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

By guest blogger Les Rose

This is a follow-up to Edzard’s post back in October last year, about a paper by Christina Ross, entitled “Energy Medicine: Current Status and Future Perspectives”. You will see from the post, and from the paper itself, that it is a curious mish-mash of scraps of real science and a large volume of speculative and invented garbage. Its opening gambit majors on physics, which caught the attention of Richard Rasker, who has a background in medical instrumentation, and whose comments were insightful and excoriating.

Edzard and I wrote to the editors of the journal, pointing out the paper’s misleading content and requesting a retraction. In particular, we asked if the paper had been reviewed by a physicist. Here is what they responded:

“This paper underwent appropriate scientific peer review. We don’t intend to retract the paper, but we encourage you to submit an official Letter to the Editor through the Journal’s website. This approach would give the author of this paper the opportunity to respond to your critiques.”

This was received on 28th October 2020. Note that they did not answer our question about a review by a physicist. The journal limits letters to 500 words, and the paper warranted rather more analysis than that, so in partnership with Richard, we posted a detailed critique on my own blog. The plan was to refer to the blog post in the letter, which we submitted on 12th November. We suggested that the paper’s poor scientific underpinnings (to put it mildly) should be sufficient reason for retraction. At the very least, we requested that our critique and the paper itself be subjected to proper scientific review, and that our letter be published alongside the paper. Well here we are five months later and still, our letter has not been published.

The journal Global Advances in Health and Medicine specialises in so-called `integrative medicine’, which is a euphemism for shoehorning quackery into mainstream practice without the inconvenience of doing rigorous research. It publishes papers on such groundbreaking disciplines as shamanic journeying and intention host devices. The joint editors are in post at Wake Forest School of Medicine, where Christina L Ross, the author of the paper at issue, is on the staff.

But let’s return to the main story. Our letter was submitted in the usual way via the Manuscript Central website, and its status remains at `awaiting reviewer selection’. We have never heard of a letter to the editor requiring peer review. One month after submitting it, ie 12th December, SAGE Publishing finally acknowledged receiving our letter, and told us it was under review from their legal team and their editors. It seemed odd that it needed legal review. I replied thus on 20th December:

“Thanks for the update. We wrote directly to the editors asking them to retract the paper, but they refused, and advised us to write a letter for publication. This was so that the author could reply publicly. We still want that to happen. I am not sure why this is a legal matter, it is about science. In the interests of transparency, please tell us when our letter will be published.”

By 9th January 2021, there was no reply to this, so I chased up SAGE Publishing, who replied on 12th:

“The status in the system is misleading, as your Letter is not in need of any peer review. As you are aware, SAGE provides Editors and/or authors with the opportunity to respond to any Letters we receive. If they choose to do so, it is our policy that the Letter and any responses are published together all at once. However, before any adequate response can be put together, an investigation of the issues raised must first be completed. Although you are correct that this is not a Legal matter,

the nature of the complaints we have received prompted us to seek their guidance, and we will be publishing a Statement of Concern on this article while finishing this investigation. Your Letter has been waiting out this process, which unfortunately has taken slightly longer than usual due to all of the recent holidays and office closures. I do appreciate that you are anxious to see this matter resolved, and am sorry for any further frustration this has caused. The original author has been given a deadline to provide her comments, and upon receiving her response, your Letter will be published immediately. I expect this will happen within the next 2-3 weeks, but can certainly keep you updated going forward.”

The emphasis is mine. I asked what happens if the author doesn’t wish to respond, and was told that “we would then move forward with publishing your Letter on its own”. The deadline for the author to respond was stated to be “the end of next week”, ie 22nd January. So I was fully expecting the letter to be published a few days after that, and certainly by the end of January. But on 27th I was told that the author did not want to respond, and that they “do not yet have a firm publication date to share, but I have a meeting to discuss this with the Editors this week”. So the assurance highlighted above, about immediate publication, was valueless.

A few days later, on 31st January, an expression of concern was published, stating that several(!) complaints about the science of the paper had been received. By 17th February I was getting somewhat exasperated, and wrote again to the publishing editor:

“I am trying to be patient, but I really don’t see why a letter to the editors can take months to be published, in this day and age. Other journals such as the BMJ publish rapid responses in hours. I realise that our letter is critical of your journal’s peer review process, but delaying publication for so long does not look good. Surely you can publish the letter and respond in some way as publisher of the article in question? Some sort of response seems appropriate, in view of the original author’s silence. As we have raised this issue, readers may well appreciate some insight into your peer review process.

“I note that the journal’s editors are colleagues of the author. How do you manage this conflict of interest?”

The publishing editor did not reply directly to this, and passed it to the joint editor in chief Professor Remy Coeytaux. After a further two weeks I still had not heard anything from either party, so again I chased them up. The reply from Professor Coeytaux on 3rd March is worth reading in full:

“I ask for your forgiveness and understanding for the time this process is taking. By way of introduction and explanation, I am the co-Editor-in-Chief who has collaborated with Dr. Christina Ross in the past. Our other co-Editor-in-Chief, Dr. Suzanne Danhauer, has no relationship with the author of the paper in question. As is typical for medical journals, Global Advances in Health and Medicine does not have a policy that precludes members of the same academic institution as the Editors-in-Chief from submitting manuscripts for review and possible publication.

“Manuscripts submitted to the Journal are assigned to either Dr. Danhauer or myself. We then assign the manuscripts to Associate Editors as indicated. Dr. Ross’ manuscript was assigned to Dr. Danhauer. I had no role whatsoever in the peer review process or decision making for this manuscript. Throughout that process, there was no conflict of interest to manage. To re-iterate, Dr. Danhauer had no conflict with Dr. Ross and I had no involvement in any way or at any time in or with the peer review process.

