MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

This recent review claimed to evaluate the evidence on the use of human and veterinary homeopathy, evidence level 1a studies were considered. Focusing on the external evidence on the use of homeopathy in infections, some evidence level 1a, 1b, 2c studies, and a case report, are described in more detail.

In conclusion, evidence for the effectiveness of human and veterinary homeopathy in general, and in particular, of homeopathic treatment for infections, is available. Especially, individualized homeopathy demonstrates effects at all quality levels according to Cochrane criteria, even in the methodologically high-quality studies. As in most areas of veterinary medicine and medicine, further good/excellent studies are necessary. In compliance with the principles of homeopathy, further methodologically high-quality trials focusing on the homeopathic treatment of infections are the next logical step. The selection of the simile (individually fitting homeopathic medicinal product) by appropriately trained homeopathic doctors/veterinarians is essential for the effectiveness of homeopathy. Implementation of studies at university facilities is a prerequisite for quality assurance. Consequently, further integration of homeopathy at universities is a necessary requirement for the patients’ best interests.

Who wrote this bizarre paper?

The authors who state to have no conflicts of interest are P Weiermayer 1M Frass 2T Peinbauer 3L Ellinger 4

  • 1Tierärztin, Tierarztpraxis Dr. Weiermayer, Diplom der Europ. Akademie für Veterinärhomöopathie (EAVH), Fachtierärztin für Homöopathie, Sprecherin der Sektion Forschung der Wissensch. Gesellsch. für Homöopathie (WissHom), Präsidentin ÖGVH, Wien, Österreich.
  • 2Facharzt für Innere Medizin und Internistische Intensivmedizin, em. Professor für Innere Medizin der Medizinischen Universität Wien, Diplom der Österreichischen Ärztekammer (ÖÄK) für Homöopathie sowie für Begleitende Krebsbehandlung, Wien, Österreich.
  • 3Arzt für Allgemeinmedizin, ÖÄK-Diplom für Homöopathie, Universitätslektor für Allgemeinmedizin und Modulbeauftragter für Komplementärmedizin, Medizinische Fakultät, Johannes Kepler Universität Linz, Österreich.
  • 4Tierärztin, Centaurea, Apeldoorn, Holland.

This already explains quite a lot, I think.

The paper itself is in German, so I will try to make some sense of part of it for you.

In their ‘methods section’, the authors explain that they evaluated meta-analyses and systematic reviews (SRs) of homeopathy for various conditions. Furthermore, they considered the ‘1st and 2nd’ NHMRC reports. Specifically for the question whether homeopathy is the answer to antibiotic resistance, the authors also considered RCTs, observational studies, heath service research and even case-studies. The authors then elaborate at length on the assumptions of homeopathy, on legal issues and on the nature of evidence-based medicine all of which I disregard for the moment (suffice to say that this material has been often and better reviewed before).

When finally discussing the evidence on homeopathy for human conditions, the authors state that, up until 2014, six comprehensive SRs had been published. In their opinion, these are the following 6 papers:

  1. Kleijnen, J., Knipschild, P., Ter Riet, G. (1991): Clinical trials
    of homeopathy. BMJ 302(6772): 316-23.
  2. Linde, K., Clausius, N., Ramirez, G., Melchart, D., Eitel, F.,
    Hedges, L.V., Jonas, W.B. (1997): Are the clinical effects of
    homeopathy placebo effects? A meta-analysis of placebo-controlled trials. Lancet 350(9081): 834–843.
  3. Linde, K., Scholz, M., Ramirez, G., Clausius, N., Melchart,
    D., Jonas, W.B. (1999): Impact of study quality on outcome
    in placebo-controlled trials of homeopathy. J Clin Epidemiol 52(7): 631–636.
  4. Cucherat, M., Haugh, M.C., Gooch, M., Boissel, J.P. (2000): Evidence of clinical efficacy of homeopathy. A meta-analysis of clinical trials. HMRAG. Homeopathic Medicines Research Advisory Group. Eur J Clin Pharmacol 56(1): 27–33.
  5. Mathie, R.T., Lloyd, S.M., Legg, L.A., Clausen, J., Moss, S.,Davidson, J.R.T., Ford, I. (2014a): Randomised placebocontrolled trials of individualised homeopathic treatment: systematic review and meta-analysis. Syst Rev 3: 142.
  6. Shang, A., Huwiler-Müntener, K., Nartey, L., Jüni, P., Dörig, S., Sterne, J.A.C., Pewsner, D., Egger, M. (2005): Are the clinical effects of homeopathy placebo effects? Comparative study of placebo-controlled trials of homeopathy and allopathy. Lancet 366(9487): 726–32.

(As it happens, I have reviewed these papers here and come to very different conclusions)

Without bothering about a critical assessment of these papers, the authors report that all arrived at a positive conclusion, except the last one. They then claim that the ‘1st’ NHMRC report was partly positive but was initially suppressed by the Australian government. Instead it was replaced with the 2nd NHMRC report which was designed to arrive at a wholly negative conclusion. Likewise, the ‘EASAC Statement’ neglected some of the available positive evidence. These facts, the authors believe, discredits all of these negative reports.

The authors then discuss the various reviews by Mathie et al and point out that, in their view, these papers are superior to all other documents as they arrive at very clearly positive conclusions.

Next the authors focus on the field of veterinary homeopathy, while admitting weaker and weaker evidence, inclusing case-reports. This is also where I lost the will to live and gave up my detailed criticism of the text; the task is too tedious and simply not worth it, I felt.

In summary, here are few points relating to the human evidence:

The authors seem to have no intention of conducting an objective, systematic review. Such a project is essentially based on two principles. Firstly, it needs to include all eligible evidence according to pre-defined criteria. Secondly, it must include a critical evaluation of the admitted evidence. This review fails on both of these principles.

