Download Lectures on Biostatistics (1971). Corrected and searchable version of Google books edition
Download review of Lectures on Biostatistics (THES, 1973).
Dangerous advice
This is the first of a several posts that have arisen from a visit to North America. One thing that the trip led to was an interest in how HR departments influence science -if you have a story about that, please email me.
Following the media publicity that surrounded the lecture in Toronto, I was sent this poem by Anne Spencer, of Canada.
It is based on the style of Jonathan Swift (1667-1745), and she had earlier went a more political version, below, which was a runner up in the international Swift satire poetry competition, 2004. Anne Spencer has been kind enough to let me reproduce both her poems here.
What men wish, they like to believe.
Julius Caesar
Verses on folly, faith and fantasy
Great Caesar saw what we still find
In much of modern humankind,
That wishful thinking will suppress
The reason we should all possess.
Take health. That is a main concern.
We look for cures at every turn
For sicknesses that cause unease
And nasty things that bring disease.
But from the science of the age
Too many now will disengage,
Forget the studies, evidence
Of remedies that will dispense
A tested way of healing those
Conditions doctors diagnose.
They say they’ve lost their confidence
In science, and have a preference
For substances that they perceive
Fit in with what they all believe
In nature’s realm of field and flowers,
Along with supernatural powers
Or energies that ebb and flow
And are released by those who know
The proper touch or breath or spell
For proper paying clientele.
And other forms of therapy
Like healing touch they all agree
Despite their failure to explain
Result in easing of their pain.
For grave conditions that could kill
It’s nature’s bounty fills the bill,
From goats a serum crushes AIDS
And grape juice makes Altzheimers fade,
Red clover makes the blood come clean
And sugar pills become routine
As remedies for things they feel
They cannot count on science to heal.
And substances that they produce
To cure complaints or pain reduce
They say they must dilute and then
Dilute, dilute, dilute again
Because the less you have, not more
Will guarantee a better cure.
(Conclusions such as this imply
There’s no attempt to reason why.)
And quite impervious they stay
To anything their critics say
About placebos and effects
That challenge rational intellects.
Their gurus sanction their belief
That things they give them bring relief
From anything they want to try,
(Because the more they wish, they buy)
If people give them hope and say
That black is white, then that’s OK.
But there’s the rub – for harm can come
By seeing this as rule of thumb
For if you disregard the facts
That science tells, then this detracts
From treatments that show evidence
Of beneficial consequence.
More harm than good can come to those
Rejecting treatments that propose
Results that doctors can compile
Which don’t depend upon a smile
Or harmony with sundry forces
Brought to bear by doubtful sources.
So those who wish upon a star
Or herb or potion in a jar
To grant relief from ache or pain
Could well decide to think again
And weigh the chances that desire
Not reason is what we require
To make us well when we succumb
To ailments that are troublesome.
For wishful thoughts beguile the mind
But leave reality behind.
And here is the political version of Anne Spence’s poem
Great Caesar, famed in Gallic wars,
A champion of the Roman cause,
Who came, and saw and conquered when
The sword was mightier than the pen,
Was yet a statesman, author, who
Knew much of human nature too.
For Caesar saw what we still find
In much of modern humankind,
That wishful thinking reason dims
And validates our selfish whims.
But more we see in public spheres
How much this maxim oft appears,
To show how leaders are consumed
By things believed their wish presumed.
And lately this seems quite okay
With rulers of the USA.
(But we, like Swift, will make our claim
By ‘lashing vice’ but sparing name).
With politics that are complex
Illusions tend to blur the specs
When men believe whate’er they wish
Some policies get devilish.
And when you add religion too
We have a complicated brew,
And here a leader we can see
Who joins the ruling company
Of men who demonstrate the state
Of those who wish with truth equate.
He left a weak addicted past
To seek his destiny at last.
Became a Christian, born again
Aspiring to a higher plane.
(Genetically he was ahead
Since daddy had the nation led.)
But, once elected by a fluke,
(That all just men would sure rebuke)
He saw his mission godly sent
To show the world enlightenment.
And he believed that evil dwelt
Within an oil producing belt,
Its ruler evil incarnate
A tyrant quite degenerate.
And so when terrorists attacked
The World Trade towers, this proved the fact,
Or so he said, for who could not
Connect events with dot to dot?
He’d purge the world of evil’s stain
In person of Saddam Hussein.
He would not shrink from duty’s call
To seek Saddam’s decline and fall,
For he believed his destiny
Proclaimed by God – Divine decree.
He’d find the hidden weapons and
He’d bring new freedom to the land
Where western values were deplored
By villains who lived by the sword
(Or torture, rape, or nasty gases
With which they murdered ethnic masses).
And so he would avenge the dead,
Depose the tyrant, and instead
Lead on his troops –at least he’d send
Them forth to bring about this end.
God chose him evil to despoil
(And as reward he’d get the oil).
Despite the cautions he received
He was inspired, he still believed
His mission was to crush this foe
Both God and Tony told him so.
So off to conquer all that’s bad
The forces left to bomb Baghdad.
Their leader stayed at home to see
How his crusade looked on tv.
The mighty tanks, the skies aflame
Were better than a video game.
The statues fell, the prisoners freed
The regime’s downfall guaranteed
The patriot missiles, patriot men
Would soon, he thought, be home again.
Though some had breathed their final breath
The ‘victory’ justified their death
And they’d be heroes ever more
While blest upon another shore.
They played their part, they fought the fight,
Their president bid them goodnight.
They left behind a populace
Who now could western life embrace.
Well, most of it – religiously
They kept their views on sanctity.
Their heaven, they said, was nicer, and
They could have virgins on demand.
(It seems this wish- belief thing will
For any culture fill the bill).
But though the war, it seemed, was won
The problems only had begun.
The leader’s view that freedom would
Make people act the way they should
Once out from under evil’s thrall,
It turned out didn’t work at all.
Because he’d only wished , not thought
Things through with wisdom as he ought,
The leader found his plans rejected
Much more than he had once expected.
His mandate from his holy source
Was not so easy to enforce.
His ignorance of tribal clans,
Of loyalties and partisans,
Reliance on intelligence
Which didn’t make a lot of sense,
Attending to his favourites
And lots of other deficits,
Caused wild confusion in the land
So hard for him to understand.
The law and order that he craved,
Now he’d removed the ones depraved
Was not forthcoming, but instead
A lot more people ended dead.
But still he had to carry on,
With pressure from the Pentagon,
Because he thought and wished it so
That God would help him beat the foe,
Despite continual loss of life
Of those confronting all the strife.
But strange! His enemies were sure
That Allah would their cause secure.
So God to God and wish to wish
The conflict grew more feverish.
And back at home the leader found
Himself on much more shaky ground,
And world opinion, never sure
He really had the grounds for war
Began to further criticize
His too aggressive enterprise.
(As still ongoing was the strife
With still ongoing loss of life).
And God and Allah seem, to date,
Not sure which side to vindicate.
And so men’s own reality
Ignores that it’s their vanity
That is at root the primal cause.
This makes us think and gives us pause.
For men in highest places show
How vain beliefs can bring us low.
And those our leaders who are prone
To wish for things we can’t condone,
Believing they are in the right,
Might look up at the sky at night.
To wish upon a star is nice
Less likely to elicit vice,
Corrupt belief and common sense
Or make ambition too intense.
(And Judy Garland did endorse
The great celestial resource)
But when as president they act
They’d better base beliefs on fact.
The truth will out, and leaders who
Ignore it, they should exit too.
As I have often said, you don’t need to be a scientist to see that most alternative medicine is bunk, though it is bunk that is supported and propagated by an enormously wealthy industry..
There were two good examples this week, John Sutherland, who was until recently professor of English literature at UCL, understands it very well. And so does political columnist, Polly Toynbee.
“Complementary and Natural Healthcare Council”
Polly Toynbee’s column, “Quackery and superstition – available soon on the NHS“, was prompted by the announcement in The Times that the government was to set up a “Natural Healthcare Council”. It was soon renamed the “Complementary and Natural Healthcare Council” (CNHC) It was instantly dubbed ‘OfQuack’ in an admirable analysis by quackometer.a>
The very name is tendentious and offensive to any thinking person. What is “natural” about sticking needles in yourself, or taking homeopathic polonium?
Toynbee comments
“Put not your trust in princes, especially not princes who talk to plants. But that’s what the government has decided to do. The Department of Health has funded the Prince of Wales Foundation for Integrated Healthcare to set up the Natural Healthcare Council to regulate 12 alternative therapies, such as aromatherapy, reflexology and homeopathy. Modelled on the General Medical Council, it has the power to strike therapists off for malpractice.”
There was only one thing wrong in this article. Toynbee says
“The alternative lobby replies that conventional medicine can also do more harm than good. They chortle with glee at an article in the Lancet suggesting there is no scientific evidence for the efficacy of 46% of conventional NHS treatments. But that’s no reason to encourage more of it.”
Professor John Garrow has pointed out (see, also Healthwatch )
“It is true they chortle, but they have got their facts wrong. The 46% of treatments which are not proven to be effective is 46% of all treatments for 240 common conditions – and very few are used in the NHS. The great majority are treatments used by alternative practitioners. “
The unconstitutional interference by the Prince of Wales in public affairs has been noted often before, and it seems that it’s happening again.
For example, there is the TV programme, “Charles, the Meddling Prince”, or, for a US view, see “Homeopathy: Holmes, Hogwarts, and the Prince of Wales“. And then there’s Michael Baum’s superb “An open letter to the Prince of Wales: with respect, your highness, you’ve got it wrong“.
