Regular readers of this blog will have noticed: when homeopathy-fans run out of arguments, they tend to conduct an ‘ad hominem’ attack. They like to do this in several different ways, but one of the most popular version is to shout with indignation: YOU ARE NOT QUALIFIED!!!
The aim of this claim is to brand the opponent as someone who does not know enough about homeopathy to make valid comments about it. As this sort of thing comes up regularly, it is high time to ask: WHO ACTUALLY IS AN EXPERT IN HOMEOPATHY?
This seems to be an easy question to answer, but – come to think of it – it is more complex that one first imagines. Someone could be an expert in homeopathy in more than one way; for instance, one could be an expert:
- in the history of homeopathy,
- in the manufacture of homeopathics,
- in the regulation of homeopathy,
- in the clinical use of homeopathy in human patients,
- in the clinical use of homeopathy in animals,
- in the use of homeopathy in plants (no, I am not joking!),
- in basic research of homeopathy,
- in clinical research of homeopathy.
This blog is almost entirely devoted to clinical research; therefore, we should, for the purpose of this post, narrow down the above question to: WHO IS AN EXPERT IN CLINICAL RESEARCH OF HOMEOPATHY?
I had always assumed to be such an expert – until I was accused of being a swindler and pretender, that is. I have no formal qualifications for practising homeopathy (and never claimed otherwise), and this fact has prompted many homeopathy-fans to claim that I am not qualified to comment on the value of homeopathy. Do they have a point?
Rational thinkers have often pointed out that one does not need such qualifications for practicing homeopathy. In many countries, anyone can be a homeopath, regardless of background. In all the countries I know, one certainly can practise homeopathy, if one is qualified as a doctor. Crucially, do you really need to know how to practice homeopathy for conducting a clinical trial or a systematic review of homeopathy? Homeopaths seem to think so. I fear, however, that they are wrong: you don’t need to be a surgeon, psychiatrist or rheumatologist to organise a trial or conduct a review of these subjects!
Anyway, my research of homeopathy is not valid, homeopaths say, because I lack the formal qualifications to call myself a homeopath. Let me remind them that I have:
- been trained by leading homeopaths,
- practised homeopathy for quite some time,
- headed a team of scientists conducting research into homeopathy,
- conducted several clinical trials of homeopathy,
- published several systematic reviews of homeopathy,
- no conflicts of interest in regards to homeopathy.
However, this does not impress homeopath, I am afraid. They say that my findings and conclusions about their pet therapy cannot be trusted. In their eyes, I am not a competent expert in clinical research of homeopathy. They see me as a fraud and as an impostor. They prefer the real experts of clinical research of homeopathy such as:
- Robert Mathie
- Jos Kleinjen
- Klaus Linde
These three researchers who are fully accepted by homeopaths; not just accepted, loved and admired! They all have published systematic reviews. Intriguingly, their conclusion all contradict my results in one specific aspect: THEY ARE POSITIVE.
I do not doubt their expertise for a minute, yet have always found this most amusing, even hilarious.
Because none of these experts (I know all three personally) is a qualified homeopath, none of them has any training in the practice of homeopathy, none of them has ever practised homeopathy on human patients, none of them has even worked for any length of time as a clinician.
What can we conclude from these insights?
We could, of course, descend to the same level as homeopaths tend to do and conclude that homeopathy-fans are biased, barmy, bonkers, stupid, silly, irrational, deluded, etc. However, I prefer to draw a different and probably more accurate conclusion: according to homeopathy-fans, an expert in clinical research of homeopathy is someone who has published articles that are favourable to their trade. Anyone who fails to do likewise is by definition not competent to issue a reliable verdict about it.
We have discussed this notorious problem before: numerous charities (such as one that treats HIV and malaria with homeopathy in Botswana, or the one claiming that homeopathy can reverse cancer) are a clear danger to public health. I have previously chosen the example of ‘YES TO LIFE’ and explained that they promote unproven and disproven alternative therapies as cures for cancer (and if you want to get really sickened, look who act as their supporters and advisors). It is clear to me that such behaviour can hasten the death of many vulnerable patients.
Yet, many such charities get tax and reputational benefits by being registered charities in the UK. The question is CAN THIS SITUATION BE JUSTIFIED?