There are virtually dozens of systematic reviews which the authors decided to ignore. Here are just six of them:

  1. … homoeopathy as a whole may be considered as a placebo treatment.
  2. We tested whether p-curve accurately rejects the evidential value of significant results obtained in placebo-controlled clinical trials of homeopathic ultramolecular dilutions. Our results suggest that p-curve can accurately detect when sets of statistically significant results lack evidential value.
  3. We found no evidence to support the efficacy of homeopathic medicinal products
  4. … no firm conclusions regarding the effectiveness and safety of homeopathy for the treatment of IBS can be drawn.
  5. Due to both qualitative and quantitative inadequacies, proofs supporting individualized homeopathy remained inconclusive.
  6. … the use of homeopathy currently cannot claim to have sufficient prognostic validity where efficacy is concerned.

Why do they do it? A reasonable reply to this question might be, because their findings did not fit the preconceived ideas of the authors. This omission alone makes the article little more than a poorly conceived marketing brochure.

Even more important is the second omission. The paper  lacks any kind of critical evaluation of the included evidence. On the contrary, the authors praise the evidence that generated what they think was a positive result (even in cases where the actual result was not all that positive; for instance: A meta-analysis of all extractable data leads to rejection of our null hypothesis, but analysis of a small sub-group of reliable evidence does not support that rejection. Reliable evidence is lacking in condition-specific meta-analyses, precluding relevant conclusions) and bash all negative findings. This goes as far as perpetuating untruth about the two NHMRC reports: what they call the 1st report was a draft that had been rejected because it was deemed to be of sub-standard quality. What is here called the ‘2nd’ report is thus the only valid document ever published. Similarly, the authors pretend that the Mathie reviews were all clearly positive and fail to mention even the most obvious problems with these articles, such as the facts that Mathie was paid by a homeopathy-lobby group or that even he included important caveats in his conclusions.

As to the focus of the review, the question whether homeopathy might be a solution to antibiotic resistance, the authors found virtually no compelling evidence from trials directly comparing antibiotics with homeopathy. This seems to bother the authors little – they conclude that “the data demonstrate the potential of a significant reduction of antibiotic usage through homeopathic treatments”. They seem to have reached this conclusion by turning a blind eye to all the evidence that does not fit their preconceived idea.

As the paper is published in German and in a journal which hardly anyone will ever read, one could easily argue that none of all this does really matter because it is merely a storm in a very small tea cup. Perhaps that’s true. But this paper nevertheless might attain some significance because it is already being heavily promoted by the homeopathy lobby. And no doubt, it will thus be cited in the English literature which, in turn, will be read by people who do not read German, unable to check the original and are thus likely to believe the nonsense promoted by Frass and friends.

For this reason, I want to conclude by making it quite clear that

this ‘review’ is a dilettante attempt to white-wash the evidence on homeopathy and mislead the public.

 

97 Responses to Another attempt to ‘white-wash’ the evidence on homeopathy

  • Selecting the studies that show homeopathy works proves that homeopathy works!

    No doubt Humpty Dumpty will be along shortly to lecture us on the importance of ensuring high-quality selection bias, because that’s how good science works.

    Checkmate, allopaths!

  • Ah. Professor Frass and his ongoing career in statistical misrepresentation, self-delusion and claiming the movements caused by his repeated kicking of his long-dead horse are signs of life.

  • ..and here the real tornado, in which Edzard’s no longer seaworthy bias-boat gets into serious distress …
    “..and I cannot fault it…”

    Homeopathy prolongs survival of lung cancer patients … Can it be true?

    YES!
    https://pubmed.ncbi.nlm.nih.gov/33010094/

    Oncologist: Ranking within Oncology-Journals (total 367)
    Ranking: 30 Oncologist journal 2.613 Q1 157 449 705 12820 3245 580 4.94 28.55
    IF 5.025
    IF 5.025
    IF 5.025

  • “… meta-analyses can arrive at different conclusions despite being based on virtually the same material. They are not performed according to strict methodology and are, to a variable extent, guided by creativity, interpretation, and personal bias. This is why everyone can find arguments for and against homeopathy in the meta-analyses of the pooled clinical data.”

    Dr Rober Hahn, MD, PhD, 2013
“Homeopathy: Meta-Analyses of Pooled Clinical Data”

  • When quoting another metaanalysis published in a conventional medical journal, this review found very similar results from previous metaanalyses:

    “Five systematic reviews have examined the RCT research literature on homeopathy as a whole, including the broad spectrum of medical conditions that have been researched and by all forms of homeopathy: four of these ‘global’ systematic reviews reached the conclusion that, with important caveats, the homeopathic intervention probably differs from placebo.”

    Mathie RT, Lloyd SM, Legg LA, Clausen J, Moss S, Davidson JR, Ford I. Randomised placebo-controlled trials of individualised homeopathic treatment: systematic review and meta-analysis. Systematic Reviews 2014; 3:142. doi:10.1186/2046-4053-3-142
    http://www.systematicreviewsjournal.com/content/3/1/142

    I ask others here to only quote reviews published in the peer review literature that analyses the 6 studies. You each can give your own points of view that you can draw up from your back-side, but I will be curious what you can report from the peer-review literature.

    For the record, the two Australian reports did not undergo peer review…and at present, these reports are undergoing an analysis by a government ombudsman for scientific misconduct and unethical actions.

    • I’m curious about this complaint to the Australian Commonwealth Ombudsman. It appears to have been made in August 2016.

      In May and August 2017 there were articles on the Australian Skeptics web site about it (links below).

      From the August article: “We mentioned in the April story that we had approached the Commonwealth Ombudsman’s office to ascertain that the submission existed. The organisation’s media office was not allowed to confirm that there was a submission, but another source within that body said that there was no record of a submission.

      And we now understand that even the NHMRC itself is unaware of any submission, making them equally curious about its existence, let alone its status with the Ombudsman.”

      Does anyone have any information about the progress of this complaint to the Ombudsman? It seems to be taking a very long time.

      Australian Skeptic links:
      https://www.skeptics.com.au/2017/05/02/homeopathy-groups-attack-on-nhmrc-the-missing-submission/
      https://www.skeptics.com.au/2017/08/04/update-the-missing-homeopathy-submission/

    • Mathie concluded just three trials met his criteria for ‘reliable evidence’: Jacobs 1994, Jacobs 2001 and Bell 2004.

