Download Lectures on Biostatistics (1971). Corrected and searchable version of Google books edition
Download review of Lectures on Biostatistics (THES, 1973).
CAM
BBC’s You and Yours programme (a lunchtime consumer programme) ran a good piece on “Helps Stop Snoring”, a dubious herbal “remedy” for snoring. They picked up the story from my site. Listen to the programme [mp3 file]
“Helps stop snoring” claims to work on the basis of a clinical trial. But the trial is flawed in many ways. In addition the author, Dr Andrew Prichard, seems to have quite forgotten to mention that a Helen Prichard who lives at the same address holds 2000 shares in the company that makes this wonder cure. [transferred from old improbable science page].
My pharmacological curiosity was stirred by a TV advertisement for a spray that, it was claimed, could stop you snoring. It’s hardly a life threatening condition, but it can be marriage-threatening. But what’s in it, and does it work?
A visit to the web site of Essential Health Products Limited looks promising. Their claim is this.
“CLINICAL TRIALS
Many products claim to have undergone tests, but Helps Stop Snoring is the only natural snoring remedy in the UK have undergone to a full, double blind clinical trial, conducted by a practicing Ear,Nose and Throat Consultant Surgeon.
Lasting over 18 months, the trial involved 140 snorers and their partners, and the results showed a headline success rate of 82%. The trial was conducted by Andrew Pritchard FRCS, Ear Nose and Throat Consultant at the Royal Shrewsbury Hospital and one of the UK`s leading specialists in the field of snoring and sleep disorders.
In a further first for a snore remedy the results of the trial were published in Phytology Research, an international journal, in October 2004.”
This claim was not so easy to check because the manufacturer mis-spells both the name of the author and the name of the journal. The paper in question seems to be this. Prichard AJ., The use of essential oils to prevent snoring Phytother Res. 2004 18(9), 696-9 [get the pdf].
Sadly this paper is not very convincing. The paper does describe the work as “preliminary”, but the manufacturer’s web site does not. There’s a surprise. For those who are interested, here are a few details.
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140 adult snorers were recruited to the study via a snoring clinic. Snorers were randomly allocated to receive a metered dose of “Stop snoring “gargle, “Stop snoring ” spray or placebo gargle (there was no placebo spray at all). It isn’t obvious what placebo could mimic the peppermint, lemon, clove, thyme, eucalyptus and pine oils that the “remedy” contains (among other things). Their concentrations aren’t stated. The paper makes no mention of what was used as placebo, but Dr Prichard tells me “The content of the placebo could not be an essential oil. I have been told by the manufacturer that we used a sugar type mix”. Actually it contained water, sodium saccharin, polysorbate 20, potassium sorbate and citric acid. It would be have been obvious tor the patient whether they got the placebo or not.
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The comparison that is made is before and after in each treatment group, rather than comparing the groups. The eminent statistician, Stephen Senn, has some trenchant criticisms of this sort of experimental design.
Senn points out that “Having made the mistake of using the within treatment group to baseline comparison he ought to then use the Wilcoxon signed ranks test rather than the rank sum but he doesn’t say which”. The results are pretty odd too. In the placebo group, 4 out of 11 patients show a big reduction in snoring severity (Fig. 4). In the spray group, a smaller proportion, 5 out of 28 show a big improvement (Fig 2). The changes in the rest of the patients are mostly very small, but there are more slight improvements in the spray group than in the placebo group. The percent of patients that “improve” (by any amount, however small, is therefore bigger in the spray group than control, but the difference in mean snoring severity was much smaller
Financial interests in the snoring study
Sadly, it is essential to consider vested interests in drug assessment, as I have noted below (and here, and here). Prichard’s paper states openly that it was “Sponsored by Essential Health Products Ltd, 4 Top Farm Barns, Pitchford, Shropshire, SY5 7DW, UK.” That doesn’t mean it’s wrong, though the bias associated with sponsorship is well known,
But there is no mention of shareholdings
Companies House will, only £1, sell you company reports. The records show that Helen Jane Prichard, holds 2000 shares in Essential Health Products Ltd.
