Updated Edition!
This study aimed at examining the feasibility issues of comparing individualized homeopathic medicines (IHMs) with identical-looking placebos for treating knee osteoarthritis (OA).
Forty eligible patients participated in this double-blind, randomized (1:1), placebo-controlled feasibility trial in the outpatient clinics of a homeopathic hospital in West Bengal, India. Either IHMs or identical-looking placebos were administered, along with mutually agreed-upon concomitant care guidelines. The Knee Injury and Osteoarthritis Outcome Score (KOOS) was the primary outcome measure, along with derived Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores from KOOS. The EQ-5D-5L questionnaire and Visual Analog Scale (VAS) were the secondary outcomes. All were measured at baseline and after 2 months. Group differences and effect sizes (Cohen’s d) were estimated using an intention-to-treat approach. p-Values less than 0.05 (two-tailed) were considered statistically significant.
Enrolment/screening and trial retention rates were 43% and 85% respectively. Recruitment was difficult owing to the coronavirus disease 2019 (COVID-19) lockdown. Group differences were statistically significant, favoring IHMs against placebos in all the KOOS sub-scales: symptoms (p < 0.001), pain (p = 0.002), activities of daily living (p < 0.001), sports or recreation (p = 0.016), and quality of life (p = 0.002). Derived WOMAC scores from KOOS favored IHMs against placebos: stiffness (p < 0.001) and pain (p < 0.001). The EQ-5D-5L questionnaire score (p < 0.001) and EQ-5D-5L VAS scores (p < 0.001) also yielded significant results, favoring IHMs over placebos. All the effect sizes ranged from moderate to large. Sulphur was the most frequently prescribed homeopathic medication. Neither group reported any harm or serious adverse events.
The authors concluded that, although recruitment was sub-optimal due to prevailing COVID-19 conditions during the trial, the action of IHMs was found to be superior to that of placebos in the treatment of knee OA. Larger and more definitive studies, with independent replications, are warranted in order to substantiate the findings.
Sorry, but I don’t understand this: the authors stated multiple times that this was a feasibility study (which tests feasibility and not effectiveness), and then they promptly report effectiveness data for which the trial was grossly under-powered (i.e. too small). Why are they doing such nonsense? Perhaps their affiliations provide a hint?
- 1Department of Materia Medica, D. N. De Homoeopathic Medical College and Hospital, Kolkata; affiliated to The West Bengal University of Health Sciences, Kolkata, West Bengal, India.
- 2Department of Repertory, D.N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, India.
- 3Department of Organon of Medicine and Homoeopathic Philosophy, D.N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, India.
- 4Department of Practice of Medicine, D.N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, India.
- 5Department of Surgery, D.N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, India.
- 6Department of Homoeopathy, East Bishnupur State Homoeopathic Dispensary, Chandi Daulatabad Block Primary Health Centre, West Bengal, India.
- 7Department of Community Medicine, D.N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, India.
I do symathise with the pressures of reporting positive findings, if your salary comes from homeopathic institutions. Yet, I cannot help but pointing out:
THESE FINDINGS ARE INVALID AND FALSE-POSITIVE!
This study aimed to explore women with breast cancer (WBC) lived experiences on the use of So-Called Alternative Medicine (SCAM) for breast cancer management. In-depth interviews guided by semi-structured questions were conducted with 21 WBC recruited using convenience sampling. The thematic analysis generated four main themes:
- Access, affordability and support for medical treatment.
- Beliefs in SCAM treatment.
- Feeling the potential benefits of SCAM.
- Acknowledging the negative aspects of SCAM.
The outcomes from using SCAM based on the lived experiences of WBC indicated that some SCAM treatments could improve quality of life. However, some fraudulent SCAM obtained from unprofessional SCAM providers could cause harmful effects, delay medical cancer treatment, and increase breast cancer treatment costs.
The authors concluded that there is an urgent need to enhance the awareness of appropriate treatment, including evidence-based SCAM, for WBC. Improved understanding in the use of SCAM as a part of quality breast cancer care services could contribute to increasing the quality of life and survival rates of women with breast cancer.
This is a very strange paper, in my view. If we disregard the fact that a small interview study cannot possibly yield reliable outcomes, we essentially have two results:
- Some SCAM treatments could improve quality of life and survival.
