I'm frequently reminded of the irregular verb theory. Val McDermid has a pithy example:
I am diplomatic
You are tactful
He/she is a liar
I think that irregular noun counting
is also becoming more common. For some time, it seems as if single studies are transformed into plurals and a handful of studies is inflated into "a plethora". (YorkTest
make this charming transformation:
There is now a plethora of data showing that people who have adapted their diet according to the YORKTEST results report an improvement in their symptoms. Some of these data have been independently reported [refs to 4 studies, one of which is unpublished, another of which is a poster at a conference and one other that is of dubious clinical relevance (like the unpublished, it is an audit of a customer satisfaction questionnaire). The only clinically relevant paper doesn't fully support their stance as the authors carefully limit its applicability to food intolerance and state that it may be irrelevant].)
The transformation of a single paper/trial into the plural happened recently when I saw Dr. Chris Steele on television; he was promoting Medinose Plus
for hayfever. The Medinose Plus
is recommended for hayfever sufferers. It involves inserting two visible red lightsources on nasal prongs into your nose, for a few minutes at a time, as a form of light therapy (or phototherapy), two or three times a day while exposure to the trigger lasts (e.g., during grass pollen season). If you have guessed that inserting these lightsources into your nose gives the unseasonal yet jolly appearance of Rudolph the Red-nosed Reindeer, then you are correct.
Dr. Steele appeared on This Morning
: the Medinose text
Using photo therapy (light therapy) medinose promises to practically eliminate allergic symptoms such as congestion, runny nose, watery eyes, and headaches within a couple of weeks of use. Using photo therapy, Medinose inhibits the release of histamine, relieving or even completely eliminating allergic reactions and complaints in a natural way.
Now, on his own website, Dr. Steele
These products have been featured on my TV, Radio or Print spots. Please note that I am NOT endorsing them or recommending them, this information is provided for your convenience only. All information has been provided by the manufacturer/retailer.
Where possible I have provided a direct link to allow you to buy the item online.
This is a little disingenuous. On his website, Dr. Steele has this description of the Medinose
but he fails to repeat the warning that the information is (presumably) from the manufacturer/retailer (even quotation marks would have helped, as would not
repeating the text in the running banner at the top of the page):
Medinose inhibits the release of histamine, relieving or even completely eliminating allergic reactions and complaints in a natural way. The body is not burdened by drugs and Medinose has no side effects...
I recently received this customer testimonial from the manufacturer which shows that the product does work.
No, it doesn't. It shows that the person who provided the testimonial had a positive experience. In the literature that I've seen (of which, more below), there is no
indication that there is any evidence that Medinose
"completely eliminates allergic reactions and complaints". The literature doesn't detail any direct measurement to prove the inhibited release of histamine. However, on the testimonial webpage, Dr. Steele does mention that he was sent the testimonial by the manufacturer: at the top of the page, in a size 8 font, in light grey on the white background. But still, he did mention it...
In the item that I saw on television, Dr. Steele said that there were papers and trials (plural) to support the use of Medinose
. He quoted the results and reported that he had seen the photographs of endoscopies that demonstrated a reduction in rhinitis swelling after use of the Medinose
I am disappointed that Dr. Steele referred to papers and trials (to emphasise, both in the plural) but I could only find one specific paper: Narrow-band redlight phototherapy in perennial allergic rhinitis and nasal polyposis
(presumably the source of the photographs).
Looking at the site of the distributors, most of them refer the reader to newspaper items for information about Medinose and its mechanism of action
. I did find a site that also claimed that "[c]linical double blind randomized trials have been undertaken
" [my emphasis, to highlight the plural] but, again, they only link to the above paper (singular). What is it with the plurals? Do references to a
clinical paper bring out royal grammar in line with the first person plural-does this account for the irregular noun counting?Entrez PubMed
has 17 articles on phototherapy and rhinitis; however, the other papers discuss the use of different light spectra and wavelengths (10 discuss ultraviolet light and one of these includes the red light; most of the remainder do not provide the abstract or sufficient detail).
Note that the title refers to perennial allergic rhinitis
and not hayfever (seasonal allergic rhinitis): the difference is that perennial allergic rhinitis typically involves 'indoor' allergens such as house dust mite and pet skin flakes. However, the majority of the current promotion (understandably) emphasises its role in hayfever symptom alleviation.