Is this just a coincidence of names? I think not. If you look up. Dr Andrew Prichard in the phone book, you see that his address is exactly the same as that of Helen Jane Prichard.
Oh dear: looks like yet another undisclosed financial interest in a clinical study.
Many thanks to the inimitable Ben Goldacre fot the totally over-the-top link to this item: it has done wonders for my hit rate.
Boots the Chemists is selling the same stuff True to their philosophy of making money and never mind the evidence, the “Boots Alternatives” range of snake oil products has, for £14.99, exactly the same stuff. They claim the Boots |
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Enquiries to Boots about this product have not been answered or have been answered inaccurately. See also below for Boots miseducation pages.
And here’s the ironical bit. Boots web site makes a big point about CSR (Corporate Social Responsibility). (Thanks to Sean
Kehoe for spotting this.)
“TRUST BOOTS
As you may have noticed, that’s the tagline which in 2005 we adopted as the sign-off to all our advertising. But it’s much more than just a slogan. It’s a concise statement of our entire corporate strategy. Our aim is to make Boots the world’s best health and beauty retailer, and we’re 100% clear that the unique trust in which we are held provides the key to achieving this. Which means, of course, that those two words are also the rationale for all our CSR activities. Everything we do that builds trust is good for our business; anything which could compromise it, a risk we can’t afford to take.”
Trust Boots to provide straight answers.
They must be joking.
Les Rose debates with homeopath Katherine Armitage on the Vanessa Feltz show on BBC Radio London. Listen to the clip to hear some of the best pseudo-scientific gobbeldygook on record.
Read full entry on the original IMPROBABLE SCIENCE page.
In the course of a long correspondence with the MHRA about their endorsement of a dishonest label for a herbal preparation, arnica gel, I eventually got an admission from them that the stuff doesn’t work.
For earlier episodes in this saga, see part 1, part 2, part 3 and part 4.
| “As you have clearly identified the Directive is far from perfect. The vast majority of herbal products currently on the UK market without claims are of unproven benefit.” Dr Linda Anderson, B.Pharm., PhD, Pharmaceutical assessor at the MHRA. |
Which herbal medicines have been assessed by the Regulator?
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“Both these kinds of medicines are regulated by the MHRA and meet assured standards.” would, by most people, be interpreted to mean that the MHRA was providing some sort of asssurance that the stuff worked. It doesn’t. This wording is, to my mind, misleading and disgraceful.
One of the zaniest bit of quantum bollocks of all time. Sigh,.
Read full entry on the original IMPROBABLE SCIENCE page.
The Medicines and Healthcare products Regulatory Agency (MHRA) is an executive agency of the Department of Health). It is roughly the UK equivalent of the Food and Drugs Administration (FDA) in the USA.
The MHRA has just betrayed the trust placed in it by the public by allowing untrue claims to be put on the labels of homeopathis and herbal treatments, apparently under pressure from the government and the Prince of Wales, as described below, and here. The cause such outrage that the MHRA was censured by an annulment debate in the House of Lords, It also caused condemnations to be issued by the many learned societies, most of which you can read at the links here. For example, Royal Society, the Medical Research Council, the Academy of Medical Sciences, the Royal College of Pathologists, the Biosciences Federation (which represents 40 affiliated societies), the Physiological Society and the British Pharmacological Society.
In contrast, the main medical organisations have kept disgracefully silent. Nothing has been heard from the British Medical Association (I hear that a move to say something was heavily defeated). Nothing either from the Royal College of General Practitioners or from the Royal Society of Medicine.