- Some fraudulent SCAM obtained from unprofessional SCAM providers could cause harm.
So, which SCAM is good and which bad?
By definition, such an investigation cannot answer this crucial question.
If you do nevertheless want answers, I recommend you read my evidence-based assessments summarised in a recent book. For those who don’t want to wait, here is the answer in a nutshell:
- A few SCAMs are indeed proven to inprove the quality of life of cancer patients.
- No SCAM has been shown to improve survival.
- Almost all SCAMs have the potential to harm cancer patients.
My conclusion:
“Lived experiences” may sound interesting, but scientific evidence is the only reliable guide.
‘DOC Check’ just published an interesting article. Allow me to translate some passages for you:
In 2023, the German Federal Insititute for Drugs and Devices (BfArM) stated: ‘To date no homeopathic medicinal product has been authorised by the BfArM based on a study submitted by the applicant.’ So why are homeopathic medicines still covered by statutory health insurance? Jörg Windeler, then head of IQWiG (the German equivalent of NICE), gave an indication in 2019: ‘It is simply a way of attracting customers. Homeopathy is popular, and customers are more likely to go to the health insurance fund that pays for homeopathy.’ This laissez-faire attitude is expensive. And not just in terms of the cost of medicines.
If you delve a little deeper into the world of homeopathic medicine, further grey areas emerge. They concern the doctors’ fees that are charged as part of the therapy.
In Germany, the normal billing of fees by doctors follows strict rules. To rule out fraud, they are subject to a plausibility check by the health insurance. Among other things, the time profiles are checked to ensure that the practitioner is billing the number of examinations correctly. There are also fee budgets. If these are exceeded, doctors will only receive a pro rata payment for their services.
Doctors have different possibilities for homeopathic services. One popular version is the billing option that the German Central Association of Homeopathic Doctors (DZVhÄ) offers its members. In this case, the plausibility checks of the insurance are not carried out. Furthermore, the services are extra-budgetary. This is possible because the DZVhÄ has concluded selective contracts via its own management company, MGL Managementgesellschaft für Gesundheitsleistungen mbH.
Access to participation in these selective contracts is gained via a ‘homeopathy diploma’, which is awarded by the DZVhÄ after 6 weeks of training. Trainee homeopaths have to fork out around 3,000 Euros to obtain this document – but the expense is well worth it. Once a doctor has obtained the homeopathy diploma, he/she participates in the selective contract. Subsequently, the health insurance pay fixed fees beyond the hotly contested pot. Only a few rules have to be adhered to: a time frame of at least 60 minutes for an initial homeopathic history and at least 30 minutes for a follow-up session. There is no evidence that these time limits are strictly monitored.
This uniquely lax construction in the German healthcare system is a potential gateway for abuse and fee fraud. It is easy to cheat on the time used for medical histories without a plausibility check. A practitioner can even conduct the initial homeopathic history and the ‘conventional medical’ consultation in parallel. The conventional medical service could then be billed via the health insurance, the homeopathic service again via the DZVhÄ route.
We asked the DZVhÄ in an editorial enquiry whether they were aware of this problem and how they ensure that everything is carried out correctly. The association remained silent – a tactic they have been using for years. The DZVhÄ only get vocal when they suspect attacks on their business model.
It would be interesting to know the volume of fees billed in Germany via the DZVhÄ’s selective contracts. Unfortunately, these figures are difficult to determine. A homeopath receives 97 Euros for the initial consultation. If each of the approximately 7,000 members of the DZVhÄ took an initial medical history on 200 working days per year, this would translate into a fee volume of more than 130 million Euros per year. This does not include follow-up sessions and so-called ‘repertorisations’. In other words, 200 million Euros could quickly be spent of doctors’ fees. Admittedly, these figures are speculative. However, the DZVhÄ could easily clarify the matter – if only they wanted to do so.
German health politicians ignore these hidden costs of homeopathy. They like to point to the notion that ‘only’ around 22 million Euros are spend on homeopathics.
__________________________
It would be a mistake, I think, to assume that financial reasons provide the only motivations for German doctors to use homeopathy. There are, in my experience, several others:
- Some occasionally use homeopathy as a placebo for patients where they feel a placebo is the best solution.
- Some use homeopathy for patients want it.