“All of us at the Journal are taking your concerns seriously. Dr. Danhauer and I have complementary scientific expertise. She is a psychologist by training, while I am a physician and epidemiologist by training. We decided that I should be the one to manage the process of arriving at the most appropriate resolution to the concerns that you have brought to our attention. Your Letter to the Editor was assigned to me, and I am personally managing the process of seeking independent input from an additional set of peer reviewers for Dr. Ross’ original paper. By “personally,” I mean that I have not relegated this important task to one of our Associate Editors.

“We have very nearly completed the process on our end. We are awaiting the comments of one final peer reviewer. We expect to have that process completed within the next three weeks.

“I should also note that we believe it is appropriate for us to wait to publish your Letter to the Editor until we have completed our internal review process that we initiated in response to your concerns. It is for this reason that we have not yet published your Letter. I would like to take this opportunity to ask you, please, to send me another copy of your Letter to the Editor after deleting the reference to the internet link. It is the Journal’s policy to not publish such links. I would like to ask you, please, to send the revised letter to me directly in a PDF format via email attachment.

“Thank you for engaging in this scientific discourse and for your patience during the process.”

Some of this is very odd. He admits to being Ross’ collaborator but says this is not a conflict of interest. The journal’s instructions for authors do not say anything about `internet links’. It is perfectly normal for academic papers to use URLs as references. This looks suspiciously like an exercise in damage limitation. Hence I deleted the embedded hyperlink in the text and added the URL as a reference at the end. I replied the next day, and asked whether the current peer reviewers include those from outside the field of complementary and/or alternative medicine. I have not heard anything further from Professor Coeytaux or the publisher.

Is it really so time-consuming to find an authoritative reviewer? I put the word out, and got a response from Professor Jim Al-Khalili OBE FRS FinstP. He is a very well-known TV presenter on science topics, and as well as an eminent physicist and a professor for the public engagement in science. He could not be more appropriate to review this paper, and here is what he said:

“This notion that the body has ‘different kinds of energy’ is utter nonsense and a clear sign that someone does not have a firm background in science. If we do want to explore what different kinds of energy living organisms have then we can say there is kinetic energy due to macroscopic motion controlled by, say, muscles, then there is thermal energy due to vibrations of the molecules within our cells, chemical energy due to the thousands of biochemical reactions taking place inside cells, and finally electromagnetic energy from for example, the tiny induced magnetic fields due to moving charged particles in ion channels. None of these forms of energy is mysterious and the wording in this paper referring to detecting ‘subtle energies’ or resonances is utterly unscientific. While scanners, such as MRI, x-ray, PET or CT machines can image the body by measuring interactions with, for example, magnetic fields or responses to bombarding electromagnetic radiation, there is no mystery here. We know how they work. After all, it was physicists who invented these machines based on our understanding of the laws of physics. To buy into any of the notions in this paper would mean that the whole edifice of modern physics has to be demolished and rebuilt. And if anyone thinks that may be necessary then I would argue they really have not studied science at all and do not understand the scientific method.

“Basically, the science that this paper challenges is the very science that has allowed us to understand the workings of the body in the first place. You cannot call upon science (quantum field theory) to justify unscientific ideas that would mean that quantum field theory has to be thrown away. Also, using scientific jargon to make something sound clever when it’s not should not fool anyone, and certainly not serious scientific research journals.”

One has to wonder how Ross obtained a degree in physics. I sent this to Professor Coeytaux on 22nd March, pointing out how quick and easy it was to get such a review. I said that the paper had obviously not received “appropriate scientific review”, and asked for a response by return explaining the status of our letter. You guessed it, I have heard nothing.

I always try to go for the ball and not the player, but it’s worth looking in a bit more detail at Christina Ross’ academic credentials. She styles herself as Dr, but her PhD is from Akamai University in Hawaii. Although the university proudly displays a statement of accreditation, it is from the Accreditation Service for International Schools Colleges and Universities (ASIC). This is not listed by the US Department of Education as a recognised accreditation body. It is actually a UK company that validates visas for international students, but its credibility is quite doubtful:

“The legitimacy of ASIC’s international accreditation service is unclear and some of its internationally-accredited institutions have been deemed ‘diploma mills’ offering worthless qualifications.”

Ross is also a `Board Certified Polarity Practitioner’. Americans love the term `board certified’, it lends considerable gravitas. But anyone can set up a board and issue certificates. What is polarity therapy? Well, as is usual with quackery, it is a personality cult, which combines various evidence-free modalities and doesn’t clearly say what use it is. I don’t think I need to look into `Certified Energy Medicine Practitioner’ any further.

So this is what happens when pseudoscience is called out in academia. SAGE Publishing is obviously not a bit concerned about science, despite their assurances, or they would never have launched a journal such as this. The editors do not worry about conflicts of interest or scientific evidence. They try to obfuscate when detailed criticism is published. The author does not even attempt to defend what she has written. I assume all of them are hoping that we will get weary of this and give up. They are wrong about that as well.

66 Responses to This is what happens when pseudoscience is called out in academia

  • It is worth pointing out that the move towards Integrated Health as far as the UK is concerned anyway, is based on only three registers for non-medical practitioners accredited by the Professional Standards Authority. The registers are as follows:
    The British Acupuncture Council , The Complementary & Natural Healthcare Council, & the Federation of Holistic Therapists. Registrants are only accepted if they offer evidence based treatments, do not make false medical claims, maintain the highest professional standards and are fully insured.
    All this information is freely available on the NHS website https://www.nhs.uk/conditions/complementary-and-alternative-medicine/

    • I can’t see how this is relevant to the post, but please observe the conditions for commenting here. What is the evidence that these registers require evidence based practice?

      • The NHS only accepts Evidence Based practitioners

        • That is not entirely true, and doesn’t answer the question. Please provide a quote from the conditions of membership from any of the registers you mention, that shows they demand evidence based clinical practice.