      Jacobs 1994: Treatment of Acute Childhood Diarrhea With Homeopathic Medicine: A Randomized Clinical Trial in Nicaragua

      This was a small study (n=81) of children with a history of acute diarrhoea given either homeopathy or re-hydration treatment plus homeopathy

      It should be noted that Mathie et al. claim:

      We conducted a systematic literature search to identify RCTs that compared individualised homeopathy with placebos…

      It is therefore not clear why they chose to include this trial because it fails this inclusion criterion: the control arm was not a placebo, but was an active treatment to which was added the homeopathy treatment. This is an A+B versus B trial design and these will always generate positive results (unless the treatment in question does actual harm).

      However, it concluded:

      The statistically significant decrease in the duration of diarrhea in the treatment group suggests that homeopathic treatment might be useful in acute childhood diarrhea. Further study of this treatment deserves consideration.

      Although Mathie et al. regarded this as reliable evidence, it has been criticised on a number of grounds.

      Jacobs 2001: Homeopathic treatment of acute otitis media in children: a preliminary randomized placebo-controlled trial

      The paper itself describes this as a preliminary trial (n=75) of homeopathy vs placebo for otitis media.[29]

      It concluded:

      These results suggest that a positive treatment effect of homeopathy when compared with placebo in acute otitis media cannot be excluded and that a larger study is justified.

      Bell 2004: Improved clinical status in fibromyalgia patients treated with individualized homeopathic remedies versus placebo

      This was a test of increasing LM dilutions (starting at 1:50,000) in alcohol (n=62), of homeopathy vs placebo for fibromyalgia.[30] Note that the dilutions started as a 1:50,000 but was repeatedly serially diluted in the same ratio for each subsequent dose. A total of 41 different homeopathic preparations were used:

      Homeopathic remedy choices over the whole sample were highly individualized to the same degree in both groups (homeopaths prescribed 41 different remedies for 62 participants) (supplementary data, Table 3). Only two remedies,
      Calcarea carbonica and Rhus toxicodendron, each were chosen for four patients.

      The actual preparations used are identified in the supplemental data to the paper, but there is no analysis of outcome measure vs each preparation.

      Note that the authors state:

      This study was designed as a feasibility or pilot study rather than a definitive clinical trial

      It concluded:

      This study replicates and extends a previous 1-month placebo-controlled crossover study in fibromyalgia that pre-screened for only one homeopathic remedy. Using a broad selection of remedies and the flexible LM dose (1/50 000 dilution factor) series, the present study demonstrated that individualized homeopathy is significantly better than placebo in lessening tender point pain and improving the quality of life and global health of persons with fibromyalgia.

      All these three trials had various and significant methodological flaws, yet they were the best identified by Mathie et al. It is not clear why the many criticisms of these trials were not fully addressed by Mathie.

      It is worth emphasising the number of participants in these three trials (81, 75 and 62 participants) and that Jacobs 2001 self-describes as ‘preliminary’ and Bell 2004 as ‘a pilot study’. It is difficult to understand why he chose to categorise them as being ‘reliable evidence’.

      However, taking these three and then adding in many other even lower quality trials, Mathie concluded:

      Medicines prescribed in individualised homeopathy may have small, specific treatment effects. Findings are consistent with sub-group data available in a previous ‘global’ systematic review. The low or unclear overall quality of the evidence prompts caution in interpreting the findings. New high-quality RCT research is necessary to enable more decisive interpretation. [Emphasis added]

      Moreover, he emphasised

      The overall quality of the evidence was low or unclear, preventing decisive conclusions.

      It’s difficult to understand how this could be viewed as compelling evidence for homeopathy.

      Anyone find this evidence compelling? But even if it was compelling, the ‘reliable evidence’ refers only to acute childhood diarrhea, acute otitis media in children and fibromyalgia: no reasons are given as to why this would ever be generalisable either to other conditions or to other homeopathic concoctions.

      Have the further studies recommended by the various authors been carried out yet, Dana? Why not, do you think?

      • “It is therefore not clear why they chose to include this trial because it fails this inclusion criterion: the control arm was not a placebo, but was an active treatment to which was added the homeopathy treatment. This is an A+B versus B trial design and these will always generate positive results (unless the treatment in question does actual harm).”

        Alan, I’m not surprised you’re a liar.

        Jacobs 1994: Identical pellets without homeopathic medication were used for placebo. There was no detectable difference in taste, odor, or color between the treatment medication and placebo, and they were packaged in identical blue plastic tubes that were sealed at the laboratory and remained unopened until delivery to the patient.

        • Rather than calling Alan a liar (funny how you leap straight to assuming malice), how about you post a link to the full Jacobs ’94 paper so he/we can crosscheck and issue a correction as needed.

          Also, is it just me or does the following statement in Mathie strike anyone else as an appalling condemnation of both quantity and quality of homeopathic research:

          Thirty-two eligible RCTs studied 24 different medical conditions in total. Twelve trials were classed ‘uncertain risk of bias’, three of which displayed relatively minor uncertainty and were designated reliable evidence; 20 trials were classed ‘high risk of bias’.

          Remember, this is a $5 BILLION global industry already selling its products to millions of consumers, and the best it can offer to justify that behavior is 3 not-completely-crap trials out of 32. And of this you’re proud?

      • New high-quality RCT research is necessary to enable more decisive interpretation.

        Which raises the obvious question: Why don’t homeopaths stop selling homeopathy while they go away and do these high quality RCTs that they keep saying are needed, and resume sales only when and if the totality of high quality evidence shows clear therapeutic effect above and beyond placebo?

    • For the record, the two Australian reports did not undergo peer review…and at present, these reports are undergoing an analysis by a government ombudsman for scientific misconduct and unethical actions.

      And here we go again with another demonstration of the tenuous grasp of what constitutes truth that Dana and, indeed, homeopathy as whole has.

      Firstly, any scientific misconduct is ALLEGED until proven. Since no proof has been shown, Dana’s statement is libelous and a flat-out lie.

      Secondly, as prl mentions, there is no indication of the complaint ever having been made, although the HRI has proudly trumpeted about the submission. and one would have thought that, after four years, some conclusions would have been made.