Oddly enough, Medinose
makes an appearance in the Daily Mail
's Hayfever Survival Kit
. The journalist claims:
with the help of two of the country's leading allergy experts - Jonathan Brostoff, professor of allergy and environmental health at King's College, London, and Dr Alexandra Croom, consultant allergist from Glenfield Hospital, Leicester - we show you the treatments that have been proven to work.
Whether you're a first-time sufferer or a veteran of 20 summers, these are the remedies that will make a difference.
However, it is difficult to know when any of the remedies have been recommended by the experts. In the Pros and Cons footer to the item about Medinose, the Cons acknowledges,
Scientific data behind this sort of product is limited.
I expected rather more of something which claimed to show me "the treatments that have been proven
to work" (my emphasis).
Several newspaper articles and the Medinose FAQ of one distributor
detail the influence of Medinose
on a variety of symptoms:
Swelling of the eyes and other allergic symptoms arise due to the release of the substance histamine from the mast cells in the nasal mucous membranes. Photo therapy with the Medinose works via the nasal mucous membranes. However, by using red light therapy, it isn’t only nose complaints that disappear, but also the oppressive feeling associated with allergies, watering or swollen eyes, coughing, itches and headaches.
The claims extend beyond efficacy for hayfever to other allergies:
The Medinose helps with allergies of the nasal mucous membranes i.e. not just hayfever, but also animal hair and house dust allergies.
The FAQ also says,
The Medinose has undergone extensive clinical testing, with over 70% of patients reporting a significant reduction in allergic symptoms.
According to Healthyliving
(Ireland), "Medinose has already been proven and tested in thousands of cases!" I have no opinion as the the efficacy of Medinose
; I have never met anyone who used or prescribed it (although several parents have now asked me about it, following all the recent publicity) and there is a distinct lack of clinical literature. The only published paper is from 1997 and I'm still waiting to see a copy from the British Library
. However, I do know that the sole paper can not possibly be interpreted as evidence of "extensive clinical testing". This was not
a multi-centre research project involving hundreds or even thousands of people with allergic rhinitis. There were "50 patients with allergic rhinitis and 10 with nasal polyposis" in the treatment arm of the study and "[t]wenty-nine rhinitic patients and one patient with polyposis" in the placebo group who used a sham light. The treatment schedule lasted for 14 days.
The researchers evaluated the outcome of the treatment by assessing the participants' symptom scores and a clinical assessment that included pre-treatment and post-treatment videotaped rigid and flexible nasendoscopy.
[I]mprovement of symptoms was reported by 72% of the allergic rhinitis patients and objective improvement was endoscopically demonstrated in 70% of them as compared with 24% and 3%, respectively, in the placebo group. These differences were significant. No improvement was obtained in any of the patients with polyposis.
I need to see the full paper before I can comment on the extent of the changes and the clinical significance associated with them. However, even with the paper, there is no evidence that the beneficial reduction of swelling in the nose continues beyond the 14 treatment days, or even with continuous use. Although a reduction in nasal swelling is a useful proxy, it is not direct evidence of a reduction in histamine production.
The only objective assessment in the paper was the nasal examination. Despite the optimism of the distributors and the newspaper articles, it is not possible to claim that there is any verifiable evidence of efficacy for the "oppressive feeling associated with allergies, watering or swollen eyes, coughing, itches and headaches".
The authors of the paper conclude their abstract as follows:
Allergic rhinitis, if uncomplicated by polyps or chronic sinusitis, can be effectively treated by narrow-band red light illumination of the nasal mucosa at 660 nm, with marked alleviation of clinical symptoms. Whenever possible, candidates for phototherapy should be selected by endoscopic examination. [Emphases added.]
I've read a number of articles about the Medinose
and browsed the websites of several distributors. No articles or product descriptions that I've seen have mentioned that the device is not recommended for people with polyps or chronic sinusitis. Nor have any of the journalists or distributors mentioned the recommendation that candidates should be selected on the basis of an endoscopic examination. It is entirely possible that the journalists and website copywriters consider that the cost of the Medinose
(around £80) and the 30 days moneyback guarantee mean that it would be cheaper and more convenient for some people to purchase and test the product (and return it if necessary) than attempting to obtain a timely professional opinion, but it would have been useful if they had acknowledged the recommendation of the authors of the clinical study.Allergy UK offers advice on the self-management of hayfever
Labels: allergic rhinitis, allergies, hayfever, irregular noun counting, irregular verb theory, Medinose, phototherapy, YorkTest