- Some use homeopathy because they are not fully aware of what it is.
- Some use homeopathy because they are ill-informed about the evidence.
Very few German doctors who I know have ever used it because they are convinced that it is effective.
After all these years, some homeopaths still manage to make me (almost) speechless. Here is the abstract of an article (Ravi Raghul.G, Shivaprasad J. Overuse Injuries in Children: A Homoeopathic Approach. Indian J Integr Med. 2024; Online First.) that achieved this rare feast of incompetence:
The increasing participation of children in organized competitive sports has led to a rise in overuse injuries, posing risks of limb deformity and impairment. This article explores the diagnostic, prognostic, and therapeutic applications of HOMOEOPATHY in addressing overuse injuries in children. Overuse injuries result from repetitive strain on musculoskeletal structures, particularly prevalent during periods of physical growth and immaturity. Common injuries include stress fractures, traction apophysitis, and chronic physeal damage. In the Indian context, lack of awareness and inappropriate self-treatment exacerbate these injuries. Recognition of warning signs, such as persistent soreness, is crucial for early intervention. Rehabilitative approaches involve rest, gradual strengthening, and attention to flexibility. HOMOEOPATHY offers personalized remedies targeting specific musculoskeletal entities, aiding in recovery and preventing recurrence. Remedies such as Rhus Toxicodendron, Ruta, and Bryonia address tendon and joint issues, while Arnica montana and Symphytum officinale target trauma-related injuries. Individualized homeopathic treatment, alongside appropriate rehabilitation regimens, facilitates faster recovery from overuse injuries in children.
As this does not provide any concrete insights into how to treat overuse injuries of kids, let me also show you the ‘results’ section of this paper:
Arnica Montana
Indications: Arnica is one of the most used homeopathic remedies for injuries. It is particularly effective for muscle soreness, bruising, and inflammation resulting from overexertion and trauma. Athletes often use Arnica to reduce pain and swelling associated with overuse injuries [6].
Rhus Toxicodendron
Indications: This remedy is beneficial for conditions characterized by stiffness and pain that improve with movement and worsen with rest. Rhus tox is particularly suitable for tendinitis and bursitis where the affected area feels better after initial movement but stiffens up after periods of inactivity [7].
Ruta graveolens
Indications: Ruta is indicated for injuries involving tendons and ligaments. It is particularly useful for conditions like tendinitis and sprains where there is a sensation of bruising and lameness. This remedy is also effective in promoting the healing of bones and connective tissues [8].
Bryonia alba
Indications: Bryonia is suitable for conditions where pain is aggravated by movement and relieved by rest. It is particularly helpful for joint and muscle pain that worsens with the slightest movement [9].
Symphytum officinale
Indications: Known as “knitbone” Symphytum is particularly effective for promoting the healing of fractures and bone injuries. It is also used for periosteal injuries where the covering of the bone is affected [10].
As in this section the authors (from Dept. of Homoeopathic Paediatrics, and Father Muller Homoeopathic Medical College, Mangaluru, India) do also not provide any real evidence, let’s have a look at their references 6 – 10:
6. Tveiten D, Bruset S. Effect of Arnica montana in marathon runners. Homeopathy. 2003; 92(4):187-189.
7. Ernst E. A systematic review of systematic reviews of homeopathy. Br J Clin Pharmacol. 2002; 54(6):577-582.
8. Oberbaum M, Schreiber R, Rosenthal C, et al. Homeopathic treatment in emergency medicine. A case series. Homeopathy.
2003; 92(1):44-47.
9. Bell IR, Schwartz GE, Boyer NN, et al. Advances in integrative nanomedicine for improving infectious disease treatment in
public health. Eur J Integr Med. 2013; 5(1):39-56.
10. Vickers AJ, Fisher P, Smith C, et al. Homeopathic Arnica 30X is ineffective in preventing pain after tooth extraction. Br J Clin
Pharmacol. 1998; 45(4):532-535.
I happen to know all of these papers well (particularly the one I authored myself!). And I can assure you that none of them backs up the notion that the listed homeopathic remedies are effective for overuse injuries of children.
So, what is this paper?
- Scientific misconduct?
- Fraud?
- Sloppy research?
- Pseudo-sciene?
- Wishful thinking?