      The flanneling, handwaving, smoke and mirrors, special pleading and outright lying is what you expect from people who want to belive that shaken water has magic powers. When evidence shows their beliefs are false, what do we get but further flanneling, handwaving, smoke and mirrors, special pleading and outright lying – especially from Humpty Dumpty Mr Uncredible Ullman, homeopathy’s tame halfwit.

    • FTA: “The overall quality of the evidence was low or unclear, preventing decisive conclusions.”

      Congratulations on proving GIGO.

    • The only recent information about the complaint that I could find was a video on Facebook from the HRI: Leading Australian lawyer on NHMRC Homeopathy Review, a to-camera by Dr Teresa Nicoletti dated 20 March 2020.

      The text under the video says “As we await the verdict promised in March 2020…” The video doesn’t mention any that awaited “verdict” at all.

      In any case, the Ombudsman doesn’t issue “verdicts”. It makes recommendations (“What happens if there is an investigation?” section; the anchor for that section doesn’t work). And in their own words: “The Ombudsman cannot override the decisions of agencies, or compel them to comply with his or her recommendations.” It says that agencies generally do comply, but if they don’t, the Ombudsman can make a report to the relevant Minister.

      Four years appears to be an unusually long investigation. In the same page on the Ombudsman’s Web site (under “Complaints about Commonwealth Agencies”): “Some complaints need a more detailed investigation to seek information from the agency complained about. Investigations usually take up to 90 days, although some are more complex and take longer. We’ll keep you updated if this happens in your case. Overall, 95 per cent of complaints should be finalised within 90 days, and 99 per cent within 12 months.”

  • Ernst, finally homeopathy have a clear and conclusive review favouring homeopathy!

  • It’s not a humor, Ernst, your career is over.

    • Ernst, your career is over.

      Ah-hah! You are Charles Windsor and I claim my five pounds.

    • “Ernst, your career is over”
      it seems that you forgot to tell the rest of the world; as of today, they quoted my papers 2733 times in 2020 and 88385 times in total.
      https://scholar.google.fr/citations?hl=en&user=BVRt8QgAAAAJ

      • @Edzard

        Lolly is a homeopathy freak. Stuff like objective facts doesn’t impinge on their Worldview.

      • Do you really think the number of bibliographic citations you’ve received ignores that your career is over? Most of your articles are editorials or letters to the editor, which inflates your number of posts. Several of them are repetitions of the same and others are chapters of your books, which again inflates your number of quotations received. Others like your “historical” publication of the Nazis and homeopathy have no historical value because you are not even a professional historian and your grade cannot compare with the quality of the works of real historians like Josef Schmidt. Other publications you have plainly contradict your own conclusions!

        • is there any stick of which you don’t get the wrong end?

          • Ernst, I have seen some of your early trials and I found an interesting double face behaviour. For example, your trials with conventional medicine use small sample size but your conclusions are very positive. However, clinical trials with homeopathy and with the same or nearly sample size with positive conclusion are rejected on the basis or plausibility. Methodological rigour in many homeopathic trials are more rigorous than conventional trials. Yes, your career is over!

          • Bravo!!!
            well-done Watson!
            It means that I was on a learning curve.
            It means that I, like most of us, had to learn how to think critically.
            It means that I was able to improve.
            It means that, when I became the head of a research team (~1990) and could determine the rigor of the work and influence its critical analysis, the conclusions became more cautious.
            Thank you!
            [btw: I don’t think I ever rejected a hypothesis because of implausibility. if you know better, show me the paper.]
            … and please carry on your detective work into my research – heaven knows, perhaps one day you will find something interesting!?!
            [alternatively, you could just read my memoir A SCIENTIST IN WONDERLAND where much of this is described in some detail]

          • I read your books, even the one you mention. And instead of having a learning curve, you show a clear sharp dogmatism curve, even thinking that some of your own reviews and clinical trials came to clear positive evidence, which you dismiss using “theoretical” objections. What I’ve been thinking is that you’re just taking advantage of the easy fame that the media and pseudo-skeptical lobbies offered you, loosers as James Randi, Neil de Grasse Tyson, Harriett Hall or Richard Dawkins.

          • “some of your own reviews and clinical trials came to clear positive evidence, which you dismiss using “theoretical” objections”
            give me an example

          • “give me an example”

            Homeopathy for Postoperative Ileus?: A Meta-analysis (1997):
            “In conclusion, our analyses suggest that homeopathic treatment administered immediately after abdominal surgery may reduce the time to first flatus when compared with placebo administration. They do not provide evidence for the use of a particular homeopathic remedy or for a combination of remedies for postoperative ileus.”

            A systematic review of systematic reviews of homeopathy (2002):
            Collectively the findings do not provide
            strong evidence in favour of homeopathy. With the exception of postoperative ileus [10] and influenza [17] (see below) there is no condition for which homeopathy is convincingly effective [10, 11, 13, 18–20].”

            A systematic review of homoeopathy for the treatment of fibromyalgia (2010):
            “In summary, the findings of the four existing RCTs all favour homoeopathy over controls. Yet none of the studies is sufficiently rigorous to provide a definitive answer. Future studies should minimise bias more effectively than did the trials available so far.

            Homeopathy: the undiluted facts (2016):
            Several well-conducted clinical studies of homeopathy with positive results have been published. It is therefore not true to claim that there is no good trial evidence at all.

          • Homotoxicology—a review of randomised clinical trials (2004):
            Despite mostly positive findings and high ratings on the Jadad score, the placebo-controlled, randomised clinical trials of homotoxicology fail to demonstrate the efficacy of this therapeutic approach… It is noteworthy that, according to the Jadad scores [5] (Table 2), most of the included RCTs are of high methodological standards. In the present instance, this does not totally exclude bias.”

            Efficacy of homeopathic therapy in cancer treatment (2006):
            Five out of six trials included in this systematic review yielded positive results, which suggest the effectiveness of homeo pathic remedies for cancer care… The evidence for homeopathic remedies in cancer care may not be fully conclusive but it does seem to warrant further study”

            Oscillococcinum (Anas barbariae hepatis et cordis extractum 200CK HPUS) (2011):
            Oscillococcinum has been shown to reduce the severity and shorten the duration of influenza symptoms within a few days. 1,2 However, despite modest positive findings for the treatment of influenza, additional studies are warranted to evaluate this product’s prophylactic effectiveness.”