Currently, the UK Charity commission want to answer it. Specifically, they are asking you the following question:
- Question 1: What level and nature of evidence should the Commission require to establish the beneficial impact of CAM therapies?
- Question 2: Can the benefit of the use or promotion of CAM therapies be established by general acceptance or recognition, without the need for further evidence of beneficial impact? If so, what level of recognition, and by whom, should the Commission consider as evidence?
- Question 3: How should the Commission consider conflicting or inconsistent evidence of beneficial impact regarding CAM therapies?
- Question 4: How, if at all, should the Commission’s approach be different in respect of CAM organisations which only use or promote therapies which are complementary, rather than alternative, to conventional treatments?
- Question 5: Is it appropriate to require a lesser degree of evidence of beneficial impact for CAM therapies which are claimed to relieve symptoms rather than to cure or diagnose conditions?
- Question 6: Do you have any other comments about the Commission’s approach to registering CAM organisations as charities?
I am sure that most readers of this blog have something to say about these questions. So, please carefully study the full document, go on the commission’s website, and email your response to: email@example.com . Don’t delay it; do it now!
The aim of this pragmatic study was “to investigate the effectiveness of acupuncture in addition to routine care in patients with allergic asthma compared to treatment with routine care alone.”
Patients with allergic asthma were included in a controlled trial and randomized to receive up to 15 acupuncture sessions over 3 months plus routine care, or to a control group receiving routine care alone. Patients who did not consent to randomization received acupuncture treatment for the first 3 months and were followed as a cohort. All trial patients were allowed to receive routine care in addition to study treatment. The primary endpoint was the asthma quality of life questionnaire (AQLQ, range: 1–7) at 3 months. Secondary endpoints included general health related to quality of life (Short-Form-36, SF-36, range 0–100). Outcome parameters were assessed at baseline and at 3 and 6 months.
A total of 1,445 patients were randomized and included in the analysis (184 patients randomized to acupuncture plus routine care and 173 to routine care alone, and 1,088 in the nonrandomized acupuncture plus routine care group). In the randomized part, acupuncture was associated with an improvement in the AQLQ score compared to the control group (difference acupuncture vs. control group 0.7 [95% confidence interval (CI) 0.5–1.0]) as well as in the physical component scale and the mental component scale of the SF-36 (physical: 2.5 [1.0–4.0]; mental 4.0 [2.1–6.0]) after 3 months. Treatment success was maintained throughout 6 months. Patients not consenting to randomization showed similar improvements as the randomized acupuncture group.
The authors concluded that in patients with allergic asthma, additional acupuncture treatment to routine care was associated with increased disease-specific and health-related quality of life compared to treatment with routine care alone.
We have been over this so many times (see for instance here, here and here) that I am almost a little embarrassed to explain it again: it is fairly easy to design an RCT such that it can only produce a positive result. The currently most popular way to achieve this aim in alternative medicine research is to do a ‘A+B versus B’ study, where A = the experimental treatment, and B = routine care. As A always amounts to more than nothing – in the above trial acupuncture would have placebo effects and the extra attention would also amount to something – A+B must always be more than B alone. The easiest way of thinking of this is to imagine that A and B are both finite amounts of money; everyone can understand that A+B must always be more than B!
Why then do acupuncture researchers not get the point? Are they that stupid? I happen to know some of the authors of the above paper personally, and I can assure you, they are not stupid!
I am afraid there is only one reason I can think of: they know perfectly well that such an RCT can only produce a positive finding, and precisely that is their reason for conducting such a study. In other words, they are not using science to test a hypothesis, they deliberately abuse it to promote their pet therapy or hypothesis.
As I stated above, it is fairly easy to design an RCT such that it can only produce a positive result. Yet, it is arguably also unethical, perhaps even fraudulent, to do this. In my view, such RCTs amount to pseudoscience and scientific misconduct.
CBC news (Canada) reported yesterday that, more than a decade ago, the Manitoba Chiropractic Health Care Commission had been tasked to review the cost effectiveness of chiropractic services. It therefore prepared a report in 2004 for the Manitoba province and the Manitoba Chiropractors Association. Since then, this report has been kept secret. The report makes 37 recommendations, including:
- Manitoba Health should limit its funding to “chiropractic treatment of acute lower back pain.”