- Stupidity?
- Or just normal behaviour of pseudo-researchers in homeopathy?
I let you decide.
The aim of this non-inferiority randomised controlled study was to assess the efficacy and safety of laughter exercise in patients with symptomatic dry eye disease.
Recruitment was from clinics and community and the trial took place at Zhongshan Ophthalmic Center, Sun Yat-sen University, the largest ophthalmic centre in China, between 18 June 2020 to 8 January 2021. Patients were admitted with symptomatic dry eye disease aged 18-45 years with ocular surface disease index scores ranging from 18 to 80 and tear film break-up time of eight seconds or less.
Participants were randomised 1:1 to receive laughter exercise or artificial tears (0.1% sodium hyaluronic acid eyedrop, control group) four times daily for eight weeks. The laughter exercise group viewed an instructional video and participants were requested to vocalise the phrases “Hee hee hee, hah hah hah, cheese cheese cheese, cheek cheek cheek, hah hah hah hah hah hah” 30 times per five minute session. Investigators assessing study outcomes were masked to group assignment but participants were unmasked for practical reasons.
The primary outcome was the mean change in the ocular surface disease index (0-100, higher scores indicating worse ocular surface discomfort) from baseline to eight weeks in the per protocol population. The non-inferiority margin was 6 points of this index score. Main secondary outcomes included the proportion of patients with a decrease from baseline in ocular surface disease index score of at least 10 points and changes in dry eye disease signs, for example, non-invasive tear break up time at eight weeks.
A total of 299 participants (mean age 28.9 years; 74% female) were randomly assigned to receive laughter exercise (n=149) or 0.1% sodium hyaluronic acid (n=150). 283 (95%) completed the trial. The mean change in ocular surface disease index score at eight weeks was −10.5 points (95% confidence interval (CI) −13.1 to −7.82) in the laughter exercise group and −8.83 (−11.7 to −6.02) in the control group. The upper boundary of the CI for difference in change between groups was lower than the non-inferiority margin (mean difference −1.45 points (95% CI −5.08 to 2.19); P=0.43), supporting non-inferiority. Among secondary outcomes, the laughter exercise was better in improving non-invasive tear break up time (mean difference 2.30 seconds (95% CI 1.30 to 3.30), P<0.001); other secondary outcomes showed no significant difference. No adverse events were noted in either study group.
The authors concluded that the laughter exercise was non-inferior to 0.1% sodium hyaluronic acid in relieving subjective symptoms in patients with dry eye disease with limited corneal staining over eight weeks intervention.
Laughter or humour therapy is the use of laughter for therapeutic purposes. Laughter therapy is mostly practised in groups. In some hospitals, clowns are also employed for laughter therapy of children. The contagious nature of laughter is used to make participants laugh. Consequently, they relax which can have positive effects on health. Laughter is said to decrease blood levels of cortisol, epinephrine, growth hormone, and 3,4-dihydrophenylacetic acid (a major dopamine catabolite), indicating a reversal of the stress response. Laughter therapy is claimed to provide physical benefits, such as helping to:
- Relax muscles throughout the body
- Trigger the release of endorphins (the body’s natural painkillers)
- Relieve pain
- Improve mental functions (i.e., alertness, memory, creativity)
- Improve overall attitude and well-being
- Reduce stress/tension
- Improve sleep
- Strengthen social bonds and relationships.
Many of these outcomes are, however, not as well-documented as claimed by proponents. A systematic review concluded that “trials with clown doctors in pediatric population have shown conflicting results in allaying anxiety amongst children undergoing either hospitalization or invasive procedures.” Another assessment was more positive: “the meta-analysis confirmed the effectiveness of pre-operative clown therapy on reducing psychological distress in children and parents.” Yet another review concluded that “there exists sufficient evidence to suggest that laughter has some positive, quantifiable effects on certain aspects of health.” Finally, the most recent recent review showed that laughter therapy “can have beneficial effects on a variety of health-related outcomes including mental health, physical health, and physiological parameters.”
[references are in my book]The above trial is a well designed study with an interesting result. Laughing can, of course, produce tears; thus the findings seem plausible. Yet, I am not convinced that vocalising the phrases “Hee hee hee, hah hah hah, cheese cheese cheese, cheek cheek cheek, hah hah hah hah hah hah” 30 times per five minute session is the best way to do laughter therapy. Perhaps chopping omions for five minutes would be even be more tear-inducing?