            It is interesting to note how much of your work reports positive effects, even in high-quality trials, but in all cases you dismiss them by alluding to some unknown bias or appealing to “impossibility”. Your articles are a huge example of how a biased “scientist” can reject even his own results just because they don’t fit his frame of reference.

          • very good! we drew cautious conclusions in these cases because there were good reasons to do so.
            it’s called critical analysis; you should try it some time!

  • Bjorn…HOW can you say or even imply that there is ‘nothing’ in homeopathic medicines when a major study published in LANGMUIR and replicated elsewhere has confirmed that nanoparticles of six different metals persisted in water solutions no matter how many times they underwent dilution and succussion.

    You are using old, tired, and now inaccurate criticism of homeopathy. Wake up, guy, this isn’t the 20th century.

    Sorry, but science seemed to get in the way of your theories.

    Chikramane PS, Kalita D, Suresh AK, Kane SG, Bellare JR. Why Extreme Dilutions Reach Non-Zero Asymptotes: A Nanoparticulate Hypothesis Based on Froth-Flotation. Langmuir. 2012 Oct 19. http://www.ncbi.nlm.nih.gov/pubmed/23083226

    • ” a major study published in LANGMUIR”
      I always suspected that you have humour after all, Dana.

    • ROFL! LOL!

      “Work of Chikramane 2012
      Prashant S. Chikramane et al. presented another often cited paper on the topic in 2012 [28]. With the publication in Langmuir, the authors succeeded in placing the nanoparticle synthesis in a renowned peer-reviewed scientific journal published by the American Chemical Society.

      […]

      Implausibility of the conclusions drawn from the measurement results
      In fact, some of the numerical values given in the paper are highly implausible and are not able to support this hypothesis, but in some cases even contradict it: [23]

      The original work spoke of “nanobubbles” that were supposed to be created when shaking. The diameters of the bubbles now formed in the experiment (Figure 4 of the publication) are rather in the millimeter range. In general, the measurement accuracy of the bubble size does not allow a distinction below one millimeter. The authors do not discuss at all that the “nanobubbles”, which are still considered essential in the hypothesis [B 12], could not be detected in the experiment.

      The authors investigate the concentration changes of the added nanoparticles under different conditions: In addition to the gradual dilution and shaking that is common in the production of homeopathic remedies, the bubbles are also produced by gassing or ultrasound between the dilution steps for comparison. The authors do not discuss what significance it would have for the production of homeopathic remedies according to their hypothesis that they measure that the concentrations of gold particles in the top layer decrease even more slowly under gassing than under shaking (comparison of figure 6 and 7 in the Chikramane paper). Nor do they discuss that of the three processes considered, fumigation is the one that produced the largest bubbles.

      Both figure 6 and 7, which show the progression of the concentrations of the bubbles introduced into the solution with the dilution, have logarithmic scaling. Therefore, a drop in concentration of less than one power of ten quickly appears as a “plateau” in such a representation.

      Although the results shown in Figures 6 and (especially) 7 of this paper show that the bubbles on the surface actually slow down the decrease in concentration of the gold nanoparticles in the uppermost liquid layer, they also show that this effect cannot support the hypotheses of Chikramane et al. from their 2010 publication: The last potentiation steps in the figure (the figure goes up to C15) already lower the concentration below the detection limit. However, a C15 is still many dilution steps away from the C30 and C200 considered in the original 2010 work.

      In general, the authors give no reason why they stopped their experiment at the C15, although according to their own statement, they want to provide an explanation with this article on how nanoparticles can hold up to the C30 or C200.
      The authors justify the very clear drop in concentration between C12 and C15, even in the logarithmic representation, by the difficulty of catching the top layer of the solution: In the model presented, the bubbles are supposed to produce a “mono-layer” of nanoparticles contained in the solution on the surface. Since this layer is very thin, it would be difficult to manually skim off this top 1% of the liquid volume and carry it over to the next dilution step [B 13] The fact that this actually leads their entire hypothesis ad absurdum is not discussed at all: In the production of homeopathic remedies, no meticulous attention is paid to removing the very top thin layer of the shaken solution. With the single glass method, the liquid that adheres to the vessel walls is simply poured off and reused. For the multi-glass method, there is no instruction as to where in the solution the reused amount of liquid should be removed. Hahnemann also did not leave any such instructions.”

      https://www.xn--homopedia-27a.eu/index.php/Artikel:Nanopartikel#Arbeit_von_Chikramane_2012

      As I said before, dear Dana, you have no idea about science in general and chemistry in particular.

      • The GWUP article, “INH,” must be a joke. Throughout the article they do not deny that such concentrations exist, their objections are insignificant details such as variations in the concentration of nanoparticles, which can be solved or minimized if the process is done in a controlled and careful manner.

        • See my comment below.

          You continue to cite this garbage. It only makes you look more foolish. You delude yourselves that you are building an evidence base. You are only finding fresh turds to add to your festering shit-heap.

          • “You continue to cite this garbage. It only makes you look more foolish. You delude yourselves that you are building an evidence base. You are only finding fresh turds to add to your festering shit-heap.”

            I need to remind you that you’re not a scientist, Lenny. Your point of view or opinion can be sent to the dumpster.

          • I need to remind you that you’re an anonymous who, as far as we know, is nothing

          • Hi again Lollypop/Lollypo

            Any progress on that thought process of yours?

          • Lollypopsykins my sweetest

            I am trained to degree level in science.

            Not that it means anything when deconstructing the fatuous claims of homeopaths. A twelve year old with a basic grasp of science could do that.

            What I state is not a point of view or an opinion. It is empirical fact.

            You could, of course, prove me wrong. And do so easily with some unarguable evidence but all you have is flimflam, handwaving, whataboutery and laughable bullshit.

            200 years of this, Pops.

            You’re being ignored. Laughed at. Held up as an example of delusional thinking. And with every post you make, you only get held up a little higher so even more people can laugh at you.