- Manitoba Health should provide “limited coverage of the treatment of neck pain.” The report called the literature around the efficacy of chiropractic care for neck pain “ambiguous or at best weakly supportive” and noted such treatment carried a “not insignificant safety risk.”
- Manitoba Health should not fund chiropractic treatment anyone under 18 “as the literature does not unequivocally justify” the “efficacy or safety” of such treatment.
A Manitoba Ombudsman’s Office report from 2012 might shed some light on why the Manitoba Chiropractic Health Care Commission’s report was never made public. Someone had attempted to get a copy of the report, but large parts of it were redacted. “Access to this record was refused on the basis that disclosure would be harmful to a third party’s business interest,” the ombudsman report notes, “and harm the economic or financial interests or negotiating position of a public body.”
The report also challenged claims that chiropractic treatments can be address a wide variety of medical conditions. It stated that there was not enough evidence to conclude chiropractic treatments are effective in treating muscle tension, migraines, HIV, carpal tunnel syndrome, gastrointestinal problems, infertility or cancer, or as a preventive care treatment. It also said there was not enough evidence to conclude chiropractic treatments are effective for children.
The report urged Manitoba Health to establish a monitoring system to keep a closer eye on “the advertising practices of the Manitoba Chiropractors Association and its members to ensure claims regarding treatments are restricted to those for which proof of efficacy and safety exist.” It suggested the government should have regulatory powers over chiropractic ads.
A recent CBC I-Team investigation found Manitoba chiropractors advertising treatment for a wide range of conditions including Alzheimer’s, autism and pediatric services. The commission report contained sharp criticisms of previous reports that suggested funding chiropractic care could save the health-care system money. Dr. Pranlal Manga authored two widely cited reports which claim that by offering publicly funded chiropractic care, provinces can cut health-care costs. “The Manga study on Manitoba must be rejected as a guide to public policy,” the commission report states, “because its assumptions, methodology and costing of recommendations are all deeply flawed.” The reports states, “What limited evidence the Commission has suggests he [Manga] grossly exaggerates possible medical savings.” Dr. Manga did not respond to CBC’s repeated attempts to contact him.
The commission report also made recommendations around the use of X-ray machines by chiropractors. It suggested chiropractors not own and operate X-ray machines “Given the restrictive conditions under which X-rays are advisable, their poor correlation with low-back problems, their apparent limitation as a guide to appropriate treatment …[and] the apparent complete lack of monitoring [of] the use of X-ray by chiropractors.” Instead, it recommended consulting with radiologists when imaging is deemed necessary. “The Commission is of the view that the public interest, and even chiropractic itself, would be better served if chiropractors had access to radiologists for this service, rather than perform it themselves,” the report said.
All three report authors declined comment. Calls to Dave Chomiak, who was health minister at the time the report was prepared, were not returned. In an email to CBC, Manitoba Chiropractors Association president Perry Taylor said, “I personally have never seen this 13-year-old document and [it] pre-dates my time as President. As such I have no comment on this.” The CBC I-Team offered to go through the report with Taylor but he did not respond.
This report seems to confirm much of what we have discussed repeatedly on this blog: Chiropractic is not nearly as effective and safe as chiropractors try to make us believe. To hide this fact is certainly dishonest and unethical, but it is in some ways understandable: this knowledge would directly threaten the income of most chiropractors.
Yesterday I commented on another post: “the conflict of interest seems obvious: if homeopaths speak the truth, they are out of business. therefore, they are taught untruths from the first day of their training and eventually end up believing them. there is only one solution, as far as I can see: regulators must prevent them from making false claims. if not, this will go on for another 200 years and damage many patients’ health”. In the light of the above report, I will now re-phrase this: the conflict of interest seems obvious: if chiropractors allowed the truth to be known, they would soon be out of business. Therefore, they are taught untruths from the first day of their training and many end up believing them. There is only one solution, as far as I can see: regulators must prevent chiropractors from making false claims. If not, this abuse will go on for another 120 years and damage many patients’ health.