It isn’t that regulation isn’t needed, but that the sort of regulation being proposed won’t do the trick. The framework for the “Natural Healthcare Council” has been set up by Professor Dame Joan Higgins, and it seems to be very much along the lines proposed by the Prince of Wales. Here’s what’s wrong.
| Professor Dame Joan Higgins (Jan 10th) says “Complementary therapists have been in practice for many years” and “If complementary therapy is not to be banned, is it not, therefore, wise to regulate it and offer the public some measure of protection”. That’s fine, but I think the sort of regulation that she, and the Prince of Wales, are proposing won’t do the trick. We don’t need new laws, or new quangos, just the even-handed application of existing laws. Homeopathic arnica 30C contains no arnica, and one would expect that the Office of Fair Trading would have banned it. It is no different from selling strawberry jam that contains no strawberries. But absurd legal loopholes make homeopaths immune to prosecution for this obvious mislabeling, whereas jam fraudsters would be in deep trouble. The Advertising Standards Authority, likewise, is prevented from doing its job by legal loopholes, and by the fact that it has no jurisdiction over web advertising, which is now the main source of untrue claims. If alternative medicine advocates had to obey the same laws as the rest of us, the public would be better protected from fraud and delusion. What won’t work is to insist that homeopaths are “properly trained”. If one takes the view that medicines that contain no medicine can’t work, then years of being trained to say that they do work, and years spent memorizing the early 19th century mumbo-jumbo of homeopathy, does not protect the public, it imperils them. |
The “Natural Healthcare Council” isn’t the only example either. Try Skills for Health.
Skills for Health
This appears to be a vast bureaucratic enterprise devoted to HR-style box-ticking. Just in case you don’t know about this latest bit of HR jargon, there is a flash movie that explains all.
“Competences are descriptors of the performance criteria, knowledge and understanding that are required to undertake work activities. They describe what individuals need to do, and to know, to carry out the activity -regardless of who performs it.”
That sounds OK until you realise that no attention whatsoever is paid to the little problem of whether the “knowledge and understanding” are pure gobbledygook or not. It’s rather like the HR form that ensures UCLH that you are a fully-qualified spiritual healer “Laying on of hands: just tick the box“.
It is an invidious insult to human intelligence to suppose that exercises like this are an appropriate way to select people for jobs. They have precisely the opposite effect to that intended.
An indication of the level of their critical thinking is provided what is written about the 62 items listed under “Complementary Medicine” These include “CHH5 Provide Healing”.
“This workforce competence is applicable to:
- healing in the presence of the client
- distant healing in contact with the client
- distant healing not in contact with the client
Both healing in the presence of the client and distant healing use exactly the same mental and spiritual processes. Clearly, however, distant healing does not involve many of the physical aspects of healing in the presence of the client. The performance criteria have been written so as to be able to be interpreted for use in any healing situation.
The workforce competence links to CHH6 which is about evaluating the effectiveness of the healing.”
It also includes homeopathy, for example “HM_2: Plan, prescribe and review homeopathic treatment“.
I sent an email to Skills for Health to ask who wrote this stuff. A reply from their Technical Development Director failed to elicit any names.
| We develop competences to fit sector needs and demands. When that need is moved into a competence project we establish a number of groups from the specific area to work with us to develop the competences. One of these groups is a “reference” group which is made up of experts from the field. In effect these experts give us the content of the competences, we write them in our format. So I guess the answer as to who is the author is Skills For Health, but with more complexity behind statement.Please do not hesitate to get in touch with me for further clarity. |
A conversation with Skills for Health
I did want more clarity, so I phoned Skills for Health. Here are some extracts from what I was told.
“It’s not quite as simple as that”
“the competencies on our data base are written by “experts in the field”
DC. Yes and it is their names that I was asking for
“I’m not sure I can give you the names . . . We’re starting to review them in the New Year. Those competencies are around six years old. ”
“We are working with the Prince’s Foundation for Integrated Health [FIH] via Ian Cambray-Smith to review these competencies, all the complementary therapy competences on our web site”
“They are written as a consensus decision across a wide number of stakeholders across that area of …”
DC. Written by whom though?
“written by a member of Skills for Health staff or a contractor that we employ simply to write them, and the writing is a collation of information rather than their original thoughts, if you like”
DC yes, I still think the sources can and should be given.
“FIH didn’t spend any money with us on this project. This project was funded by the Education act regulatory bodies, QCA, the Qualifications and Curriculum Authority . . . ”
“They [FIH] may well have put in and supported members of their professions or groups to do part of this . . they were there as experts on that particular area of complementary therapy ”
DC it’s their names that I was after
“There may well have been members [of FIH] on the reference groups that I’ve referreed to who are members of the FiH . . .they were there as experts from that area of complementary therapies.”
DC Oh, and are the names of [the people on] these reference groups published?
“No they are not published”
DC ah, why not?
“We do not consider it necessary”
DC Well, I consider it very necessary myself
“Tell me why”
DC It’s a question of public accountability
“I guess the accountability lies with us as the owners of those competencies”
DC Uh I’m afraid your bureaucratic jargon is a bit much for me there. “The owners of those competencies”? I’m not sure what that means
“Why do you want the information?”
DC haha, well if you want me to be entirely blunt, it’s because I’m appalled that this black magic is appearing on a government web site
“. . . can I say that as an organisation funded by a number of sources, one being Department of Health England, none of our work condones the practice you’ve just suggested. Our work supports best practice in areas that are evidence- and research-based”
DC Ah would you mind pointing me to the evidence for homeopathy and distant healing?
“Uh [pause] there is [pause]”
DC Yes, go on
“Well homeopathy is a contentious issue, because every newspaper article I read seems to suggest that homeopathy, in itself, is not an appropriate, uh, not an, uhm, appropriate, uh, therapy.”
DC Yes so why are you laying down standards in it?. You know I’m curious. I’m genuinely curious about this
“The areas involved in them have asked us to, including the Prince’s Trust hence the reason we are doing . . .”
DC But the Prince’s Trust is not part of government. Ha, it behaves as though it was , I agree, sometimes but it is surely for the Department of Health to ask you to do these things, not the Prince of Wales.
“We cover the whole health sector.. We don’t purely work for, or are an organisation of, the Department of Health.”
DC. I’m very baffled by the fact that you say, you very accurately the research on homeopathy, namely that it doesn’t work, but you are still setting standards for it. It’s quite baffling to me.
“Working with the Foundation for Integrated Health, as we are doing, homeopathy is one of the 10 areas that is listed for regulation by FIH ”
DC. Well yes the Prince of Wales would like that. His views on medicine are well known, and they are nothing if not bizarre. Haha are you going to have competencies in talking to trees perhaps?
“You’d have to talk to LANTRA, the land-based organisation for that.”
DC. I’m sorry, I have to talk to whom?
“LANTRA which is the sector council for the land-based industries uh, sector, not with us sorry . . . areas such as horticulture etc.”
DC. We are talking about medicine aren’t we? Not horticulture.
“You just gave me an example of talking to trees, that’s outside our remit ”
After explaining that talking to trees was a joke, the conversation continued
DC So can I clarify then? Who is it that said you must include these fairly bizarre things like distance healing and homeopathy? Who decides whether it goes in?
“We did”
“We are going to do a major review. We are doing that review in partnership with the FiH and the awarding bodies that award the qualifications that are developed from these competencies”
“When that need is moved into a competence project we establish a number of groups from the specific area to work with us to develop the competences. One of these groups is a “reference” group which is made up of experts from the field. In effect these experts give us the content of the competences, we write them in our format.”
Conclusions from this dialogue
We still don’t know the names of the people who wrote the stuff, but a Freedom of Information Act request has been submitted to find out
The Skills for Health spokesperson seems to a a bit short of a sense of humour when it comes to talking to trees.
The statement that “Our work supports best practice in areas that are evidence- and research-based” is not true, and when pressed the spokesperson more or less admitted as much.
Most importantly, though, we do now know that the revision of this gobbledygook will be carried out entirely by the Prince’s Foundation for Integrated Health and the people who set exams in the relevant form of gobbledygook. No critical voice will have an input, so don’t expect much improvement. “We are working with the Prince’s Foundation for Integrated Health [FIH] via Ian Cambray-Smith to review these competencies”. And in case you don’t know about the medical expertise of Ian Cambray-Smith, it is described on the FIH web site. He is the FIH’s Health Professionals Manager.
 |
Ian Cambray-Smith acts as the focus for FIH’s involvement with healthcare professionals. He works collaboratively to develop a range of work programmes, policies and initiatives to support healthcare professionals and help them to deliver a truly integrated approach to health. Ian’s background is in plastics research, project management and business development; he has an MSc in polymer technology. He joined the Foundation in 2006. |
Happy new year. not least to the folks at the homeopathy4health site . They are jubilant about a “proof” that homeopathic dilutions could produce effects. albeit only on wheat seedlings. But guess what? After some questioning it was found that they hadn’t actually read the paper. Well I have read it, and this is the result.
The paper is “A Biostatistical Insight into the As2O3 High Dilution Effects on the Rate and Variability of Wheat Seedling Growth”. Brizzi,
Lazzarato, Nani, Borghini, Peruzzi and Betti, Forsch Komplementärmed Klass Naturheilkd 2005;12:277–283
The authors compared these treatments (30 seedlings each).