        • Which may be why that NHS webpage that you linked to says:
          “The availability of CAMs on the NHS is limited, and in most cases the NHS will not offer such treatments.”
          and
          “Some complementary and alternative medicines or treatments are based on principles and an evidence base that are not recognised by the majority of independent scientists.”

          somehow i don’t think that page means what you seem to think it does.

        • That’s circular logic, and is false.

    • This is certainly not the case.

      There’s no “move” towards “Integrated Health”, just a lot of hot air from certain people, often with something to sell.

      The idea that BAcC, CNHC and FHT only accept registrants who offer evidence based treatments etc is very wrong. For example, NICE guidance on allergy testing states that things like hair mineral analysis, kinesiology and bioresonance testing are “do not do”. Some members of these registers offer these bogus tests yet the registers don’t seem to be overly concerned.

      The PSA is currently reviewing the Accredited Registers scheme and one thing they are looking at is whether ARs need to provide evidence of efficacy for the modalities they represent.

  • You don’t say why you thought it worth pointing this out or what relevance you believe it had to the post, but the PSA certainly doesn’t care what evidence there is – or isn’t – for the practices of those on the registers it accredits and I’m not sure we can rely on the trade bodies you mentioned to be impartial. And there are many other quacks purporting to provide ‘integrated health’ practices.

    • If you don’t trust the governance of your own country , then society falls apart. Would you apply the same argument to the General Medical Council? The relevance to the article is that a comment was made that suggests there is no regulation of CAM. Patients look for CAM practitioners on the accredited registers as they believe this is safe & regulated.

      • I don’t think I said there is no regulation of CAM, and the post is about a US university not the UK NHS.

      • LOL!

        As I said, the PSA do not consider – and make no pronouncement on – the efficacy or safety of any practice carried out by anyone on any of their Accredited Registers. If the general public believe that being regulated by the PSA means the practice is safe and effective then it is a failing of the registers and the PSA to make the actual position clear.

      • @ David Harrison

        the alleged “accreditation” provided by these means is WORTHLESS!

        What they class as “evidence based” is meaningless.
        You should be aware that until very recently the PSA accredited Homeopathy – the worst quackery of them all.
        Where is the evidence base for that?

        “Integrated medicine” is a sham and a trick to get SCAM into conventional medicine by the back door.
        This should be resisted in the strongest possible manner.

        If a treatment works then it is medicine. If it doesn’t then it is just bogus.
        There is no need for an “alternative” category.

        That is why we don’t have “alternative” architecture, car mechanics, engineering, aeronautics etc.
        This ought to be blindingly obvious.

  • Dont give up. You are promised an LTE and a Statement of Concern. Retraction must still surely be on the cards? (I mean of the journal, not this particular paper, or even of the field from the PSA?).

  • Poor Richard, after insisting as his colleague Alan Henness, has realized that the scientific journal Global advances to which he sent his complaint will not yield to his senseless pressures. This may be because after the various, mostly unjustified, retractions in which they have participated, editors have begun to realize that “scientific skepticism” is not science, but a cult based on censorship. By the way, Ernst says that Richard is a “specialist in medical instrumentation”, but he is extremely suspicious that when searching for the name “Richard Rasker” there is not a single publication of him, nor patents or anything, the only thing that is about him are comments on blogs like “Science-Based Medicine”.

    • Indeed, I have no scientific credentials or other articles to my name. However, I do have a fair amount of knowledge in the fields of physics, electronics, biomedical engineering, and chemistry. I also run a small but quite successful business in electronics engineering, specializing in biomedical applications.

      However, none of this really matters, as even a moderately bright high school student can see that Mrs. Ross’ paper is rife with errors, unscientific claims, and unproven assumptions.

      … that “scientific skepticism” is not science, but a cult based on censorship.

      If a paper is retracted, it is not taken offline or otherwise made inaccessible. It merely receives the label ‘RETRACTED’ alongside proper motivation for the retraction, so that anyone can see why it is retracted. The original authors are also invited to provide extra explanations, corrections or a rebuttal beforehand, which may prevent retraction.
      This has nothing to do with censorship; this is how good science works.

      Ironically, the only censorship so far appears to pertain to our criticism: even after almost 6 months, our letter to the editor is still not published, our questions in connection to that letter are not addressed at all, and Mrs. Ross appears unwilling to engage in any discussion with regard to the scientific merits of her work (or the lack thereof).
      If that lack of a response is motivated by my lack of proper credentials, I can understand – but that still does not mean that what I say is untrue, and that her work is above criticism. Hence our decision to have a ‘second opinion’ from an esteemed physicist, who so far appears to fully affirm my assessment.

      • “I have no scientific credentials or other articles to my name”

        This says a lot about you, Richard. You write a blog on the Internet, you don’t understand what the article says (even in the comments section of your blog to see that you were pretty bad and ridiculous), and now you victimizas because publishers do not want to publish your letter because you do not have credentials. Was it not Ernst himself who in several comments dismissed criticism because he believes that all his critics lack credentials or belong to the “demonic homeopathic lobby”?

    • @Censored by Ernst
      The post was by me not Edzard. Have you actually read the paper at issue? Do you think that Jim Al-Khalili is wrong? Have you even read this post carefully? The editors are not simply resisting pressure, they agreed to publish our letter and now make excuses. If they wanted to reject the letter they could have done so 5 months ago instead of spinning this out in the hope we will go away. We will not.

      I don’t recall participating in any retractions. But if any occurred, please tell us why they were unjustified. We will need the journal citation and the link to the retraction.

      Why does Richard have to have a publishing record? He is not the one making claims about science and health.

      Your handle on this site is not clever or funny.

    • @Richard

      Have you any idea what he’s on about?

      • Hi Alan,
        Admittedly, I’m not quite sure, but this ‘Censored by Ernst’ person seems an obsessive homeopathy proponent, or at least someone who has gone through the trouble of digging up the most prominent names and papers defending homeopathy – even though homeopathy is only mentioned once in Mrs. Ross’ paper.

