MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

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    by Frank Odds - Friday 20 October 2017 16:10
    I've made this comment in the past, but it may be worth repeating in this thread. James Randi, who offered a million dollar prize to anyone making a paranormal claim that could be proved under controlled conditions, came up with the following trial protocol to test homeopathy. All patients, regardless of their condition, receive the usual individualized loving care and attention from a homeopathic consultation and they are prescribed whatever the homeopath deems necessary. Prescription changes on return visits are allowed, as usual. Behind the scenes, each patient is randomized to receive the genuine, potentized 'medicine(s)' or an identical placebo (not difficult with homeopathic medicines). Both the homeopath(s) and their patients are blinded to the true nature of the product they receive. (Detailed protocols for this sort of thing are the bread and butter of good, prospective, randomized clinical trials. After a time (negotiable), the patient makes a return visit to the homeopath and, on the basis of a consultation, the homeopath judges whether the patient received verum or placebo treatment. If the homeopath(s) call things correctly more often than statistically predicted by chance, then there's something worthy of further investigation in homeopathic medical products. Edzard can point us to a small number of trials that have been done in a broadly similar manner, but with the important difference that they're restricted to specific medical conditions and an objective assessment is used to judge clinical response. Under the Randi protocol, the person who makes the extraordinary claim that ultra-dilute, succussed preparations have a detectable medical effect are put in the position where they need to show they can truly detect the effect of those preparations. Of course, there would need to be a far more detailed account of the protocol, and it would need to have the full agreement of participating homeopaths. But I bet you'd never get a homeopath to agree to such a protocol (and/or enrol sufficient patients to make the exercise robust science).

    by UK Homeopathy Regulation - Friday 20 October 2017 16:10
    The Department of Health (DH) have the legal power to blacklist products and prevent their prescription by NHS England GPs but despite pressure from the Good Thinking Society requesting a judicial review, they've shown no inclination to blacklist homeopathic medicines. NHS England and CCGs do not have the power to prevent GPs prescribing. I suspect that part of the DH's "hands off" approach here is the desire for NHS England to take the blame for what might be seen as an unpopular decision. Politicians seem to have a distorted view of how many votes there might be in homeopathy. I've written a bit more about the consultation on my blog.

    by UK Homeopathy Regulation - Friday 20 October 2017 16:04
    It's an interesting study.

    by Lenny - Friday 20 October 2017 15:07
    Greg Individualized homeopathy is the cornerstone of the modality. It is in the interest of all homeopaths to promote and fund research into it because if positive results are found, their very existence is validated. Similarly, Boiron and other manufacturers of the preparations have an iron in the fire.

    by Alan Henness - Friday 20 October 2017 14:27
    Greg said:I am not sure what the future of homeopathy research is going to be like because who will pay for research on individualised homeopathy if the result can’t be patented, trade-marked and packaged to sell in the health/medical market.That's curious. A quick search of Google Patents for homeopathy OR homeopathic returns 14,226 results; many brand names, slogans and logos for homeopathic products are trade marks and many homeopathic products are clearly packaged to sell in the 'medical/health market'. But who do you think should pay for further research if that's deemed necessary?

    by Edzard - Friday 20 October 2017 14:06
    SAME PROBLEM IN MANY FIELDS OF HEALTHCARE, e .g. surgery, physiotherapy etc. etc.

    by Greg - Friday 20 October 2017 13:00
    I am not sure what the future of homeopathy research is going to be like because who will pay for research on individualised homeopathy if the result can't be patented, trade-marked and packaged to sell in the health/medical market.

    by Edzard - Friday 20 October 2017 12:53
    " The last decades of homeopathy research have been a total waste of time and money. " I agree - but the preceding decades have been worse.

    by Greg - Friday 20 October 2017 12:22
    That blog was one of your best, fair enough. In the extract to Mathie's study, it states: 'Thirty-two eligible RCTs studied 24 different medical conditions in total.' In order for a clear investigation into individualised homeopathy to begin: the words 'medical conditions' need to be replaced with 'individual health condition'. This is because no two individuals with the same 'medical condition' are alike in other respects: measuring homeopathy against 'medical conditions' is not individualised homeopathy. The measure of individualised homeopathy is the measure of overall improvement in symptoms and condition of the individual patient. And, importantly, recognising that many 'medical conditions' are not improvable or curable with homeopathy. My conclusion: The last decades of homeopathy research have been a total waste of time and money. Thank you for your input in helping to clear this mess up Dr Ernst.

    by Edzard - Friday 20 October 2017 11:55
    because homeopaths are not the most active or gifted of researchers; they prefer outcome studies that never fail to produce positive results.

by James - Friday 20 October 2017 12:55
Holy Mother of Jesus... Did this never happen? Or this? And the whole discussion there... Can it be that I am having false memories? Does Greg operate on a periodical basis? Same hokum every couple of months (or maybe weeks)...? By the way, Björn, in all this flood of comments of the last few days, it may be possible that you have missed my (somewhat late) response? So, do you wish to take joint action for that (piece of a) paper?