The Physiological Society ‘s Newsletter for December 2006 published and excellent leading article ‘Homeopathic mumbo-jumbo], by Austin Elliott [read it here].
| The Physiological Society“The Physiological Society is concerned with the scientific investigation of how the body works “It is our view that “alternative medicine” has, with very few exceptions, no scientific foundation, either empirical or theoretical. As an extreme example, many homeopathic medicines contain no molecules of their ingredient, so they can have no effect (beyond that of a placebo). To claim otherwise it would be necessary to abandon the entire molecular basis of chemistry. The Society believes that any claim made for a medicine must be based on evidence, and that it is a duty of the regulatory authorities to ensure that this is done.” |
Austin Elliott comments thus.
 “And as the web site of the European Council for Classical Homeopathy (6) puts it: ˜To make such a claim, the manufacturers need only show that the product has been used to treat those particular conditions within the homeopathic industry. No scientific basis. No clinical trials. No evidence of effectiveness. The homeopaths, and the companies that produce over-the-counter homeopathic remedies, are understandably delighted. Well, you might say, so what? The placebo effect is not new, and a fool and his/her money are soon parted. Most scientists would agree that the labelling is a joke, but in a world awash with ridiculous claims, why get worked up? Well, firstly, perhaps, because the MHRA, acting on our behalf, is supposed to care -their web site states they ‘enhance and safeguard the health of the public by ensuring that medicines and medical devices work, and are acceptably safe’. Secondly, . . . there is a principle at stake, namely that decisions of this kind should b made on the basis of scientific and medical evidence and understanding.” |
A debate was held at the Natural History Museum on “Does Homeopathy Work?â€. You can see it on streaming video. Peter Fisher gave a talk which, after shameless cherry-picking of the evidence, went on to explain that if a memory stick can hold a lot of information, so can water (I’m not kidding).
Read full entry on the original IMPROBABLE SCIENCE page.
The BBC2 Newsnight programme, in an excellent bit of investigative journalism, has shown that an ex-arms dealer, Michael Hart Jones has conned the Swaziland government with his claims to cure AIDS with a useless and probably dangerous treatment for AIDS based on goat serum.
Read full entry on the original IMPROBABLE SCIENCE page.
The MHRA’s new policy towards CAM has already received a well-deserved drubbing in the House of Lords. Now have the first example of the MHRA allowing totally misleading labels to be put on over-the-counter treatements.
A press release dated November 8th 2006 gives the shocking news.
MHRA grants landmark registration for Traditional Herbal MedicineThe Medicines and Healthcare products Regulatory Agency (MHRA) has granted the first UK product registration under the European Directive on traditional herbal medicinal products. . Professor Kent Woods, Chief Executive of the MHRA said:“This first product registration is an important landmark. We hope that Atrogel Arnica Gel will be the first of many products to receive a traditional herbal registration. Our aim is to enable those consumers who wish to take herbal medicines to make an informed choice from a wide range of products which have been made to assured standards of safety, quality and patient information.” |
What is the evidence that Arnica Gel does the slightest good for the conditions that will appear on the label? The answer is essentially none. There are only two papers in Medline. The first shows no detectable effect of arnica gel (compared with vehicle alone) (Alonso D, Lazarus MC, Baumann L., Effects of topical arnica gel on post-laser treatment bruises. Dermatol Surg. 2002 Aug;28(8):686-8.)
The second paper claims a positive effect, but it is worthless because it was an open trial with no proper controls. (Knuesel O, Weber M, Suter A. Arnica montana gel in osteoarthritis of the knee: an open, multicenter clinical trial. Adv Ther. 2002 Sep-Oct;19(5):209-18.). The last author on this paper, incidentally, gives his address as Bioforce AG.
So yes, the MHRA’s press release is indeed a landmark. It is the first time that they have allowed a medicine to be labelled with a therapeutic claim when there is no reason to believe it to be true.
The bottom of the press release says (my emphasis) “The MHRA is the government agency that is responsible for ensuring that medicines and medical devices work, . . .”.
Uhm, surely some inconsistency there.
But no, Kent Woods tells me “The strap-line you refer to is a highly simplified statement of our role in making regulatory judgements based on risk/benefit analysis in the real world. ”
The bizarre behaviour of the MHRA is based on European Directive 2004/24/EC.This contains (para 6) the following prime example of pre-enlightenment thought.