        This person is most probably one and the same as ‘Mp3 Jukebox’ who posted similar comments at the bottom of Les Rose’s blog page with the original detailed critique.

        Anyway, the efforts made to provoke others by totally ignoring any actual science and resorting to ad hominems instead suggests that we’re dealing with a troll. No problem there, we know how to handle trolls.

        • I have disallowed several of his comments that were overtly insulting the rest has considerable amusement value, I think.
          But if he does not change, I’ll block him.

    • @ Censored by Ernst

      logical fallacy = appeal to authority. If his arguments are correct his credentials are irrelevant.

      Have you read the paper? It is unadulterated hogwash. It is completely science-free garbage.
      The woman wouldn’t know recognize an electron if one bit her on the ass. Her knowledge of quantum physics would fit on a postage stamp with lots of room to spare.
      The entire paper is a complete embarrassment.

      That it is taking so long to retract is simply unbelievable. What is even more unbelievable is that it was published in the first place. That it passed any kind of peer review is only credible if she was either related to the reviewers or large amounts of dosh changed hands or the reviewers were as completely ignorant of physics as she evidently is – take your pick. Given the title of the journal obviously number 3 is the favourite.

      Alt-meds are always invoking quantum physics to justify their favourite modalities – it just doesn’t mean what they think it does. This isn’t about censorship – it is about retracting a paper that so bad it’s not even wrong!

  • Jim Al-Khalili has expressed different comments against homeopathy, in one of his books he even goes so far as to say nonsense. Do you think Jim can send Nobel Laureate Brian Josephson, theoretical physicist Alexander Tournier, theoretical chemist Marc Henry and physicist Stephan Baumgartner to study quantum physics? They are also doctors in physics. Now, regarding Ross’s article is well referenced, if you can question his interpretation of the chakras, the rest is well grounded in literature that is gradually becoming mainstream. I am not surprised that your letter is rejected (take the example of Alan Henness). I have seen how a group of so-called skeptics spend their miserable lives sending letters to the editor to retract good homeopathy articles published in mainstream journals, so they retracted two articles in Plos One, even though there was no mistake in the methodology, Plos One rectrat them because the Russian mathematician Alexander Panchin made cries and tantrums claiming that the results are “implausible”. Your friends entered a very interesting game where we can apply their own method to make post review of articles published by representatives of the so-called”scientific skepticism”.

  • Jim Al-Khalili has expressed different comments against homeopathy, in one of his books he even goes so far as to say nonsense

    Yes, homeopathy IS nonsense, because there is no good scientific evidence at all for its viability. The fact that a handful of people with scientific credentials still believe otherwise, does not change this.

    Your comment is interesting, however, because you apparently set great store by scientific credentials – but ONLY when those credentialed people support homeopathy. Anyone who begs to differ (and that is the overwhelming majority of the scientific world), is dismissed, no matter how good their credentials are, and no matter how good their arguments are.

    This essentially means that whatever you say can be automatically dismissed as fatally biased.

    • Richard Rasker, you’re not responding to anything. Your beloved hero Jim has no relevance or experience in the field of homeopathy, it is as if you will quote Randi’s opinion. But I will be more detailed so that you do not miss anything. Jim published a book called “the world according to physics”, in this book he only once mentions homeopathy saying that it is “pseudoscience”, that’s all.

      So when Nobel laureates and reputable scientists support homeopathy they are “pseudoscientists” because Ernst believes it, but when you see scientists who are mostly engaged in” science jounalism” and the media, you believe them only because they commented on something on Twitter. Don’t you realize how ridiculous your reasoning is?

      Finally, you say that “there is no good evidence”, but that is false. The following quote comes from the book of Edzard Ernst himself:

      “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”.

      Well, you can say that Ernst has been “misinterpreted,” but it’s not. Ernst in his book tries to downplay his claim by saying that “the totality of reliable evidence fails”, but does not give a single evidence to support his conclusion. Instead, Frass after minutely reviewing the for and against review comes to the conclusion that homeopathy is supported by high-quality evidence, with the same Cochrane critiques. This is also consistent with the review by Robert Hahn and Robert Mathie.

      • @ Censored by Ernst

        hahahahah!

        “Frass after minutely reviewing the for and against review comes to the conclusion that homeopathy is supported by high-quality evidence, with the same Cochrane critiques.”

        when I finally stopped laughing I tried to figure out if you were serious?
        Whoever this Frass is he either has a great sense of humour or he badly needs to start taking his meds again.
        Anyone who believes that homeopathy is supported by any evidence whatsoever is frankly delusional.

        you are providing some great amusement value here. it sounds like you know some very unbalanced people who all live in an alternate universe. you should try reality sometime.

        • @John Travis

          Michael Frass is a proponent of homeopathy and a noted crank. He has performed numerous studies of homeopathy, all of which have returned positive results. Critical analysis of his studies has shown them to be statistically-underpowered exercises in p-hacking and Texas Sharpshooting. They have not been replicated. Clinicians have recognised them for the garbage that they are and they have been ignored. Frass has also written a book of ludicrous fantasy regarding the use of homeopathy in emergency and intensive care units. It too has been rightly ignored.

          Edzard has previously discussed Frass and his work.

          https://edzardernst.com/2015/11/prof-frass-remarkable-studies-of-homeopathy/

          • Frass was so far out that he had to be stopped by his own dean of the Vienna medical school (my former home)

          • @ Lenny

            thanks – I knew he had to be a loon!

          • How funny, Lenny, do you think a comment from Enrst refutes the Frass review? How is it possible that an Ernst comment published in 2015 refutes the review published in 2020? did you travel in your time machine?

          • John Travis:

            If Frass is a “crank”, why has he been able to publish in the best scientific journals like the Oncologist or Chest Journal, and you have not? can you show us your scientific publications?