            You’re a rain-dancer, Pops.

          • Lenny: “Not that it means anything when deconstructing the fatuous claims of homeopaths. A twelve year old with a basic grasp of science could do that.”

            No joke. Emily Rosa was 11 when she ran a scientific trial to test the claims of energy healers. Got published in the Journal of the AMA. Remarkable what can be answered just by putting thoughtful testing before deeply-held beliefs.

            And how old are Humpty and the rest of his dismal crew again? Because you hope they’d be embarrassed at having an intellectual and emotional age less than an 11-year old girl.

          • Oh, the responses of Ernst’s supporters are when not funny, the laughing stock, especially Ernst’s, which disqualifies me for being anonymous while swallowing all the nonsense of several of his anonymous minions like “RPG” or “Lenny”. The other answers are better, Lenny says he has a degree in science but has not been able to share his articles or scientific works, besides that he never has a rational answer, because he seems to live on everything that is fecal matter, which is the only thing he repeats in every comment. And finally, ” Has” mentions an essay by Emily Rose, which was actually written by Stephen Barrett of “Quackwatch,” a very low-quality trial, n = 15 and n =13. An article that ends by advertising James Randi and does not mention that Stephen Barrett is part of CSICOP. “Has,” why don’t you tell your new friends that your friend Stephen also has a conflict of interest with the American Council on Science and Health, a Monsanto partner.

          • Ernst disqualifies me for being anonymous
            ????
            really?
            another of your fanatasies!

          • Lolly darling

            Wave those hands any harder and you’re going to hurt your wrists.

            You’re rather undermining your argument by remaining anonymous. And I’m fairly certain you have no scientific publications to your name which, by your own reasoning, means your comments can be ignored.

            And what’s Monsanto got to do with the nonsense that is homeopathy?

            Two hundred years of being laughed at by science, Pops. And still you continue to beat the dead horse.

            Anyway. As I say. That nailed-on clinical evidence, Pops. The unarguable proof. Strange how such a miraculously effective system of healing is unable to provide any. It’s almost as if there isn’t any, isn’t it?

            I’m sure that if yep there was, you’d have been happy to share it.

            We’ll wait. As we always do.

          • I am considering banning her (not sure why I assume she is feminine). she was very amusing for a while but now she is a complete troll.

          • And finally, ” Has” mentions an essay by Emily Rose, which was actually written by Stephen Barrett of “Quackwatch,” a very low-quality trial, n = 15 and n =13.

            Lollipop lies by misdirection and manipulation.

            1. Rosa designed and executed the trial (both testing sessions), and the resulting paper was authored by Barrett (who documented the second session), Rosa’s mother and stepfather, and Rosa, because that’s how most papers are authored: as collaborative works, where skills are combined.

            2. The small size of this trial is a non-issue as it was asking a simple unambiguous Yes or No question: Could TT practitioners detect another person’s “energy field” when blinded? Either they could or they couldn’t. Unlike testing therapies for most active diseases, there’s no complex confounders to muddy the signal (if any) with noise, which is the reason why large numbers are needed there.

            (A comparable example might be, say, testing a new treatment for a universally fatal disease such as rabies. You don’t need a big population to discern a signal there: either the treatment group all dies, or it doesn’t. Heck, it wouldn’t even need a live control group; a historical one would be quite sufficient.)

            In other words, Lollipop’s echolalia fools nobody here that already understands some basics of how and why science operates, and can apply a bit of logic and rigor to analysing a given scenario. She(?) might impress herself at her own cleverness, and no doubt Ullman and Hummer will be happy to apply tongue too, but it really is appalling what passes amongst them for rational [sic] thought, and vomiting it here is frankly an insult to everyone else.

    • Oh dear, Dana.

      It was eight years ago that Chikramane’s efforts at studying contaminants was published. You’ve been waving it around triumphantly ever since.

      Meanwhile, science has ignored it, as it does with any claims regarding homeopathy.

      Eight years, Dana.

      Plenty of time for it to have made an impact outside your little ship of fools.

      Hasn’t happened, has it?

      And remind us. These were just metal contaminants. How does this apply to homeopathic light of venus, dolphin sonar and all the rest?

      • Oh yes…let’s ignore ALL research that is 8 years old or older!??

        And yes, homeopathic medicines are “contaminated” with the same ingredient that was its starting material AND that is listed on each bottle.

        Hmmm, methinks you are speaking from your back-side (which, in this case, is your most articulate side).

        • “let’s ignore ALL research that is 8 years old or older”
          If it relates to something that would otherwise be a scientific sensation, one can probably safely discard * year old research. this is a self-cleansing mechanism within science that has shown itself to be quite useful in preventing people barking up the wrong tree.

          • Prof Ernst is correct, Dana. But don’t just take his word for it; here is what Mathie et al say themselves:

            Better designed and more rigorous RCTs are needed in order to develop an evidence base that can decisively provide reliable effect estimates of non-individualised homeopathic treatment.

            You’ve had 8 years to do those followup trials. So either you’ve done them and they didn’t give you the answer you wanted, so you’ve suppressed their results; or you’ve not done them because you already have the answer you sought, and don’t want to risk getting a better-quality result that refutes it.

            Once again, all you seek is validation. You are simply not willing to prove yourself wrong. That is not science; that is Religion. And you are a vaunted high priest of it, so why can’t you be satisfied with that?

        • That’s right, Dana. Grab the wrong end of the stick, same as always you foolish man. If you could point out exactly where I said that all evidence over a certain age should be ignored?

          You can’t because I didn’t, did I?

          You and your reading and comprehension skills, Dana. It’s becoming more of a problem.

          Chikramane et al was recognised for the irrelevant garbage it is and was ignored from the moment it was published. Apart from a few imbeciles who imagined it validated their belief in the magic power of shaken water.

          And that starting material – as I said, Dana. Light Of Venus. Dolphin Sonar. Any traces of them left?

        • Your sensational study is for the trash can, Ullmann.
          It is full of contradictions, faulty assumptions and conclusions.
          Its results could not be replicated.

          Furthermore, I consider that you have no idea about natural science and study design.

