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Dangerous advice

This letter to The Times points out the folly of making regulations that do not require any demonstration that the product works. Can you imagine a regulation for television sets that required only that they do no harm, but did not specify that they should show a picture?

From Professor D. Colquhoun, FRS

Sir, Congratulations on your report on the deficiencies found in complementary medicine practitioners (Body & Soul, January 10).

In the face of such evidence it is natural to ask for more effective regulation of this very profitable industry. But the question is quis custodiet ipsos custodes? This question has serious implications for the universities as well as for the public (and the industry).The House of Lords report and the Government’s response to it, pointed out that the first step was to find out whether the complementary treatment worked (better than a placebo). They recommended that the Department of Health should fund research on complementary medicine, the first priority being to find out whether each therapy worked. The problem is that you cannot regulate properly an area when it is not, in most cases, known whether the product being offered has no effect above that of wishful thinking.

This raises a serious question for universities, because it leads, naturally enough, to demands for better training. But how can a university run a course on a subject about which there is so little hard evidence?  Tragically (for their own reputation), some of the new universities are running three-year BSc courses in such subjects as complementary therapies. I’m quite happy to believe that nice smells produce good placebo effects, but aromatherapy is not, by any stretch of the imagination, science, and in my view it is not honest to award Bachelor of Science degrees in it.The effect of such courses will be not to promote better regulation, but to give spurious respectability to an industry that, according to the Government, should (but does not) have, as its first priority, to find out what works and what doesn’t.

Yours faithfully,

DAVID COLQUHOUN,

A. J. Clark Professor of Pharmacology,
University College London,
Gower Street, WC1E 6BT.
d.colquhoun@ucl.ac.uk
January 10.

This is the story of my first incursion in to the fantasy world of alternative medicine.

I was asked by the producer of a television programme (QED) to look at a paper that claimed a beneficial effect of homeopathic treatment of fibrositis (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.) [download pdf].

The homeopath, Peter Fisher, was kind enough to give me the raw data for re-analysis. Curiously. the two medical co-authors (apparently guest authors), neither of them homeopath, were reluctant to hand over the raw data.

It appeared from the paper that the crossover trial had been analysed incorrectly (each patient had been counted twice). When the results were analysed correctly, no significant effects were found.

Astonishingly, the British Medical Journal declined to publish the correction, but their rival, the Lancet, did so with alacrity (Colquhoun, D. (1990). Reanalysis of a clinical trial of a homoeopathic treatment of fibrositis. Lancet 336, 441-442.).[ download pdf ].

Incidentally, the result of this exercise, despite the fact that it had been commissioned by the television producer, was entirely misrepresented in the final TV programme. The producer was evidently less interested in discovering the truth, than in giving the public what he thought they wanted, i.e. wishful thinking. In this he must have been successful, because the first letter that I received after the programme was from a lady in Fulham, who asked me to recommend a source of homeopathic flu jabs for her cat.

It’s interesting, but not surprising that this correction has been universally ignored by advocates of homeopathy. Whether this is incompetence or dishonesty is impossible to say.