It was a BBC journalist who alerted me to this website (and later did an interview to be broadcast today, I think). Castle Treatments seem to have been going already for 12 years; they specialise in treating drug and alcohol dependency. And they are very proud of what they have achieved:
“We are the U.K.’s leading experts in advanced treatments to help clients to stop drinking, stop cocaine use and stop drug use. Over the last 12 years we have helped over 9,000 private clients stop using: alcohol, cocaine, crack, nicotine, heroin, opiates, cannabis, spice, legal highs and other medications…
All other treatment methods to help people stop drinking or stop using drugs have a high margin for error and so achieve very low success rates as they use ‘slow and out-dated methods’ such as talking therapies (hypnosis, counselling, rehab, 12 steps, CBT etc) or daily medications (pharma meds, sprays, opiates, subutex etc) which don’t work for most people or most of the time.
This is because none of these methods can remove the ’cause’ of the problem which is the ‘frequency of the substance’ itself. The phase signal of the substance maintains the craving or desire for that substance, once neutralised the craving/desire has either gone or is greatly diminished therefore making it much easier to stop drinking or using drugs as per the client feedback.
When compared to any other method there is no doubt our treatments produce the best results. Over the last 12 years we have helped over 9,000 clients the stop drinking, stop cocaine use or stop using drugs with excellent results as each client receives exactly the same treatment program tailored to their substance(s) which means our success rates are consistently high, making our advanced treatment the logical and natural choice when you want help.
Our technicians took basic principles in physics and applied them to new areas to help with addiction and dependency issues. Our treatment method uses specific phase signals (frequency) to help:
- neutralise any substance and reduce physical dependency
- improve and restore physical & mental health
When the substance is neutralised, the physical urge or craving has ‘gone or is greatly diminished’ therefore making it much easier to stop drinking or using drugs. The body can also absorb beneficial input frequencies so physically and mentally our clients ‘feel much better‘ and so find it much easier to ‘stop and regain control’…
The body (muscle, tissue, bones, cells etc) radiate imbalances including disease, physical, emotional and psychological conditions which have their own unique frequencies that respond to various ‘beneficial input frequencies’ (Hz) or ‘electroceuticals’ which can help to improve physical and mental health hence why our clients feel so much better during/after treatment…”
END OF QUOTE
To me this sounds like nonsense on stilts.
Bioresonance is, as far as I can see, complete baloney. It originates from Germany and uses an instrument that is not dissimilar to the e-meter of scientology (its inventor had links to this cult). This instrument is supposed to pick up unhealthy frequencies from the body, inverses them and thus treats the root cause of the problem.
There are two seemingly rigorous positive studies of bioresonance. One suggested that it is effective for treating GI symptoms. This trial was, however, tiny. The other study suggested that it works for smoking cessation. Both of these articles appeared in a CAM journal and have not been independently replicated. A further trial published in a conventional journal reported negative results. In 2004, I published an article in which I used the example of bioresonance therapy to demonstrate how pseudo-scientific language can be used to cloud important issues. I concluded that it is an attempt to present nonsense as science. Because this misleads patients and can thus endanger their health, we should find ways of minimizing this problem (I remember being amazed that a CAM journal published this critique). More worthwhile stuff on bioresonance and related topics can be found here, here and here.
There is no good evidence that bioresonance is effective for drug or alcohol dependency (and even thousands of testimonials do not amount to evidence: THE PLURAL OF ANECDOTE IS ANECDOTES, NOT EVIDENCE!!!). Claiming otherwise is, in my view, highly irresponsible. If I then consider the fees Castle Treatments charge (Alcohol Support: Detox 1: £2,655.00, Detox 2: £3,245.00, Detox 3: £3,835.00) I feel disgusted and angry.
I hope that publishing this post somehow leads to the closure of Castle Treatments and similar clinics.
Dana Ullman is an indefatigable promotor of bogus claims and an unwitting contributor of hilarity. Therefore he has become a regular feature of this blog (see for instance here, here and here). His latest laughable assertion is that lead and other poisonings can be successfully treated with homeopathy.
Just to make sure: lead poisoning is no joke. The greatest risk is to brain development in babies, where irreversible damage can occur. Higher levels can damage the kidneys and nervous system in both children and adults. Very high lead levels may cause seizures, unconsciousness and death.
