MD, PhD, FMedSci, FSB, FRCP, FRCPEd

This is a post that I wanted to write for a while (I had done something similar on acupuncture moths ago); but I had to wait, and wait, and wait…until finally there were the awaited 100 Medline listed articles on homeopathy with a publication date of 2016. It took until the beginning of August to reach the 100 mark. To put this into perspective with other areas of alternative medicine, let me give you the figures for 3 other therapies:

  • there are currently  1 413 articles from 2016 on herbal medicine;
  • 875 on acupuncture;
  • and 256 on chiropractic.

And to give you a flavour of the research activity in some areas of conventional medicine:

  • there are currently almost 100 000 articles from 2016 on surgery;
  • 1 410 on statins;
  • and 33 033 on psychotherapy.

This suggests quite strongly, I think, that the research activity in homeopathy is relatively low (to put it mildly).

So, what do the first 100 Medline articles on homeopathy cover? Here are some of the findings of my mini-survey:

  • there were 4 RCTs;
  • 3 systematic reviews;
  • 8 papers on observational-type data (case series, observational studies etc.);
  • 9 animal studies;
  • 14 other pre-clinical or basic research studies;
  • 1 pilot study;
  • 14 investigations of the quality of homeopathic preparations;
  • 15 surveys;
  • 2 investigations into the adverse effects of homeopathic treatments;
  • 49 other papers (e. g. comments, opinion pieces, letters, perspective articles, editorials).

I should mention that, because I assessed 100 papers, the above numbers can be read both as absolute as well as percentage figures.

How should we interpret my findings?

As with my previous evaluation, I must caution not to draw generalizable conclusions from them. What follows should therefore be taken with a pinch of salt (or two):

  1. The research activity into homeopathy is currently very subdued.
  2. Arguably the main research question of efficacy does not seem to concern researchers of homeopathy all that much.
  3. There is an almost irritating abundance of papers that are data-free and thrive on opinion (my category of ‘other papers’).
  4. Given all this, I find it hard to imagine that this area of investigation is going to generate much relevant new knowledge or clinical progress.

37 Responses to The current state of research into homeopathy

  • One might expect the field of imaginary medicine to show more imagination. Fortunately the low level of activity can be a good thing as it represents less time and fewer resources wasted.

  • Perhaps you might learn something new if you attend the 11th Annual conference on the Physics, Chemistry & Biology of Water

    OCTOBER 6-9, 2016 in Sofia, Bulgaria.

    Held annually since 2005, this international scientific conference provides participants and attendees a diverse multi disciplinary setting to present and discuss profound topics of research dealing with water.

    Featuring prominent speakers: Nobel Laureate Luc Montagnier, Gerald Pollack Phd., Dr. Konstantin Korotkov and Dr.Vladimir Voeikov, Dr. Bernd Kröplin, Dr. Elmar C. Fuchs and many others. Including ground breaking water science and research topics – Holographic, Memory, Consciousness, Cellular Communications, DNA Molecule, Electrical Dynamic, Marine & Sound Therapies and more.

    Hosted by Gerald Pollack, Founder and chair of the Conference, Professor of Bioengineering, University of Washington; Chief editor of The Water Journal; Executive Director of the Institute for Venture Science. His interests have ranged broadly, from biological motion and cell biology to the interaction of biological surfaces with aqueous solutions. Author of 8 books and more than 300 papers.

    • @Karyse

      “Perhaps you might learn something new if you attend the 11th Annual conference on the Physics, Chemistry & Biology of Water.”

      Groan! I learn mainly from archived, written publications in peer-reviewed journals. I attend meetings where responsible people are likely say sensible things, but remain conscious that people can say anything they like at meetings. The speakers at your water meeting include so many well-known wackaloons it’s obvious they’ll be talking bollocks, sometimes backed up by incompetent experimentation.

    • Oh god! The programme and abstracts are hilarious.

      Anyway, Karyse, what do you think that conference will add to scientific research into homeopathy?