Osteoarthritis of the knee (OAK) is a chronic degenerative musculoskeletal disorder that strongly affects the elderly population and decreases their quality of life. Pain, stiffness, and restricted knee movements are the major characteristic features of OAK. There are no studies available on the effect of the liver 7 (LR 7) acupuncture point on pain and range of motion. This study therefore tested the effectiveness of the LR 7 acupuncture point on pain and range of motion in chronic OAK patients.
Thirty-five subjects aged between 40 and 65 years were recruited from Government Yoga and Naturopathy Medical College, Chennai. Participants were included in the study after they fulfilled the eligibility criteria. The duration of acupuncture was 20 minutes (5 days/week) for 2 weeks. Baseline and post-intervention assessments were performed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the degree of knee flexion and extension was measured using a goniometer.
Pre- and post-trial outcomes were compared using paired t-tests. LR 7 acupuncture reduced the WOMAC score from 49 to 30 (p < 0.001), indicating that pain was alleviated. Treatment increased the range of knee flexion from 110 to 115 degrees and reduced knee extension (p < 0.01) from 16 to 9 degrees (p < 0.001). These findings indicate that acupuncture treatment improved the range of knee movement.
The authors concluded that the present study showed that 10 sessions of LR 7 acupuncture for people with OAK significantly reduced pain and increased range of motion. We conclude that LR 7 acupuncture is an adjuvant therapy for alleviating pain and managing OAK.
On several levels, this is a shocking paper:
- There already are many controlled clinical trials of acupuncture for OAK; thus there is no reason whatsoever to conduct and publish a trial that is methodolagically inferior to this body of evidence.
- The conclusions are incorrect; as the study had no control group, it is impossible to establish causaality between the treatment and the outcome. The pain reduction might have been caused by phenomena that are unrelated to acupuncture, e.g. placebo effect, regression towards the mean, social desirability.
- The authors state that they are “grateful to principal and faculities of government of yoga and naturopathy medical college and hospital for their support”. This means that they were misguided by a governmental medical college and hospital in planning and running a study that is a waste of resources and thus arguably unethical.
Research of this nature is dangerous:
- It undermines the trust people put in science.
- It makes a laughing stock of more serious attempts to test the value of acupuncture.
- It misuses the cooperation of patients who give their time and good will to advance our knowledge.
- It wasts precious resources.
- It is an incentive for others to do similarly nonsensical pseudo-science.
- It misleads patients and carers into believing in quackery.
The only valid conclusion that can be drawn from this paper is, I think, this:
The people involed in planning, conducting, supporting and publishing this study have little understanding of clinical research and should receive adequate education and training before they are allowed to continue.
Acute encephalitis syndrome is a health burden to a populous country like India. It is characterized by a sudden onset of fever, altered sensorium with or without seizures, irritability, abnormal behaviour, or unconsciousness. This study aims to augment further evidence on the effects of add-on homeopathic treatment in reducing mortality and morbidity in children.
This comparative retrospective study included children hospitalized with acute encephalitis syndrome between July 2016 to December 2016. The researchers compared the parameters of children for whom decisions on Glasgow Outcome scale and Liverpool outcome score aided by add-on homeopathy against those of children from the same year when the add-on homeopathy was not used. All the children were on conventional supportive care and treatment tailored to each child. We also counted the days until the resumption of oral feeding and the length of hospital stay.
Ordinal regression analysis on analyses on 622 children (IH +CSC=329; IMP only=293) was done. Odds of a shift towards increased recovery were superior in the homeopathy-added group than in the IMP group without adjustment (crude OR 2·30, 95% CI 1·66 to 3·20; p=0·0001) and with adjustment (adjusted OR 3.38, 95% CI 2·38 to 4.81; p=0·0001). There was 14.8% less mortality and 17.4% more recovery in the add-on homeopathy group compared to CSC alone. Individualized homeopathic remedies commonly used were: Belladonna (n =238), Stramonium (n =17), Opium (n = 14), Sulphur (n=11) and Hyoscyamus niger (n = 7).