“The long tradition of the medicinal product makes it possible to reduce the need for clinical trials, in so far as the efficacy of the medicinal product is plausible on the basis of long-standing use and experience. Pre-clinical tests do not seem necessary, where the medicinal product on the basis of the information on its traditional use proves not to be harmful in specified conditions of use.â€
Evidently the MHRA have decided to go along with the licence for snake-oil salesman that this provides. It isn’t clear that they were compelled to do so (MHRA’s response here).
This is what the packet looks like. On the right, one panel is enlarged. The claim “It helps relieve symptoms including:” is quite outrageous. There isn’t the slightest reason to believe anything of the sort. I know the bit above that says “based exclusively on long-standing use”, but it certainly won’t be obvious to most shoppers that this is meant to imply that the clear claim that “it helps to relieve symptoms” may be so much nonsense.
In a recent speech and interviews, Tony Blair confirms that he thinks science is just for making money, and that homeopathy and creationism don’t concern him.
Read full entry on the original IMPROBABLE SCIENCE page.
The regulations that allow unjustified claims to be made for homeopathic pills were the subject of an annulment debate in the House of Lords on 26 October 2006. The regulations were introduced as a statutory instrument.
“Statutory Instruments (SIs) are a form of legislation which allow the provisions of an Act of Parliament to be subsequently brought into force or altered without Parliament having to pass a new Act.”
In other words a minister just decides to do it without any debate or parliamentary approval
“The instrument is laid after making, subject to annulment if a motion to annul (known as a ‘prayer’) is passed within 40 days.”
The BBC Today programme covered the event before the debate. Lord (Dick) Taverne put the view of reason and common sense superbly, against some totally evasive fantasies from Imogen Spencer of the Society of Homeopaths. He is the author of “The March of Unreason: Science, Democracy, and the New Fundamentalism“). [Listen to the interview: mp3 file, 5.6 Mb]
Read the debate
The debate can be read in Hansard. In the archaic language of the House.
“Lord Taverne rose to move, That an humble Address be presented to Her Majesty praying that the regulations, laid before the House on 21 July, be annulled (S.I. 2006/1952). [44th Report from the Merits Committee].”. Here are a few quotations.
Lord Taverne
“There is one very important, absolutely fundamental objection to this regulation. For the first time in the history of the regulation of medical products, it allows claims of efficacy to be made without scientific evidence. It is an abandonment of science and the evidence-based approach. Under this new regulation, the sole basis on which claims of efficacy can be made for homeopathic products quite legally is "homeopathic provings". There is no need for clinical or scientific tests. Homeopathy is not based on science and is not a science in any sense whatever.”
.Let me read just three of the comments, the first from the British Pharmacological Society. I quote it first because two members of the MHRA, including the chairman, have pharmacological qualifications. The society says:
“The British Pharmacological Society believes that any claim for a medicine must be based on evidence, and that it is the duty of the regulatory authorities, in particular the MHRA, to ensure that no claims can be made for the efficacy of any form of medicine unless there is good evidence that the claim is true. Despite many years of investigation, we have no convincing scientific evidence that homeopathic remedies work any better than placebo”.
.
“What it has done is to promote what is in effect the selling of snake oil. This statutory instrument should be withdrawn;it is a disgrace. I beg to move.”
Lord Rees of Ludlow (Martin Rees, President of the Royal Society)
“ My Lords, the Royal Society, of which I have the honour to be president, believes that all complementary and alternative medicines should be subject to careful evaluation of their efficacy and their safety. All treatments so labelled should be properly tested and patients should not receive misleading information.
There are no great concerns about the safety of homeopathic treatments. What is at issue is their effectiveness. Obviously placebo effects can be powerful, nobody denies that. It is, however, quite different to assert that homeopathic treatments offer benefits beyond a placebo. Indeed, if medicines can really work even when so diluted that barely a single molecule is left, this would entail some fundamentally new scientific principle with amazingly broad ramifications. It would mean that materials like water carry imprints of their past and can remember their history, as it were, in some quite novel and mysterious way. If that were the case, it would have fundamental implications for precise experiments over the whole of science.