      • Sweet Jebus. My eyes hurt.

        Don’t follow the link if you appreciate your sanity!

      • “Ground Breaking Science”. Hilarious!

        That term covers such things as fracking [hydraulic fracturing]. At least they aren’t claiming to present “Groundbreaking Science”.

      • It reads like a sci-fi comic book!

      • A beautifully presented document! Easy on the eyes, in fact, if lightly skimmed. If the conference lives up to that it should be an uplifting occasion.
        Being a conventionally trained scientist, when I view the contents critically (eyes fully open) my scepticism rises. From my narrow perspective as a clinical virologist, however, I realise that I am not qualified to comment with authority on everything in the document. Please could other responders confirm that all within is total bull-shit and that no slivers of scientific truth have been allowed through?
        Many thanks.

    • Do they also discuss the behavior of sugar globules? Those deserve their own theory as well.

    • I believe it was Richard Feynman who coined the term “Cargo-Cult Science” – although in this case I think “Clown-Car Science” would be the most apropos. (Especially if said car runs on H2O too.)

  • How terribly disingenuous! The Homeopathic Profession has tirelessly strived the last 200 years to comprehensively address all the important questions:

    1. Is it effective?

    Brings in billions of dollars.

    2. Is it safe?

    Suckers don’t sue.
    Nor do dead people.

    Also, tallying the number of homeopathy papers on Medline is pure silliness: don’t forget, the less homeopathic research gets published, the more potent it becomes!

    • “Brings in billions of dollars.” I followed the link and found an expression I never ran into previously: “Diluted EPS [earnings per share]” I now understand the difference between diluted and [raw] EPS, but I guess the accountants at Boiron instinctively favour the former. Thanks has for enhancing my financial education.

  • It really is time that PubMed de-indexed the Homeopathy journal though.

  • And to give you a flavour of the research activity in some areas of conventional medicine:
    there are currently almost 100 000 articles from 2016 on surgery;
    1 410 on statins;
    and 33 033 on psychotherapy.

    It is always interesting to find out why so many articles? A detailed analysis would show:

    Majority studies disproving the earlier studies or trying to reconfirm earlier studies.

    Great understanding of data or just an empty boast?

    • @Iqbal Krishna

      You really haven’t a clue, have you?! I just searched Ovid Medline for papers with ‘surgery’ in all fields and ‘2016’ for date of publication. The search returned 12,053 hits: where do you get your 100,000 figure from?

      “Majority studies disproving the earlier studies or trying to reconfirm earlier studies.” Balderdash. It’s the nature of science to build on earlier foundations: science is a tool for refining understanding of reality. But your comment is just plain stupid. I’ve got better things to do than to analyse the content of 12,000 papers and assign them to categories. Instead I’ve just pasted the titles of the first 20 hits below. I don’t expect you to read them: they’re full of words you almost certainly don’t understand.

      Effects of Mechanical Stretch on Cell Proliferation and Matrix Formation of Mesenchymal Stem Cell and Anterior Cruciate Ligament Fibroblast.
      Physiotherapy scoliosis-specific exercises – a comprehensive review of seven major schools. [Review]
      A Fast-Track Referral System for Skin Lesions Suspicious of Melanoma: Population-Based Cross-Sectional Study from a Plastic Surgery Center.
      Systematic review of measurement properties of patient-reported outcome measures used in patients undergoing hip and knee arthroplasty. [Review]
      Three-year outcome analysis of alpha 1-blocker naftopidil for patients with benign prostatic hyperplasia in a prospective multicenter study in Japan.
      Prednisone and Deflazacort in Duchenne Muscular Dystrophy: Do They Play a Different Role in Child Behavior and Perceived Quality of Life?.
      Postoperative hepatitis B virus reactivation in hepatitis B virus-related hepatocellular carcinoma patients with hepatitis B virus DNA levels <500 copies/mL.
      Two-gene signature improves the discriminatory power of IASLC/ATS/ERS classification to predict the survival of patients with early-stage lung adenocarcinoma.
      Clinical significance of TIPE expression in gastric carcinoma.
      MicroRNA-490 inhibits tumorigenesis and progression in breast cancer.
      Viral-mediated Ntf3 overexpression disrupts innervation and hearing in nondeafened guinea pig cochleae.
      Comparison of Diaphragmatic Breathing Exercise, Volume and Flow Incentive Spirometry, on Diaphragm Excursion and Pulmonary Function in Patients Undergoing Laparoscopic Surgery: A Randomized Controlled Trial.
      Clinical Outcomes and Complications of Cortical Button Distal Biceps Repair: A Systematic Review of the Literature. [Review]
      Innovations in Glaucoma Surgery: Improving the Results.
      Comment on "Exotropia Is the Main Pattern of Childhood Strabismus Surgery in the South of China: A Six-Year Clinical Review".
      Two Rare Cases Involving the Spread of Tuberculosis: A Tuberculous Abscess of the Chest Wall Invading the Liver by Way of the Diaphragm.
      Intimal Sarcoma of the Pulmonary Artery Treated with Pazopanib.
      Ischemic retinopathy associated with Crohn's disease.
      A case of optic-nerve hypoplasia and anterior segment abnormality associated with facial cleft.
      Coverage of Axillary Lymph Nodes with Tangential Breast Irradiation in Korea: A Multi-Institutional Comparison Study.

  • @Frank Odds on Wednesday 17 August 2016 at 13:13

    “where do you get your 100,000 figure from?”

    Ernst likes to tamper with figures. As always. I just took the figure from his article for someone to point out. You did.

    “Instead I’ve just pasted the titles of the first 20 hits below. I don’t expect you to read them: they’re full of words you almost certainly don’t understand.”

    Do YOU understand? And what do they do with so many studies? Who bothers? Dr. David Eddy, in his comments on “Evidence based medicine” says 85% of the activities of the allopathic doctors are NOT based on evidence. The studies that Ernst boasts of add to this mess. Which doctor has the time or the patience to go through this garbage truck and take out that one diamond that has meaning!

    Look at some ineffective surgeries:

    http://www.newsmax.com/Health/Health-News/knee-surgery-repair-ineffective/2013/12/26/id/543834/
    http://www.mdalert.com/article/spinal-fusion-surgery-is-ineffective-costly
    http://www.nytimes.com/2011/11/09/health/research/surgery-to-prevent-strokes-is-found-ineffective.html?_r=0

    Two questions that you can answer to your self:
    1. On what basis did these surgeries start? Which science (physics, chemistry, bio-chemistry…) logic or study led to starting these surgeries?
    2. Have these ineffective surgeries been stopped based upon these studies?

    I can pick up and present to you more than 20 such studies that show that there was no FOUNDATION for the activity. Remember: One flew over the cuckoo’s nest? There were thousands of lobotomy and Neurologist António Egas Moniz even received a Noble prize for this procedure.

    Do YOU recognize garbage when you see it?

    • Iqbal, your comment actually raises some points of interest.

      Which doctor has the time or the patience to go through this garbage truck and take out that one diamond that has meaning!

      This comment shows you don’t comprehend the scope of medical (and other fields of) research. Ignoring the rhetorical “garbage truck” remark, the answer is, of course, that no one person has the time or patience to go through even part of the medical (or other scientific) literature. The millions of real doctors and scientists work in highly specialized fields and they have to search the literature for ‘diamonds’ in their speciality. Up to twenty years ago that was a hard slog through paper-based ‘abstracting services’ (Index Medicus, Chemical Abstracts, Biological Abstracts, Current Contents, etc.) but nowadays the web has made the job much easier.

      If homeopathy had followed a similar path to medicine, it would by now have loads of subspecialities in the ‘profession’. Instead, homeopaths still cling to a single outdated and long ago discredited notion that every symptom can be cured on the principle of ‘like cures like’ (no evidence) and succussion (preferably by banging bottles on a leather-bound book) combined with extreme dilution makes things more potent (no evidence). ‘Provings’ still demonstrate the (fictitious) effects of different substances. Homeopathy has not progressed an inch since Hahnemann first pulled the principles out of his posterior. Do you yet have ‘thoracic homeopaths’? ‘orthopaedic homeopaths’? ‘genitourinary homeopaths’?

      1. On what basis did these surgeries start? Which science (physics, chemistry, bio-chemistry…) logic or study led to starting these surgeries?
      2. Have these ineffective surgeries been stopped based upon these studies?

      The answer to question 1 is that there was seldom science behind the very initial surgical approaches, but there was most definitely logic and study (to give a simple example, if you see a large tumour growing, logic suggests it should be removed), and nowadays there’s a growing amount of science involved.

      Most certainly ineffective surgeries — let’s expand this to all medical remedies — have been stopped. The recent rash of formal management guidelines for huge numbers of conditions reflects this. It doesn’t happen overnight; doctors are people and human nature is slow to adapt to change, but it very definitely does happen all the time. I should dismiss your links to ineffective surgeries as a tu quoque, but let’s do the comparison. I reckon it will be at least 10 years before orthopaedic surgeons all respond to the Finnish study about the inefficacy of knee surgery (Bjorn can give a better estimate — I’m not a surgeon). In the interim there will be a lot of repeats and extensions of the study done before the procedure is abandoned, in case the Finns got something wrong, but if the information is confirmed, the procedure will be abandoned and dropped from formal guidelines.

      Now, how many homeopathic ‘remedies’ have been dropped from your materia medica when they’re found not to be effective? You’ve had more than two centuries of studies to demonstrate treating people with water has no demonstrable efficacy for any condition. Have these ineffective remedies ever been stopped based upon these studies?

      • @Frank Odds on Sunday 28 August 2016 at 08:54

        “The millions of real doctors and scientists work in highly specialized fields and they have to search the literature for ‘diamonds’ in their speciality.”

        I like the use of word speciality: The kidney specialist removed the effected kidney. The operation was successful. The patient died of heart attack the next day. The problem not explained was, before the patient was confirmed for operation, a through health check was carried out to find suitability for operation!!!!! A little different from replacing the fuel injection unit in a car that does not effect its battery.

        A human body, at any time, consists of a few hundred chemical compounds, a dozen organs, a few billion cells, a trillion microbes, genetic variations, bones and nerves, working in tandem. This changes every hour and with time. You really believe a specialist can take out one piece of this jigsaw and make the right sense of it? If you have hives, you visit the liver or the skin specialist?

        And how does one doctor recognize the diamond in the truck that is covered with 10,000 copies of trash?

        “If homeopathy had followed a similar path to medicine, it would by now have loads of subspecialities in the ‘profession’.” Homeopathic logic considers the person as a whole individual. You would like your kidney to function, or YOU to feel good?

        “Homeopathy has not progressed an inch since Hahnemann first pulled the principles out of his posterior. Do you yet have ‘thoracic homeopaths’? ‘orthopaedic homeopaths’? ‘genitourinary homeopaths’?”

        You have “internet” knowledge of homeopathy. Homeopathy has developed a lot since Hahnemann and continues to be updated.
        http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3085232/

        “The answer to question 1 is that there was seldom science behind the very initial surgical approaches, but there was most definitely logic and study (to give a simple example, if you see a large tumour growing, logic suggests it should be removed), and nowadays there’s a growing amount of science involved.”

        When was “arthroscopic knee surgery” started? With no science behind it? Something wrong here. Would you like to retract your statement? And spinal fusion surgery?

        As for the removal of tumor, there cannot be more stupid approach to medical science. In homeopathy it is called SUPPRESSION. Does removal of tumor cure the patient or remove the cause of tumor? What happens when the tumor is removed: https://www.sciencebasedmedicine.org/is-there-a-reproducibility-crisis-in-biomedical-science-no-but-there-is-a-reproducibility-problem/

        “Most certainly ineffective surgeries — let’s expand this to all medical remedies — have been stopped.”
        You have no clue. The disadvantages of by pass surgery is many times more than benefit.
        1. Joesefson D. Early bypass surgery increases the risk of stroke. BMJ 2001; 323: 185
        2. Bucher HC, Hengstler P, Schindler C, and Guyatt GH. PTCA verses Medical treatment for non-acute coronary heart disease. BMJ 2000; 321: 73-77
        3. Kalaycioglu S, Sinci V, and Oktar L. CABG after successful PTCA. Is PTCA a risk for CABG? Int. Surg 1998; 83: 190-193
        4. Yusuf S, Zucker D, Peduzzi P. et.al. Effect of CABG on survival.. Lancet 1994; 344: 565-568
        5. Hornick P, Smith PL, Taylor KM. Cerebral complication following coronary bypass grafting. Curr. Opin. Cardiol 1994; 9: 670-679
        6. Selens OA and McKhann GM. Coronary Artery Bypass and the Brain. N. Engl.J.Med 2001; 344: 451-453”

        You are aware of the present status? Look at the dates!!!!

        “…the procedure will be abandoned and dropped from formal guidelines.” This is known for over 10 years
        http://jackuldrich.com/blog/health-care/unlearning-knee-back-and-spinal-surgery/

        http://www.forbes.com/sites/robertlangreth/2011/01/10/why-you-should-never-get-fusion-surgery-for-plain-back-pain/#4d07a08300c0 This appeared over 5 years ago. The problem is, it continues unabated, and is continuing to increase. Forget science. Finance is more important. (“It is difficult to get a man to understand something when his salary depends on not understanding it.” Upton Sinclair)

        And the dead and maimed patients? Modern medicine killed over 300,000 Americans in 2014. It has continued to kill, and the trend is increasing. After 100 years of being “modern science based” there is no safety provision for the patient who pays for the treatment?

        “Now, how many homeopathic ‘remedies’ have been dropped from your materia medica when they’re found not to be effective?”

        The homeopathic method of defining medicine does not bring into materia medica ineffective drug that causes colletral damage.
        The studies that you talk of are themself being found to be based upon fundamentally flawed principles.
        https://www.sciencebasedmedicine.org/whither-the-randomized-controlled-clinical-trial/

  • Iqbal Krishna said:

    Dr. David Eddy, in his comments on “Evidence based medicine” says 85% of the activities of the allopathic doctors are NOT based on evidence.

    Oh dear, oh dear, oh dear. You’ve not really looked into that at all, have you? Just accepted the same old nonsense put about by quacks.

    I’m willing to help you out here on this one – a bit at least… Please provide a link to where Eddy claimed that and tell us why he did and to what he was referring, Let’s see if YOU recognise garbage when you see it.

    • @Alan Henness on Saturday 27 August 2016 at 10:25

      Look at the amount of garbage being dumped on poor patients, under cover of science based medicine, who are also made to pay for it.

      “This judgment pertains to a shocking number of conditions or diseases, from cardiovascular woes to back pain to prostate cancer. During his long and controversial career proving that the practice of medicine is more guesswork than science, Eddy has repeatedly punctured cherished physician myths. He showed, for instance, that the annual chest X-ray was worthless, over the objections of doctors who made money off the regular visit. He proved that doctors had little clue about the success rate of procedures such as surgery for enlarged prostates. He traced one common practice — preventing women from giving birth vaginally if they had previously had a cesarean — to the recommendation of one lone doctor. Indeed, when he began taking on medicine’s sacred cows, Eddy liked to cite a figure that only 15% of what doctors did was backed by hard evidence.”

      “We don’t have the evidence [that treatments work], and we are not investing very much in getting the evidence,” says Dr. Stephen C. Schoenbaum, executive vice-president of the Commonwealth Fund and former president of Harvard Pilgrim Health Care Inc. “Clearly, there is a lot in medicine we don’t have definitive answers to,” adds Dr. I. Steven Udvarhelyi, senior vice-president and chief medical officer at Pennsylvania’s Independence Blue Cross.

      “The limitation is the human mind,” Eddy says. Without extensive information on the outcomes of treatments, it’s fiendishly difficult to know the best approach for care.The human brain, Eddy explains, needs help to make sense of patients who have combinations of diseases, and of the complex probabilities involved in each.

      ” In one study, he ferreted out decades of research evaluating treatment of high pressure in the eyeball, a condition that can lead to glaucoma and blindness. He found about a dozen studies that looked at outcomes with pressure-lowering medications used on millions of people. The studies actually suggested that the 100-year-old treatment was harmful, causing more cases of blindness, not fewer.”

      “The predictions of success invariably ranged from 0% to 100%, with no clear pattern. “All the doctors were trying to estimate the same thing — and they all gave different numbers,” he says. “I’ve spent 25 years proving that what we lovingly call clinical judgment is woefully outmatched by the complexities of medicine.” Think about the implications for helping patients make decisions, Eddy adds. “Go to one doctor, and get one answer. Go to another, and get a different one.” Or think about expert testimony. “You don’t have to hire an expert to lie. You can just find one who truly believes the number you want.”

      “As a consultant on Blue Cross’s insurance coverage decisions, Eddy testified on the insurer’s behalf in high-profile court cases, such as bone marrow transplants for breast cancer. Women and doctors demanded the treatment, even though there was no evidence it saved lives. Insurers who refused coverage usually lost in court. “I was the bad guy,” Eddy recalls. When clinical trials were actually done, they showed that the treatment, costing from $50,000 to $150,000, didn’t work. The doctors who pushed the painful, risky procedure on women “owe this country an apology,” Eddy says.”

      “More troubling, many doctors hold not just a professional interest in which treatment to offer, but a financial one as well. “There is no question that the economic interests of the physician enter into the decision,” says Kirsh. The bottom line: The conventional wisdom in prostate cancer — that surgery is the gold standard and the best chance for a cure — is unsustainable. Strangely enough, however, the choice may not matter very much. “There really isn’t good evidence to suggest that one treatment is better than another,” says Klein.”

      Quite funny: Let me know if these processes have stopped or doctors continue to follow the science that stopped working long ago. I am sure Ernst can find studies that show most of the processes worked in the first place. Then for some reason these stopped and science is new learning every day.

      The question that remains, Which science was used to start these activities and what new theories have been updated in this science.

    • @Alan Henness on Saturday 27 August 2016 at 10:25

      “Oh dear, oh dear, oh dear.” :

      You don’t have to wail like an old lady. Just copy the message, put it on google, and all information will become available. Science, when used correctly, works.

      • “Science, when used correctly, works.”

        Indeed it does, which is why our ancestors were correctly informed, more than 150 years ago, that homeopathy doesn’t work, by:
        Dan King, MD
        https://en.wikisource.org/wiki/Quackery_Unmasked/Chapter_VI

        Oliver Wendell Holmes, Sr.
        https://en.wikisource.org/wiki/Homoeopathy_and_Its_Kindred_Delusions

        • @Pete Attkins on Saturday 27 August 2016 at 17:06

          “Indeed it does, which is why our ancestors were correctly informed,…”

          If that were your ancestor, then I can only pity you that you maintain connection. The medical science they read, was prehistoric: blood letting, using crude mercury, sulfur, arsenic as medicine. If the medical proponents of present science continue to make blunders in the name of science, what do you expect these poor creatures with their prehistoric notion of medical science to write?

          You should disown them or, as Jesus said: “Father, forgive them, for they know not what they do.”

          • Iqbal Krishna,

            It was Jesus, not Samuel Hahnemann, who was the creator of homeopathy:
            1. Loaves 3X and Fish 3.4X, for “the Feeding of the 5,000”;
            2. Loaves 2.76X and Fishes undocumented X, for “the Feeding of the 4,000”.

            Jesus and Hahnemann were ignorant of physiology, germ theory, the scientific method, and quantum mechanics. The vast majority of 21st Century homeopaths, and other types of sCAM quacks, revel in their ignorance: pretending to know things that they don’t know, in order to maximally exploit the vulnerable members of society.

            Your reply to me demonstrates very clearly that you did not bother to read the references that I cited: the book by Dan King, MD (1858); and the two lectures delivered before the Boston Society for the Diffusion of Useful Knowledge, by Oliver Wendell Holmes, Sr. (1842).

            Homeopathy doesn’t work — it never has and it never will — because homeopathy is NOT medicine. It is nothing other than a lucrative delusion, aka: a confidence trick; snake oil; quackery; health fraud.

      • Iqbal Krishna said:

        @Alan Henness on Saturday 27 August 2016 at 10:25

        “Oh dear, oh dear, oh dear.” :

        You don’t have to wail like an old lady. Just copy the message, put it on google, and all information will become available. Science, when used correctly, works.

        Not wailing, just despairing at your lack of knowledge and understanding, simply repeating old, tired tropes.

        In your other comment, you quoted this:

        Eddy liked to cite a figure that only 15% of what doctors did was backed by hard evidence.

        Liked to cite? Really? Is that the best you can do? And that newspaper article you quoted from isn’t even the original source for his claim – where did he get it from? Try using Google…

        • @Alan Henness on Saturday 27 August 2016 at 18:20

          “Liked to cite? Really? Is that the best you can do? And that newspaper article you quoted from isn’t even the original source for his claim – where did he get it from?”

          It is from Bloomberg and they aptly named it “MEDICAL GUESSWORK”.

          I quite liked the selected synonyme for Science Based Medicine.

  • Iqbal Krishna, you said “Dr. David Eddy, in his comments on “Evidence based medicine” says 85%” but the article you quote says “when he began taking on medicine’s sacred cows, Eddy liked to cite a figure that only 15%” so it’s about the original values, not current figures. That article further says ( http://www.bloomberg.com/news/articles/2006-05-28/medical-guesswork ) “And while there has been progress in recent years, most of these physicians say the portion of medicine that has been proven effective is still outrageously low — in the range of 20% to 25%”
    So by 2006 there had been some improvement, and 2006 is 10 years ago. Does Dr. David Eddy still say 85% lacks evidence, or is this an old figure that has escaped its historical context and refuses to die despite progress in evidence based medicine ? I suspect the latter, with the 85% figure being spread by proponents of so-called alternative treatments.

    Frank Odds & Iqbal, a simplistic pubmed search (SURGERY) AND (“2016/01/01″[Date – Publication] : “20160828”[Date – Publication]) gave me 109681 which fits Prof. Ernst’s round 100,000 number.

    • @DavidP

      Thank you for running the pubmed search and resolving the ‘numbers issue’. Indeed, the search you ran gives >100,000 publications. The devil’s in the detail: it all depends how you run the search. For example, pubmed searched with ‘surgery’ as ‘MESH major topic’ and this year as date of publication returns only 10,265 hits. Web of Science searched under ‘surgery’ as topic with 2016 as publication year produces 33,886 and Medline, as I already stated, returned 12,053 the way I ran the search.

      The important point is that the respective figures for ‘homeopathy’ are 117 (all PubMed), 15 (MESH major topic), 69 (WoS) and 100 (Medline, the way Prof. Ernst searches it). That seems pathetic by comparison, considering the amount of money swishing around among producers of homeopathic medicine.

      Of course, dear Iqbal regards all these publications as rubbish anyway.