by Edzard - Friday 20 October 2017 11:58
you lost me

by Greg - Friday 20 October 2017 10:58
This is pure gold: Edzard: there is no good evidence that it (Epsom Salts) works. Now, I know exactly your thinking about homeopathy as you also think there is no good evidence that it works. Let me tell you: Epsom Salts works. See: https://www.drugs.com/mtm/epsom-salt.html

by Edzard - Friday 20 October 2017 10:52
"Epsom salt has the reputation of being very safe. But unfortunately, even something as seemingly harmless as Epsom salt can become dangerous in the hand of people who have little understanding of physiology and medicine." why don't you learn to read properly? [my post had no 'CONCLUSION']

by Edzard - Friday 20 October 2017 10:48
at least you seem to have understood my point. CONGRATULATIONS!

by Greg - Friday 20 October 2017 10:46
Lol

by Greg - Friday 20 October 2017 10:45
Your conclusion to your article stated: Naturopaths have advocated Epsom salt for gall-bladder problems since centuries, yet there is no good evidence that it works. It is time that alternative practitioners abide by the rules of evidence-based medicine. It seems to me that the emphasis is on the Epsom Salts and not the practitioner. See: http://edzardernst.com/2017/10/severe-liver-injury-due-to-naturopaths-prescription-of-epsom-salt/

by Steve Tonkin - Friday 20 October 2017 10:39
Tell us, ‘Dr’ Leifsson, at which hospitals have you performed bariatric surgery? In which country are you registered as a medical practitioner?Greg, have you considered looking at Björn's LinkedIn page as he suggested? This information is there.

by Greg - Friday 20 October 2017 10:21
Right, and tu quoque: there are literally thousands of medical doctors out there killing patients at this very moment. Got it? Is it due to the drugs/treatment provided or the practitioner: hard to know at this point.

by Edzard - Friday 20 October 2017 10:15
I know you are slow, so let me point it out to you: the problem was not so much the Epsom salt but the practitioner. got it?

by Edzard - Friday 20 October 2017 10:17
all of this goes (almost) without saying. which concrete study are you trying to criticise?

by Tom Osborn - Friday 20 October 2017 07:55
Yes. A testable hypothesis needs to be specific, ideally informed by a proposed mechanism or process. A lot of amateur studies are not much better than anecdotes with confirmation bias, etc. Or worse, with cherry picking. The analysis of an experiment or trail needs to be designed and planned before it is run, otherwise it's an opportunistic hunt for flukes. Meta-studies like Cochrane collaboration do an adjustment for this. Eg, if you choose alpha = 0.05, but post hoc test 10 different hypotheses/contrasts on the same data, the chance of at least 1 false positive is about 0.4. If you test 20 it's about 0.64.

by Edzard - Friday 20 October 2017 07:31
are you sure you know what you are talking about?

by Tom Osborn - Friday 20 October 2017 07:13
So, one can design an experiment, but what kind of hypothesis would be useful. " Homeopathic remedies work no better then placebos" isn't useful because I don't know what "work" means, or specific proposed remedies. Otherwise, post hoc analysis is going to be a nightmare.

by Richard Rawlins - Friday 20 October 2017 09:54
The article concludes: "The worst case scenario is that UCI learns, through research, that integrative medicine is ineffective. But I would rather dismiss something after I receive evidence for its dismissal rather than dismiss it simply because it clashes with my perceptions of medicine." The article's author, Sharmin Shanur "is a second-year cognitive sciences major. She can be reached at sshanur@uci.edu". Let us hope that by the end of her course Miss Shanur will have studied the scientific method, understand the necessity of applying the null hypothesis and appreciate that there is no need for 'evidence for dismissal' (of any proposition) - in other words, those who make claims must provide evidence for them. IM is ineffective until proved otherwise - but due to clever marketing and cherry picking of ideas, much which is promoted by camists is of course already part of 'medicine', which gives the false impression of IM's validity. Miss Shanur presently has an erroneous 'perception of medicine' - there are not two dimensions (Eastern and Western), but simply that which works and that which does not. 'Eastern' doctors know this full well and many have made major contributions to 'medicine' without the false dichotomy of East/West. I look forward to her musings when she qualifies (as I hope she does), and moves onwards.

by Alan Henness - Thursday 19 October 2017 19:14
Given the author is a student there, I think New University need to have a close look at their cognitive sciences curriculum.

by Woo Fighter - Thursday 19 October 2017 17:30
What credulous nonsense. Dr. Prasanta Banerji, a famed doctor for his homeopathy treatments, has cured so many cancer patients in India (using the integrative medicine techniques that Western doctors seem to hate) that there has been a cancer treatment protocol named after him. In fact, on a personal level, I have seen family members with autism improve their social skills due to homeopathic remedies. He gave it that name himself! It's his clinic! Sheesh!

by Edzard - Thursday 19 October 2017 17:19
a very strange comment on the subject: https://www.newuniversity.org/2017/10/17/benefits-of-homeopathy-should-be-reconsidered/

by Edzard - Friday 20 October 2017 07:43
interesting to see that both chiros in this practice have changed their titles from 'Dr' to 'DC' a bit late, but...

by S. Cox, MD - Friday 20 October 2017 03:34
Richard, their goal is to con the public into thinking they are equivalent to physicians in training and expertise, which is blatantly false. They are inferior to Physical Therapists who offer legitimate musculo-skeletal treatments and rehab without the bogus claims of Chiros of fixing and preventing M-S spinal issues as well as numerous other totally unrelated ailments with their magic manipulations, machines, vitamins, herbs and other nonsense.

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