So it seems to me that the burden of proof on homeopathic remedies should actually be higher, not lower, than for conventional ones. Extraordinary claims demand extraordinary evidence. To put it mildly, so-called “homeopathic provings”; seem to fall far short of that. That is why I wholeheartedly support what the noble Lord, Lord Taverne, is saying on this issue.
Excellent speeches were made on the side of reason by Lord Turnberg (ex-professor of medicine and ex-president of the Royal College of Physicians) and Lord Jenkin of Roding . (who, as Patrick Jenkin, was a member of Margaret Thatcher’s government).
The 30th Countess of Mar
All of this counted for little with the Countess of Mar, a heriditary peer and organic farmer who opposed the annulment. She was, I fear, rather selective with the evidence. She quotes, for example,
“Professor Madeleine Ennis of Queen’s University, Belfast, with a large pan-European research team led by Professor Roberfroid of the Catholic University, Louvain, set out to show that homeopathy and water memory were utter nonsense. This was an exercise conducted with extreme scientific rigour.” . . . “In the end, she had to concede that high dilutions of the active ingredients in homeopathic solutions worked, whether or not the active ingredient was present in the water”
Bits of Lady Mar’s speech bear an extraordinary resemblence to an article written in the Guardian in 2001, by Lionel Milgrom (maverick chemist and apologist for homeopathy). I wonder who wrote it for her?
The Noble Countess appears not to have noticed that the first author on both of Ennis’s papers was Philippe Belon. who is a director of the huge French homeopathic company, Boiron. In fact the address on the papers is not the University of Belfast (or Louvain), but it is “Boiron, 20 rue de la Liberation, 69110 Sainte-Foy-Les-Lyon, France.”
Boiron makes profits from homeopathy of about 20 miilion euros a year, on net operating revenues of about 300 million euros. It is big business. Philippe Belon has an interesting record.
He was one of the authors of the notorious Benveniste paper which lead to Beneveniste’s dismissal form INSERM in disgrace. The Countess also seems to have missed the careful refutation of Benveniste’s results by Hirst, Hayes, Burridge, Pearce and Foreman (1993, Nature.366, 525-7.
Belon was also senior author in Fisher, P., Greenwood, A., Huskisson, E. C., Turner, P., & Belon, P. (1989). (Effect of homoeopathic treatment on fibrositis (primary fibromyalgia) British Medical Journal 299, 365-366.). That is the paper which I was asked to check (by a TV programme). After Peter Fisher gave me the raw data I found that a naive mistake had been made in the statistical analyis. There was NO evidence for the effect of the treament at all, as described below. This correction was published (Colquhoun, D. (1990). Reanalysis of a clinical trial of a homoeopathic treatment of fibrositis. Lancet 336, 441-442.), though the correction is usually ignored by homeopaths (see below). [Get pdf].
How odd that all Belon’s papers seem to favour homeopathy.
Lord Colwyn
(The Rt Hon Lord Colwyn, CBE, a Conservative peer) also supported mumbo jumbo. Don’t you love this bit?
“I went on a course about 15 years ago on the relationship between quantum physics and homeopathy. I probably did not understand a word I was told at the time, but at least there was evidence that the two were linked.”
But he shouldn’t worry if he didn’t understand a word: it was just gobbledygook.
Lord Colwyn finished his speech thus.
“It is interesting to consider why homeopathy, which of all complementary therapies is probably at most variance with orthodox medicine, should have received sufficient support from the Government to be able to maintain a number of specialised hospitals.”
Well, agreed again, it is interesting -in fact it’s quite incredible.
What a pity, though, that Lord Colwyn quite forgot to declare his interests. He is vice-president of the Blackie Foundation Trust. This trust was “founded by Dr Margery Blackie in 1971, at that time homoeopathic physician to Her Majesty, the Queen. Dr Blackie saw the need to promote homoeopathic remedies to the wider community and to educate the public about the success of homoeopathy in treating illness.”.