        • “you are providing some great amusement value here. it sounds like you know some very unbalanced people who all live in an alternate universe. you should try reality sometime.”

          So anyone who says that homeopathy has validity is a “unbalanced people”? Are you saying that all the editors of scientific journals (including Cochrane) who have agreed to publish homeopathy trials and experiments are “unbalanced people” too? Are you saying that the millions of homeopathy users are “unbalanced people” too? Are you saying that even professors emeritus who have reported biological effects or physical changes in homeopathic dilutions are also “unbalanced people” too? Come on, John, put aside the ad hominems and show us your scientific articles so we can assess if they at least meet the minimum methodological quality.

          • @CBE

            We know you’re a crank, but please explain how one has to have authored published studies in order to assess quality of evidence?

            With each post you make, all you do is further demonstrate the warped thought-processes of homeopathy loons.

            Are you saying that even professors emeritus who have reported biological effects or physical changes in homeopathic dilutions are also “unbalanced people” too?

            Yes.

  • Your beloved hero Jim has no relevance or experience in the field of homeopathy

    Oh dear. That old canard again.

    I have no relevance or experience in the field of rain dancing or geomorphics. But I need neither to tell you that rain dancing doesn’t work and the Earth is not flat. But there are cranks out there who believe the opposite. And so it is with homeopathy.

    And anyone who supports homeopathy is, by definition, not a reputable scientist. You believe that the support of a Nobel laureate lends credence to your claims. It does not. And, additionally, does Josephson have “relevance or experience in the field of homeopathy”?

    No.

    So, by your logic, we can ignore his claims.

    You can continue with your fatuous blathering and we’ll continue to show you why you are wrong. You could, of course, shut us up by showing us some well-conducted replicated studies which demostrate the unarguable effectiveness of homeopathy. If it’s as great as you claim, there should be loads.

    We’ll wait. As we always do.

  • @ Censored by Ernst – you said:

    “Finally, you say that “there is no good evidence”, but that is false. ”

    NO – it is perfectly true. There is ZERO good evidence in favour of homeopathy being able to treat ANY condition or disease. Any perceived effect is down to placebo effect that is all.
    NONE.
    There are some badly conducted studies that have turned up some highly equivocal results, and many studies of the design A vs A + B that are GUARANTEED to result in a positive result. Aside from these there are zero rigorously conducted RCTs of a double blinded random controlled design with sufficient numbers of participants and conducted under proper conditions that have demonstrated that homeopathy has any effect greater than placebo.

    Not only that – because homeopathy is very highly implausible we have to be aware that because of the vast number of very badly conducted studies that have been carried out by poorly informed homeopaths who are convinced that their quackery works and are therefore attempting to squeeze the data into the proof rather than following it where it leads that all of these studies require very close inspection. And there will be some slightly positive ones by random chance.

    So often a homeopathy study will be declared “positive” when a look at the workings will reveal that it is at best neutral or more likely negative but the triallists have somehow managed to move the goal-posts or put a positive spin on it to make is look positive. Another trick they use is p hacking or sub-group analysis of very small numbers that was not mentioned prior to the study beginning. In fact the data will often be sliced and diced in any way possible to produce some kind of result to fit the foregone conclusion that is required.

    Have a read here of what the UK NHS and NICE think of Homeopathy studies, and also the Australian Medical Boards and Cochrane reviews. They all find evidence of Homeopathic efficacy unsurprisingly lacking.
    It is a case of the “Emperor has no clothes!”

    Homeopathy is a matter of faith like religion – it is not a matter of evidence. No-one in their right minds could truly believe that the “Law of Similars” was a sane approach to medicine. Or that succussion would magically impart some magical power to the liquid in a bottle. Or that counter-intuitively the more you dilute a remedy the more powerful it gets.
    These are all beliefs that would not be out of place in Alice in Wonderland – they have no place is a supposed system of medicine. Homeopathy is a laughing stock – it ought not to be allowed as a system to treat real patients.

    https://www.nhs.uk/conditions/homeopathy/

    https://blogs.bmj.com/bmj/2016/02/16/paul-glasziou-still-no-evidence-for-homeopathy/

    https://www.evidence.nhs.uk/search?om=%5B{%22srn%22:[%22Cochrane%20Database%20of%20Systematic%20Reviews%22]}]&pa=1&q=homeopathy NICE UK – all zero!

    https://jdc325.wordpress.com/2010/02/05/cochrane-reviews-of-homeopathy/

    https://www.smithsonianmag.com/smart-news/1800-studies-later-scientists-conclude-homeopathy-doesnt-work-180954534/

    https://www.veterinarypracticenews.com/homeopathy-december-2019/

    Give it up and go play dungeons and dragons or Pokemon or something else harmless instead.

    • “There are some badly conducted studies that have turned up some highly equivocal results, and many studies of the design A vs A + B that are GUARANTEED to result in a positive result”

      Then explain to us why there are trials with that type of design that have reported negative results. Explain why even Ernst himself has reported positive results using another type of design (as in his article from the 90s and his positive meta-analysis published in the Journal of Clinical Gastroenterology). Or can you just repeat what you read on Ernst’s blog? Are you ever able to think for yourself?

      It seems that apart from the insults, you have a magical thought in which you believe that your words can dematerialize all the evidence in favor of homeopathy. I’m sorry Lenny, your songs and rites have no effect, no matter how much you pray and wish nothing will happen in your favor.

      • @CBE

        Oh dear. You’re not very good at this, are you? MANY studies, CBE. MANY. Not ALL. Why do homeopathy freaks have such limited powers of reading and comprehension? They think words say what they want them to say, not what they actually do.

        It seems that apart from the insults, you have a magical thought in which you believe that your words can dematerialize all the evidence in favor of homeopathy.

        “All the evidence”?

        Well where is it, then?

