MD, PhD, FMedSci, FSB, FRCP, FRCPEd

Over the years, I had to get used to some abominably poor research in alternative medicine, particularly homeopathy. This new paper takes the biscuit, in my fairly well-informed opinion.

The article in question reports a survey investigating the management of paediatric tonsillopharyngitis, with a focus on natural remedies. For that purpose, 138 paediatricians, general practitioners and ear-nose-throat (ENT) specialists from 7 countries were sent a self-made, non-validated questionnaire.

The results indicate that a rapid strept test (RST) to diagnose acute tonsillopharyngitis was routinely used by 41% of the respondents. The use of RST allowed 200 diagnosis/year compared with 125 diagnosis/year for clinicians who did not use this tool. Homeopathic remedies were prescribed as a supportive therapy by 62% of participants. Among different homeopathic remedies, SilAtro-5-90 was the most frequently prescribed. In the chronic setting, homeopathy was suggested as a supportive therapy by 59% of all participants, phytotherapy by 28% and vitamins/nutritional supplementation by 37%.

The authors of this paper concluded from these results that the management of tonsillopharyngitis in paediatric patients still remains empiric. Natural remedies, and homeopathy in particular, are used in the management of URTIs. An integrative approach to these infections may help reduce excessive antibiotic prescription.

No wonder that homeopathy and research into it are the laughing stock of the scientific community!

A survey of this nature is already a fairly daft idea. What could it possibly show? That health care professionals who like homeopathy answer, while the vast majority don’t!

But the pinnacle of silliness must be the conclusions drawn from such ‘research’. Let’s take them step by step:

  1. the management of tonsillopharyngitis in paediatric patients still remains empiric – this is not true nor is it borne out by the data generated.
  2. Natural remedies, and homeopathy in particular, are used in the management of URTIs – this may be true, but it has been known before; we therefore do not need to waste time and effort to re-state it.
  3. An integrative approach to these infections may help reduce excessive antibiotic prescription – this is not supported by the data and it also seems nonsensical: if it truly successful in reducing antibiotic prescribing, it is arguably no longer integrative but alternative.

So?

Say no more!

28 Responses to This must be the worst ‘peer-reviewed’ article on homeopathy for a long time

  • You have to wonder what they thought they would ever get out this survey. It is so poor and small in scope, it reminds me of the ridiculous ‘proving’ that homeopaths perform at the end of their ‘education’.

  • A while ago I had an Email argument with a long- term friend-intelligent, University-educated- who now lives in France,where this nonsense is extremely popular of course, and who seems to have been drawn into the clutches of these people.
    He explained to me that French medical students have to do an extra 2 years on their Degree courses in order to be awarded a homeopathic ‘qualification’. I replied that since it’s all nonsense it didn’t make any difference whether it were an extra 20 or 200 or 2,000 years.
    So I didn’t really understand the point he was making.
    The clincher was when he said ‘You know I don’t believe in homeopathy. It’s all nonsense. But some of it can work’. It was when I said ‘Did you actually read that before you sent it?’ and tried to argue that the basis upon which it doesn’t work precluded it from working at all-a bit like the cliche of being a little bit pregnant-that he decided to Unfriend me from Facebook. I’d also said that just because millions of people believe something doesn’t mean it’s valid, and that millions of people believed in UFOs. He replied-not for the first time-that I was exaggerating, and couldn’t expect to win an argument that way. i said there were millions in the USA alone who had this belief.
    I checked later.
    It’s reckoned to be between 35 and 50 million.
    A bit more seriously- how DO some trained doctors believe in this quackery? What somersaults do they do in order to allow themselves to do so? It’s a point that many homeopaths refer to in a woeful attempt at triumphalism.

    • I think I understand how clinicians get convinced:
      they see some patients who make dramatic improvements, they fail to rationalise why this is and assume that it was the homeopathic remedy, if this happens repeatedly, they get hooked and supress the memory of the cases where it did not work. eventually they swear by it.

    • Any physician who buys into this junk is truly diluted. Their judgment, professionalism, medical knowledge and training and common sense have been watered down to pee.