He also forgot to mention that he is a patron of the National Federation of Spiritual Healers.
Lord Warner
(Lord Warner of Brockley, Minister of State at the Department of Health) defended quackery on behalf of the government. He says the legislation
“will, for the first time since the PLR scheme in 1971, allow homeopathic products to be marketed with information to the consumer about what they can be used for. This will provide better information to the consumer and reduce the risk of confusion. “
Lord Warner makes no comments about how claims made for efficacy in the absence of evidence can be called “better information” for the consumer
“We have done much as a Government to support science and research, and will continue to do so. Homeopathic products are, however, in a different category. Provided that such products are safe, properly manufactured and clearly labelled without making false claims, which they will be under the new national rules scheme, patients should not be denied access to them for the conditions to which they relate. “
What, one wonders, does “a different category” mean? The magic category? And since the manufacturers have just been excused from producing any evidence of efficacy, who is to judge what are “false claims”.
Some reports
The BBC report before the debate
The Daily Mail -pretty good stuff.
Interview with DC, vainly trying to counter the bunkum from the two previous speakers.
Read full entry on the original IMPROBABLE SCIENCE page.
The Consumers’ Association has had a good record in distinguishing true claims from false in washing machines and dishwashers. But in CAM, they seem to be out of their depth. They have been giving some very bad advice, of the sort you might expect from the lifestyle pages of the Daily Mail.
Read full entry on the original IMPROBABLE SCIENCE page.
Wearing magnets in the hope of benefit is one of the best know delusions (see below). It was therefore a shock when the NHS said it would pay for magnetic bandages. Using the Freedom of Information Act (FoI) II asked the Prescription Pricing Authority (PPA), and then the Department of Health (DoH), for documents that referred to this bizarre decision. Both refused, as related below.
When the Department of Health refused my FoI request, I asked for an internal review. Nothing happened for months, but on 10th Oct 2006, a parcel of papers arrived.
Michael King is Director of Planning and Corporate Affairs at the PPA He said (see below)
“There is no judgement offered about whether a product in the Drug Tariff is more (or less) efficacious than any other, or the placebo effect.”
This is not true, The papers from the DoH show that the PPA considered at length the evidence provided by the manufacturer, Magnopulse Ltd.
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And in an email dated 19 Dec 2005
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So the ‘efficacy’ of the product was assessed. It was just assessed incompetently.
The PPA do not seem to have noticed that a quite different conclusion about the paper in the Journal of Wound Care was reached by a different bit of the NHS. The NHS National Electronic Library for Health concludes (and also the NHS Clinical Answers Service)
“Therefore, no firm conclusions can be made on the basis of this study alone.”
The PPA do not seem to have noticed the endless evidence from other sources that magnets are boloney (see below)
And the the PPA do not seem to have noticed that the author of this paper is the is the Founder, CEO and Medical Director of one of the wackiest alternative medicine clinics, the Chiron Clinic (see below). He will charge you £135 for a consultation for which you’ll get magnets and phony nutrient treatment.
Follow-up
The regulations that allow unjustified claims to be made for homeopathic pills were the subject of an annulment debate in the House of Lords on 26 October 2006. The regulations were introduced as a statutory instrument.
“Statutory Instruments (SIs) are a form of
legislation which allow the provisions of an Act of
Parliament to be subsequently brought into force
or altered without Parliament having to pass a
new Act.”
In other words a minister just decides to do it without any debate or parliamentary approval
“The instrument is laid after making, subject to annulment if a motion to annul (known
as a ‘prayer’) is passed within 40 days.”
The BBC Today programme covered the event before the debate. Lord (Dick) Taverne put the view of reason and common sense superbly, against some totally evasive fantasies from Imogen Spencer of the Society of Homeopaths. He is the author of “The March of Unreason: Science, Democracy, and the New Fundamentalism“).