In view of this, Ullman’s claim is surprising, to say the least. In order to persuade the unsuspecting public of his notion, Ullman first cites a review of basic research on homeopathy and toxins published in Human and Experimental Toxicology. “Of forty high-quality studies, 27 showed positive results from homeopathic treatment”, Ullman states.
Now, now, now Dana!
Has your mom not taught you that telling porkies is forbidden?
Or did you perhaps miss this line in the article’s abstract? “The quality of evidence in these studies was low with only 43% achieving one half of the maximum possible quality score and only 31% reported in a fashion that permitted re-evaluation of the data. Very few studies were independently replicated using comparable models.”
Hardly ‘high quality studies’, wouldn’t you agree?
But this review was of pre-clinical studies; what about the much more important clinical evidence?
Here Ullman cites one trial where a potentized homeopathic remedy, Arsenicum Album 30C, was administered to 55 people who were entered into a double-blind, placebo-controlled trial. According to Ullman, the homeopathically treated group “experienced higher excretion of arsenic in their urine for the first eleven days, compared to those given a placebo.”
Na, na, na, Dana, this is getting serious!!!
Another porky – and not even a little one.
The authors of this study clearly stated that, at the end of the 11-day RCT, there was no significant difference between the homeopathy and the placebo group: “The differences in the concentration between the two groups (drug versus placebo) were generally a little higher during the first week, but subsequently the differences were not so palpable, particularly at the 11th day.” And for those who are a bit slow on the uptake, they even included a graph that makes it abundantly clear.
The only other clinical study cited by Ullman in support of his surprising claim is a double-blind randomized trial which was conducted with 131 workers who suffered lead poisoning at the Ajax battery plant in Bauru, São Paulo State, Brazil. Subjects were prescribed homeopathic doses of lead (Plumbum metallicum 15C) or placebo which they took orally for 35 days. The results of this RCT show that homeopathy is not better than placebo.
So, we seem to have all of two RCTs on the subject (I did a quick Medline-search and also found no further RCTs), and both are negative.
Anyone who is not given to compulsive porky-telling would, I guess, conclude from this evidence that people suffering from lead poisoning should urgently see conventional experts and avoid homeopaths at all costs – not so Dana Ullman who boldly concludes his article with these words:
“As an adjunct to conventional medical treatment, professional homeopathic care is recommended for people who have been exposed (or think they have been exposed) to toxic substances… Even if you do not have a professional homeopath in your town, many homeopathic practitioners “see” their patients via Skype or do consultations over the telephone. Unlike acupuncturists, who put needles in you, or chiropractors, who adjust your spine, homeopaths are not “hands-on”: they simply need to conduct a detailed interview… If your symptoms are serious or potentially serious, it is important to see a professional homeopath and/or physician. While a homeopath will commonly prescribe a safe homeopathic dose of the toxic substance to which one was exposed, the homeopath may instead decide that a different substance more closely matches the patient’s unique symptoms…”
It takes a lot these days to make me speechless but there, Dana, you almost succeeded!
‘Natural News’ are not my favourite source of information. In fact, they consistently misinform the public about vaccines, alternative therapies and many other things. In other words, they have proven themselves to be vile mis-informers and a danger to public health.
Yet recently they have provided a valuable service to all of us: they have shown that the natural treatments they regularly promote for every ailment do not actually work for paranoia. Let me explain.
Natural News just announced that Google have “blacklisted the entire Natural News domain and removed over 140,000 pages from its index. The take down of Natural News happened this morning, and it follows a pattern of censorship we’re seeing being leveled against other pro-Trump websites. Google sent no warning whatsoever to our “webmaster tools” email address on file with them. The shut off of Natural News was clearly driven by a human decision, not an algorithm. We’re currently attempting to determine Google’s claimed justification for censoring our entire website, and we hope to have NaturalNews.com restored in Google’s index.”