    • “… how DO some trained doctors believe in this quackery?”
      Let me share my experience in India (where homeopathy is considered to be a valid mode of therapy and enjoys tremendous state support with its own degree-granting “medical” schools). Three major points:

      1. Most doctors trained in medicine are not concurrently trained in science equally well, and hence simply don’t understand (and can’t evaluate) the fact that in order for homeopathy to be real, the sum total of physics/chemistry/biology knowledge gained by humankind will have to be suddenly wrong. They are oftentimes taken in – as are the gullible and vulnerable patients – by the clever naming tradition of homeopathic nostrums, which is designed to project the impression that these nostrums actually contain some active principle from the herb or animal or organic matter they are named after. The doctors simply do not realize the implausibility inherent in the impossible dilutions of homeopathy.

      2. Those doctors, who are indeed aware of the science and consider homeopathy nonsensical, oftentimes do not care whether their patients are taking homeopathy or not. They don’t mind if the patient is taking useless homeopathy as long as the patient takes the prescribed proper medication as well. They know that if the patient is a priori taking homeopathy and their condition doesn’t improve, sooner or later the patient will end up at their doorstep seeking proper treatment.

      (Homeopaths, on the other hand, often insist that the homeopathic nostrum *not* be taken in conjunction with “allopathic” medicine. I have heard this many times from our family quack while growing up.)

      3. The shortage of qualified medical professionals of course means, sadly, the many people – especially poorer and interior rural patients – will not have access to necessary treatment. This is the demographic that is often targeted by well-meaning but foolish homeopaths and altmed practitioners, and why not – since they enjoy full support from a woo-obsessed government. What of people with need? Well, life is cheap.

      • That is an interesting categorisation. Group 2 might be less willing to prescribe homeopathy if they considered that by supporting the trade they are promoting the tragedies that occur when homeopaths prevent proper treatment of patients.

      • Klownsick Data:

        “implausible dilutions at which it is physico-chemically impossible to have any molecule of the starting material left in the solution. “

        Really?

        “Naturally, every core of my scientist being revolted against this idea that went against all the physics, chemistry and mathematics that I have ever learnt,”

        All physics, chemistry and mathematics? Show me the evidence! Feel to free share the fully and complete demonstration.

        Let’s my shown your “non sense”:

        “it is also easy to see that the concentrations of the substances in the diluted samples don’t make sense, the most parsimonious explanation for which would be that the dilution process was inadequate or incomplete or horribly inefficient, or that the people who make up these dilutions have zero understanding of analytical chemistry

        The pseudoskeptiks again misunderstanding the Occam Razon. Your response is an straw man fallacy (“have zero understanding of analytical chemistry”).

        “Orac’s argument in favor of industrial/environmental contamination with metallic nanoparticles in the purchased preparations seems the most reasonable and parsimonious explanation”

        How does explain the presence of specific metal nanoparticles in 200C potencies of specific metal nanoparticles?

        “Chikramane et al. had conjured up a handwaving hypothesis in the discussion, mentioning ‘nanobubbles’ with zero evidence.”

        Need that the Chikramane team spelling the evidence in your ears?

        http://www.sciencedirect.com/science/article/pii/S1878973015001218

        Maximum Egger!

        • Note regarding Chikramane: A fool with an electronic microscope is still a fool 🙂

          https://www.sciencebasedmedicine.org/homeopathy-as-nanoparticles/

          • Wooosh….. an critique dated on December 17, 2012 about of the first paper of Chikraman “debunks” the second paper of Langmuir.

            The articles is surprising:

            ” technobabble,”

            Wow, postmodern languague (Derrida):

            “Let’s deconstruct a bit, shall we?”

            The stupid question:

            “It couldn’t have anything to do with the fact that most homeopathic dilutions are made in glass vials, could it? “

            Wow, the author need a mistery: if arsenicum album 200C contains arsenicum album nanoparticles, Is Ars Album leached glass or carbon dioxide?

            “First off, this article appears in the journal Homeopathy. Yes, there is indeed a journal called Homeopathy. Given the level of pseudoscience that must be within the pages of a journal called Homeopathy”

            Wow, the same journal on the Ernst has benn fired! For the same proposotion all work of Ernst in Homeopathy journal is a pseudoscience, ok? Circular logic!

            “I was a chemistry major, and, even though it was nearly 30 years ago, I still remember that concentrated nitric acid contained a fair number of heavy metal impurities.”