[Listen to the interview: mp3 file, 5.6 Mb]
Read the debate
The debate can be read in Hansard. In the archaic language of the House.
“Lord Taverne rose to move, That an humble Address be presented to Her Majesty praying that the regulations, laid before the House on 21 July, be annulled (S.I. 2006/1952). [44th Report from the Merits Committee].”. Here are a few quotations.
Lord Taverne
“There is one very important, absolutely fundamental objection to this regulation. For the first time in the history of the regulation of medical products, it allows claims of efficacy to be made without scientific evidence. It is an abandonment of science and the evidence-based approach. Under this new regulation, the sole basis on which claims of efficacy can be made for homeopathic products quite legally is “homeopathic provingsâ€. There is no need for clinical or scientific tests.
Homeopathy is not based on science and is not a science in any sense whatever.â€
.Let me read just three of the comments, the first from the British Pharmacological Society. I quote it first because two members of the MHRA, including the chairman, have pharmacological qualifications. The society says:
“The British Pharmacological Society believes that any claim for a medicine must be based on evidence, and that it is the duty of the regulatory authorities, in particular the MHRA, to ensure that no claims can be made for the efficacy of any form of medicine unless there is good evidence that the claim is true. Despite many years of investigation, we have no convincing scientific evidence that homeopathic remedies work any better than placebo”.
.
“What it has done is to promote what is in effect the selling of snake oil. This statutory instrument should be withdrawn—it is a disgrace. I beg to move.â€
Lord Rees of Ludlow (Martin Rees, President of the Royal Society)
“ My Lords, the Royal Society, of which I have the honour to be president, believes that all complementary and alternative medicines should be subject to careful evaluation of their efficacy and their safety. All treatments so labelled should be properly tested and patients should not receive misleading information.
There are no great concerns about the safety of homeopathic treatments. What is at issue is their effectiveness. Obviously placebo effects can be powerful, nobody denies that. It is, however, quite different to assert that homeopathic treatments offer benefits beyond a placebo. Indeed, if medicines can really work even when so diluted that barely a single molecule is left, this would entail some fundamentally new scientific principle with amazingly broad ramifications. It would mean that materials like water carry imprints of their past and can remember their history, as it were, in some quite novel and mysterious way. If that were the case, it would have fundamental implications for precise experiments over the whole of science.
So it seems to me that the burden of proof on homeopathic remedies should actually be higher, not lower, than for conventional ones. Extraordinary claims demand extraordinary evidence. To put it mildly, so-called “homeopathic provings†seem to fall far short of that. That is why I wholeheartedly support what the noble Lord, Lord Taverne, is saying on this issue.
Excellent speeches were made on the side of reason by Lord Turnberg (ex-professor of medicine and ex-president of the Royal College of Physicians) and Lord Jenkin of Roding . (who, as Patrick Jenkin, was a member of Margaret Thatcher’s government).
The 30th Countess of Mar
All of this counted for little with the Countess of Mar, a heriditary peer and organic farmer who opposed the annulment. She was, I fear, rather selective with the evidence. She quotes, for example,
“Professor Madeleine Ennis of Queen’s University, Belfast, with a large pan-European research team led by Professor Roberfroid of the Catholic University, Louvain, set out to show that homeopathy and water memory were utter nonsense. This was an exercise conducted with extreme scientific rigour.†. . . “In the end, she had to concede that high dilutions of the active ingredients in homeopathic solutions worked, whether or not the active ingredient was present in the waterâ€
Bits of Lady Mar’s speech bear an extraordinary resemblence to an article written in the Guardian in 2001, by Lionel Milgrom (maverick chemist and apologist for homeopathy). I wonder who wrote it for her?
The Noble Countess appears not to have noticed that the first author on both of Ennis’s papers was Philippe Belon. who is a director of the huge French homeopathic company, Boiron. In fact the address on the papers is not the University of Belfast (or Louvain), but it is “Boiron, 20 rue de la Liberation, 69110 Sainte-Foy-Les-Lyon, France.”