The announcement continues:
“Natural News is, of course, one of the world’s top educational and activism sources exposing the lies of dangerous medicine, toxic mercury in vaccines, the corporate-quack science behind GMOs, cancer industry fraud and so on. By providing truthful, empowering and passionate information to the public, we harm the profit model of the corrupt medical cartels that fund the media, lobby the government and influence internet gatekeepers with advertising money. (Google has already declared war on natural medicine and nutritional supplements, all but banning them from being advertised on Google Adsense.)
“The removal of Natural News from Google’s index means that millions of people may now be unnecessarily harmed by toxic medicines, herbicides and brain-damaging mercury in vaccines because they are being denied the “other side of the story” that’s censored by the corporate-controlled media. By censoring Natural News, Google is, in effect, siding with the criminal pharmaceutical industry that has been charged with multiple felony crimes and caught bribing doctors, fraudulently altering scientific studies, conducting medical experiments on children and price fixing their drugs to maximize profits.
“In effect, censorship of Natural News is part of the establishment’s war on humanity which includes depopulation measures (Bill Gates), covert infertility vaccines, corporate-run media disinfo campaigns and a full-on assault against scientific truth and free speech conducted in the public interest…
“It’s clear to me that Natural News is being targeted primarily because of our support for President Trump and his review of vaccine safety. It is now apparent that any person who engages in real science, critical thinking or any attempt to protect children from the brain damaging effects of mercury in vaccines is going to be silenced, discredited, smeared and blacklisted. This is an astonishing realization about the depths of total corruption in society today and how the medical cartels control information to maximize their profits off human suffering…”
END OF QUOTE
Regular readers of my blog might remember that Natural News have caught my eye several times before. Here are just 4 of the many more posts where they featured prominently:
- ‘Chiropractors Without Scruples’
- Have yourself a merry little detox
- Charlatans rush to jump on Donald Trump’s band-waggon
- Unbelievable: ‘THE TRUMP WELLNESS PLAN
Like so many in alternative medicine, Natural News seems to be driven by conspiracy theories to a point where paranoia is hard to deny. And that is precisely the service Natural News are providing us today; after so many years of disservice this must surely be celebrated! They demonstrate quite clearly that none of the treatments they are deeply involved in works for this condition. They do that by not even considering that Google banned them because they are constantly endangering the health of the public in the most vile, libellous and objectionable ways imaginable.
Hardly surprising, you will say, the therapies in question are all bogus!
Yes, of course, but it is nice to have a confirmation directly from the horse’s mouth, isn’t it?
A recent article in the Guardian revealed that about one third of Australian pharmacists are recommending alternative medicines with little-to-no evidence for their efficacy, including useless homeopathic products and potentially harmful herbal products.
For this survey of 240 Australian pharmacies, mystery shoppers were sent in to speak to a pharmacist at the prescription dispensing counter and ask for advice about feeling stressed. The results show that three per cent of the pharmacists recommended homeopathic products, despite a comprehensive review of all existing studies on homeopathy finding that there is no evidence they work in treating any condition and that ‘people who choose homeopathy may put their health at risk if they reject or delay treatments’. Twenty-six percent of all pharmacists recommended Bach flower remedies to relieve stress. A comprehensive review of all existing studies on Bach flower remedies found no difference between the remedies and placebos. Fifty-nine per cent of people were just told the complementary and alternative product recommended to them worked, and 24% were told the product was scientifically proven, without any evidence being provided to them.
Asked about these findings, Dr Ken Harvey, a prominent Australian expert, said they demonstrated that some pharmacists were failing in their professional duty to consumers. “Pharmacists are giving crazy advice, and it is dangerous in some cases,” he said. “My view is that pharmacists, if they are going to sell these products, need to have a big shining sign over the shelves of the complementary and alternative medicine section that says ‘these products have not been assessed by the government regulators to see if they work, please talk to pharmacist’.Pharamacists are giving poor advice and they clearly have a conflict of interest,” Harvey said.
If you had hoped that in other countries pharmacists behave more responsibly, I must disappoint you. The information available shows that, when it comes to alternative medicine, pharmacists across the globe act much more like shop-keepers than like health care professionals. They are in the habit of putting profit before their duty to abide by the rules of evidence-based practice. And, in doing do, they violate their own ethical codes so regularly that I ask myself why they bothered to even implement one.
