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

There are plenty of people who find it hard to accept that highly diluted homeopathic remedies are placebos. They religiously believe in the notion that homeopathy works and studiously ignore the overwhelming evidence (plus a few laws of nature). Yet, they pretend to staunchly believe in science and keep on conducting (pseudo?) scientific studies of homeopathy. To me, this seems oddly schizophrenic because, on the one hand, they seem to accept science by conducting trials, while, on the other hand, they reject science by negating the scientific consensus.

The objective of this recent study was to evaluate the quality of life (QoL) of women treated with homeopathy within the Public Health System of Belo Horizonte, Brazil.

The study was designed as a prospective randomized controlled pragmatic trial. The patients were divided into two independent groups, one group underwent homeopathic treatment during a 6-month period, while the other did not receive any homeopathic treatment. In both randomized groups, patients maintained their conventional medical treatment as necessary. The World Health Organization Quality of Life abbreviated questionnaire (WHOQOL-BREF) was used for QoL analysis prior to treatment and 6 months later.

Randomization was successful in that it resulted in similar baseline results in three domains of QoL analysis for both groups. After 6 months’ treatment, the investigators noted a statistically significant difference between groups in the physical domain of WHOQOL-BREF: the average score improved to 63.6 ± (SD) 15.8 in the homeopathy group, compared with 53.1 ± (SD) 16.7 in the control group.

The authors concluded that homeopathic treatment showed a positive impact at 6 months on the QoL of women with chronic diseases. Further studies should be performed to determine the long-term effects of homeopathic treatment on QoL and its determinant factors.

I would not be surprised if the world of homeopathy were to celebrate this trial as yet another proof that homeopathy is effective. I am afraid, however, that I might have to put a damper on their excitement:

THIS STUDY DOES NOT SHOW WHAT YOU THINK IT DOES.

Why not?

Regular readers of this blog will have already guessed it: the trail follows the infamous ‘A+B versus B’ design. Some people will think that I am obsessed with this theme – but I am not; it’s just that, in SCAM, it comes up with such depressing regularity. And as this blog is mainly about commenting on newly published research, I am unable to avoid the subject.

So, let me explain it again.

Think of it in monetary terms: you have an amount X, your friend has the same amount X plus an extra sum Y. Who do you think has more money? You don’t need to be a genius to guess, do you?

The same happens in the above ‘A+B versus B’ trial:

  • the patients in group 1 received homeopathy (A) plus usual care (B);
  • the patients in group 2 received usual care (B) and nothing else.

You don’t need to be a genius to guess who might have the better outcomes.

Because of homeopathy?

No! Because of the patients’ expectation, the placebo effect, and the extra attention of the homeopaths. They call this trial design ‘pragmatic’. I feel it is an attempt to mislead the public.

So, allow me to re-write the authors’ conclusion as follows:

The effect of a homeopathic consultation and the administration of a placebo generated a positive impact at 6 months on the QoL of women with chronic diseases. This was entirely predictable and totally unrelated to homeopathy. Further studies to determine the long-term effects of homeopathic treatment on QoL and its determinant factors are not needed.

 

7 Responses to Homeopathic Treatment of Women with Chronic Diseases: a new ‘pragmatic’ trial

  • This is yet another depressing attempt by homeopaths to use so-called research to dupe the public into believing in their pathetic SCAM by duplicitous means. They are past masters at this particular trial design and at maximising the placebo effect to make it appear that their utterly useless “remedies” have some minimal effects.

    The potential for harm by having people delay or forego effective treatment while they are instead taking some useless diluted nonsense is very real. What is also very real is the way they pollute the world of information with their babble and confuse the public with all this misinformation.

    It is beyond time definitive legal action was taken to stop them practising altogether and remove this form of deceptive practice from the public sphere of health altogether,

  • I am sure it would have been easy enough to do a blinded trial of Sham A (dummy homeopathy pills) + B (conv. treatment) versus Real A (genuine homeopathy pills) + B (conv. treatment). That, one feels, would be more revealing.

    And of course a simple randomised blinded A+B would be more revealing again, and entirely unethical.

  • The confidence interval, plus and minus one SD, includes both average scores which to me is no significant difference.
    Also what was the baseline score at the beginning? Is the end score significantly different from from it?

    • I don’t think they were confidence intervals, which are usually about two standard deviations, not one. The standard deviation is a measure of how wide the spread of the data is. Though it is a bit confusing to report it as +/- (SD) as the plus and minus signs are superfluous here.

      Apart from that I completely agree with you.

  • I’d love to know what would have happened is the non-homeopathic group were given a sugar pill. Would both groups come out the same?

  • Your explanation is ridiculous, a few months ago you commented on a clinical trial in which the authors used the A + B design and did not find that homeopathy improves the quality of life in asthma. Another counterexample that refutes you is the clinical trial published in the Oncologist, in this trial A (standard therapy) + B (placebo) and A + B’ (homeopathy) were used, but the A + B’ group exhibited higher survival than the A + B group.

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