- C1, C2, C3 (untreated water p.a. Merck, control);
- WP (potentized water p.A. Merck) 5x, 15x, 25x, 35x, 45x;
- AD (diluted arsenic trioxide) 10–5, 10–15, 10–25, 10–35, 10–45;
- AP (potentized arsenic trioxide) 5x, 15x, 25x, 35x, 45x.
The allocation of seedlings to treatments was stated to be blind and randomised. So far, so good.
But just look at the results in Figure 1. They are all over the place, with no obvious trend as ‘potency’ (i.e. dilution) is increased. The
results with homeopathic arsenic at 45 days (the only effect that is claimed to be real) is very little different from the that of shaken water (water that has been though the same process but with no arsenic present initially).
For some (unstated) reason the points have no standard errors on them. Using the values given in Table 3 I reckon that the observation for AP45 is 1.33 ± 0.62 and for the plain water (WP45). it is 1.05 ± 0.69. The authors claim (Table 3) that the former is ‘significant’ (with a profoundly unimpressive P = 0.04) and the latter isn’t. I can’t say that I’m convinced, and in any case, even if the effect were real, it would be tiny.
Later the authors do two things that are a very dubious from the statistical point of view. First they plot cumulative distributions which are notoriously misleading about precision (because the data in adjacent bins are almost the same). They then do some quite improper data snooping by testing only the half of the results that came out lowest. If this were legitimate (it isn’t) the results would be even worse for homeopaths, because the difference between the controls and plain water (WP45) now, they claim, comes out “significant”.
Homeopaths claim that the smaller the dose, the bigger the effect (so better water down your beer as much as possible, making sure to bang the glass on the bar to potentise it). I have yet to see any dose-response curve that has the claimed negative slope. Figure 1 most certainly doesn’t show it.
Of course there is no surprise at all for non-homeopaths in the discovery that arsenic 45x is indistinguishable from water 45x.
That is what we have been saying all along.
The press releases (STOP PRESS)
Uhuh, here we go again.
All over the media we see headlines like “Honey ‘beats cough medicine’ “.
Take for example, the Daily Telegraph, where Ben Farmer writes “Honey is better at treating children’s coughs than an ingredient used in many over-the-counter medicines, according to new research”.
That is NOT what the research found This is what the research paper itself says (DM refers to the standard ‘cough suppressant’ dextromethorphan, which is already known to be ineffective).
| “honey was significantly superior to no treatment for cough frequency’ DM was not better than no treatment for any outcome. Comparison of honey with DM revealed no significant differences.” |
See it? No detectable difference between honey and standard cough medicine.
Everyone in the media misinterpreted what the paper said, but at least one blogger is already on to it, with Today’s “duh” study is a honey”.
At first sight, the results seem contradictory, No difference between honey and DM, No difference between DM and ‘no treatment’. So how can honey be better than ‘no treatment’?
The study was by Ian M. Paul, MD, MSc; Jessica Beiler, MPH; Amyee McMonagle, RN; Michele L. Shaffer, PhD; Laura Duda, MD; Cheston M. Berlin Jr, MD, published in Archives of Pediatrics & Adolescent Medicine 2007, 161, 1140 – 1146.
What was done
The design of this trial was pretty good apart from one thing Three things were compared (a) buckwheat honey, (b) a standard ‘cough suppressant’, dextromethorphan in a honey-flavoured syrup that was designed to be similar to the honey (DM for short), and (c) no treatment whatsoever.
The median age of the children who completed the study was 5.2 years (range, 2.2 – 16.9 years). They all had coughs attributed to upper respiratory tract infection. Thirty-five patients received honey, 33 received DM, and 37 received no treatment.The good thing is that the treatments were allocated randomly to the children, and that the person doing the assessment didn’t know which treatment each child had received. The children didn’t know whether they were getting honey or DM either, but they DID know when they got ‘no treatment’. The trial was carried out over two days. On day one nobody got a treatment, but they filled in a survey that asked, for example, “How frequent was your child’s coughing last night”. The parent had to tick one of seven boxes, from ‘not at all’ (score zero) to ‘extremely’ (score 6). They were then given the treatment allocated to them in a brown paper bag, so the person who gave it didn’t know which it was. The patients then went home and on the next day the same survey was completed by the same parent, over the telephone.
What happened?
First look at the raw data. Here is Figure 2 from the original paper.
The charts show the results for 5 different measures of the severity of cough, and the last chart (F) shows the aggregate score for all the criteria.
The first thing to notice is that there are no error bars on these charts. In my area, at least, no journal would accept a chart like this with no indication of scatter. There is a snag, though. Each patient acts as his/her own control, and that would not be reflected properly if errors bars were calculated for the numbers plotted in Fig. 2. It would therefore have been better to have a chart in which the difference in score between day 1 and day 2 was calculated from each patient, and the size of these differences plotted, with a standard deviation of the mean to indicate the amount of scatter in the observations. I have asked Dr Paul to send me a version that indicates the scatter of the numbers in this way (but I don’t think it will come).
The second thing to notice is that there is there is quite a big difference between the score on the first day (pale columns) and on the second day (dark columns), even in the no treatment group .
Thirdly, the pale columns are all much the same. On the first day the average score was about 4 (“a lot”) though on the second day, even with no treatment, the score fell quite a lot, to something between 2 (“a little”) and 3 (“somewhat”). This is a bit baffling because no treatment was given on either day. Presumably it results from the different settings in which the survey was given, or because the kids were getting better anyway.
Fourthly, insofar as the pale columns (baseline values) are all much the same, the thing you need to concentrate on is the difference, on each chart, between the height of the dark bars, for honey, DM and no treatment. These differences are pretty small, but on all the charts, the honey score is slightly smaller than the DM score, and the DM score is slightly smaller than the ‘no treatment’ score. What are we to make of that?
Here beginneth the statistical lesson.
Because the differences are small, and the scatter is quite big, we have to ask whether the differences are just random fluctuations rather than a result of any real difference between the treatments. That means we need statistics. Here is how the statistical argument works. Put roughly, we ask “how probable is it that the observations could arise by chance”. More precisely, the question is this. If there were no difference between the treatments, what is the probability that we would observe by chance a difference as big as, or bigger than, that seen in the experiment? (You need the subjunctive mood to explain statistics -pity it’s vanishing.)
Above each chart in the Figure we see P < 0.001. This means that there is less than a one in 1000 chance of the results arising by chance. More precisely, if all three treatments (honey, DM and no treatment) were actually identical, it is very unlikely that we’d see these results. The reasonable conclusion is, therefore, that all three treatments are not identical. The problem with this argument is that it tells you nothing about where the differences lie, so it is of no help whatsoever to a patient who is trying to decide what to do about a cough. The other problem is that it includes the ‘no treatment’ group, which was not blind. Both the children and parents were well aware that no treatment was given.
The most helpful comparison is really the properly-blinded comparison between honey and DM. And when this was looked at the result was no significant differences. In other words the small differences between the heights of the dark columns for honey and DM could perfectly well have arisen by chance if honey and DM were identical in their properties.
There isn’t any reason at all to think that honey is better than the standard (but ineffective) cough medicine.
The direct comparison between DM and ‘no treatment’ also shows no significant difference. Yet there are signs of a real difference between ‘no treatment’ and honey, though only for the cough frequency, not the other four measures. The aggregate measure (F in the figure) gave P = 0.04 for the comparison, so the authors are running a risk of 1 in 25 of being wrong in claiming a real effect. Although some people seem to regard a value of P = 0.05 as indicating a real effect, the fact that you’ll make a fool of yourself 1 time in 20 by claiming a real effect when none exists has never seemed to me to be good enough odds to stake one’s reputation on.
The ‘no treatment’ group certainly has some interest, but the fact that it was not blind means that the fact that honey was marginally better than ‘no treatment’ could perfectly well mean that taking honey has a better placebo effect that doing nothing at all. It provides no evidence at all that honey has any genuine therapeutic effect. If it had, one would then have to find out if the therapeutic effect was specific to buckwheat honey, or whether any old honey would do. It could be argued that even if the effect were real rather than placebo, the size of the effect is too small to make all that effort worthwhile.
A couple more things
It is already well known, from several good studies, that DM is useless, no better than placebo. This inconvenient fact has not yet reached many places that it should have (not even mentioned on wikipedia for example), but the American Academy of Pediatrics says
“Numerous prescription and nonprescription medications are currently available for suppression of cough, a common symptom in children. Because adverse effects and overdosage associated with the administration of cough and cold preparations in children have been reported, education of patients and parents about the lack of proven antitussive effects and the potential risks of these products is needed.”
The discussion in the paper by Paul et al, seems surprisingly upbeat about honey, in the light of their own findings. I’m surprised that they use the term ‘demulcent’ which I had thought to have died out, like the word ‘tonic’, on the grounds that it had no defined meaning
It is because meaningless terms and useless medicines die out eventually that medicine makes progress. The problem with alternative medicine is that nothing dies out: on the contrary they keep adding myths.
And finally
Always look at the end of the paper. On this one we see that the study was paid for by the National Honey Board. Dr Paul assures me that the funding source had no say in the design or analysis, which is as it should be.
Financial Disclosure: Dr Paul has been a consultant to the Consumer Healthcare Products Association and McNeil Consumer Healthcare.
Funding/Support: This work was supported by an unrestricted research grant from the National Honey Board, an industry-funded agency of the US Department of Agriculture.
So what is the practical outcome?
My conclusion from all this is simple. If you have got a cough, tough luck. There isn’t really anything available, conventional or alternative, that does much good. You’ll just have to wait for it to get better. But if you want to take something that tastes nice, why not honey? It almost certainly won’t do any good but it tastes good and it’s safer than the standard cough medicine.