On this blog I have written so often about this issue that one could come to the conclusion that I have a bee under my bonnet:
- Pharmacists: to sell quackery means you are quacks – or have I got that wrong?
- Pharmacists must use their professional judgement to prevent the supply of homeopathic remedies
- A pharmacist’s defence of homeopathy
- When will pharmacists finally stop selling homeopathic remedies?
- The homeopathic emergency kit: it must be good, it’s recommended by pharmacists
- Why do pharmacists sell bogus medicines?
- Pharmacists should finally get their act together…or lose credibility
The truth, however, is not that I am the victim of a bee.
The truth is that this is a very important public health issue.
The truth is that pharmacists show little signs of even trying to get to grips with it.
The truth is that pharmacists who sell bogus medicines put profit before professional ethics.
The truth is that such behaviour is not that of health care professionals but that of shop-keepers.
The truth is that I intend to carry on reminding these pharmacists that they are behaving like charlatans.
The British Homeopathic Association (BHA) is a registered charity founded in 1902. Their objectives are “to promote and develop the study and practice of homeopathy and to advance education and research in the theory and practice of homeopathy…” and their priority is “to ensure that homeopathy is available to all…” The BHA believes that “homeopathy should be fully integrated into the healthcare system and available as a treatment choice for everyone…”
This does not bode well, in my view. Specifically, it does not seem as though we can expect unbiased information from the BHA. Yet, from a charity we certainly do not expect a packet of outright lies – so, let’s have a look.
The BHA have a website (thank you Greg for reminding me of this source; I have long known about it and used it often for lectures when wanting to highlight the state of homeopathic thinking) where they provide “THE EVIDENCE FOR HOMEOPATHY“. I find the data presented there truly remarkable, so much so that I present a crucial section from it below:
START OF QUOTE
The widely accepted method of proving whether or not a medical intervention works is called a randomised controlled trial (RCT). One group of patients, the control group, receive placebo (a “dummy” pill) or standard treatment, and another group of patients receive the medicine being tested. The trial becomes double-blinded when neither the patient nor the practitioner knows which treatment the patient is getting. RCTs are often referred to as the “gold standard” of clinical research.
Up to the end of 2014, a total of 104 papers reporting good-quality placebo-controlled RCTs in homeopathy (on 61 different medical conditions) have been published in peer-reviewed journals. 41% of these RCTs have reported a balance of positive evidence, 5% a balance of negative evidence, and 54% have not been conclusively positive or negative. For full details of all these RCTs and more in-depth information on the research in general, visit the research section of the Faculty of Homeopathy’s website. Also, see 2-page evidence summary with full references.
END OF QUOTE
But is it true?
Let’s have a closer look at the percentage figures: according to the BHA
- 41% of all RCT are positive,
- 5% are negative,
- 54% are inconclusive.
These numbers are hugely important because they are being cited regularly across the globe as one of the most convincing bit of evidence to date in support of homeopathy. If they were true, many more RCT would be positive than negative. They would, in fact, constitute a strong indicator suggesting that homeopathic remedies are more than placebos.
One does not need to look far to find that these figures are clearly not correct! To disclose the ‘mistake’, we do not even need to study any of the 104 RCTs in question, we only need to straighten out the BHA’s ‘accounting error’ and ask: what on earth is an ‘inconclusive’ RCT?
A positive RCT obviously is one where homeopathy generated better outcomes than the placebo; similarly a negative RCT is one where the opposite was the case; in other words, where the placebo generated better outcomes than homeopathy. But what is an ‘inconclusive’ RCT? It turns out that, according to the BHA, it is one where there was no significant difference between the results obtained with placebo and homeopathy.
Yes, you understood correctly!
Outside homeopathy such RCTs are categorised as negative studies – they fail to show that homeopathy out-performs placebo and therefore confirm the null-hypothesis. An RCT is a test of the null-hypothesis (the experimental treatment is not better than the control) and can only confirm or reject this hypothesis. Certainly finding that the experimental treatment is not better than the control is not inconclusive bit a confirmation of the null-hypothesis. In other words it is a negative result.
So, let’s look at the little BHA – statistic again, and this time let’s do the accounting properly:
- 41% of all RCTs are positive,
- 59% are negative.