        Once again, you can continue with your fatuous blathering and we’ll continue to show you why you are wrong. You could, of course, shut us up by showing us some well-conducted replicated studies which demostrate the unarguable effectiveness of homeopathy. If it’s as great as you claim, there should be loads.

        We’ll wait. As we always do.

        • Lenny, if you are so “Scientific” you would have no problem putting your list of scientific articles, probably non-existent, to evaluate their quality.

          • @ Censoredbyernst

            like all homeopaths you fail to understand how science works – it is not up to us to prove that your batshit crazy ideas don’t work. people are coming up with all kinds of batshit ideas all the time – it would by sheer tedium to prove that silly ideas that are obvious by their very notion and from first principles unworkable are empirically false.

            It is ALWAYS up to the person proposing a hypothesis to provide the evidence for their thesis.

            This is something that homeopaths have time and time again failed to do no matter how much they screw around with the trial design or try to falsify the results.

            I have posted a long lists of highly respected academic institutions who have denounced homeopathy as pure pseudoscience with no evidence that it can treat any condition. They state that it should not be used for treating ANY patient.

            Very embarrassingly for homeopaths this includes NCCAM – the National Center for Complementary & Alternative Medicine or National Center for Complementary and Integrative Health (NCCIH) as it is now known.

            WHEN EVEN THE NATIONAL RESEARCH CENTRE FOR SCAMS DISOWNS YOU AND SAYS THAT YOUR SCAM IS NONSENSE AND THAT THERE IS NO WAY IN WHICH IT CAN POSSIBLY WORK THEN YOUR SCAM MUST REALLY BE TRULY AWFUL AND BEYOND ALL POSSIBLE REDEMPTION.
            I think at this stage anyone with more than a few remaining neurons should finally realize that the fight has been lost!

            IT IS NOW OFFICIAL – HOMEOPATHY DOESN’T WORK. PERIOD.

          • @CBE

            Oh dear. Another day, another logical fallacy and another dodge and obfuscation.

            I have no publications to my name because I am not a researcher. I am a clinician. Somehow you imagine that researchers are the only people who are qualified to evaluate evidence. As with all things you have said here, you are wrong.

            As John says; you’re making the claim – you prove it.

            I repeat: Once again, you can continue with your fatuous blathering and we’ll continue to show you why you are wrong. You could, of course, shut us up by showing us some well-conducted replicated studies which demonstrate the unarguable effectiveness of homeopathy. If it’s as great as you claim, there should be loads.

            We’ll wait. As we always do.

            Homeopathy is a dead horse, CBE, and has been since Mad Sam dragged it out of the stable 200 years ago. It doesn’t matter what you use to beat it and how hard you do it, your claims that you see signs of movement can be ignored.

      • @ Listener

        “hat your words can dematerialize all the evidence in favor of homeopathy.”

        the only “evidence” in favour of homeopathy that exists is in your imagination.
        I have given you links to demonstrate the Cochrane, the UK NHS, NICE, the Australian Government Medical regulator, the UK Houses of Parliament and everybody else who has examined THE EVIDENCE has found that there IS NO EVIDENCE IN FAVOUR OF HOMEOPATHY.

        NONE EXISTS. So what evidence are you talking about?
        Because I can find none.
        None of the above organizations can find any and none of the august personages who people them can find any either.
        So if you see any “evidence” you are suffering from delusions.

        Homeopathy is a belief system, a religion. Those who believe in it do so IN SPITE of all the evidence to the contrary.
        They are immune to rational argument and all the evidence. They are not amenable to scientific debate or proof.
        They will continue to believe in their silly little magical system no matter how many studies prove them wrong.
        They will go to their graves protesting that HOMEOPATHY WORKS FOR THEM.
        But this is not how science works – and it is impossible to reason with unreasonable people.

        All the evidence demonstrates perfectly clearly – HOMEOPATHY DOES NOT WORK.
        IT IS A FATUOUS SILLY IDEA AND ANYONE WITH HALF A BRAIN OUGHT TO BE ABLE TO SEE THAT AFTER A MOMENT’S THOUGHT. ANYONE LEFT STILL PROTESTING OTHERWISE IS SIMPLY DELUDED. QED.

        • @john travis

          lol… John, you must have me mixed up with someone else. I don’t promote homeopathy, neither do I condemn it. That said, I stay as far from CON-Med as I think is healthy for me.

          As for me being an anti-vaxer
          You’re wrong again. I’ve received two flu vaccines in the last sixteen months, one shingles vaccine, and a covid-19 vaccine. How I fit into your anti-vaxer criteria… I’m not sure. Are you daft ? … or just an idiot. You call me anti-vax because I’m leery about mRNA vaccines that have never been used previously and haven’t been proven yet….. you’re pathetic. One third of the US population have said that won’t take the vaccine. I’m confident that more than 50% have their doubts. You’re akin to the idiot government leaders that assume the general public knows nothing and needs a daddy to lead them.

          You have no ability to reason, and I therefore I can put no confidence in ANYTHING you have to say here.

          Wake up and smell the coffee.

          • @ Listener

            my ability to reason is fine.

            you are just dissembling then and deliberately taking up false positions to be argumentative and cryptic. You have made clear anti-vaccine comments in earlier posts and you are clearly against the Covid-19 vaccines.

            If you wish to be deliberately deceptive and then come out from behind that position and deny your earlier arguiments then you are nothing but a troll.

            stupid comments about smelling the coffee – do you believe that makes you sound clever?

            “idiot government leaders that assume the general public knows nothing and needs a daddy to lead them.”

            you applaud the anti-vaccine sentiments that you ssay the population n at large exhibits yet you still say you are not anti-vaccine – I say that you are.
            ANybody who hides behind the line “I am not anti-vaccine I am pro safe vaccine ” is an anti-vaxxer. That is a line straight out of the anti-vaxxer playbook.