            30 years? If Ars album nanoparticles of homeopathic Ars Album appear, this is not “metal impurities”. Wow, the chemistman need some basic courses of logic.

            More ad-hominem’s

            “Magical thinking”

            “Nobel Disease and become a crank.”

            Björn you’r text is garbage.

          • Egger. Are you sober? M

          • Be Groove:

            Are you Randi the little child?

      • Good luck with your Randi’s prize and Alan Henness legal bussines against the new experiments:

        http://www.sciencedirect.com/science/article/pii/S0167732215312277

        The results indicate that even in extreme dilutions the molecules of acidum salicylicum may be present in these homoeopathic formulations. Both the presence of acidum salicylicum as well as succussion phenomenon may be responsible for the variation of the physicochemical properties of these homoeopathic formulations.

        • @Egger
           
          For once I was able to access this paper via my institution. Please try to comprehend that a lot of worthless stuff gets published in the scientific literature.
           
          I’m not a physical chemist, but even I can see the many tables and graphs show exactly the same values for all but one of the parameters measured at every dilution from 2C to 30C (succussed or unsuccussed). So now we not only have a supposedly peer-reviewed paper suggesting that 30C dilutions contain the starter material, but it also suggests the concentration of salicylic acid — sorry acidum salicylum (sounds more impressive) — must be the same at every dilution. So now the joke that is homeopathic dilution adds a new smile: its practitioners can’t dilute competently even at the high end of the concentration scale.
           
          When a journal that supposedly uses a competent system of peer review allows an introduction that contains the following statements, its credibility approaches 300C. “The homoeopathic medicines are “extremely diluted solutions” exhibiting anomalous behaviour in their properties and efficacy.” [No reference to evidence supporting the ‘anomalous behaviour’ claim]. “The effectiveness of homoeopathy is well supported by research evidences…” [no citations given].
           
          Even for a homeopath the paper is scientifically illiterate. It keeps talking about the the formulations contained in ‘succussed ethanol’ and ‘unsucussed ethanol’. It’s the solution that is supposed to be succussed, not the solvent, dunderheads! (Ditto referees and editor.)
           
          For connoisseurs, this paper reveals (for the first time to me, at least) that homeopaths (cf. psychopaths, sociopaths) now have a prop to rival the chiros’ click-and-diddle stick. “The process of ‘succussion’ consists of violent agitations of solution by means of a mechanical apparatus called potentizer.” (The paper doesn’t make clear if this apparatus does or does not contain the leather-bound book recommended by Hahnemann.)

          • Chapman debunking style:

            “I’m not a physical chemist,”

            That’s all folks!

            “o now the joke that is homeopathic dilution adds a new smile: its practitioners can’t dilute competently even at the high end of the concentration scale.”

            Blagh!

            “When a journal that supposedly uses a competent system of peer review allows an introduction that contains the following statements, its credibility approaches 300C. “The homoeopathic medicines are “extremely diluted solutions” exhibiting anomalous behaviour in their properties and efficacy.” [No reference to evidence supporting the ‘anomalous behaviour’ claim]. “The effectiveness of homoeopathy is well supported by research evidences…” [no citations given].”

            Crank O! You’re response is a non-sensical ad-hominem.

            “ven for a homeopath the paper is scientifically illiterate. It keeps talking about the the formulations contained in ‘succussed ethanol’ and ‘unsucussed ethanol’. It’s the solution that is supposed to be succussed, not the solvent, dunderheads! (Ditto referees and editor.)”

            Need’s kindergarden courses.

            “For connoisseurs, this paper reveals (for the first time to me, at least) that homeopaths (cf. psychopaths, sociopaths) now have a prop to rival the chiros’ click-and-diddle stick.”

            Alan Henness pseudodebunk style:

            LOL!

            Edzard Ernst arcaic responses:

            LOL!

            All pseudoskeptiks:

            Martin Gardner formula: Laugh.

          • Chapman debunking style:

            “I’m not a physical chemist,”

            That’s all folks!

            You deny Chspmsn’s [actually Frank Odds’s] ability to comment because he is not a physical chemist.

            Are you a physical chemist?

          • Are Ernst or Clownsick Pata a physical chemists? No.