The sponsor’s interpretation
It seems that the sponsor of the work is happy with the misinterpretation.
Charlotte Jordan a project manager of research at the National Honey Board, believes the finding confirms what your grandmother told you.
“This is a really exciting finding,” she said. “For a long time it’s been folklore medicine to use honey when you have a cough or a cold, but it’s exciting to have a scientific study to back that up.”
Just one problem, That is NOT what the paper says.
How did all this mis-reporting happen?
One reason is misleading press releases. Universities and Academic journals now engage in shameless PR, spin and hype. They prostitute good science.
Download press releases from Penn State, JAMA and Press Association [pdf file]
Here is the highly misleading bit of hype that came from the Press Office of the Pennsylvania State University. The headline is “Honey a better option for childhood cough than OTCs” (OTC means over-the-counter medicines that contain DM). That contradicts directly the paper which says “Comparison of honey with DM revealed no significant differences”.
Likewise the statement in the Penn State release “Honey did a better job reducing the severity, frequency and bothersome nature of nighttime cough from upper respiratory infection than DM or no treatment” is equally incompatible with “Comparison of honey with DM revealed no significant differences”. Its only possible justification is from the 3 way comparison by analysis of variance and that does not tell us what we need to know.
To make matters worse, the media office is not to blame this time. Ms Manlove told me tonight that the press release had been approved by Dr Paul himself.
| Contact: Megan W. Manlove Penn State Honey a better option for childhood cough than OTCs A new study by a Penn State College of Medicine research team found that honey may offer parents an effective and safe alternative than over the counter children’s cough medicines. The study found that a small dose of buckwheat honey given before bedtime provided better relief of nighttime cough and sleep difficulty in children than no treatment or dextromethorphan (DM), a cough suppressant found in many over-the-counter cold medications. Honey did a better job reducing the severity, frequency and bothersome nature of nighttime cough from upper respiratory infection than DM or no treatment. Honey also showed a positive effect on the sleep quality of both the coughing child and the child’s parents. DM was not significantly better at alleviating symptoms than no treatment. . . . |
All that Candice Yakel, of the Office for Research Protections at Penn State had ro say in the matter was
“Our investigators stand by the conclusions of the study as reported in the Archives of Pediatric and Adolescent Medicine and as characterized in our press release of December 3, 2007.”
And here is the equally misleading bit of hype issued by the Journal of the American Medical Association (Ms Manlove tells me that this was also approved bt Dr Paul).
| JAMA and Archives Journals Study suggests honey may help relieve children’s cough, improve sleep during colds
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The Press Association release was equally bad, and probably the one used by many of the reporters as a basis for stories in the media. The opening statement is totally wrong.
| 1 HEALTH Honey Embargoed to 2100 Monday December 3 HONEY BEST FOR KIDDIES’ COUGHS SAY RESEARCHERS By John von Radowitz, PA Science Correspondent Natural honey is a better remedy for children’s coughs than expensive over-the-counter medicines, researchers said today. A dose of buckwheat honey before bedtime easily outperformed a cough suppressant widely used in commercial treatments, a US study found. . . . |
Follow-up
There is a review of over-the-counter cough medicines in the BMJ (2002) [free full text]. It concludes “Recommendation of over the counter cough medicines to patients is not justified by current evidence”.
Well, guess what turned up in a brown envelope this morning. A copy of the Society of Homeopaths’ Newsletter
It makes interesting reading, not least when the homeopaths’ discussion group are abuzz with talk of the demise of homeopathy
“The Society is urging its members to be cautious when responding to phone calls and e-mails following reports of enquirers appearing to be trying to catch out homeopaths”
“It seems to be part of an organised campaign to discredit homeopathy, with enquiries focusing on AIDS, malaria and vaccination. Members’ responses are then being used on anti-homeopathy blogs and web sites”
Dead right there. And the reason that the answers are being used on anti-homeopathy web sites because they are very often utterly irresponsible. Now we see they are being told to tone down their claims in public, so if you want to know what a homeopath really recommends, the only way to discover is to ask them in private.
” . . . the Society is asking all members to check that their [web] sites adhere to the code of ethics and practice, and clearly differentiate between ‘evidence’ and ‘speculative theory’ “
Well of course that distinction is very rarely made – that alone shows that the SoH’s “regulation” is utterly ineffective.
“Chief executive Paula Ross said: “it is a sad state of affairs when members have to be suspicious of every call or e-mail, and it’s important not to let it cloud genuine interaction with people who are interested in having homeopathic treatment”
All this can have only one meaning: if a homeopath suspects that the enquirer is a sceptic, tell them one story, but if they are a paying customer tell them a different story.
Why on earth should the SoH make such a fuss about enquiries from anyone if they have nothing to hide?
Later, on page 21, the theme continues.
“Members urged to be wary when questioned” (by Trish Moroney, their Professional Conduct Officer)
“Case histories are useful and you can always preface your comments with ‘it is my opinion’, this makes it clear that what you are saying is opinion not fact.”
That comment is certainly well-worded. Indeed most of the advice you get from homeopaths is “not fact”.
“The Advertising Standards Agency (ASA) has clear guidelines for what may or may not be used in written advertisements, but this does not cover the web.
Words like ‘cure’ and ‘treat’ are not allowed to be used in advertising in any published form.”
Not allowed? You must be joking Ms Moroney.
You yourself are quoted thus: “Trish commented: “One of our products is a homeopathic birthing pack and I complement this with a treatment programme tailored specifically to the requirements of the individual.”. Or here ” She [Moroney] has also found that homeopathy is useful for treating a number of women’s problems including heavy or painful periods and the menopause. It can also help with a number of ailments in pregnancy including tiredness and nausea.”. Or how about this. “I was suffering from high blood pressure,” she [Moroney] said. “I went to a homeopath and after taking the right remedy my blood pressure dropped, even though my work situation had not changed. Homeopathy really can help.” If that is not a claim that homeopathy can treat high blood pressure, what is?
Moroney ends her article, by modestly comparing herself with Galileo
Yet again, one must quote Robert Park
“Alas, to wear the mantle of Galileo it is not enough that you be persecuted by an unkind establishment; you must also be right.”
But Moroney’s claims are very mild compared the those of people like Jeremy Sherr. Read all about him at gimpy’s blog. Sherr is (in)famous for his “provings” of hydrogen, plutonium and chocolate, and for his advocacy of homeopathic treatment of malaria and AIDS And look at the results of a complaint against the dangerous fantasies of homeopath Sue Young here.
The fact that Sherr is a Fellow of the Society of Homeopaths shows very clearly that the Society of Homeopaths’ attempts at regulating professional conduct are a no more than a pathetic sham.
A letter from the Chief Executive Paula Ross
The letter on page 5 starts “It’s been a tough few weeks for homeopathy” and it continues the grumbling about the number of complaints the SoH has been getting. More remarkably, Paula Ross boasts about the legal action that SoH took against the quackometer site (which she mistakenly confuses with the US site, Quackwatch). When one realises the major disaster for SoH that this legal action caused, it’s a bit surprising that the Chief Executive hasn’t been fired. The banned page, the Gentle Art of Homepathic Killing, popped up on at least 60 sites around the world, and a Google search for “the Society of Homeopaths” soon produced eight out of ten results on the first page of results that pointed to the banned page.
Is there a homeopathic remedy for shooting yourself in the foot?
Institute launch marks a new era of research
The Newsletter has this headline on page 4. “The aim of the Homeopathic Research Institute (HRI) is to promote and facilitate high-quality scientific research, and communicating about the science relating to homeopathy” . Don’t hold your breath, I suggest. Neither of the two projects they list addresses the main questions . Their publications page lists only two papers, both by Clare Relton. The first of them is Patients treated by homeopaths registered with the Society of Homeopaths: a pilot study C Relton, K Chatfield, H Partington and L Foulkes Homeopathy 2007 Apr 96 (2):87-9 This paper concludes
| This was an uncontrolled study and participants were self-selected; there were no checks on whether homeopaths returned all MYMOP forms for consecutive patients. Despite the apparent improvement overall in MYMOP2 primary symptom scores and MYMOP2 profile scores reported by patients, due to the uncontrolled design of this pilot study we cannot draw any firm conclusions regarding the improvement that patients gain from homeopathic treatment with SoH homeopaths. |
Are medical homeopaths any better?
The same brown envelope that contained the SoH newsletter also brought me a copy of Health and Homeopathy, the magazine for friends of the British Homeopathic Association. This magazine, unlike SoH’s Newletter is available to anyone. Try it yourself. Mostly it reads like a medical textbook that was written at the beginning of the 19th century. Which, of course, is exactly what it is. So 200 years and no progress.
The British Homeopathic Association is a quite different outfit from SoH because it is allied to the Faculty of Homeopathy, which is for the small number of medically-qualified homeopaths. Needless to say, it has far fewer members than the non-medical Society of Homeopaths.
The Winter 2006 edition already had references to the declining support for homeopathic fantasies (as I would put it) . They had a whole article by Sally Penrose, Homeopathic Hospitals under Threat. Tunbridge Wells Homeopathic Hospital has gone. The Royal London is under great threat, and the Bristol Homeopathic Hospital is endangered. The only outposts of delusion that seem safe (for the moment) are in Glasgow and Liverpool.
This magazine may emanate from medical homeopaths who balk at claiming to be able to cure malaria and AIDS, but is in other ways no less delusional. For example eczema, it seems, can be cured by eating tiny amounts of common salt, as described here.
| “He prescribed six powders of Nat mur in increasing potencies to be taken on consecutive days and my eczema got better within a matter of weeks,” |
You couldn’t make it up.