            You copy their dissembling and deceitful methods and their lies about mRNA and all the other pseudoscientific tosh they spew. ANd alll your patronising and condescending babble to hide your ignorance and your fear of science and technology is hilarious.

            YOU wouldn’t have confidence in anything that I say? Yet you would 100% have confidence in your own fetid ignorance and cretinous thinking? That is typical of the Dunning Kruger and alt-med type anti-vaxxer that you are – an anti-science troll spewing doubt and hate against the Covid-19 vaccines – you would rather see the country and the world overcome with disease than face your own ignorance and technofear.

            To be frightened of mRNA when your own body produces so much of the stuff already on a daily basis. To be afraid of things just because you lack the ability or the education to understand them.
            What a terrified life you must lead!

            You really are hilarious – you are so typical of the other trolls who hide behind their fear and ignorance, pretending some deep knowledge with their cryptic comments and smart-ass snide remarks when all you are doing is exposing yourself as an ignoramus with a deep-seated fear bred by your own ignorance. It would all be funny if it wasn’t so terribly sad.
            That you lack the insight to see over the depth of even your own miserable shallowness!
            What an epitaph.

          • @john travis

            Say John
            Are you pro all cancer treatment, or just pro safe cancer treatment ?

            lol

          • @Listener

            what kind of a stupid question is that?

            do you think you are clever asking these pseudointellectual snide questions trying to give the impression that you have some hidden knowledge when all you are doing is revealing your colossal ignorance and your total lack of insight of this fact.

            take your dross to elsewhere where it might be appreciated

        • All the sites they mention talk about ” insufficient evidence”, not about “lack of evidence.” Your typical prayers and spells of a magical thought will not dematerialize the conclusion of the most robust review published to date. Don’t be so grumpy.

          • @ Censoredbyernst

            NO evidence is NO evidence – so what are you talking about?

            The position remains the same – THERE IS NO EVIDENCE THAT HOMEOPATHY IS A TREATMENT FOR ANY CONDITION. PERIOD.

            WHICH PART OF THAT SENTENCE DO YOU NOT UNDERSTAND?

          • enough now!
            we all read your numerous comments with much patience.
            either you write something meaningful about the topic of this post or I will not post any further drivel from you.

  • I was almost going to say that your stubborn promotion of homeopathy is off-topic, but actually it supports the theme of this blog posting in that it provides a clear view of the mindset of incurable believers, desperately hanging on to the tiniest shreds of ‘evidence’ to defend their cult, rejecting the majority of scientific evidence for them being wrong.

    “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”.

    Sure, if you look at thousands of trials, there will always be a few with positive results, if only as a result of statistical uncertainty. And homeopaths routinely cherry-pick these handful of flukes as proof of their silly belief system. Also, those positive outcomes usually only describe weak effects, getting weaker still with increasing quality of studies. And oh, there is of course always a chance of fraud and deception. India in particular produces lots of very positive homeopathy ‘studies’ – studies that no-one can replicate and are almost certainly made up.

    Real scientists, however, (indeed) look at the totality of the evidence, and that totality tells us that homeopathy is simply a placebo treatment. There is no good, consistent evidence whatsoever supporting homeopathy, its basic principles (the similia principle, the ‘law’ of infinitesimals, proving), or its purported health effects. The academies of science worldwide spent many millions of dollars on research over the course of the years, and they all reached the same conclusion: there is no compelling evidence that homeopathy is better than placebo for treating any condition.
    If what you believe were true, then 99.99% of all doctors and scientists worldwide are incompetent fools for rejecting homeopathy and not recognizing the evidence for its efficacy. This of course is very unlikely. It is far more plausible that those few who still believe in it are wrong.

    And given that everything about homeopathy is hugely implausible to begin with, you will have to produce far more and far better quality evidence for its viability than just a few dozen studies finding a some weak effects, with only a handful of deluded scientists supporting it. To quote Sagan’s old adage: Extraordinary claims require extraordinary evidence. So far, nothing even coming close has materialized.

    • Richard Rasker, this is the funny thing. You claim that “there is no single evidence” and that positive essays are “always of poor quality”, but Ernst himself in his book comes to contradict you.

      In relation to cherry picking, Hahn has already shown that Ernst and Egger are the ones who skewed literature to create a type of false negative error.

      Not Richard Rasker, Linde demonstrated in 1999 that both the trials of homeopathy as orthodox medicine tend to reduce the effect when the greater is the size of the sample, but this is a general phenomenon but as the Linde said, exist a set of high-quality trials in homeopathy that continued to show better effect than placebo, ironically this was confirmed by Ernst when he published a review of homotoxicology. Mathie later found that some high-quality trials did not show a reduction in the effect when they had higher quality.

      If you look at it together, all the global meta-analyses, systematic reviews, physical chemical and laboratory evidence show that homeopathy cannot fully explain by placebo effect. So your belief is equal to believing that the Earth is flat and that there are goblins, because you deny science and evidence.

      Define “extraordinary”.

      • If you look at it together, all the global meta-analyses, systematic reviews, physical chemical and laboratory evidence show that homeopathy cannot fully explain by placebo effect.

        But it can when you account for the fact that most homeopaths are quite incompetent as researchers and scientists. They tend to cut corners, cherry-pick results, and fail to take confounding factors into account, to name just a few of the most common errors they make. I’ve come across laughably bad studies, often from India, where the whole ‘methodology’ is described in one pathetic little 2-by-2 table, merely listing an intervention group and a placebo group versus percentages cured and not cured. And lo and behold, the intervention group always shows significantly better outcomes. But lacking any more detailed data, this essentially boils down to homeopaths saying “we see that it works.”

        Yet even these ‘studies’ are never retracted, but instead end up on the heap of positive studies, eagerly quoted by homeopaths. And even if more serious reviews assign these studies low weight or even exclude them completely due to their appalling quality, there are quite a few of them, and together they will still slightly raise the outcome above a zero result. And once again: any effects found are invariably small, strongly suggesting that in reality, there is nothing there.

