If you’re guessing that the correct answer to the title question is ‘nothing’ then congratulations, you have the correct answer but please permit me to elaborate a little further.

At the beginning of May I wrote about David Stevens, a Leatherhead-based quack who trades under the names Vital Body Health Limited and the College of Chirokinetic Therapy. At the conclusion of that article I noted that I would be inviting the Advertising Standard Authority to review the extensive list of conditions he purports to have been successfully treated using chirokinetic therapy at his ‘college’ website.

The ASA’s adjudication on the manner in which Stevens’ markets his woo has now been published and it makes for rather interesting reading – but before we get to that I should throw in a bit of additional background information about Mr Stevens, just so everyone is absolutely clear who – exactly – it is we’re dealing with here.

So…

Mr Stevens’ full name is Humphrey David Stevens DC, according to this information registered at Companies House for his current business – Vital Body Health Limited – and the seven other dissolved companies of which he was either a director or company secretary between 1991 and 2003. These records indicate that Stevens started out in the property management/building trade, trading as Humphrey Stevens Limited (dissolved 1993), Kember Properties Limited (dissolved 1994), Fairway Property Services Limited (dissolved 1997) and Fairway Building Management Services Ltd (dissolved 1998).

None of these companies, two of which had a registered address in Epsom, are in any way associated with any other businesses trading under the same or similar name.

Stevens switched tack in the mid-90s and obtained a Diploma in Chiropractic in 1996 from the Witney School of Chiropractic (part of the McTimoney group) and appears in a number of places, including records held by Companies House, to by using the letters ‘DC’ after his name, even though this is professionally meaningless and, even within the realms of chiropractic, potentially misleading – amongst chiropractors the letters DC typically refer to the title ‘Doctor of Chiropractic’, a qualification that can be obtained by studying in the United States, but not in the UK.

He is not currently registered as chiropractor with either McTimoney or the General Chiropractic Council, which is just as well as his previous encounter with ASA, in 2004, came as a result of a complaint from the GCC.

After gaining his ‘qualification’ and inventing chirokinetic ‘therapy’ in 1997 he’s traded as Chiro Kinetic Therapy Limited (dissolved 2007), Food Allergy Help.com Limited (dissolved 2006) and Vital Body Limited (dissolved 2006) – or rather he hasn’t traded as such as all three companies were dormant at the point of dissolution. All three of these companies operated – if that’s the right word – from premises located at 8, The Crescent, Leatherhead, as does his latest venture and, interestingly, these premises have D1 planning consent for a Chiropractic Clinic, despite the fact that Stevens cannot trade as a chiropractor as he’s not registered with the GCC.

Planning documents lodged with Mole Valley Council in regards to a 2009 application – by a third party – for a relaxation of planning conditions which would have allowed a dental surgery on the premises indicate that at various times, Mr Stevens has been none too popular with some of his neighbours, who’ve complained about noise emanating from his premises outside of the business hours specified in its planning consent as a result of Stevens permitting a freelance massage therapist to use the premises out of hours.

Currently, Stevens has two main operational websites:

– ‘Chirokinetic Therapy’ (www.chirokinetictherapy.com) which also serves as the online ‘home’ for his ‘College of Chirokinetic Therapy’, and

– ‘Vital Body Health’ (www.vitalbodyhealth.co.uk) from which Stevens’ promotes a book called ‘Every Woman’s Guide to Vital Breast Health’ using testimonials that show Stevens to be dabbling in cancer quackery.

So that’s the ‘who’ now what are we complaining about?

Well, as I noted last time out Stevens provides this description of chirokinetic therapy on his ‘college’ website:

The treatment itself is very straightforward. It employs muscle testing as a way of communicating with the body to establish areas of imbalance. The CKT conversation with the body is at a cellular level. Cellular memory, communication and intelligence are of particular importance in CKT.

The body communicates with the CKT practitioner by relaxing a muscle group, allowing cellular memory to be investigated. Testing may include checking for allergies, digestive and eliminative concerns, also the hormonal, structural and emotional effects. The aim is to build up a clear picture of the imbalances that the body considers a priority.