Here is an interchange of letters from this week’s BMJ. George Lewith says more money should be spent by the government on research on alternative medicine. Well, only if it is spent properly, and that is not what has happened in the past. (Letters here, if you have a subscription.)
In all probability money spent in this way would be money down the drain, just as it has proved to be in the USA. As pointed out by Wallace I. Sampson, M.D., NCCAM has spent almost a billion dollars on research into alternative medicine, and
“. . it has not proved effectiveness for any “alternative” method. It has added evidence of ineffectiveness of some methods that we knew did not work before NCCAM was formed.”
It is a bottomless pit, and there are more promising ways to spend the money.
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| George T Lewith, Reader in Complementary Medicine, University of Southampton Primary Medical Care, Aldermoor Health Centre, Southampton SO16 5ST Send response to journal: Re: Valuing Research |
I remain unclear about John Garrow and David Colquhoun’s position with respect to “funding CAM”. Are they suggesting that there should be no funding for CAM research or are they suggesting this embargo should apply to the provision of CAM services within the NHS? If the former, how do they justify this position with respect to the many UK taxpayers who use CAM each year and for whom the government has some obligation to provide information? Competing interests: None declared |
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| John S. Garrow, vice-chairman HealthWatch The Dial House, Rickmansworth, WD3 7DQ Send response to journal: Re: Taxpayer funding of CAM research |
Dr Lewith wants clarification of my view about public funding of CAM research. It has changed over the last 7 years. In 2000 the House of Lords Select Committee (HLSC)advised the Department of Health to fund research on acupuncture, chiropractic, herbal medicine, homeopathy and osteopathy to see if these therapies were safe, more effective than placebo and good value for money, At the time I supported this decision. However in 2003 it was disclosed that £1.3m had funded 8 research projects, at the Universities of Leeds, Southampton, Bristol, Brunel, Sheffield and York, but none of these were directly testing the safety, efficacy or value-for- money of the main CAM therapies.[1] I noted that these Universities did not have as good a record of research into the efficacy of CAM as Exeter, which had applied but failed to get funding. It was also noticable that the panel awarding the grants tended to work at the funded Universities. CAM research is not so impoverished as Dr Lewith implies. The onus is now upon the researchers who received £1.3m from the taxpayer, and more from the Foundation for Integrated Health, to tell us what answers they have found to HLSC’s very pertinent questions. Only in the light of these answers can we judge if they deserve further public funding. If initially the Government had an “obligation” to fund CAM research I think the £1.3m discharged it, and now there is an obligation on CAM practitioners to show that they have not misappropriated these funds. [1]Garrow JS et al. UK government funds CAM research. FACT 8:397-402, 2003 Competing interests: None declared |
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| David Colquhoun, Prof of Pharmacology UCL Send response to journal: Re: Funding for alternative medicine research |
I agree entirely with John Garrow’s response. A corollary of his analysis is that, if there is to be any more funding for research in alternative medicine, it is essential that the allocation of the money should not be in the hands of alternative medicine people. The reason for that is that past experience has shown that they will give the money to projects that don’t answer the real questions. If no applications are received that address the proper questions with rigorous experimental design then the money should be clawed back and spent on something that has a better chance of being a real advance. I am perpetually amazed by the reluctance of advocates of alternative medicine to subject their claims to proper tests. The only interpretation that I can see of this failure is that they themselves believe, deep down, that the tests would be failed. I hope that isn’t the explanation though, because if they were convinced that the tests would fail, it would mean that we are dealing with fraud, not just delusion. Competing interests: None declared |
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If you read nothing else on the topic, read Ben Goldacre’s best ever piece, A Kind of Magic? (Guardian, 16 Nov 2007). This started as response to “In defence of homeopathy” in the same newspaper on 13 November. On the same day, the Lancet carried a rather more academic piece by Goldacre “Benefits and Risks of Homeopathy” , The same issue of the Lancet carried a commentary ” Pressure grows against homoeopathy in the UK“, as well as a sadder report, “Homoeopathy booming in India“.
There is going to be plenty of commentary on these pieces. There is one bit of “A Kind of Magic” that is particularly important, and that is about how to do a proper trial. It is one of the most persistent myths of all sorts of quack that, for reasons that are never explained, their particular form of magic is not susceptible to being tested in the normal and well-established way. This is simply not true, and the fact that the myth is repeated again and again is perhaps the best reason to doubt that homeopaths are really genuine in the beliefs that they claim to have. If they were really so confident they would do the tests. But they don’t and won’t. When the government supplied money for doing tests, the money was distributed by a committee of “experts in alternative medicine” (though it beats me how you can be an ‘expert’ in something that isn’t true), all the money was given to projects that were incapable of answering the main question, namely ‘does it work better than placebo?’.
How to do the test
Here is Goldacre’s description of how to do the test. It has been said before, but it must be said again and again. Until homeopaths take this seriously, there is no option but to regard them as frauds.
“You could do a randomised, controlled trial on almost any intervention you wanted to assess: comparing two teaching methods, or two forms of psychotherapy, or two plant-growth boosters – literally anything. The first trial was in the Bible (Daniel 1: 1-16, since you asked) and compared the effect of two different diets on soldiers’ vigour. Doing a trial is not a new or complicated idea, and a pill is the easiest thing to test of all.
Here is a model trial for homeopathy. You take, say, 200 people, and divide them at random into two groups of 100. All of the patients visit their homeopath, they all get a homeopathic prescription at the end (because homeopaths love to prescribe pills even more than doctors) for whatever it is that the homeopath wants to prescribe, and all the patients take their prescription to the homeopathic pharmacy. Every patient can be prescribed something completely different, an “individualised” prescription – it doesn’t matter.
Now here is the twist: one group gets the real homeopathy pills they were prescribed (whatever they were), and the patients in the other group are given fake sugar pills. Crucially, neither the patients, nor the people who meet them in the trial, know who is getting which treatment. ”
Winterson and the Maun Project and AIDS
This particular round of discussion was started by Jeanette Winterson’s “In defence of homeopathy“.
It is an interesting article because, like the whole world of homeopathy, Winterson herself is split between homeopathy as a harmless placebo and homeopathy as a dangerous “treatment” for dangerous diseases. On one hand she claims that she is all for proper anti-retroviral treatment of AIDS, yet at the bottom of the article it says “Jeanette Winterson is donating the fee for this article to the Maun homeopathy project. ” .
“Since 2002, The Maun Homeopathy Clinic has been running free homeopathy outreach clinics in Maun, a fast growing town in the north of Botswana, where over 35% of the people are infected with HIV or AIDS, one of the highest rates in the world.”
Hilary Fairclough, much praised by Winterson for reducing her high temperature with pills that (didn’t contain) any snake venom, describes herself as “clinical director” of the Maun project. She is, of course, qualified in neither science nor medicine, but is registered with the now notorious Society of Homeopaths. The Maun project newsletters have all the usual accounts of amazing cures. They quote
“The homeopaths are so loved here, and at the clinics we see daily miracles.”
Do they really believe in miraculous cures? I’m inexorably reminded of an earlier generation of missionaries who went to Africa, to impose on the poor benighted natives a different brand of irrationality. At least the missionaries did some education too, and didn’t, on the whole, kill people.
The ladies of Devon who contribute their money to this project, rather than proper treatment, are, sadly, contributing to the gentle art of homeopathic killing.
Referring to Goldacre’s article in the Lancet, Winterson says ” where is the scientific sense is saying that because we don’t understand something, even though we can discern its effects, we have to ignore it, scorn it, or suppress it?”. Needless to say, no pharmacologist has ever said anything of the sort. Quite the opposite. Goldacre comments
“The article does not say that, and I should know, because I wrote it. It is not an act of fusty authority, and I claim none: I look about 12, and I’m only a few years out of medical school. “
Winterson’s article goes on about ” boosting the patient’s immune system so they are better able to fight off the opportunistic viruses that follow behind HIV”.
Sorry, but there is not the slightest reason to think the sugar pills do anything whatsoever to the immune system: that is no more than a ritual form of words, a mantra recited by every homeopath.
Winterson also falls for the latest fashion in homeopathic gobbledygook, to describe it as nanopharmacology. It isn’t nano, it’s zero.
She also gives support, though it is intriguingly ambivalent, to the forthcoming conference of the Society of Homepaths, You can download the flyer for this conference, It defies belief. As well as Winterson’s homeopath, Hilary Fairclough, it features Harry van der Zee and Peter Chappell.
“Harry believes that using the [Chappell’s] PC1 remedy, the AIDS epidemic can be called to a halt, and that homeopaths are the ones that can do it. “
That is a direct claim for a cure. It is as good example as any of the Gentle Art of Homeopathic Killing, in the now immortal words of the quackometer blog.
Peter Chappell’s web site says (no, really, seriously),
“Right now AIDS in Africa could be significantly ameliorated by a simple tune played on the radio across Africa. Or there is a slower solution using pills, and drops that works very well, but is harder to deliver. ”
“The second creative idea is again is implied by those above, and relates to the ability to deliver healing aurally, instead or orally, so healing downloads and ehealing is possible and practical. Instead of taking pills containing resonance information, you listen to a very short piece of music which contains the same information. “
Just beat that, if you can.
You can get free samples here. Try the tuberculosis tune. Sounds like pretty standard 50s or 60s jazz (anyone recognise it?). Don’t be fooled though. It’s explained that
The music is not the download
The music is simply the carrier and alerts you to listen. The download is engrafted on the music by a special process. That is the new technology.