The authors concluded that this retrospective cohort study advocates for add-on homoeopathy in children suffering acute encephalitis which can produce notable improvements in terms of mortality and morbidity. Further studies in different settings are warranted.
If responsible physicians come across such an unexpected and implausible finding, instead of publishing it unchecked, they must properly test the hypothesis in a rigorous trial. As it stands, the results are meaningless and might even do untold harm, if some doctors drew the conclusion that homeopathy saves lives in acute encephalitis.
The most likely explanation for the reported outcomes is that there was considerable selection bias in recruiting patients to this study. The less severely ill patients might thus have ended up in the homeopathy group. The plausibility for the outcomes being due to the homeopathic treatment is virtually zero.
So, why did the authors of this paper publish such utterly unreliable findings and did not even include a hint of critical thinking? I think their affiliations might go some way in answering this question:
- Ramesh Prasad, Clinical Trial Unit Homoeopathy,BRD Medical College and Hospital, GorakhpurAlok Upadhyay, Clinical Trial Unit Homoeopathy (Viral encephalitis) BRD Medical College and Hospital, Gorakhpur
- Vinod Kumar Maurya, Clinical Trial Unit Homoeopathy (Viral encephalitis) BRD Medical College and Hospital, Gorakhpur
- Preeti Verma, Clinical Trial Unit Homoeopathy (Viral encephalitis) Medical College and Hospital, Gorakhpur
- Shashi Arya, Clinical Trial Unit Homoeopathy (Viral encephalitis) Medical College and Hospital, Gorakhpur
- Supriya Singh, Central Council for Research in Homoeopathy
- Purnima Shukla, Clinical Trial Unit Homoeopathy (Viral encephalitis) BRD Medical College and Hospital, Gorakhpur
- AK Gupta, Clinical Trial Unit Homoeopathy (Viral encephalitis) BRD Medical College and Hospital, Gorakhpur
- Arvind Kumar, Central Council for Research in Homoeopathy
- Praveen Oberai, Central Council for Research in Homoeopathy
- Raj K Manchanda, Central Council for Research in Homoeopathy, New Delhi
And why did they take all of 8 years to publish this nonsense?
Search me!
Available data suggest that general practitioners (GPs) in Germany use so-called alternative medicine (SCAM) modalities more frequently than GPs in many other countries. German researchers investigated the country differences perceived by GPs who have worked in Germany and in one of four other European countries with regard to the role of SCAM in primary care.
A qualitative study was conducted using semi-structured interviews with 12 GPs who had worked both in Germany and Italy, the Netherlands, Norway or the United Kingdom (UK; n = 3 for each of the four countries). Participants were asked how they perceived and experienced country differences regarding health system, relevance of SCAM modalities, the role of evidence-based medicine (EBM) and science, and how they handle so-called indeterminate situations. For the analysis, we followed a thematic analysis approach according to Braun and Clarke with focus on themes that cover SCAM.
Participants unanimously reported that they perceived SCAM to be more relevant in general practice in Germany compared to the other countries. The researchers identified four overarching themes in relation to the perceived reasons for these differences.
- Physicians with experiences in countries with a strong EBM and science orientation (Netherlands, Norway and the UK) considered the deeply ingrained view in national healthcare systems and GP communities that SCAM modalities are not evidence-based as the main reason for the lower use of SCAM by GPs.
- Extensive training of communication skills was cited as a reason that reduced the need for SCAM in the Netherlands, Norway and the UK.
- Differences in patient expectations and demands were perceived as a factor contributing to greater utilisation of SCAM by German GPs compared to the other countries.
- Country-specific reimbursement mechanisms were considered as a factor influencing the role of SCAM in general practice.
The authors concluded that their study results point to major differences between countries with regard to the role of SCAM in GP care. Differences in basic attitudes in the discipline of general practice, patient expectations and system conditions appear to play an important role here.
The authors comment that a remarkable finding is the very consistent narrative with regard to the Netherlands, Norway and the United Kingdom that a stronger scientific and EBM orientation is seen as the main reason for the lower utilisation of SCAM by GPs compared to Germany. I agree that this is an important and, as far as I can see, new aspect. It concurrs with my personal impression that many German doctors feel that EBM is some sort of ‘KOCHBUCH MEDIZIN’ [cookbook medicine] that limits their freedom of prescribing based on intuition and experience. This, I have always felt, is a profound misunderstanding of what EBM is about.