During this testing procedure, cellular intelligence becomes more active or acute directing the practitioner to a specific cranial spot. These cranial energy portals work in a unique way, redirecting healing energy to areas of the body which have become depleted. Once the portal is activated using a gentle flicking technique, the treatment can have an immediate effect, structural imbalances causing back, neck or joint pain may be improved within a few minutes following treatment.

The next step is to establish with the body a response time, this is to enable your body to begin the re balancing process. After your response time, you will then be retested to ensure that the treatment has been successful.

‘Muscle testing’ is a reference to applied kinesiology which Steven Novella has, since my last missive, helpfully dissected as follows:

[Applied kinesiology is]… a diagnostic test that is fraudulent. It is not based upon any valid scientific principle. The basic elements of the technique have never been established, and in fact are unscientific (the existence of vital force or its alleged influence on muscle strength), and the technique has been shown to be ineffective when tested scientifically. It’s also plainly absurd. But even absurd-sounding claims may be accepted as true if they are backed with sufficient rigorous evidence. In this case the absurd claim was exposed as false when studied scientifically.

And everything else in Stevens’ description of chirokinetic therapy is similarly a complete load of pseudoscientific drool, not least the concept of ‘cellular memory’ (or ‘body memory’) which was comprehensively picked to piece by Susan E Smith, in the context of ‘survivor psychology’ in a paper published in 1993. [1]

A little pseudo-scientific terminology and a lot of pseudo-psychological mumbo-jumbo and the blind commitment of true believer fanaticism creates an internal logic that appears to make sense, but the body memory theory is wrong.  If the body memory theory had any credibility, neuroscientists could stop looking for a cause or cure for Alzheimer’s in the brain and just activate all the body memories, which survivor psychologists claim “remember everything the mind forgets” (Bass & Davis, 1988).

Misguided and unethical therapists use the body memory theory to manufacture “evidence” of sexual abuse and traumatic memories where none exist.  When the therapist interprets flushing, hives, rashes, headaches, stomach aches, or other physiological sensations of stress and emotional arousal as forms of memory” during counseling sessions, hypnosis or groups, the notion of body memories becomes a means of indoctrination into survivor logic.  When therapists teach clients that everything from the common cold to cancer are body memories, clients develop attentional biases or predispositions to interpret mundane sensations to serious illnesses as body memories.  This means of divination used by therapists to convince clients with no memories of sexual abuse that they are “survivors” is not responsible, credible, or supportable.

Last, and definitely least, we have the reference to ‘cranial energy portals’ which puts Stevens’ activities firmly within the realms of the sizeable majority of alt-med practitioners who avoid charges of fraud only by virtue of professing to have thoroughly deluded themselves before setting out to delude their marks – its pure woo.

Nevertheless, Stevens claims that his personal brand of woo has been used to ‘successfully’ treat more than 50 different conditions including Anaphylaxia [sic], Anorexia, Arthritis, Asthma, Depression, Infertility, ME, Oedema, Palpitations, Rheumatism and Urticaria. Many of the conditions listed by Steven are either serious in their own right or – potentially – symptoms of very serious conditions and require the attention of a genuine medical practitioner rather than a quack with a diploma in woo.

So, naturally enough, I chose to invite the ASA to ask Stevens to put up the evidence to support these claim, to which they got the following response, as noted in the full adjudication.

The College of Chirokinetics submitted several documents relating to anaphylaxis, which provided the results of individuals relating to various food, environmental and insect sensitivities. The documents showed various immunoglobulin (lgE) tests pre and post CKT, some of which were several years apart. They also submitted several testimonials and a patient consultation which the advertiser said related to the success of CKT.

Back in 2004, when Stevens’ claims were challenged by the General Chiropractic Council, Stevens gave the following information to the ASA:

The advertiser sent several letters and feedback forms from patients; the letters and forms reported health improvements from his chirokinetic therapy (CKT). He sent a letter template that was sent to potential participants in a pilot trial to study the effect of CKT on anaphylaxia, with which that he was involved.