Boiron makes profits from homeopathy of about 20 miilion euros a year, on net operating revenues of about 300 million euros. It is big business. Philippe Belon has an interesting record.
He was one of the authors of the notorious Benveniste paper(see also below), which lead to Beneveniste’s dismissal form INSERM in disgrace. The Countess also seems to have missed the careful refutation of Benveniste’s results by Hirst, Hayes, Burridge, Pearce and Foreman (1993, Nature.366, 525-7.
Belon was also senior author in Fisher, P., Greenwood, A., Huskisson, E. C., Turner, P., & Belon, P. (1989). (Effect of homoeopathic treatment on fibrositis (primary fibromyalgia) British Medical Journal 299, 365-366.). That is the paper which I was asked to check (by a TV programme).
After Peter Fisher gave me the raw data I found that a naive mistake had been made in the statistical analyis. There was NO evidence for the effect of the treament at all, as described below.
This correction was published (Colquhoun, D. (1990). Reanalysis of a clinical trial of a homoeopathic treatment of fibrositis. Lancet 336, 441-442.), though the correction is usually ignored by homeopaths (see below). [Get pdf].
How odd that all Belon’s papers seem to favour homeopathy.
Lord Colwyn
(The Rt Hon Lord Colwyn, CBE, a Conservative peer) also supported mumbo jumbo. Don’t you love this bit?
“I went on a course about 15 years ago on the relationship between quantum physics and homeopathy. I probably did not understand a word I was told at the time, but at least there was evidence that the two were linked.â€
But he shouldn’t worry if he didn’t understand a word: it was just gobbledygook.
Lord Colwyn finished his speech thus.
“It is interesting to consider why homeopathy, which of all complementary therapies is probably at most variance with orthodox medicine, should have received sufficient support from the Government to be able to maintain a number of specialised hospitals.â€
Well, agreed again, it is interesting -in fact it’s quite incredible.
What a pity, though, that Lord Colwyn quite forgot to declare his interests. He is vice-president of the Blackie Foundation Trust. This trust was “founded by Dr Margery Blackie in 1971, at that time homoeopathic physician to Her Majesty, the Queen. Dr Blackie saw the need to promote homoeopathic remedies to the wider community and to educate the public about the success of homoeopathy in treating illness.”.
He also forgot to mention that he is a patron of the National Federation of Spiritual Healers.
Lord Warner
(Lord Warner of Brockley, Minister of State at the Department of Health) defended quackery on behalf of the government. He says the legislation
“will, for the first time since the PLR scheme in 1971, allow homeopathic products to be marketed with information to the consumer about what they can be used for. This will provide better information to the consumer and reduce the risk of confusion. “
Lord Warner makes no comments about how claims made for efficacy
in the absence of evidence can be called “better information” for the consumer
“We have done much as a Government to support science and research,
and will continue to do so. Homeopathic products are, however, in a different
category. Provided that such products are safe, properly manufactured and
clearly labelled without making false claims, which they will be under the
new national rules scheme, patients should not be denied access to them for
the conditions to which they relate. “
What, one wonders, does “a different category” mean? The magic category? And
since the manufacturers have just been excused from producing any evidence of
efficacy, who is to judge what are “false claims”.
Some reports
The BBC report before the debate
The Daily Mail -pretty good stuff.
The Royal Society , the UK’s national academy of science, has put a statement about alternative medicine on its “science issues” web site.
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The Royal Society believes that complementary and alternative medicines, like conventional medicines, should be subject to careful evaluation of their effectiveness and safety. It is important that treatments labelled as complementary and alternative medicines are properly tested and that patients do not receive misleading information about the effectiveness of complementary medicine. Furthermore, NHS provision for complementary and alternative medicines, as for conventional medicines, should be confined to treatments that are supported by adequate diagnosis together with evidence of both effectiveness and safety.
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Notice the very proper insistence that patents are not deceived about whether the “medicine” works or not. This is in stark contrast to the attitude of the MHRA, which has just endorsed misleading labelling.