MD, PhD, FMedSci, FSB, FRCP, FRCPEd

Seasonal allergic rhinitis (hay fever) is a common condition which can considerably reduce the quality of life of sufferers. Homeopathy is often advocated – but does it work?

A new study was meant to be an “assessment of the clinical effectiveness of homeopathic remedies in the alleviation of hay fever symptoms in a typical clinical setting.”

The investigator performed a ‘clinical observational study’ of eight patients from his private practice using Measure Yourself Medical Outcome Profile (MYMOP) self-evaluation questionnaires at baseline and again after two weeks and 4 weeks of individualized homeopathic treatment which was given as an add-on to conventional treatments.

The average MYMOP scores for the eyes, nose, activity and wellbeing had improved significantly after two and 4 weeks of homeopathic treatment. The overall average MYMOP profile score at baseline was 3.83 (standard deviation, SD, 0.78). After 14 and 28 days of treatment the average score had fallen to 1.14 (SD, 0.36; P<0.001) and 1.06 (SD, 0.25; P<0.001) respectively.

The author concluded as follows: Individualized homeopathic treatment was associated with significant alleviation of hay fever symptoms, enabling the reduction in use of conventional treatment. The results presented in this study can be considered as a step towards a pilot pragmatic study that would use more robust outcome measures and include a larger number of patients prescribed a single or a multiple homeopathic prescription on an individualized basis.

It is hard to name the things that are most offensively wrong here; the choice is too large. Let me just list three points:

  • The study design is not matched to the research question.
  • The implication that homeopathy had anything to do with the observed outcome is unwarranted.
  • The conclusion that the results might lend themselves to develop a pilot study is meaningless.

The question whether homeopathy is an effective therapy for hay fever has been tested before, even in RCTs. It seems therefore mysterious why one needs to revert to tiny observational studies in order to plan a pilot, and even less for an assessment of effectiveness.

There are few conditions which are more time-dependent than hay fever. Any attempt of testing the effectiveness of medical interventions without a control group seems therefore not just questionable but wasteful. Clinical studies absorb resources; even if the author was happy to waste his time, he should not assume that he can freely waste the time, effort and availability of his patients.

Two final points, if I may:

  • An observational study of homeopathy for hay-fever without a control group might be utterly useless but it is still an investigation that requires certain things. As far as I can see, this study did not even have ethics approval nor is there a mention of informed consent. Strictly speaking, this makes it an unethical study.
  • If we allow research of this nature to take place and be published, we give clinical research a bad name and undermine the confidence of the public in science.

I am puzzled how such a paper could pass peer review and how an Elsevier journal could even consider publishing it.

18 Responses to Homeopathy: research is for promotion, not for finding the truth (even if it is unethical)

  • According the article, the author is Vinita Pandey of the Health Zone Clinic of Wimbledon, London. Apparently, she has a PhD in Physiology from University College London.

    The short article is in the Conference Abstracts section of the homeopaths’ trade magazine, Homeopathy.

    As you say, it’s for promotion, not to answer any research question. In fact, her website says:

    Hay Fever Treatment Study by Dr Vinita Pandey

    Health Zone Clinic has an in-house allergy specialist, Dr Vinita Pandey (PhD, LCHE, RSHom) who specializes in treating various types of allergies such as asthma, eczema, hay fever, urticaria, food allergies and food intolerance. She performed a clinical observational study of eight patients in the treatment of hay fever symptoms over a two-year period (2012 and 2013) using Measure Yourself Medical Outcome. Profile (MYMOP) self-evaluation questionnaires at baseline and again after two weeks and four weeks of homeopathic treatment.

    Individualized homeopathic treatment was associated with significant alleviation of hay fever symptoms, enabling the reduction in use of conventional treatment. This study has been published in a peer-reviewed Homeopathy Journal, see link below:

    http://www.sciencedirect.com/science/article/pii/S1475491616000114

  • Homeopathy is peer reviewed? Well, not as we know it. I believe the last editor with a grasp of evidence was yourself.

    http://edzardernst.com/2013/03/ive-been-fired/

    As to this nonsense. In a seasonal disease, when does a patient want medical attention? When they are suffering, duh. What happens days and weeks later when the allergen is no longer present? They stop suffering. I can prove that anything from unicorn farts to imaginary waves from unseen supernova can work with this non trial.
    It is the anecdote dressed up with sciency nomenclature printed in a magazine pretending to be a science journal.

  • If you are delusional to the point of being batshit crazy, your peers would be… If you are a homeopath with no clue about science and ethics then your peers would be… This is a weakness of having your work judged by your peers. When, however, this sort of alternate reality shows up in a journal of science it says that the editorial staff has a double standard an puts in question all other papers published by that journal.

    • I can only assume these “researchers” are fortunate enough to have someone to dress them every the morning. To construct an observational study without even momentarily stopping to think “What could possibly go wrong?” requires not so much a oversight as an irreversible surgical bypass of the entire cerebral lobes. Either that or they’re just plain corrupt, and astonishingly stupid at it too – as Elsevier clearly is in trying to pass off “Homeopathy: the journal of the faculty of Homeopathy” as anything but the stinking old fish wrapper it is. “Science publisher” my ass.