So, eight years on, Stevens is still relying on an assortment of testimonials while the ‘pilot trial’ he purported to be setting up in 2004 is nowhere to be seen in his response.

So how did the ASA respond to Stevens’ ‘evidence’?

Results were submitted for individuals’ IgE levels, however, not all were tested pre and post allergic reaction and some tests were several years apart. The ASA understood that this test was well-established and supported by scientific literature. However, some results could give false negatives and false positives so we considered that the test should not be interpreted uncritically nor function as a sole diagnostic tool. The tests related to allergy testing not to the treatment of anaphylaxis which we understood should be treated under the supervision of a suitably qualified health professional.

The scientific status of immunoglobulin (IgE) testing is ably covered by a paper published in the Cleveland Clinical Journal of Medicine in 2011 [2].

Allergy Blood Testing: A practical guide for clinicians.

Abstract.

Blood tests are available that measure levels of immunoglobulin E (IgE) against specific allergens such as foods, inhalants, medications, latex, and venoms. These tests can confirm the diagnosis of an allergic disorder, supplementing a clinical history consistent with an immediate allergic reaction. They are particularly useful when skin testing cannot or should not be performed.

The full text of this paper is available free of charge and well worth reading, however its abstract also includes a summary of the key points from the paper, which is more than adequate for our purposes:

Specific IgE levels higher than 0.35 kU/L suggest sensitization, but that is not synonymous with clinical disease.

So, based on this threshold, some people will test positive despite exhibiting no clinical symptoms of allergy and the paper also reports instances in which people have come up negative on the test despite clearly exhibiting allergy symptoms.

Prospective studies have identified IgE levels that can predict clinical reactivity with greater than 95% certainty for certain foods, but similar studies have not been performed for most other foods, drugs, latex, or venom.

So these tests have only been validated by clinical trials for a very limited range of possible allergens – cow’s milk, eggs, peanuts, fish, soya, tree nuts and wheat are all listed in a table which gives the positive predictive value (PPV) for these tests, some of which are quite impressive (95-100%) – PPV is a measure of the percentage of people with a particular condition who are correctly diagnosed using a particular test – but there’s also a bit of catch as the paper notes that most of the data in these trials comes from ‘pediatric populations’ (children) and not all the trials met the full double-blind, placebo controlled gold standard for RCTs.

The likelihood of an IgE-mediated clinical reaction often increases with the level of specific IgE, but these levels do not predict severity or guarantee a reaction will occur.

Again, we’re back to the fact that an increase in IqE levels does not necessarily mean that an individual will experience allergy symptom nor does it predict the severity of symptoms, if any, that an individual may experience.

The sensitivity of allergy blood tests ranges from 60% to 95%, and the specificity ranges from 30% to 95%.

Sensitivity shows the percentage of positive test results that were correct out of all positive results while specificity indicates the percentage of negative result that were correct out of all negative test results – and the striking thing here is not only is their a considerable degree of variation in the accuracy of these test but also, depending exactly what’s being tested for, the possibility of very high rates of false positives and false negatives. It’s little wonder, therefore, that the paper’s list of key points concludes as follows.

In the appropriate setting, these tests can help in identifying specific allergens and assessing allergic disease.

Neither allergy blood testing nor skin testing should be used for screening: they may be most useful as confirmatory tests when the patient’s history is compatible with an IgE-mediated reaction.

In other words, in the hands of a suitably qualified and experienced clinician, IgE tests are – despite their limitations – a useful means of confirming a diagnosis where the patient’s medical history strongly suggests that may have an allergy, but otherwise, and especially in the hands of an unqualified quack, the vast majority of these tests are next to useless as a diagnostic tool in their own right.

As the ASA also correctly point out, Stevens’ evidence, in addition to be being highly unsatisfactory, also relates to the general allergy testing and not the treatment of anaphylaxis – so it fails to support the claim that CKT has been used to successfully treat anaphylaxis – leading them to conclude that:

We considered that, because they were not robust clinical studies, the various patient tests and testimonials were not sufficient to support the claim that CKT could treat anaphylaxis as the result of food, environmental or insect allergies.