University of Westminster: a new course?
I hope that the University of Westminster is proud of the fact that its degree in homeopathy is recognised by the Society of Homeopaths , who are sponsoring this nonsense. Perhaps the university should consider an advanced third year module in “downloading therapeutic resonance music”.
Read more
Andy Lewis’s quackometer “Will Homeopathy and iTunes Cure AIDS?
Nick Cohen “The cranks who swear by citronella oil”
Jeremy Laurance in the Independent (17 Nov) “Homeopathic treatment of Aids attacked by medics“
This was not written by me, but by a homeopath, in an email that has been circulating recently. It comes from the editor of hpathy.com, not one of the bigger players in the homeopathic fantasy business.
Serious panic seems to be setting in.
One amusing aspect is the description of the “huge and systematic campaign”. Actually it’s just a few dozen people who decided it was time to speak up. After all, anyone can understand “the medicine contains no medicine”. And don’t you just love “Those who are organizing this anti-homeopathy campaign have been SO SUCCESSFUL that most homeopaths in UK have seen a 50% drop in their practice in the last 2 years. In fact most of them get to see only 3-4 patients a week.” I hope that is more reliable than most numbers one gets from homeopaths.
Once again we see the ambivalent attitude to the dangerous malaria scam, the “Gentle Art of Homeopathic Killing“. It is that problem that has set the Faculty of Homeopaths and the Society of Homeopaths on opposite sides in internecine warfare.
Here are some excerpts. Download the whole email.
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Remember Kate Birch? She was the homeopath who was caught out recommending homeopathic treatment for malarie prevention (“Homeopathy is more effective that any western medication”). Still worse she advocated homeopathic cures for malaria at a clinic in Tanzania”.
The follow up to that outrageously wicked claim is posted here.
Imagine my amazement when Kate Birch knocked on my door on the morning of October 16th. Like most of the homeopaths I have met, she was earnest and rather charming. She was also, I have to say, on the high end of the delusional scale. The good thing is that she was kind enough to present me with a copy of her book,
Vaccine Free – Prevention and Treatment of Infectious Contagious Diseases with homeopathy . She seemed genuinely to think that if I read the book carefully. I would be persuaded that she was right. That is the book that first attracted the attention of a correspondent. I would not have been willing to pay £25 to buy it, but I am certainly be grateful to have the chance to quote a few passages from it.
One curious thing about the book is that the disease descriptions are given in straightforward standard scientific language. But that approach is quite inconsistent with the letter I got from North American Society of Homeopaths (NASH), which said
“NASH does not have a policy on the treatment of any disease category, in accordance with the tenet that homeopathy treats the whole person based on characteristic symptoms rather than a diagnosis.”
The claims to be able to cure serious diseases are also quite at odds with NASH’s Standards of Practice Guidelines which say
“Do not claim that you can treat any disease, condition or ailment or imply that you can do so.
Be extremely careful when speaking or writing about the treatment of particular diseases or conditions (and never offer or claim to help anybody). “
Yet Kate Birch is vice president of NASH. That organisation seems to be as much in chaos. and just as incapable of controlling irresponsible behaviour of its members, as its UK equivalent. The Society of Homeopaths.
Here are a few quotations.
Rabies.
“Curative action of the [hoemopathic] remedy depends on the degree of neurological involvement. Remedies given at the same time as the bite will act preventatively for the condition. If the mental state is strong, the appropriate remedy will help resolve it in the days following administration”
That reads to me like a claim that sugar pills will cure rabies (or is the insertion of the word “help” the getout?).
Tetanus
“Remedies given at the time of injury will reduce the susceptibilty to developing tetanus”.
Polio
“Gelsemium. This remedy is useful in early treatment with polio paralysis“. What does “useful” mean if it does not mean cure?
Diphtheria
“Diphtherinum . . . As a preventive in an epidemic, this remedy can be administered in a 200C potency once per week”.
Measles and German Measles
“The best prevention for both diseases is the homeopathic remedy Pulsatilla nigricans . . . If you are aware of being exposed, 30C daily for 7 days should be sufficient to subvert the disease.”
Smallpox
“Moreover, in the event of terrorist activity, may become prevalent once again. If this situation were to arise, there would be a need for and opportunity to use homeopathy in this area of public health.”
“The [homeopathic] remedies listed below will be useful for the treatment of the disease and for ailments from the vaccination”
Anthrax
“Homeopathy bases its prescriptions on the nature of symptoms. Because the disease progresses rapidly to death it is important commence treatment quickly and to monitor the recovery. Homeopathy can be used in addition to antibiotics if the case warrents.” Oops there seems to be a momentary touch of realism in that last sentence.
Plague
“Vipera, the homeopathic preparation of the snake venom, is useful for prevention and treatment.”
Tuberculosis
“As the person’s health deteriorates, and the tuberculosis becomes active, remedies such as Ferrum metallicum, Phosphorus, Stannum, Iodium, Kali carbonicum, or any of the remedies listed below may be more indicated to return the person to health”. See more on tuberculosis here
Hepatitis A, B and C
“In the homeopathic treatement of the acute form of hepatitis A, one would expect results within a few days to weeks of the correct homeopathic remedy.”
Dengue fever
“Homeopathy has been used succesfully around the world to treat and prevent Dengue fever.”
The list goes on an on. I am grateful to Kate Birch for giving me a copy of this book. Sincere she may be, but the advice given is, in my view a danger to humanity. This stuff leaves the Society of Homeopaths in the shade.
Follow up
The similar outrageous claims made by some members of the (UK) Society of Homeopaths have been investigated throughly on gimpyblog.
Many people now have written about the disgraceful and dangerous claims by homeopaths to be able to prevent and cure malaria. My contribution was “Homeopathic ‘cures. for malaria: a wicked scam”
One of the best contributions was on the Quackometer blog, The Gentle Art of Homeopathic Killing.
But the post vanished at midday on Thursday 11 October. Quackometer’s ISP has received threatening letters sent by lawyers on behalf of the Society of Homeopaths, who claim that the truth is defamatory, while being unwilling to say which statements are wrong. These threats have forced the removal of the post (for the moment), though you can still read it from the Google cache. And a lot of other places too.
.. . . At the very least, we could expect the Society of Homeopaths to try to stamp out this wicked practice? Could we? |
OK it’s fun to see the fantasy world of homeopaths riven by their internecine squabbles, but this is a serious matter.The Society of Homeopath’s substitute for answering reasonable questions is to try to suppress legitimate comment by brute (legal) force. It is hard to imagine such cowardly behaviour. I fear, though, that they may be in for a big surprise.Watch this space for developments.
Follow up
The storm begins.
Within 24 hours of the post being removed, it has sprung up again, all over the world. These are just the links that reproduce the whole text. Countless more refer to them.
“Blog post taken down by homeopathic complaint: a chill wind is blowing”
Gimpy’s blog: “The Society of Homeopaths silence criticism through cowardly legal means”
Andrew Clegg lends support: “A run-in with the Homeopathic Thought Police”. He reproduces the banished page.
And on Google groups in several places, for example here.
Another reproduction of the whole banished page at A day at the pharmacy (“from a provincial, small-town pharmacy in the United Kingdom”).
A mirror of the whole original page has appeared at semiskimmed.net
and “The Gentle Art of Homeopathic Killing (Cowards and Bullies)” appeared on JDC325’s weblog.
Another at badchemist.net.
Apathysketchpad , from Andrew Taylor, in Manchester,
Very soon it appeared in the USA too
Orac’s Respectful Insolence site: “Homeopathic thuggery”. The Yale surgeeon/scientist has also reproduced the full text.
The whole banned page is at skepticaldog.com too.
And on the Inalienable Rights blog (Portland, Oregon). They add the forthright comment “Go Society of Homeopaths, good on you for being complicit in murder, you bloody moronic cowards.”
The whole text is on the NNSEEK news group search engine too.
And in Russia
The whole text is here.
And all this within 24 hours since the page was pulled. The lawyers for the Society of Homeopaths are going to be very busy.
They keep coming. More full texts here.
Some are so anonymous that you can’t even be sure which country they come from, though often the US ones are distinguishable because the link mainly to US sources. Now Saturday.
- The Voyage. A blog from Ireland “Big Altie Gags the Truth, or tries to”.
- White coat underground. A doctor from the US midwest speaks out.
- Science after Sunclipse. An east coast US blog “for math, physics and the New Enlightenment”
- Conspiracy Factory. Factition’s blog: “Homeopathy, Malaria & Free Speech”.
- The Bronze Blog. “Big Altie attempts to suppress truth”. A very anonymous US blog.
- Infophilia. The Streisand Effect. From Arlington Heights, Illinois,USA.
- HappyJihad’s House of Pancakes. Another anonymous US blog, with full text.
- The GAS blog
- Skeptico. Another site from USA.
- Be Lambic or Green. From Canada (I think)
That’s 25 reproductions of the page so far. Now Sunday 14 Oct,
- Nana’s Notions. Blog from a US accountant.
- A Night on the Tiles. From Stew who works in a tile factory in France.
- Powerup. From Tyler DiPietro, a student in New England, USA.
- Unfiltered Perception. blog.tjomlid.com, from a young Norwegian.
- Action Skeptics. “Kick my ass. Society of Homepaths”, From Indiana, USA.
- bankrupt artist v3. Nice version from Canada
- Sceptiphrenia . Another from the UK.
- Thinking is Dangerous. “Be shamed, Society of Homeopaths”, for Dr T, UK.