        • The results doesn’t show this at all. The results show some modification in the physico-chemical property of the ethanol after succussion and/or add of salicylic acid. There is nothing to conclude that the molecule may be present (and the author doesn’t conclude that).

          We would wonder why a so low sample size. And why only one molecule tested. This may be some artifact of measurement after succussion process, we do not now what type of container are used during the succussion, shaking may introduce impurities affecting the solution density.

          Then, one paper is not proof of anything.

      • Klownsick Data is an example of the pseudoskeptikal herence of John Maddox and Randi’s charlatan:
        An example of non sense of Datta:

        “You are citing a 1988(!) paper, Axel. You do realize that the earth has gone many turns around the sun since then, don’t you? Benveniste’s assertions have been challenged and disproven many times over since then. This paper that you cite has been critiqued by many others, but perhaps none so in depth as Maddox et al. in Nature (vol. 334, 28th July 1988). The points presented still remain. The so-called “Water Memory” of Benveniste, an extraordinary claim, still needs extraordinary evidence to support it. So, as of now, I see that you have nothing other than ‘argument from authority’. Better luck next time?”

        Woooosh, Klownsick data exposed!
        How many debunks against with Benveniste papers exists? Well, you need more luck:

        Pro:
        1. Belon multicenter research (2004) is very positive.
        2. Spira experiments (1991)
        3. Chirumbolo experiments (2009)

        Vague:
        1. Hirst conclusion disproven:

        http://www.weirdtech.com/sci/expe.html

        Sorry Klonw’s.

        2. Baumgartner experiments (2005).

        3. Maddox report (1988). This report only pseudodebunk’s the experiments in French laboratory, no the Canadian, Israel or Italian experiments. Why? Wow, Maddox based the results in only 3 experiments from seven. Wow, the most big sample size ever see. The pooled analysis is wrong, Steward used incorrect formula. Very bad pseudresearch (as Ernst pseudodefinitions of homeopathy).0

        Con:
        1. Ovelgönne (pre Ennis research)
        2. Randi’s Bland fraud research.

        As you see, of 8 reports only two is negative. From this, only one is negative. Kausik, you’re a fraud.

    • I think the biggest reason why so many otherwise intelligent medics and vets fall for this nonsense is that so much of education, certainly in past years, was driven by authority figures and expert opinion. This makes them potential prey to authority figures who are experts in nonsense. Add a few superficially convincing anecdotes and a bit of lazy ‘there might be something in it’ and you’re down the rabbit hole.

      • ” is that so much of education, certainly in past years, was driven by authority figures and expert opinion”

        Ha, ha, ha, this phenomenona is the watermark of pseudoskeptikal movement. The criticism in your comment is very funny.

  • Reality is reality. The principles of Homeopathy, Naturopathy and most of Chiropractopathy are based on myths and magic, like their partners in deception, faith healers, palm readers, witch doctors and other voodoo specialties. Fancy, scientific words do not make snake oil pitches real.

  • “For that purpose, 138 paediatricians, general practitioners and ear-nose-throat (ENT) specialists from 7 countries were sent a self-made, non-validated questionnaire.”

    “A survey of this nature is already a fairly daft idea. What could it possibly show? That health care professionals who like homeopathy answer, while the vast majority don’t!”

    You obviously don’t understand survey research. Most surveys are “self-made,” and are often “non-validated questionnaires.” Check out any psychology, sociology, political science, or economics journal. And you have zero evidence that there was sample selection bias, such that attitudes to homeopathy predicted response propensity. Zero. You are speculating.

    I don’t know about whether their conclusions were too strong given the data, and I agree the sample size was small (though bigger than that in most studies published in Psychological Science). However, you shouldn’t bash on someone’s study when you don’t understand survey research methods.

  • “some abominably poor research in alternative medicine, particularly homeopathy.”

    Lughly assement! I’d reviewed the research of Edzard Ernst. In the first stage I found strange behaviour in the papers. In the second stage I find fraud with evidently Randi’s prize agenda (the smears background to the 2000 or earlier years). In the third stage independent researches and bloguer’s confirm my hypothesis. In general, the papers published by Ernst is a poor/fraud quality. The Editors of the journals needs the information. Enjoy Ernst!

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