On this point the website breached CAP Code (edition 12) rules 3.1 (Misleading advertising), 3.7 (Substantiation), 12.1 and 12.2 (Medicines, medical devices, health-related products and beauty products).

Anaphalaxis is just one of more than 50 conditions and symptoms that Stevens claims have been successfully treated with chirokinetic therapy, so what evidence did he manage to provide for these other conditions?

No evidence was submitted for the additional conditions listed on the marketer’s website.

Let’s be clear here. Stevens professes to be the inventor of Chirokinetic Therapy and, based on promotional literature on his own ‘college website’ charges anything up £1,000 to teach others the secrets of his personal woo, and yet, despite listing more than 50 separate conditions on his website which he claims have been successfully treated using chirokinetic therapy, he did not produce a single piece of evidence to support any of the those claims, not even a crappy anecdote or dubious testimonial.

Not a jot.

This is despite the fact that Stevens’ website lists several serious conditions, – anorexia, arthritis, infertility, asthma, etc. – which should certainly only be treated by a suitably qualified health professional, and a number of other conditions that may or not be serious in their own right but which may, in some patients, be symptoms of very serious conditions. Oedema, an abnormal accumulation of fluid beneath the skin or in body cavities that cause swelling, can be a symptom of both diabetes mellitus and congestive cardiac failure and is not something to be trifled with by quacks.

The ASA conclusions are straightforward and to the point:

We also considered the additional claims made for the efficacy of CKT, in particular depression, infertility, anorexia, addictions, asthma and arthritis to be conditions that should be treated by a suitable health professional. The website also listed other conditions under the sub-heading “The following conditions have been successfully treated using Chirokinetic Therapy”, for example, immune system, hormonal, infections and thyroid. As we did not see evidence of suitable qualifications from the advertiser or those offering CKT, we considered that by listing such conditions, including anaphylaxis, the claims may discourage essential treatment for conditions that should be supervised under a suitably qualified health professional.

On this point the website breached CAP Code (edition 12) rules 3.1 (Misleading advertising), 3.7 (Substantiation), 12.1 and 12.2 (Medicines, medical devices, health-related products and beauty products).

Stevens has, therefore, been told by the ASA not to “make claims for conditions that should be supervised under a suitably qualified health professional or make claims for the efficacy of CKT for conditions that have not been supported by robust clinical evidence.”

That, however, is not quite the end of the story.

As the complainant in this matter I have been notified by the ASA of any progress or developments with their investigation as and when these occurred, so I’ve known about the ASA’s findings for the past month as I received a draft copy of their adjudication on the 19th June and I also know that Stevens was also sent the same information at the same time.

Stevens has a twitter account – @vitalbodyhealth – and some of his tweets since the 19th June make for interesting reading:

So, on the same day that I received the ASA draft finding, Stevens’ chose to pimp the same webpage that the ASA has deemed to be misleading, not least because Stevens failed to provide any evidence to support the overwhelming majority of the claims made on that page – and what little evidence he did provide was, not to put to fine a point on it – crap.

A little over a week later, Stevens was back on Twitter and making yet more unsubstantiated claims:

Stevens may well have never had a failure in treating anaphylaxis but as the evidence he did give to the ASA did not include anything that demonstrated that he’d ever actually treated anaphylaxis, that not a claim that can be given any credence at all.

Whether these tweets are Stevens’ last hurrah before the ASA ruling is published or an indication that it won’t be too long before he joins the ASA list of non-compliant advertisers remains to be seen – although the fact that Stevens has a previous adjudication against him for peddling identical claims may suggest that the latter is more likely – but the simple fact remains that, based on the evidence that he supplied to the ASA, the answer to the question ‘What can Chirokinetic Therapy treat?’ is simply ‘nothing‘.

References

1. Smith, SE (1993). Body Memories: And Other Pseudo-Scientific Notions of “Survivor Psychology. Issues in Child Abuse Accusations 5 (4).

2. Siles, RI & Hsieh, FH (2011). Allergy Blood Testing: A practical guide for clinicians. Cleveland Clinic Journal of Medicine vol. 78 9 585-592