      • To quote the San Diego Zoo, “Some people think bats are blind bloodsuckers”. Apparently, if the numbers of subscribers are right, or the marketers at Elsevier think a journal has a chance of greater circulation due to the mere popularity of a subject, they will publish practically anything under the guise of science.

  • This a prime example of the inevitable outcome of the toxic dualistic atmosphere created by the opponents of homeopathy which forces low budget research by backing homeopathy into a corner and unable to gain any co-operation in designing trials in a spirit of co-operation that will satisfy both sides and move us forward in positive spirit of co- operation for the good of humanity. The only good that come out of this is that hopefully people will wake up to the obvious inequality of the debate and the sceptics will fall foul of their own desire for promotion. I mean, do you really want to see properly funded research undertaken that truly satisfies both sides?

    • Properly funded research has already disclosed that homeopathy does not work. Linde et al, Shang et al and the Australian NHMRC study.

      Boiron finances plenty of these low quality marketing stunts. For the same money, they could support a few high quality trials and the question is ‘Why don’t they?’

      The knowledge of designing high quality trials is readily available. It is hardly the fault of skeptics that homeopaths are not trained in it. They are obviously spending far too much time diluting water in water.

      One does not seek the cooperation of frauds when investigating them.

    • Colin said:

      This a prime example of the inevitable outcome of the toxic dualistic atmosphere created by the opponents of homeopathy which forces low budget research by backing homeopathy into a corner and unable to gain any co-operation in designing trials in a spirit of co-operation that will satisfy both sides and move us forward in positive spirit of co- operation for the good of humanity.

      Homeopaths can’t do good trials because of its opponents? Seriously?

      But why only ‘low budget’ research?

      The only good that come out of this is that hopefully people will wake up to the obvious inequality of the debate and the sceptics will fall foul of their own desire for promotion. I mean, do you really want to see properly funded research undertaken that truly satisfies both sides?

      That’s a problem purely and solely for homeopaths and no one else.

    • Sorry, what ‘debate’?

    • “I mean, do you really want to see properly funded research undertaken that truly satisfies both sides?” CAM is big business, turning over billions of dollars every year. Your implication of impecunious little homeopaths unable to gain any cooperation “for the good of humanity” doesn’t shape up to reality. Nor does your attitude: homeopathy has been with us for over 200 years. It has had more than enough time to shape up or ship out. Its purported mode of action is ridiculous, and plenty of well designed clinical trials have shown it to be a worthless sham.

    • the toxic dualistic atmosphere

      Dualistic only in the sense that homeopaths are in the wrong and the skeptical side in the right.

      Do you really think the homeopathic turkeys wish to vote for more Christmases? The outcomes of well-conducted trials show homeopathy to be nonsense. Why would you want more?

  • ‘I am puzzled… how an Elsevier journal could even consider publishing it.’

    Why? That Elsevier continues to publish that rot of a journal speaks volumes as to its primary motivation, no?

  • This has just been pointed out on Twitter by Frederic Restagno:

    Journal Citation Reports are:

    a unique Web-based research tool that allows you to evaluate and compare journals using citation data drawn from approximately 12,000 scholarly and technical journals and conference proceedings from more than 3,300 publishers in over 80 countries. Journal Citation Reports is the only source of citation data on journals, and includes virtually all specialties in the areas of science, technology, and social sciences.

    They have just issued a notice that includes the journal Homeopathy, criticising it for excessive self-citations:

    Title Suppressions

    Metrics for the titles listed below are not published due to anomalous citation patterns found in the 2015 citation data. These patterns result in a significant distortion of the Journal Impact Factor and rank that does not accurately reflect the journal’s citation performance in the literature. The Journal Impact Factor provides an important and objective measure of a journal’s contribution to scholarly communication. In the interest of fairness and accuracy for all journals, the distortion of the Journal Impact Factor by an excessive concentration of citations gives rise to the need for suppression. JCR staff will monitor these journals going forward and the titles will be included in a future edition of JCR when the anomalous patterns are resolved. Coverage of these journals in Web of Science and other Thomson Reuters products is not immediately affected by suppression from the JCR, however, the titles may be subject to review to determine if they continue to meet the quality and publication standards necessary for inclusion in Web of Science. More information on journal suppression is available at: http://wokinfo.com/media/pdf/jcr-suppression.pdf.

    Self Citation Suppressed Titles with Key Data Points

    This table lists the categories for each journal (note that each journal may be included in multiple categories), the percentage of citations in the Journal Impact Factor numerator that are self cites, and the distortion in category rank due to self cites. The distortion in category rank is based on analysis of all journals in all categories of the JCR ranked both with and without the inclusion of self cites. Here distortion equals the percentage shift in rank with self cites included versus excluded.

    It gives the following figures for Homeopathy:

    % Self cites in JIF numerator: 71%
    % Distortion of category rank: 48%

    It seems others also have serious concerns about this journal.

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