The Canadian Kwantlen Polytechnic University (KPU) has announced that it will launch Canada’s first bachelor’s degree in Traditional Chinese Medicine (TCM). Greenlit by the B.C. government to fill what it calls rising demand in the labour market, the new program marks a major step in Canadian recognition of TCM. However, skeptics of TCM and other so-called alternative medicine (SCAM) remain wary of movement in this direction.
TCM is regulated in British Columbia, Alberta, Quebec, Ontario and Newfoundland and Labrador, with more than 7,000 licensed practitioners working in these provinces.
John Yang has worked for nearly a decade toward KPU’s bachelor’s degree, which will welcome its inaugural cohort starting September 2025. As chair of KPU’s TCM program, he hopes the new offering will boost its acceptance and encourage more integration with the Canadian health-care system. “The degree program can let the public [feel] more confident that we can train highly qualified TCM practitioners. Then there will be more mainstream public acceptance,” he said. “Currently we are not there yet, but I hope in the future there’s an integrated model.”
The degree will add topic areas like herbology and more advanced TCM approaches to the current diploma’s acupuncture-focused study, as well as courses in health sciences, arts and humanities, ethics and working with conventional health practitioners, says Sharmen Lee, dean of the B.C. school’s faculty of health. “You’re getting a much broader, deeper education that allows you to develop additional competencies, such as being able to critically think, to evaluate and participate in research, and all of those other things that a university-based education can provide.” Lee believes future graduates will be able to work alongside with biomedical professionals, with some becoming researchers as well — able to pursue post-grad studies abroad. “They start to understand the fundamentals of conducting research, of reviewing published studies and then … to critically analyze what that means so that they can apply that to their practice,” Lee said. “It’s going to help to elevate the practice of traditional Chinese medicine … in our province.”
With the World Health Organization (WHO) encouraging governments toward integrating traditional and complementary medicine into their health-care systems, there’s a need for researchers to develop strong evidence to guide policy-makers, says Nadine Ijaz, an assistant professor at Carleton University in Ottawa and president of the International Society for Traditional, Complementary and Integrative Medicine Research. “Most Canadians at some point in their lifetime are using some form of what we call traditional and complementary medicine: that might be acupuncture, chiropractic, massage therapy, vitamins, yoga … people who are participating in Indigenous healing ceremonies within their own communities,” she said. “How are governments to make good determinations about what to include? What is rigorous? What is safe? What is effective and what is cost effective, in addition to what is culturally appropriate?”
More research and scientific inquiry is a good thing, but it depends on the type of research, says Jonathan Jarry, a science communicator for the McGill Office of Science and Society and co-host of the health and medicine podcast Body of Evidence. Jarry said many studies on SCAM are low quality: too few participants, too short in duration, lacking follow-up or a proper control group. It’s an issue that plagues research on conventional therapies too, he acknowledged. “I’m all for doing research on things that are plausible enough that they could realistically have a benefit, but then you have to also do very good, rigorous studies. Otherwise you’re just creating noise in the research literature.”
Ijaz and a group of colleagues around the globe are working toward determining strong research parameters without forcing alternative approaches “into a box where they don’t fit.” For instance, a randomized controlled trial is the gold standard of research in biomedicine and excellent for studying pharmaceutical drugs and their effects, because participants in the control group get a placebo, perhaps a sugar pill, that means they can’t tell if they’re being treated with medication or not. But it doesn’t work for studying acupuncture treatment, chiropractic or even psychotherapy, Ijaz pointed out. “If you’re getting an acupuncture treatment, you usually know that you’re getting a treatment…. It’s a little bit challenging to develop a placebo control for for those approaches,” said Ijaz. “When we apply that particular gold standard to researching all therapeutic approaches … it sort of privileges the issue in favour of pharmaceutical drugs immediately.”
“A randomized controlled trial is the gold standard of research in biomedicine and excellent for studying pharmaceutical drugs … but it doesn’t work for studying acupuncture treatment, chiropractic or even psychotherapy.” When I hear nonsensical drivel like this, I know what to think of a university course led or influenced by people who believe this stuff. They should themselves go on a course of research methodology for beginners rather that try brainwashing naive students into believing falsehoods.