- Rants and Raves, From Kulvinder Singh Matharu. “Homeopathy; Failure of truth and integrity (again)”.
On Sunday night, for the first time, one of them comes up on the first page of Google search for “The Society of Homeopaths”
More on Monday 15 Oct. Now five of the first ten hits on a Google search for “The Society of Homeopaths” refer to this row.
- Skeptix, The Central Alberta Skeptics Association.
- No Nonsense. “Society of Homeopathetics – censoring unfavorable comment!”. From Italy?
- The Millenium Project, From Australia. “The constant misspelling of the word “millennium” with only one “n” inspired me to create a millenium – that is, a collection of a thousand arseholes.”
- Rich Speaks. From Richer Lockwood, UK.
And from Tuesday onwards, they kept coming.
- A rather fine rant from Song, by Toad. “The Gentle Art of Homeopathic Killing – Fuck You, Society of Homeopaths”
- EnoNomi. Another complete text, from Phoenix Arizona
- D-notice: homeopathic killing. From London
- The Macho Response. From Oakland California
- Homeopathiccompliants.
- Ordinarygirl. “Homeopaths censor blogger” from Kansas, USA.
- Tabasco da Gama From USA “Society of Homeopaths thug tactics”
- Planet Atheism
- Skeptikeren.
- Blogher. A curious on from US. The full text has been posted as a comment on a pro-homeopathy site.
- Dikki’s diatribe. Another from AUSTRALIA.
- Qnoodle
- Freeborn John. Internet censorship again
- Skeptobot. A UK PhD student
- And, at last, James Randi (with comments)
- Skeptigator Another US one
- Bishop Hill From “an Englisman lvining in rural Scotland”
- Counterknowledge. “This you have to read”. From UK writers.
- Ministry of Truth. “Shades of Uzmanov”
- The Wardman Wire. “Society of Homeopaths are doing an Usmanov”.
- Mediawatch.org.uk.
- Mike Powers. “Not just fat oligarchs” (another allusion to the Usmanov affair).
- Aharonic.net. Art and culture.
- Amused cynicism. From “a computer programmer living in north west Europe”.
- Humaniform.
- Chicken Yoghurt. from Justin McKeating. “The Usmanov strain -mutating”
- The Devil’s Kitchen. “Homeopathic, sociopathic, psychopathic”.
- Starshun.com. “Society of Homeopaths threaten blogger”
That’s 64 now, from UK, USA, Russia, Canada, France, Norway and Australia. And still counting. The story is now reaching the political blogs too.
On the morning of 25 October, six of the first ten links ona Google search fot the “The Society of Homeopaths” led to re-postings of “The Gentle Art of Homeopathic Killing”.
By 1st November, all the Google front page links apart fron the first two pointed to sceptical sites (one was to the BBC’s “Homeopathy’s Benefit Questioned“, the rest to harder-hitting criticism).
Andy Lewis and Ben Goldacre have both posted Andy’s incredibly polite email to the Society of Homeopaths. This is the letter that got no reply apart from another letter from lawyers.
More from quackometer
“You Very Naughty Girls and Boys.” Tut tut, look at al those postings!
“The Society of Homeopaths: Truth Matters” A follow up on recent events. In particular, a letter that the Society of Homeopaths wanted to publish is demolished.
Two definitions of lawyers
Dice, n. Small polka-dotted cubes of ivory, constructed like a lawyer to lie on any side, but commonly the wrong one. [Bierce, Ambrose, The Enlarged Devil’s Dictionary, 1967]
The duty of an advocate is to take fees, and in return for those fees to display to the utmost advantage whatsoever falshoods the solicitor has put into his brief. [Bentham, Jeremy, The Elements of the art of packing as applied to special juries, 1821]
| A paper published in the Postgraduate Medical Journal, October 2007, has been reported widely. In the same issue there was a commentary by Edzard Ernst. They show the astonishingly poor evidence than herbal treatments work, despite the fact that they have been around for thousands of years. They looked at 1330 published trials on herbal medicines and found 3 (yes three) that stood up to scrutiny, Of those three, two were negative and one indecisive |  Red clover, Derwentwater. |
A systematic review of randomised clinical trials of individualised herbal medicine in any indication, R. Guo, P. H. Canter, and E. Ernst, Postgrad Med J 83: 633-637 [Get the reprint]
Herbal medicine: buy one get two free, E. Ernst, Postgrad Med J 83: 615-617 [get the reprint]
Grab the reprints before I am told to remove them.
The paper says
“Systematic searches of electronic databases and contacting
experts and professional bodies in the field resulted in the
location of only three randomised clinical trials of individualised
herbal medicine. It should be stressed that professional
bodies representing the interests of different practitioner
factions from around the world were unable to contribute any
more studies than this. In view of the long history and
widespread use of medical herbalism, Chinese herbal medicine
and Ayurvedic herbal medicine in many and diverse indications,
this should be a cause for concern. It indicates that
individualised herbal medicine has an extremely sparse
evidence base and that there is no convincing evidence
supporting its use in any indication.”
The National Institute of Medical Herbalists says
“More and more people are turning to herbal medicine as a kinder alternative to mainstream medicine, with its over reliance on pharmaceutical products.”
Wrong. Herbal medicines are pharmaceutical products. They are just unstandardised, and often impure and contaminated, pharmaceutical products.
In the Guardian we find Ann Walker quoted thus.
“Ann Walker, director of the British Herbal Medicines Association, insisted that most herbalists were well-trained and knew when to refer patients. She said herbalists took a three or four-year degree course before accreditation.
She acknowledged the lack of proof of efficacy for individualised herbal medicine. “The evidence is scanty because the studies have only recently been started,” she said. This did not mean there was no efficacy.”
Just a thought: shouldn’t you have some evidence that they work before you start selling them? These things have been around for thousands of years but the “studies have only recently been started”. You couldn’t make it up. You can’t have a high level of training if there is no evidence. The paucity of trials makes it very hard to know how you can fill up a three or four year course with anything but idle speculations. Universities should not being giving degrees in idle speculation.
Quote of the day. . Of all the pathetic defences offered by herbalists, this one, quoted in the Daily Mail, is my favourite.
“Jane Gray, of the National Institute of Medical Herbalists, said: “We would challenge the conclusions reached by this study based on such little data.”
“We want more research, but we’re all in private practice and cannot afford to stop earning to run a trial over several months.”
The fact that there is “so little data” is the conclusion. And perish the thought that a herbalist should “stop earning” just in order to find out whether what they are selling does any good.
The regulation scam
Alison Denham, speaking for the National Institute of Medical Herbalists, is quoted as saying
“But there are certainly issues around the expertise of practitioners which need to be addressed, and we look forward to government regulation which imposes a high standard of training on anyone who wants to register.”
Like all forms of alternative medicine, herbalists are desperate for government “regulation” because they know it gives the appearance of official approval without requiring them to show that they can do the slightest good.
Reports on this paper
The BBC web site: “Tailored herbal medicine ‘futile'”.
The Guardian report, by Sarah Boseley, is pretty good. “Herbalists’ cocktails may do more harm than good, say researchers.”
- Call for individualised remedies to be banned
- Little evidence to support claims of efficacy
The Times has another excellent report by Nigel Hawkes. “High street herbalists can offer no evidence that their remedies work”
The Independent. “Natural medicine on trial: The trouble with herbs. Traditional herbal remedies have never been more fashionable: sales have almost doubled in eight years. There’s just one problem: science suggests that they don’t work.”. This time Jeremy Laurance got the headline right (unlike the acupuncture piece). But where did that list of “Herbal remedies that work” at the end come from? Had he checked the Cochrane Reviews? I think not.
The Daily Mail. “Herb cures that ‘do you more harm than good’ “. Pretty good report. specially for the Daily Mail.
The Scotsman. “A natural cure?” Lyndsay Moss. Sadly, and unusually, this is the only really poor report. Just look at the end of it.
Postscript
On Saturday morning (6 October) I did an interview on the Dublin radio station, Newstalk. The host, Brendan O’Brien spoke also to Mary Plunkett, from the Professional Register of Traditional Chinese Medicine. She assured us that that, although there may be no evidence that it works published in the West, there were lots written in Chinese. What a pity that I had not yet read Ben Goldacre’s column, on this week’s bad news for herbalists. He cited a reference that was new to me.
You can read the abstract here. [download pdf]. The paper, by Vickers, Niraj, Goyal, Harland and Rees (1998, Controlled Clinical Trials, 19, 159-166) has the title “Do Certain Countries Produce Only Positive Results? A Systematic Review of Controlled Trials”. The conclusion is riveting.
“In the study of acupuncture trials, 252 of 1085 abstracts met the inclusion criteria. Research conducted in certain countries was uniformly favorable to acupuncture; all trials originating in China, Japan, Hong Kong, and Taiwan were positive, as were 10 out of 11 of those published in Russia/USSR. In studies that examined interventions other than acupuncture, 405 of 1100 abstracts met the inclusion criteria. Of trials published in England, 75% gave the test treatment as superior to control. The results for China, Japan, Russia/USSR, and Taiwan were 99%, 89%, 97%, and 95%, respectively. No trial published in China or Russia/USSR found a test treatment to be ineffective.”
| At a meeting of the West Kent PCT board, on 27 September 2007, it was decided to withdraw all funding for homeopathy from the end of this financial year. This means the end for the Tunbridge Wells Homeopathic Hospital.. |
 |
Congratulations to Dr James Thallon (Medical Director of the West Kent PCT) who done a good job for patients in his area by ensuring that NHS money is well spent. He appeared briefly on Channel 4 News to explain that if the cost of the Hospital were saved, a lot of patients would be able to benefit from the latest treatments.