This means that, according to this very simplistic method, the majority of RCTs is negative. I say ‘very simplistic’ because, for a proper analysis of the trial evidence, we need to account, of course, for the quality of each trial. If the quality of the positive RCTs is, on average, less rigorous than that of the negative RCTs, the overall result would become yet more clearly negative. Most assessments of homeopathy that consider this essential factor do, in fact, confirm that this is the case.
Once all this has been analysed properly, we still have to account for factors like publication bias. Negative trials get often not published and therefore the overall picture gets easily distorted and generates a false-positive image. At the end of a sound evaluation along these lines, the result would fail to show that homeopathy differs from placebo.
Regardless of all these necessary and important considerations, the BHA website then tells us that the RCT method is problematic when it comes to testing homeopathy: “The RCT model of measuring efficacy of a drug poses some challenges for homeopathic research. In homeopathy, treatment is usually tailored to the individual. A homeopathic prescription is based not only on the symptoms of disease in the patient but also on a host of other factors that are particular to that patient, including lifestyle, emotional health, personality, eating habits and medical history. The “efficacy” of an individualised homeopathic intervention is thus a complex blend of the prescribed medicine together with the other facets of the in-depth consultation and integrated health advice provided by the practitioner; under these circumstances, the specific effect of the homeopathic medicine itself may be difficult to quantify with precision in RCTs.”
What are they trying to say here?
I am not sure.
Are they perhaps claiming that, even if an independent scientist disclosed their ‘accounting error’ and demonstrated that, in fact, the RCT evidence fails to support homeopathy, the BHA would still argue that homeopathy works?
I think so!
It looks to me that the BHA is engaged in the currently popular British past-time: THEY WANT THE CAKE AND EAT IT.
All this is more than a little disturbing, and I think it begs several questions:
- Is this type of behaviour in keeping with the charitable status of the BHA?
- Does it really ‘promote and develop the study and practice of homeopathy and to advance education and research’?
- Is it not rather unethical to mislead the public in such a gross and dishonest fashion?
- Is it not fraudulent to insist on false accounting?
I would be interested to get your views on this.
We use too many opioids; some experts even speak of an epidemic of opioid over-use. This is a serious problem not least because opioids are addictive and have other serious adverse-effects. But what can be done about it? Currently many experts are trying to answer this very questions.
It must be clear to any observer of the ‘alternative medicine scene’ that charlatans of all types would sooner or later try to jump on the ‘opioid band-waggon’. And indeed exactly this has already happened!
In particular, chiropractors have been busy in this respect. For instance, Alison Dantas, CEO, Canadian Chiropractic Association (CCA) has been quoted in a press-release by the CCA stating that “Chiropractic services are an important alternative to opioid prescribing… We are committed to working collaboratively to develop referral tools and guidelines for prescribing professions that can help to prioritize non-pharmacological approaches for pain management and reduce the pressure to prescribe… We are looking to build an understanding of how to better integrate care that is already available in communities across Canada… Integrating chiropractors into interprofessional care teams has been shown to reduce the use of pharmacotherapies and improve overall health outcomes. This effort is even more important now because the new draft Canadian prescribing guidelines strongly discourage first use of opioids.”
I find it hard to call this by any other name than ‘CHIROPRACTIC MEGALOMANIA’.
Do chiropractors really believe that their spinal manipulations can serve as an ‘alternative to opioid prescribing’?
Do they not know that there is considerable doubt over the efficacy of chiropractic manipulation for back pain?
Do they not know that, for all other indications, the evidence is even worse or non-existent?
Do they really think they are in a position to ‘develop referral tools and guidelines for prescribing professions’?
Do they forget that their profession has never had prescribing rights, understands almost nothing about pharmacology, and is staunchly against drugs of all kinds?
Do they really believe there is good evidence showing that ‘integrating chiropractors into interprofessional care teams… reduce(s) the use of pharmacotherapies and improve overall health outcomes’?
Personally, I cannot imagine so.
Personally, I fear that, if they do believe all this, they suffer from megalomania.
Personally, I think, however, that their posturing is little more than yet another attempt to increase their cash-flow.
Personally, I get the impression that they rate their income too far above public health.