The German ‘TAZ’ recently reported about an interesting homeopathic research project. Here I have translated a few excerpts for you:
The title of the research project at the University of Oldenburg is unspectacular: ‘Microbiological investigation of the maturation process of mother tinctures’. However, the sponsor and the word ‘mother tincture’ make you wonder. The project, which ran from 2016 to 2023, investigated the microbiome of various medicinal plants that are used to produce ‘mother tinctures’. These are the undiluted starting materials for homeopathic remedies. The project was financed and largely controlled by the homeopathy company Wala … According to the German Medical Association, homeopathy is generally incompatible with rational medicine and medical ethics. So why is a state university researching ‘mother tinctures’?
The person responsible is marine biologist Meinhard Simon … a member of the university’s Commission for Good Scientific Practice since 2020 and is therefore responsible for ensuring compliance with scientific standards. Prior to that, he was Chairman of the Ethics Committee for ten years. Meinhard Simon describes questions about ethical aspects of the collaboration with Wala as ‘pointless’. When asked, he explained that current studies do indeed prove the effectiveness of homeopathy. Publications and press articles stating otherwise are ‘one-sided’ and ‘tendentious’.
For years, he has used his position to give homeopathy a scientific veneer. He has co-authored several studies on the subject, supported by homeopathic companies and lobby groups. If he and his colleagues are unable to prove an effect despite funding from the homeopathy industry, they simply blame the study design for the failure, as in a 2011 study, and remain in line with the funders, despite their own data. Simon and colleagues assume ‘force-like (immaterial) resonance effects’ of homeopathy. In other words: magic.
In the past, Wala has funded a lobbyist who has publicly denounced scientists and journalists who have criticised homeopathy and warned of its risks. Among them was Edzard Ernst who said of the university’s collaboration with Wala: ‘I take a rather critical view, especially when it’s a company whose advertising misleads customers.’
‘As a basic researcher in microbiology, I believe that cooperation projects with a company like Wala are not only justifiable in terms of medical ethics, but also important and in keeping with the times,’ explains Simon. He himself is a member of a lobby group for alternative medicine, which is part of the Wala-affiliated ‘Foundation for Integrative Medicine & Pharmacy’. Among other things, it campaigns for the treatment of cancer with mistletoe.
When asked, the University of Oldenburg explained that it saw no reason to judge Simon’s research as negative and referred to his good reputation. It does not answer questions about Wala’s dubious methods or how Simon’s relaxed relationship with science can be reconciled with his role as a guardian of scientific rigour and ethics.
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Prof Simon’s papers on homeopathy include the following:
Development of a test system for homeopathic preparations using impaired duckweed (Lemna gibba L.).
Effects of potentised substances on growth rate of the water plant Lemna gibba L.
Duckweed (Lemna gibba L.) as a test organism for homeopathic potencies.
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All of this seems to beg the following question: should Simon be adnitted to my ALTERNATIVE MEDICINE HALL OF FAME?
I think the answe is a clear YES!
So, welcome, Prof. Meinhard Simon, you are in excellent company:
- Richard C. Niemtzow (acupuncture)
- Helmut Kiene (anthroposophical medicine)
- Helge Franke (osteopathy, Germany)
- Tery Oleson (acupressure , US)
- Jorge Vas (acupuncture, Spain)
- Wane Jonas (homeopathy, US)
- Harald Walach (various SCAMs, Germany)
- Andreas Michalsen ( various SCAMs, Germany)
- Jennifer Jacobs (homeopath, US)
- Jenise Pellow (homeopath, South Africa)
- Adrian White (acupuncturist, UK)
- Michael Frass (homeopath, Austria)
- Jens Behnke (research officer, Germany)
- John Weeks (editor of JCAM, US)
- Deepak Chopra (entrepreneur, US)
- Cheryl Hawk (chiropractor, US)
- David Peters (osteopathy, homeopathy, UK)
- Nicola Robinson (TCM, UK)
- Peter Fisher (homeopathy, UK)
- Simon Mills (herbal medicine, UK)
- Gustav Dobos (various SCAMs, Germany)
- Claudia Witt (homeopathy, Germany/Switzerland)
- George Lewith (acupuncture, UK)
- John Licciardone (osteopathy, US)