The announcement of intention to withdraw NHS funding was followed by a public consultation. But the supporters of homeopathy could muster only 6273 votes and they were spread over four petitions (we shall never know how many people signed all four). A web site for the supporters of the homeopathic hospital has a movie of their town centre demonstration. The numbers there were less than overwhelming, though they were led by a rather fine piper.
The local MP, Greg Clark (Cons, Tunbridge Wells) made a short speech, but sounded, it must be said, less than convinced. He is an MP better known for his support for nuclear missiles.
At 08.30, the morning talk show on BBC Radio Kent that preceded the meeting had a discussion about the homeopathic hospital. If you can stand talk shows, listen here (a London homeopath, DC and Sally Penrose from British Homeopathic Association). The first speaker says “someone even called it crackpot medicine”. Ahem. Could that have been me?
Who owns the Homeopathic Hospital?
You might expect to be able to find out from NHS Choices, but that site is unhelpful (how does the Department of Health manage it?). Here is the information that I have.
The Tunbridge Wells Homeopathic Hospital building is owned by the Mental Health Trust. The building houses three services. (1) The homeopaths, who are owned by Maidstone Tunbridge Wells (MTW) Acute Trust, (2) a child and adolescent mental health service CAMHS, which is owned by the Mental Health Trust, and (3) Community Paediatrics which owned by W Kent PCT. It will be for MTW as provider to decide if they want to close the department in the light of the commissioning decision but if they did then the building itself would continue to house medical services though not the Department of Homeopathy.
Follow up in the press
BBC News 24 had a short report.
The Times said ” Patients will no longer be able to receive homoeopathy treatments at a specialist hospital because they are a waste of money and do not work, an NHS trust said. ”
The final outcome
According to a report in the local newspaper, a year later it is, at last happening. Peter Fisher of the Royal London Homeopathic Hospital said
“Of course homeopathy needs more research, but so do many areas of conventional medicine – without these NHS hospitals, this research won’t get done.”
The first part might be true, but the second is fantasy. The hospital did not produce a shred of good research. The report goes on.
“The PCT originally decided to withdraw funding for homeopathy – which costs the trust £200,000-a-year for 750 patients – last September, but the decision was challenged by patients through a judicial review which proved unsuccessful and led to the final decision being made last week.
Current patients will finish their treatment over the next eight months but the PCT will not pay for further routine homeopathic consultations or treatments after the end of March next year.”
21 September 2007
Channel 4 News reported on the pressure to save money by stopping NHS funding for “unproven and disproved treatments”.
Watch the video.
The report started badly when the journalist, Victoria Macdonald, said that the bottles of homeopathic pills contained “only natural ingredients”.
Wrong
They contain NO ingredients. That is just as well perhaps, when you recall that natural ingredients in homeopathic pills include things like polonium. In the Nature newsblog that followed my piece about BSc degrees in anti-science, I responded
“Well CAM is a bit like university management. Don’t try to satirise it, because the next thing you know the satire has come true.
There is even a whole book about homeopathic polonium, and you can by not only polonium, but also holmium, dysprosium, europium, gadolinium, Terbium, Thulium (this is beginning to sound like Tom Lehrer), And don’t forget Excrementum caninum (yes, you got it, dog shit). With the 3C “potency” of the latter you might even get a few molecules of it. All this at http://www.archibel.com/homeopathy/synthesis/newremedies/
And don’t forget your homeopathic bioterrorism protection kit.”
The thrust of the report was to suggest that our attempts to improve NHS treatment were some sort of Big Pharma funded conspiracy to suppress those nice homeopaths and so kill old ladies whose lives depended on taking medicines that contain no medicine.
Peter Fisher sounded a bit desperate in his attempts to associate me and my colleagues with the defence of GM foods, a topic on which, as far as I know, none of us uttered a word in public.
Sorry, Dr Fisher, but there is no conspiracy, and no involvement of Big Pharma. Just a disparate bunch of doctors and scientists who decided it was time to do something about the spending of scarce NHS money being spent on new age nonsense. It really is that simple.
I’m always a bit amused when people who make a lot of money from alternative medicine accuse me of representing some vested interest. The media ‘nutritional therapist’, Patrick Holford, said, in the British Medical Journal
“I notice that Professor David Colquhoun has so far not felt it relevant to mention his own competing interests and financial involvements with the pharmaceutical industry “
To which my reply was
” Oh dear, Patrick Holford really should check before saying things like “I notice that Professor David Colquhoun has so far not felt it relevant to mention his own competing interests and financial involvements with the pharmaceutical industry”. Unlike Holford, when I said “no competing interests”, I meant it. My research has never been funded by the drug industry, but always by the Medical Research Council or by the Wellcome Trust. Neither have I accepted hospitality or travel to conferences from them. That is because I would never want to run the risk of judgements being clouded by money. The only time I have ever taken money from industry is in the form of modest fees that I got for giving a series of lectures on the basic mathematical principles of drug-receptor interaction, a few years ago.”
I spend a lot of my spare time, and a bit of my own money, in an attempt to bring some sense into the arguments. The alternative medicine gurus make their livings (in some cases large fortunes) out of their wares.
So who has the vested interest?
Sorry Dr Fisher, but there is no conspiracy. Tim Crayford (Association of Directors of Public Health), put the matter very simply in the interview.
It is more to do with a point of principle. There are very many really effective treatments that the NHS can’t currently afford to provide. And we should we not be ensuring that the limited resources we’ve got in the NHS go to the things that really work well, and are going to save lives”
That is all there is to it.
A new judgment today from the Advertising Standards Authority .
A direct mailing for books by Patrick Holford, a nutritionist, contained a booklet entitled “100%health”. Headline text stated “You don’t swallow junk food. Why swallow junk health advice?” Text in a letter from the “Editor of 100%health”, Patrick Holford, on an inner page of the booklet stated
“I would like you and your family to stay healthy, free of pain and the need for drugs. But if I told you the truth in this letter, I would break the law … I’d love to tell you how powerful nutrition is, both for your mind and body. But I can’t. Why? Because advertising law prohibits me saying anything that claims to ‘treat, prevent or cure’ any condition! Even if there’s undisputed proof that nutrient ‘x’ cures condition ‘y’ I’m not allowed to tell you here. By law, I can tell you in my newsletters, but I can’t in this publication … So, excuse me if you have to read between the lines …”.
The ASA upheld a complaint against this passage
” the ad breached CAP Code clauses 3.1 (Substantiation), 7.1 (Truthfulness), 50.1 (Health & beauty products and therapies – General) and 50.20 (Health & beauty products and therapies – Vitamins, minerals and other food supplements). “
Text on a separate page stated “Don’t waste your money on vitamins Myth: ‘If you eat a balanced diet you get all the vitamins and minerals you need.’ WRONG!”. The ASA upheld a complaint against this passage too.
the ad breached CAP Code clauses 3.1 (Substantiation), 7.1 (Truthfulness) and 50.21 (Health & beauty products and therapies – Vitamins, minerals and other food supplements).
The code for “truthfulness” reads thus
7.1 No marketing communication should mislead, or be likely to mislead, by inaccuracy, ambiguity, exaggeration, omission or otherwise.
What a pity that Mr Holford has been judged not to live up to this criterion.
This was not a first offence either. In 2003 four complaints to the ASA about Holford were all upheld, as pointed out in the comment by Shinga, below.
Read more at badscience.net
And at quackometer
The current issue of the British Journal of Clinical Pharmacology has what looks like a good placebo controlled trial of homeopathy from France. “Effect of homeopathy on analgesic intake following knee ligament reconstruction: a phase III monocentre randomized placebo controlled study, Paris et al., 2007″.
Conclusion The complex of homeopathy tested in this study (Arnica montana 5 CH, Bryonia alba 5 CH, Hypericum perforatum 5 CH and Ruta graveolens 3 DH) is not superior to placebo in reducing 24 h morphine consumption after knee ligament reconstruction
Another thing that makes the paper interesting is that one of the authors is Philippe Belon. who is a director of the huge French homeopathic company, Boiron. This is properly declared at the end.
Conflicts of interest: Dr Belon is the head of the clinical research department of Laboratoires Boiron. The Laboratoires Boiron financially supported the study. None of the other investigators had any conflict of interest.
Boiron makes profits from homeopathy of about 20 million 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 here), which lead to Beneveniste’s dismissal from INSERM in disgrace. Benveniste’s results were refuted by, among others, 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 treatment at all, as described here. 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 here). [Get pdf].
The Truth about Homeopathy
This is the title of a commentary on the Paris et al. paper by Edzard Ernst, published in the same issue if British Journal of Clinical Pharmacology.
“Heavens!” I hear the homeopathic fraternity shout. “We need more research!” But are they correct? How much research is enough to show that any treatment does not work (sorry, is not superior to placebo)? Here we go full circle: should we really spend several lifetimes in order to arrive at a more robust conclusion?”
“Most readers and even many homeopaths will be surprised to learn that that has already happened! During the Third Reich the (mostly pro-homeopathy) Nazi leadership wanted to solve the homeopathy question once and for all. The research programme was carefully planned and rigorously executed. A report was written and it even survived the war. But it disappeared nevertheless – apparently in the hands of German homeopaths. Why? According to a very detailed eye-witness report [9 – 12], they were wholly and devastatingly negative.”
Ernst sums up the situation incisively –download a copy of his paper.