    • Oh, dear. You need to find another line of argument, Dana. This one’s spent 🙂

      What amateur electronmicroscopist Chikramane found was dust and dirt, which he interpreted without switching his brain on. Real scientists know how to clean their instruments and analyse what they find.

  • 1.

    “(As it happens, I have reviewed these papers here and come to very different conclusions)”

    The meta-analysis of Linde and Cucherat are included in the Hahn analysis, which is also included in the Frass review with the Mathie’s metaanalysis. Ernst, in your post you just say that:

    ” my conclusions from all this: some systematic reviews and meta-analyses do suggest that the test data is positive. However, everyone warns that such a result could be false positive. None of these documents provide anything close to a test of the effectiveness of homeopathy. Homeopathy has been shown to be nothing more than placebo therapy. Making statements to the contrary is dishonest.”

    Your comment of opinion is contradictory, on the one hand you say that these three meta-analyses suggest that homeopathy is better than placebo, but then you say that none has shown that it is better than placebo. The exposed trap can be removed simply if removing your opinion.

    2.

    “There are virtually dozens of systematic reviews which the authors decided to ignore. Here are just six of them: … homoeopathy as a whole may be considered as a placebo treatment. We tested whether p-curve accurately rejects the evidential value of significant results obtained in placebo-controlled clinical trials of homeopathic ultramolecular dilutions. Our results suggest that p-curve can accurately detect when sets of statistically significant results lack evidential value. We found no evidence to support the efficacy of homeopathic medicinal products
    … no firm conclusions regarding the effectiveness and safety of homeopathy for the treatment of IBS can be drawn.
    Due to both qualitative and quantitative inadequacies, proofs supporting individualized homeopathy remained inconclusive. … the use of homeopathy currently cannot claim to have sufficient prognostic validity where efficacy is concerned.”

    Ernst, I read the Frass review and I can conclude that you are the dishonest one since some of those reviews were included in the Frass review.

    *Mathie’s reviews published in 2017 is included.
    *Hawke’s Cochrane review published in 2018 is inclued.
    *Peckham’s review is included.
    *Doehring’s review is included.

    What about the another reviews not included?

    https://pubmed.ncbi.nlm.nih.gov/30456773/
    16 positive systematic reviews were included, nine of these were of high quality. Interestingly, the authors excluded without any reason many positive reviews.

    https://pubmed.ncbi.nlm.nih.gov/30893676/
    This review is very positive:

    Most of them were double blind, randomized, parallel arm, and placebo controlled, and homeopathy was mostly used as additive to standard care. The majority of the studies were positive, and the level of evidence could be graded as A (strong scientific evidence). All the controlled trials testing complex homeopathic products were funded and yielded positive results, thus raising additional concern regarding whether these studies were free from vested interest or not. Proof in support of individualized homeopathy remained equivocal and inconclusive.

    https://pubmed.ncbi.nlm.nih.gov/30697492/
    This review should be a joke, the authors do not seem to have understood that the conclusion depends on the set of studies analyzed. In page 8, they said:

    “Another weakness of our analysis is the assumed impotence of homeopathic ultramolecular dilutions. Many proposed mechanisms of action for ultramolecular dilutions have been published, including but not limited to molecular clustering (Samal & Geckeler, 2001), oscillatory effects (Hyland & Lewith, 2002), non-local quantum effects (Weingartner, 2005), and nanobubble-induced superstructures (Demangeat, 2018). However, proposed mechanisms of action for such dilutions are either implausible within the framework of currently known physical laws or would require fundamental revisions to basic sciences such as Biochemistry or Physics (Sehon & Stanley, 2010; Grimes, 2012).”

    The authors simply disqualify a review by Dr. Demangeat published in 2018 and are left with an opinion article by Grimmes, who is a collaborator of yours Ernst, and with the opinions of Sehon and Stanley. Then, after excluding that review, they decide to take a few positive clinical trials and do a P-curve test, that is biased. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0149144

    • ” I can conclude that you are the dishonest one”
      oh really

    • Hi Lollypop!

      Any progress on answering this? I’m sure I’m not the only one on tenterhooks waiting for you to reveal your thought processes.

    • As ever, Lolly.

      Handwaving and special pleading.

      It would be so, so easy for you to shut us all up by giving us a couple of decent, replicated trials which show just how well homeopathy works. You know. The ones we’ve been waiting for for the last 200 years.

      Maybe a few trials showing how homeopaths under blinded conditions can identify different remedies. Should be easy enough to do given how effective Roger claims provings to be.

      Maybe even a few properly blinded and controlled provings.

      The last two don’t need industry funding, Lols. If they do, I’m sure Boiron would be happy to help.

      We’ll wait for the results.

    • Pops,
      Sometimes I like to follow up on posted citations…

      Your own citation and comment:
      “https://pubmed.ncbi.nlm.nih.gov/30893676/
      This review is very positive:”

      …was not very positive at all. The authors in that article conclude that the _qualitative_ impression was interesting but:
      “Though few trials were rated as 1a or 1b, they still suffered from many important caveats including inadequate power and sample size and less robust designs in terms of randomization, blinding, and choice of outcome measures. Independent replications and further evaluation in appropriate and rigorous designs are warranted.”

      and

      ” they are not adequately supported by level A evidence.”

      And that’s the problem in a nutshell isn’t it?

      If this is representative of your other “homeopathy-positive” citations I am unimpressed. To paraphrase an old quotation, I can’t define all aspects of dishonesty but I know it when I see it.

      • “If this is representative of your other “homeopathy-positive” citations I am unimpressed. To paraphrase an old quotation, I can’t define all aspects of dishonesty but I know it when I see it.”

        How wonderful, accusing me of dishonesty because I proved Ernst was the one who didn’t read Frass’s review! Being kind, the two reviews you mention are positive, but like any review there are always caveats or shortcomings, it’s a normal way to advance in science.

  • Useless piece of opinion and bad ad hominem trying to compare my arguments with creationists.

    • My search in this thread says: You are the first who is talking about “creationism” or rather “creationists.”

      But unconsciously you have had a brilliant idea. For homeopathy is to evidence-based medicine what creationism is to evolution: a credo without any scientific basis.

      I applaud you for this realization.

      • “But unconsciously you have had a brilliant idea. For homeopathy is to evidence-based medicine what creationism is to evolution: a credo without any scientific basis.”

        Everything you say sounds convincing to a journalist who wants to write a yellowing note, except it’s stupid. Homeopathy does not deny evolution, and while creationism has some works, they are very few compared to the volume of evidence published about homeopathy, so much so that even your guru Ernst’s own works have confirmed dozens of times that homeopathy works better than a placebo. Go back to the school kid!

        • Hey! Lollypop.

          You seemed to have missed backing up your nasty allegations!

          Maybe you didn’t actually have a train of thought when you spouted that?

        • Lol.

          The “volume of evidence published about homeopathy” has the same value as the “volume of evidence published about creationism/intelligent design”: Almost nothing. Both are useful as toilet paper or for lighting fireplaces.

          Go back to your retirement home, pop, have a refreshing homeopathic herbal tea sweetened with globuli.

          • Comparing homeopathy to creationism confirms the total BANKRUPCY of the skeptics’ point of view.

            Homeopathy has hundreds of studies published in peer-review medical journals, including the Lancet, BMJ, Pediatrics, Rheumatology, Chest, Pediatrics Infectious Disease Journal, and many many more.

            The extremist point of view of skeptics is stuck in the rotary phone era. Whose the POPS here?

          • “Homeopathy has hundreds of studies published in peer-review medical journals, including the Lancet, BMJ, Pediatrics, Rheumatology, Chest, Pediatrics Infectious Disease Journal, and many many more.”
            TRUE
            But the totality of this evidence fails to demonstrate that homeopathics are more than placebos.

          • So says the deaf, dumb, and blind man with the big axe to grind in his hands.

            And so says the man who cites studies and when he can’t provide adequate critique, he simply says that the researchers must be cheating or goes back to the old and tired and now disproven claim that the mechanism of action is unknown.

          • thanks for demonstrating yet again that you have no real arguments

          • Dullman: “hundreds”

            ?????

            There are 30 million papers on PubMed. No wonder you buy homeopathy: you have absolutely NO understanding of scale at all.

          • GAD…You bring daftness to a whole new level.

            Conventional medical research “proves” that its treatments work until the next decade when they show that they don’t work as much as they thought…and then the next decade shows that the drug causes more harm than good. It is no wonder that there is so much research…because they consistently show how dangerous conventional drugs are.

            As for homeopathics, these medicines can’t be patented and are dirt-cheap.

            In any case, thanx for confirming that there are hundreds of clinical trials showing the efficacy of homeopathy AND their safety!

          • Oh Dana

            Comparing homeopathy to creationism confirms the total BANKRUPCY of the skeptics’ point of view.

            Homeopathy has hundreds of studies published in peer-review medical journals, including the Lancet, BMJ, Pediatrics, Rheumatology, Chest, Pediatrics Infectious Disease Journal, and many many more.

            Not the places you normally look for articles relating to evolutionary biology, Dana. Not that you read any of those journals.

            Creationists, like homeopaths, have had pieces published in plenty of leading journals. And, like the ones the homeopaths get published, they show absolutely nothing to prove the preposterous claims of the authors.

            Homeopathy and creationism are very similar, Dana. Faith-based, scientifically-implausible garbage regarded as an irellevant amusement by realists. Both are reliant on the use of junk science and logical fallacy to try to support their arguments, both delight in claiming the support of Nobel laureates.

            Homeopathy and creationism do differ in one fundamental way though, Dana. 40% of your fellow US citizens believe in creation theory yet not even these credulous halfwits are thick enough to believe in magic shaken water.

            There you go, Dana. I’ve got a new slogan for you:

            “Homeopathy!

            Too stupid even for creationists!”

            THAT daft, Dana.

            Like you.

          • Dana: “Conventional medical research “proves” that its treatments work until the next decade when they show that they don’t work as much as they thought…and then the next decade shows that the drug causes more harm than good. It is no wonder that there is so much research…because they consistently show how dangerous conventional drugs are.”

            And you have the PubMed citations to back up all these assertions, yes? Because that which is claimed without any evidence can be dismissed just as easily.

            Real medicine is all about balancing costs against benefits. All drugs have (multiple) effects, some of which are desirable; others not. (And not always the same way round either, depending on the disease being treated.) While it’d be wonderful if 100% of medical treatments were 100% effective and 100% safe, out here in reality nothing is ever perfect and we do the best with what we currently have, while always working to improve further. Only a fool or a manipulator interprets self-criticism and self-correction as a sign of weakness. And only a crook or a loon sells a magical bullet that cannot harm and cures all ills. So I wonder, Mr Ullman, which are you?

          • I think you already used all these sentences and comment texts several times before, Dana. Are you all out of original ideas for your boilerplate rants?

          • Björn: “Are you all out of original ideas”

            You meant “citations to high-quality double-blinded RCTs showing statistically significant effects above and beyond placebo” shurely?

            Although I’m quite certain Dana just picks the ones that say exactly what he wants to hear and ignores what all the rest are telling him. Then, when that cherry-picking fails to impress anyone else, resorts to Humpty Dumptyism and throwing his own poop. And this is what homeopathy sends as the representative for its cause? Not exactly a Cool Pope.

          • “As for homeopathics, these medicines can’t be patented and are dirt-cheap.”

            1 kg Arnica C 30 Globuli: 620 €
            1 kg refined sugar: 0,76 €

            Every drug dealer dreams of such margins. Profits from homeopathic remedies are dirty money.

          • @RPGNo1: Ouch. Poor Dana, hoist by his own profit margin!

    • If the hat fits, Pops, you’re going to have to get used to wearing it.

Leave a Reply to Lollypop Cancel reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Subscribe via email

Enter your email address to receive notifications of new blog posts by email.

Recent Comments

Note that comments can be edited for up to five minutes after they are first submitted but you must tick the box: “Save my name, email, and website in this browser for the next time I comment.”

The most recent comments from all posts can be seen here.

Archives
Categories