        So again no, there is no good evidence at all that homeopathy has any significant effects. Otherwise, scientists and doctors worldwide would be using and promoting it on a large scale, now wouldn’t they? And India wouldn’t have the horribly bad public health record it has, what with homeopathy part of the state-supported system of healthcare. And oh, you wouldn’t have to keep on proselytizing, trotting out all the usual, long-dead arguments just like religious fanatics wave their pamphlets to ‘prove’ that they are Always Right.

        Don’t get me wrong: it would be absolutely wonderful if homeopathy worked: it would give us an endless supply of effective medicines that are literally childishly easy to make, cost next to nothing, and cannot possibly have side effects to boot. (And this, by the way, is what I mean by ‘extraordinary claims’.)
        Yes, you read this correctly: I really wish you were right.

        But alas, wishing for things doesn’t make them real. Homeopathy not just sounds too good to be true, it is too good to be true. So let’s finally bury this long-obsolete ‘medicine’ already, alongside bloodletting, manure-laden poultices and other things that we know don’t work.

        • Richard Rasker, your original claim was that “there is no evidence,” but you yourself refute your own accusation by commenting that there are positive clinical trials. After this you make up a new excuse saying that “there are no quality trials”, but again you ignore that although there are poor quality clinical trials in homeopathy (as there are in all areas of science), there is still a set of high quality clinical trials with positive results. It is not clear how you define “extraordinary”, but it does not seem extraordinary that a medicine can work with minor or no side effects, it is not only a wonder, it can be developed to synthesize new drugs based on homeopathic technology and dispose of them in a standardized way. It would be selfish and unethical to take away from humanity this kind of technology.

      • Hahn has already shown

        Hahn, CBE, has shown nothing other than his own bias and wilful ignorance of the importance of prior probability.

        Hahn is also a loon. As Björn Leifsson has commented elsewhere on this blog:

        “Dr. Hahn and his wife are a spiritualists. His wife, Marie-Louise, thinks she is a medium and they have been actively exploring these ideas. They have co-authored several books on the subject of spiritism.
        Dr. Hahn is involved in anthroposophy, a religious cult that runs a famously controversial “clinic” in his home country Sweden. Homeopathy is extensively used by this cult.
        If I recall correctly Dr. Hahn thinks he has found his former life in a person from the 13th century.

        His web at http://www.roberthahn.se/ is in Swedish but you can translate the text easily and quite satisfactorily.
        If you use Google Chrome browser it may offer to or translate the pages automagically.
        Or you can copy paste the link (the URL) of a page into the left field in “translate.google.com” and choose Swedish as the original language and in the right field choose your preferred language and click the link that appears.”

        Anything Hahn says about homeopathy is the rambling of a fool and can be disregarded

  • Richard Rasker, your original claim was that “there is no evidence,”

    Allow me to correct you: I said there is no GOOD scientific evidence.

    but you yourself refute your own accusation by commenting that there are positive clinical trials.

    Yes, and those are generally so low-quality that they can’t be considered ‘good evidence’.

    After this you make up a new excuse saying that “there are no quality trials”, but again you ignore that although there are poor quality clinical trials in homeopathy (as there are in all areas of science), there is still a set of high quality clinical trials with positive results.

    All this this is of course just splitting syntactic hairs on your behalf for whatever reason.

    Those high-quality homeopathy trials are VERY rare – so rare, that they most probably represent the inevitable statistical noise. Don’t forget that if you use a significance cut-off at p=0.05, you can expect up to 1 in every 20 trials to yield a false positive result.
    Also, those positive trials are rarely if ever independently replicated. And once again: you have to take into account that homeopaths are usually not competent in either medicine or scientific research, and that their work is riddled with bias and errors.

    To press my point: try locating just three independent(*) high-quality trials where one particular condition is successfully treated with homeopathy. I think you will find this exceedingly difficult.

    *: There are of course homeopaths who replicate their own trials – which for some mysterious (hahaha) reason always yield basically the same results – something that also rarely happens in real medicine. When looking up systematic reviews, it is not uncommon for included trial results to differ by an order of magnitude.

    It is not clear how you define “extraordinary”

    I find it extraordinary that homeopathic ‘research’ and ‘provings’ basically never report negative results, and that homeopaths so far have NEVER doubted let alone abandoned even one ‘remedy’ they came up with. In other words: they claim to find almost 100% of their ‘remedies’ efficacious(**), no matter how ludicrous or implausible.
    The cliche example here is the flu remedy oscillococcinum: it was erroneously based on a bacterium (‘oscillococcus’) that doesn’t even exist, with the discoverer believing that it was the cause of the Spanish flu (which turned out to be completely wrong) and could be found in the heart and liver of ducks (which is also completely wrong). And to add insult to injury, proper research found it to be useless as an anti-flu medicine.
    Yet in spite of this huge pile-up of incompetence and errors, I have never heard even one homeopath denounce oscillococcinum as the colossal mistake it is. People worldwide are still falsely made to believe that it helps them prevent and shorten flu infections, landing Boiron a tidy profit of more than half a billion euros annually.

    So I am sorry to have to tell you that homeopaths are seriously deluded people, who somehow cannot accept that they are wrong. And as I’m getting a bit bored with running in circles, I’ll leave it at this; I have better things to do with my time.

    **: Which is all the more extraordinary when compared to new medicinal substances that are researched in the real world, of which less than 1 in 1,000 eventually achieves the status of ‘viable medicine’.

  • Thank you (to the authors of this blog post — I won’t attempt to wade through the comments) for exposing this mess. At least a yellow banner “Expression of Concern” banner now heads the original article, even if the editors don’t yet dare publish or link to your specific criticisms.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6396053/

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