Yes, there is a new paper on homeopathic Arnica!
And yes, it arrives at a positive conclusion.
How is this possible?
Let’s have a look.
The authors conducted a systematic review and metaanalysis, following a predefined protocol, of all studies on the use of homeopathic Arnica montana in surgery. They included all randomized and nonrandomized studies comparing homeopathic Arnica to a placebo or to another active comparator and calculated two quantitative meta-analyses and appropriate sensitivity analyses.
Twenty-three publications reported on 29 different comparisons. One study had to be excluded because no data could be extracted, leaving 28 comparisons. Eighteen comparisons used placebo controls, nine comparisons an active control, and in one case Arnica was compared to no treatment. The metaanalysis of the placebo-controlled trials yielded an overall effect size of Hedge’s g = 0.18 (95% confidence interval -0.007/0.373; p = 0.059). Active comparator trials yielded a highly heterogeneous significant effect size of g = 0.26. This is mainly due to the large effect size of non-randomized studies, which converges against zero in the randomized trials.
The authors concluded that homeopathic Arnica has a small effect size over and against placebo in preventing excessive hematoma and other sequelae of surgeries. The effect is comparable to that of anti-inflammatory substances.
This review has many remarkable (or should I say, suspect?) features, e.g.:
- Its authors are famous (or should I say, infamous) advocates of homeopathy not known for their objectivity (including Prof Walach).
- Some of the trials included in the analysis are unpublished conference proceedings usually only published as an abstract (ref 29).
- Others were published in journals such as ‘Allgemeine Homoeopathische Zeitung‘ which is unlikely to manage a decent peer-review system (ref 46).
- Some trials used Arnica in low potencies that contained active molecules, and nobody doubts that active molecules can have effects (ref 32 and 37).
- One study seems to be a retrospective case-control study (ref 38).
- The primary endpoints of several studies were not those evaluated in the review (e.g. ref 42).
- One study used a combination of herbal and homeopathic arnica in the verum group which means the observed effect cannot be attributed to homeopathy (ref 31).
Perhaps the strangest feature relates to the methodology used by the review authors: “Where data were only available in graphs, data were read off the graph by enlarging the display and reading the figures with a ruler.” I have never before come across this method which must be wide open to bias.
Considering all of these odd features, I think that the small effect size over and against placebo in preventing excessive hematoma and other sequelae of surgeries reported by the review authors is most likely due to a range of factors that have nothing whatsoever to do with homeopathy.
So, does the new review show that homeopathic Arnica is “efficacious”? I don’t think so!
9 Responses to A new review of the ‘efficacy’ of homeopathic Arnica by Harald Walach & Co
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I would like to add some information on the “AHZ – Allgemeine Homöopathische Zeitung”.
It sounds like a free maganzine you can get at the drug store. However, this is not ture. It is one of the oldest medical magazines we have. Founded in 1832, it is today part of Haugg publishing company which belons to Thieme publishing company, an at least in Germany well known scientifc publisher with lots of national and international reputable scientific magazines. They have editors and a sceintific adivisory board. The eiditor decdes which papers are accepted and which aore not. However, I could not find a hint on a classic peer review approach. This approach within the world of homeopathy may be not so easy to find. Maybe editors plus adivsiory council is already the major fraction of scientific working experts in homeopathy in Germany – but I do not know.
You can have a look at very old editions of this magazine:
https://de.wikisource.org/wiki/Allgemeine_hom%C3%B6opathische_Zeitung
To me it looks scientific in a very honourable way. Looking at that old magazines, I have almost the smell of the archives in the old university libraries I have been when I was much younger in my nose …
I did provide a link so that readers can inform themselves. Here is the list of editors (not one of them is a leading scientist)
Dr. med. D. Albrecht, Ganderkesee
U. Koch, Hofheim
Dr. med. C. Lucae, München
Dr. med. A. Sparenborg-Nolte, Marburg/Lahn
And this is the scientific board:
Dr. phil. M. Baschin, Stuttgart
Dr. sc. nat. S. Baumgartner, Bern
Dr. med. M. K. H. Elies, Laubach
Dr. med. U. Fischer, Freiburg
… and look!!! it includes one of the authors of the review.
After Thieme published one of the seminal books criticizing homeopathy in 1991 (Hopff W, Homöopathie kritisch betrachtet), they eventually decided to take homeopathic publications under their wing. They make possible the continued existence of many of them. The fact that it is a comprehensible business model does not change the fact that what is being published here is about the futile search for nothingness.
The “Allgemeine homöopathische Zeitung” first appeared on July 1, 1932. Homeopaths love fossils.
Comment regarding usage of data from graphics:
yopou wrote:
Perhaps the strangest feature relates to the methodology used by the review authors: “Where data were only available in graphs, data were read off the graph by enlarging the display and reading the figures with a ruler.” I have never before come across this method which must be wide open to bias.
We have a problem in the way scientific results are published. When I was active at university, data were only added rarely to the papers. Nowadays, things are different. However, still not all papers give their raw data for independent analysis. I remember a few overview papers where they tried to get the data by means of autmatically analysing the points in graphics turning them into numbers. You won’t get data with high precision that way. However, yccuracy should be OK. Depending on the precision of the method used to measure the the values used in the paper, you may even get a very usable dataset that adds not very much bias.
I published my 1st paper in the mid 1970s and can assure you that all quality journals always insisted on numerical data.
It depends on the kind of data you have used for the paper. If you have large amounts of data points it could be a problem to give an appendix with data that is 10 times the size of the paper itself.
However it is a possible way to extract data from figures. Here you find some techniques described:
https://www.researchgate.net/post/How-can-I-extract-the-data-published-figures-in-a-journal
https://towardsdatascience.com/extracting-digitising-data-from-plots-in-scientific-papers-or-images-6e098cb887aa
It has nothing to do with playing with a ruler in front of a monitor. If the figures are prepared in a precise way, you can generate precise data from it.
Systematic review of tooth-fairy science is also tooth-fairy science.
I’ve not heard of this journal, but one does wonder about its peer review process. Should the paper be retracted?
The article homeopathic Arnica was published in Frontiers in Surgery (!) which is part of Frontiers Media SA.
https://en.wikipedia.org/wiki/Frontiers_Media
The Wikipedia article has listed a number of controversies, e.g: