MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

On this blog, we are all fond of what homeopathy-guru DUllman tells us (see for instance here, here and here). It seems only fair, therefore, to show you an excerpt of his latest article, particularly as it is on the highly topical subject of the flu:

Scientific Evidence That Homeopathy Works for the Flu

There are several scientific studies published in peer-reviewed medical journals that have confirmed Oscillococcinum’s efficacy. One large study of 487 patients found that almost twice as many patients who were given Oscillococcinum recovered from the flu within 48 hours as those given a placebo (17 percent versus 10 percent).10

A different group of researchers conducted a randomized, double-blind study involving 372 patients (188 treated with Oscillococcinum and 187 with placebo) of both sexes, ranging in age from 12 to 60, who presented rectal temperature ≥ 100.4 F, muscle pains, headache, or at least one of the following symptoms: shivering, chest pain, spine pain, coughing, irritation of nasal mucosa or feeling of malaise.12

Patients received three tubes of Oscillococcinum or placebo each day (morning, noon and night) for three days. The results of this trial show a highly statistically significant difference between the two groups, for what concerns disappearance of symptoms after 48 hours (19.2 percent in the Oscillococcinum group versus 17.1 percent in the placebo group) and improvement in symptoms (43.7 percent vs 38.6 percent for placebo) ) (p = 0.0028).

Moreover, the frequency of use of concomitant medicines was slightly higher for the placebo group, as was also the use of multiple medicines. Only 13.8 percent of the Oscillococcinum group used two or three drugs (analgesics and antirheumatics), against 19.6 percent in the placebo group.

Another parameter considered was the percentage of patients able to return to work, which was higher in the Oscillococcinum group, both two days after the onset of the illness (16.3 percent against 9.3 percent) and after four days, with highly significant differences.

Homeopathic Treatment Reduced Length of Influenza Illness

The Cochrane Collaboration is an internationally respected group of researchers who evaluate scientific studies. In 2004, they reviewed seven studies using Oscillococcinum in the treatment or prevention of influenza.13 Four treatment trials (n = 1,194) and three prevention trials (n = 2,265) were evaluated.

Only two studies had sufficient information to complete data extraction fully, and both of these studies only evaluated the use of this medicine in the treatment of influenza or influenza-like conditions (the two studies mentioned above were the two studies that were evaluated).

Oscillococcinum treatment reduced length of influenza illness by 0.28 days (95 percent confidence interval 0.50 to 0.06). Oscillococcinum also increased the chance of a patient considering treatment effective (relative risk 1.08; 95 percent CI 1.17, 1). This review also concluded that the number of days needed to return to work were significantly reduced by 0.49 days (95 percent CI 0.89-0.08) compared to the control (average of 4.1 days).

The relative risk from treatment was 0.60 (0.37-0.98), meaning that the proportion of patients treated with Oscillococcinum who considered the treatment to be useless was 0.6, relative to 1.0 for the placebo (a significant difference of 40 percent). The authors of this research review considered these results “promising,” though not strong enough to warrant a general recommendation to use Oscillococcinum for “first-line” treatment of influenza or influenza-like syndromes.

As for the use of Oscillococcinum in the prevention of the flu, the researchers concluded that it was not effective. However, it should be highlighted that the company that makes Oscillococcinum does not market this medicine for “prevention” of the flu, only for the treatment of it (and for “influenza-like” syndrome).

In 2012, a new analysis of research on Oscillococcinum in the treatment of influenza was conducted by the Cochrane Collaboration, and their conclusion was more conservative than previous analyses by this organization.14

The 2012 analysis concluded, “Although the results from four other clinical trials (total of 1196 participants) suggested that Oscillococcinum relieved flu symptoms at 48 hours, this might be due to bias in the trial methods.” In other words, even though two of these studies were double-blind, randomized and placebo controlled, these studies did not achieve the higher caliber of standards of research, thereby enabling the possibility of bias in the results….

END OF QUOTE

It is perhaps not unusual for DUllman to fail noticing that Vickers review [ref 13] has long been withdrawn. It is, however, highly unusual for DUllman not to accuse the authors of the current Cochrane review of bias. After all, they concede that the effect might be an artefact due to bias! In fact, their published conclusions (in both the 2012 and 2015 reviews; the latter was not mentioned by DUllman at all) are quite different from DUllman’s interpretation:

There is insufficient good evidence to enable robust conclusions to be made about Oscillococcinum(®) in the prevention or treatment of influenza and influenza-like illness. Our findings do not rule out the possibility that Oscillococcinum(®) could have a clinically useful treatment effect but, given the low quality of the eligible studies, the evidence is not compelling. There was no evidence of clinically important harms due to Oscillococcinum(®).

The reason why DUllman is so unusually restrained seems obvious: the authors of the review are some of the most vociferous promoters of homeopathy who he knows well and they are pals: Fisher, Frye, Robert Mathie.

[For those who are interested, their COI statements (which might explain the rather off conclusion ‘Our findings do not rule out the possibility that Oscillococcinum(®) could have a clinically useful treatment effect…’) are here:

Robert T Mathie: Dr Mathie is Research Development Adviser, British Homeopathic Association. He was a member of the International Scientific Committee on Homeopathic Investigations, which ceased its committee activities in July 2013.

Joyce Frye: Dr. Frye received partial salary support from Standard Homeopathic Company, which terminated June 2013 and honoraria from the International Scientific Committee on Homeopathic Investigations, which was dissolved in July 2013.

Peter Fisher: I am Expert Adviser on Complementary and Alternative Medicine to the National Institute for Health and Clinical Excellence (NICE), which may take an interest in the evidence in this review. I am Editor in Chief of an international, peer-reviewed journal dedicated to homeopathy. All payments and reimbursements for lectures have been from universities or professional or learned societies. None of these lectures has been dedicated to the subject of this review. Some meetings have been supported by grants from commercial interests, including the manufacturer of the product that is the subject of the review.]

Moreover, DUllman does not mention how dismal the quality of the RCTs really is. Here is the quality rating by Mathie et al:

Figure 1. ‘Risk of bias’ summary: review authors’ judgements about each risk of bias item for each included study.

And here is the crucial quote from the review: The standard of trial reporting was poor or very poor.

But this might just be nit-picking. What is much more important in my view is this:

  1. Even at the most optimistic interpretation of the findings, these results are clinically meaningless. Their effect size is minute and therefore not relevant.
  2. If we consider the prior probability of less than one molecule of duck liver per universe (more on Oscillococcinum here) having any effect at all, the results (which DUllman calls ‘highly significant’) are not statistically significant at all.

My conclusions are simple:

  1. Oscillococcinum is a placebo (a fact that has been affirmed by several US judges).
  2. DUllman is great fun but not a great scientist (also confirmed by a US judge):…The Court found Mr. Ullman’s testimony to be not credible. Mr. Ullman’s bias in favor of homeopathy and against conventional medicine was readily apparent from his testimony. He admitted that he was not an impartial expert but rather is a passionate advocate of homeopathy… 

21 Responses to ‘Homeopathy Works for the Flu’… and if Dana Ullman says so, it must be true!!!

  • DUllman is not great fun. He’s a bluffer! (And finds a highly appropriate proxy home in Mercola’s dreck platform.) To admit his cherry-picking bias would be too humiliating for him. Hence he has no choice but to maintain the lie.

    • Ullman wrote a puff piece on homeopathy for the HuffPo. It was taken down but it re-appeared on that bastion of sound scientific medical advice, greenmedinfo: Compelling Facts, Figures, and Scientific Studies about Homeopathic Medicine (aka “the original nanomedicine”) [sic].

      In the comments, I and some others took the liberty of correcting just about everything Ullman had said. Ullman tried to deflect some of that criticism, but quickly gave up, I assume because even he realised he’d been exposed and could not answer the rebuttals.

      • Still waiting on Dana to respond to my 1 atom of gold as the source material challenge to his nanomedicine claim. http://www.greenmedinfo.com/blog/compelling-facts-figures-and-scientific-studies-about-homeopathic-medicine-aka-or#comment-3621304149

      • I took a deep look throughout the comments on the greenmedinfo article… Correcting Dana Ullman is a complete waste of time, and his comments prove it yet again. The occasional mindless homeopathy supporter jumps in to reinforce their beliefs, usually just to heat things up. There is almost zero critical thought exercised in there. Also, Ullman makes extensive use of childish sarcasm. I mean…”…how convenient, said the church lady…”? Is the guy for real? Is he past primary school?

        With Dana, there is no debate or rebuttals. His arguments are so empty and ignorant and, to make matters worse, he repeats endlessly and decorates his arguments with ironies of the infantile type… One had better argue with a wall instead. How deep into delusion land can he be?

        • Indeed, but I rarely argue to change the mind of the person with whom I’m arguing… they usually have completely closed minds.

        • Dana is just the means. Think of someone playing “devil’s advocate” to be able to talk about a point. When Dana joins in we don’t need someone to play that role.

          The purpose though, is to have the conversation for the fence sitters. It also allows for us to point out just how irrational Dana is and how little Dana bases his opinion on. The constant unaddressed challenges would, hopefully, speak volumes to any fence sitter following the conversation.

          • Yes.. Arguably so, I concede. I have also taken turns trying to be rational in here, for the same reasons. The most striking thing to note from a passionate alternative medicine advocate is their concurrent gut feelings of both believing they are right, and feeling sorry for the opposition for not understanding or for embarrassing themselves by not knowing enough (cf. Courtier’s reply). This is immensely fun and childish at the same time… Deep into delusion-land…

  • And he’ll re-paste it elsewhere, I don’t doubt.

  • The preparations of Oscillococcinum(®) available most drug stories in my part of the world (Central Texas, USA) are all the super powerful 200CK preparations. If the standard C serial dilution technique were not ridiculous enough the K modification (dump out and refill the solvent) is even more so. At least only one duck had to die to provide the whole world with this powerful medication. It must be powerful since it “works” over the counter without even the need of a caring homeopath. All that is needed is a believing patient. I have tried to speak with such patients, but once faith is involved, facts are useless.

    • The K describes that process? Ha! I didn’t realise that. I’d heard that this was one of the methods used. Containers of a certain size would hold enough fluid to the sides when emptied that when filled again the ratio was just right. My favourite description of that was along the lines of “In the real world we call that ‘rinsing’.” 🙂

  • I am sorry but, when faced with a case, where important scientific resources are devoted to undertake serious research on the efficacy of such a helpless failure as duck liver and heart diluted to nonexistence, i.e. plain diluent, as a treatment for the flu, I cannot help but wonder where our society is going…

    Oscillococcinum… A funny joke of the times, so it seems.

  • The biggest joke of them all is the one Boiron is playing on the consumers. Boiron settled a class action lawsuit in the US several years ago for a $12 million compensation instead of providing evidence for the efficacy of their product. Their market value took a short and shallow dive but two years later it was worth four times what it had been worth previously. Their net income for 2016 was €85.000.000
    Material costs are practically only water, sugar and containers. They claim to have invested €3.952 thousand in research in 2016 One wonders where this rather limited (for a pharmaceutical company with a gross revenueof almost 610 million Euro) research money went. According to their investors reference document for investors, this is what their research strategy:

    The aim of BOIRON is to provide healthcare professionals and patients with medicines which are effective, safe and useful
    for public health.
    Christian Boiron has personally led the BOIRON group’s Research Department since January 2013 and has defined its strategy.
    He wishes to further strengthen the effectiveness of homeopathy in order for it to be better understood, better promoted and
    better prescribed.
    In 2016, BOIRON continued its investigations in the following areas:
    • the highlighting of specific properties of homeopathic medicines and the understanding of their pharmacological actions
    at different dilution levels and in various living organisms, in areas such as inflammation, the central nervous system or
    oncology;
    • the comprehension of the physicochemical properties of infinitesimal dilutions;
    • the development of cellular and animal models to evaluate the impact of production and storage processes on the
    effectiveness of our medicines;
    • the confirmation of the therapeutic value of homeopathy and homeopathic medicines, through the implementation of the
    most modern investigation methods. Such is the case for the EPI3 study which we conducted with one of the top scientific
    teams in the field of pharmacoepidemiology. The study lasted for over six years and produced some very satisfactory results
    concerning the usefulness of our medicines and the ability of doctors to prescribe homeopathic medicines for three groups
    of the most commonplace pathologies in general medicine: sleep disorders and anxio-depressive symptoms, infections of
    the upper respiratory tracts and musculo-skeletal pains.

    Anyone else sense the fetid smell of fake science?

    The Moscovy duck they sacrifice each year (if they even bother, who is going to check, and how?) is certainly laying golden eggs, posthumously.

    • It is depressing to note that this thing actually runs in families… There are actual doctors using that stuff, people who spend their entire lives in a huge unfortunate coincidence, people who trust significant matters of their health to this joke. Their personal anecdotes never fail them… Manufacturers make big money, but I feel sorry for the people for living in a delusion more than for wasting their money. I think science does not get enough respect really. It should be considered a disgrace to exploit it in the wrong ways, along with enforcement measures for compensation.

      All things considered, I fear that if one delves into the details of the referenced “science” and studies, they’ll be needing buckets of “scientific detergent” to clean up the mess. If you see terms such as infinitesimal dilution referenced, things are rather blurry, to begin with…

    • And, of course, I really can’t help but express the same question. Do they really get a duck at all?

  • What follows is not new: somebody else made a similar comment on this blog a year or two ago, and I’ve forgotten exactly who it was, so apologies to them!

    The purest water available is that used in laboratories where an experiment may be particularly vulnerable to impurities. Such water is subjected to a combination of repeated distillation, ultrafiltration, reverse osmosis and so on. Ultrapure water type I is the highest grade of water purity known, meeting the exacting standards of the American Society for Testing of Materials. It has the lowest conductivity/highest resistivity of any water (see the link for details), yet it may still have total organic carbon (TOC) content of 50 µg/L, sodium and chlorine content of 1 µg/L and silica content of 3 µg/L.

    If Ultrapure Water type 1 is used to prepare a 30 C dilution of a homeopathic mother tincture, that is, 10^60 dilution, then the concentration of whatever was in the mother tincture will be vastly exceeded by the concentrations of silica, sodium, chlorine and various organic compounds already present in the water. Any therapeutic effect of a homeopathic preparation (yet still to be demonstrated in a scientifically respectable manner after >200 years) is therefore more probably the consequence of the (inevitable) impurities in the water than anything in the mother tincture.

    • Yes, I have also noted that a while ago (e.g. here and here), although I am certain that someone else will have also caught this earlier in here. All in all, beyond 4C-5C (about the order of ppb, that is), one is done with dilutions… It is impossible to distinguish diluted ingredients from impurities.

      In fact, if viewed properly, it is a sufficient observation to disprove most hypotheses of homeopathy. It is also sufficient to prove that homeopathy is based on completely unfalsifiable premises. It is such a grave misunderstanding. But in some laboratories, some people think instruments are toys and use them accordingly, so it seems. Then, they perform measurements beyond the instrument resolution capacity, record noise, perform the tests enough times to capture a randomly emerging pattern, and that’s it. A paper is ready! Disgust is a word that does not even begin to cover the situation, in terms of science, deep in delusion land.

      • @James

        I hadn’t forgotten your two posts on this topic, but I think the first I saw was from Guy Chapman a few years ago — though I may be wrong. In any case, it’s obvious from some comments that many visitors to this blog only read a single post and sometimes just individual comments. So it’s always worth repeating these trenchant criticisms.

        • Definitely so! I am very fond of this observation about impurities, it is very simple, elegant and as close to reality as can be! Infinitesimal dilution is a parody in general!

          The trouble is that such an argument will only convince rational people. The rest are “religiously” involved.

  • The Rosendez v. Green Pharmaceuticals case features another bright pearl, which, I think, is more telling as a fact than the court’s ruling of Ullman’s testimony as not credible.

    Mr. Ullman’s credibility was undermined by his admission that he advocated the use of a radionics machine, whereby a physician puts a picture of his patient on one side, and a few medicines on the other side, and then sees which of the medicines the needle points towards.

    A RADIONICS machine that points at the medicine? Where did he think he was, at a bazaar? A circus? The guy truly believes in magic, huh? I mean… for real

  • And then there is the notion, which homeopaths nurture and encourage, that their remedies are comparable to herbal potions. The general public in my part of the world commonly use the words homeopathy and homeopath for any self professed purveyor of healing services or goods.
    An eminent ancestor in my wife`s family was a famous herbalist and the skills have been propagated in generations before and after him. His legacy is highly revered. The family tree is even named “Grasaættin”, which litterally means herb-ancestry. When I first published a critical blog post against homeopathy I was scolded fervously by several sisters in law. How dare I taint the grand ancestors memory, he who was so famously skilled and helped so many people and so on…
    I managed to save my skin by digging in his writings and finding evidence that the old master despised his contemporary homeopaths and knew how homeoremedies did not contain anything and did not work at all. 🙂

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