    • @DavidP

      It’s far worse than that. I was hoping that Iqbal would manage to cite the source for Eddy’s assertion, but it seems I have to do his work for him:

      In 1991, Dr. David Eddy, at a conference in Manchester, England, claimed that only 15% of medical practice was based on any evidence at all. He apparently based this sweeping conclusion entirely on his studies of treatments for just two specific conditions: arterial blockage in the legs and glaucoma.[1]

      Imrie et al. found:

      Evidence for evidence-based practice includes those listed below.
      • 96.7% of anesthetic interventions (32% by RCT, UK)13
      • approximately 77% of dermatologic out-patient therapy (38% by RCT, Denmark)14
      • 64.8% of “major therapeutic interventions” in an internal medicine clinic (57% by RCT, Canada)15
      • 95% of surgical interventions in one practice (24% by RCT, UK)16
      • 77% of pediatric surgical interventions (11% by RCT, UK)17
      • 65% of psychiatric interventions (65% by RCT, UK)18
      • 81% of interventions in general practice (25.5% by RCT, UK)19
      • 82% of general medical interventions (53% by RCT, UK)20
      • 55% of general practice interventions (38% by RCT, Spain)21
      • 78% of laparoscopic procedures (50% by RCT, France)22
      • 45% of primary hematology-oncology interventions (24% by RCT, US)23
      • 84% of internal medicine interventions (50% by RCT, Sweden)24
      • 97% of pediatric surgical interventions (26% by RCT, UK)11
      • 70% of primary therapeutic decisions in a clinical hematology practice (22% by RCT, UK)25
      • 72.5% of interventions in a community pediatric practice (39.9% by RCT, UK)26
      [references as in original]

      And that was in 2001.

      __________
      1 Imrie R, Ramey DW. The evidence for evidence-based medicine. Complementary Therapies in Medicine 2000;8:123–6. doi:10.1054/ctim.2000.0370

      • @Alan Henness on Monday 29 August 2016 at 12:54

        “And that was in 2001.”

        http://www.scientificamerican.com/article/demand-better-health-care-book/

        This is 2011. No mention of the studies you referred.!!!!!!

        The funny thing is that all the studies referred to prove evidence base are dated between 1995 and 2000 immediately followed by collection paper by Imrie and Ramey. Studies specifically done to take away the lack of evidence taint brought in by Dr. Eddy. So it will be interesting to go through each study for modality and check present evidence status of the same process. Will revert back.

        • @Alan Henness on Monday 29 August 2016 at 12:54

          The Imrie paper was cited by Earnst also and therefore I was sure of its CORRECTNESS. A little check and the result is here:

          https://www.mja.com.au/system/files/issues/180_06_150304/buc10752_fm.pdf

          “While these figures are substantially higher than earlier estimates, critical evaluation of the reported studies high lights the potential for biased results. Most studies examine treatment decisions made during a series of patient encounters over a few weeks in a particular setting. Some have low numbers of participants, are confined to the practice of a small group of doctors, or are undertaken in atypical settings. Moreover, they often concern only one aspect of care, assume that all relevant information was recorded, and do not adequately note possible underprovision of care.”

          The process was still being worked upon in 2006:

          http://www.acpjc.org/Content/pdf/ACPJC-2006-145-2-A08.pdf

          A meta check would shown evidence base is possible only if it is done for a planned biased study.

        • Iqbal Krishna said:

          @Alan Henness on Monday 29 August 2016 at 12:54

          “And that was in 2001.”

          http://www.scientificamerican.com/article/demand-better-health-care-book/

          This is 2011. No mention of the studies you referred.!!!!!!

          The funny thing is that all the studies referred to prove evidence base are dated between 1995 and 2000 immediately followed by collection paper by Imrie and Ramey. Studies specifically done to take away the lack of evidence taint brought in by Dr. Eddy. So it will be interesting to go through each study for modality and check present evidence status of the same process. Will revert back.

          Oh you are amusing Iqbal!

          You provided an unreferenced quote from a newspaper and failed to substantiate it. I provided you with evidence that Eddy simply made that claim in a conference speech in 1991.

          The onus is still on you, Iqbal, to substantiate your claim for that 15%. I can wait for that before I pose the next (obvious) question.

    • Alan, I also think those may be percentages of treatment types, not percentages of patient interventions, so the proportion of daily practice that is evidence-based may be much higher.

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