to police the "medical cyber-market with a view to preventing fraudulent and potentially harmful practices may well be justified." She commends "Barrett's concern for unsubstantiated promotion and hype," and states that "Barrett's concern for fraudulent and potentially dangerous medical practices is important," but she sees Barrett's use of "an antiquarian term such as 'quack'" as part of a "dichotomising discourse that aims to discredit the "'old-fashioned', 'traditional', 'folksy' and heterodox by contrasting it with the 'modern', 'scientific' and orthodox." Ernst also interprets Barrett's attempt to "reject and label as 'quackery' each and every approach that is not part of science-based medicine" as one which minimizes the patient's role in the healing process and is inimical to medical pluralism.

A review paper in the Annals of Oncology identified Quackwatch as an outstanding complementary medicine information source for cancer patients.

Helen Pilcher writing for Nature News believes "Up to 55% of the Internet's 600 million users gather medical information from it. Patients with life-threatening diseases, such as cancer, often use the web to seek out alternative therapies, but with over half a million sites offering advice, the quality of that information varies greatly." Edzard Ernst says, "Good websites do exist, and the majority of those tested provided useful and reliable information. Two sites, Quackwatch and Bandolier, stood out for the quality of the information they provide.

The Handbook of Nutrition and Food explains "Maintaining adequate nutrition is important for general health of cancer patients, as it is with all patients, and diet plays a role in preventing certain cancers. However, no diet or dietary supplement product has been proven to improve the outcome of an established cancer. Detailed information on today's questionable cancer methods is available on the Quackwatch web site".

Steven L. Brown states "Dr. Stephen Barrett's website www.quackwatch.com provides excellent, detailed, well-researched, and documented information about alternative therapies that have been disproved."

Journalist John MacDonald, writing for the Khaleej Times, called Quackwatch "a voice of reason on everything from the efficacy of alternative medicine to the validity of advice from best-selling diet gurus, and the various forms of medical quackery being perpetrated on gullible consumers".

The 2009 Internet Directory advised that "Have you ever read a health article or had a friend suggest a remedy that sounded too good to be true? Then check it out on Quackwatch before you shell out any money or risk your health to try it. Here you will find a skeptical friend to help you sort out what's true from what is not when it comes to your physical well-being."

The book Chronic Pain For Dummies says "Although many reliable resources are on the Internet, including those we list in this chapter, sadly, far too many sites offer only incorrect and/or outdated information, and many are downright hoaxes designed to sell empty promises. Make sure you gather information only from reliable resources. Two good sites for checking out possible hoaxes are www.quackwatch.org and http://hoaxbusters.ciac.org."

The Arthritis Helpbook articulated that "One good source for information about questionable treatments is Quackwatch.org, a nonprofit corporation whose purpose is to combat health-related frauds, myths, and fallacies (www.quackwatch.org). They also have other sites that are accessible from Quackwatch."

Katherine Chauncey, in Low-Carb Dieting for Dummies, writes "The main purpose of Quackwatch (www.quackwatch.org) is to combat fraud, myths, fads, and fallacies in the health field. This is a hard-hitting site developed by Stephen Barrett, MD. Not only is quackery-related information targeted, but quack individuals are named. You'll find information here that you won't find anywhere else. One of the goals of the site is to improve the quality of information on the Internet. Just reviewing this site will show you how to recognize information that may be coming from dubious sources."

Writing in the trade-journal The Consultant Pharmacist, pharmacist Bao-Anh Nguyen-Khoa characterized Quackwatch as "relevant for both consumers and professionals". Nguyen-Khoa noted two Quackwatch articles to be of interest to consultant pharmacists - "Selling of Dubious Products" about pharmacists stocking and recommending dubious alternative products that they have a poor knowledge of but continued stocking them because of the higher profit margins, and "Misuse of Compounding" about some pharmacies compounding readily available commercial products from bulk instead of available prescriptions because the ingredients may be less expensive. Nguyen-Khoa remarked that the "site makes an effort to cross-reference keywords with other articles and link its citations to the Medline abstract from the National Library of Medicine". The site has received praise from reputable reviewers and rating services. As of 1999, steps were taken to correct the presence of so many articles written by Barrett which left one with a sense of a lack of fair balance in one author's condemnation of many dubious health therapies, as many reputable professionals have signed on to populate the site in their area of expertise. Nguyen-Khoa stated that the implementation of a peer review process would improve the site's legitimacy, which is a logical transition for a site that uses a lot of accepted medical literature as its foundation. The success of Quackwatch has generated other related sites. According to The Consultant Pharmacist, Barrett often "inserts his strong opinions directly into sections of an article already well supported by the literature. Although entertaining, this direct commentary may be viewed by some as less than professional medical writing and may be better reserved for its own section."

The former U.S. Department of Health and Human Services Science Panel on Interactive Communication and Health named Quackwatch as a credible source for exposing fraudulent online health information in 1999. Dr. Thomas R. Eng, the director of the panel's study, later stated, "The government doesn't endorse Web sites." Still, he said, "[Quackwatch] is the only site I know of right now looking at issues of fraud and health on the Internet."

The organization has often been challenged by supporters and practitioners of the various forms of alternative medicine that are criticized on the website.