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

Monthly Archives: December 2022

Before the New Year, many journals publish retrospectives of the things that have been happening in the year that is about to end. I have often thought that this is mainly due to the laziness of the journalists and editors. These pieces can be prepared in advance and thus do not disturb their holiday routine between Christmas and New Year. Well, I have to admit that I too am a lazy chap who has prepared a post about the preceding year.

Listed below are all the posts of 2022 that prompted at least 50 comments.

  1. British MP, Andrew Bridgen, claims that mRNA Covid vaccines are “not safe, not effective and not necessary”
  2. Homeopathy kills vulnerable patients
  3. Individualized exercise therapy for chronic low back pain
  4. ‘Arguments’ used to defend so-called alternative medicine
  5. The market for homeopathics is predicted to grow significantly
  6. Catastrophic injuries after chiropractic treatment
  7. A residential health programme that poses “a risk to the health and safety of members of the public”
  8. Homeopathy for COVID-19: A randomized, double-blind, placebo-controlled trial shows that it does not work
  9. The body of evidence on homeopathy is rotten to the core
  10. Excess mortality due to the COVID-19 pandemic
  11. Preference of so-called alternative medicine predicts negative attitudes to vaccination
  12. “Nothing much new here about Chucky Windsor’s credulity …” A review of the reactions to my biography of Prince Charles
  13. Acute Subdural Hemorrhage Following Cervical Chiropractic Manipulation
  14. Double-sided vertebral artery dissection in a 33-year-old man. The chiropractor is not guilty?
  15. Chiropractic spinal manipulation is not safe!
  16. Best Practices for the Chiropractic Care of Children
  17. The ‘moral and intellectual decay’ of COVID disinformants
  18. What are the reasons for opposing COVID vaccinations?
  19. No-Vax Djokovic: an “anti-scientific crank hiding in plain sight”

In 2022, I published in excess of 300 posts. Some attracted no comments at all; most prompted about a dozen, and some generated many more comments (the record was in excess of 200). The latter group is not necessarily the most popular, perhaps just the most controversial set of posts. They are also not necessarily my best articles; they are just the ones that caused you, my readers, to submit the most comments.

So, what were the best posts? I am probably not in the best position to judge but, for what it’s worth, here are some that I felt were better than average:

  1. Osteopathy: an absence of good-quality evidence
  2. ‘Arguments’ used to defend so-called alternative medicine
  3. INSTRUCTIONS FOR CHILD ABUSE: Three best-selling books on homeopathy for kids
  4. Most healthcare interventions tested in Cochrane Reviews are not supported by high-quality evidence
  5. Widespread fraud in natural health products research 
  6. Quackery is on the rise, and the placebo effect is part of the problem
  7. Protecting vulnerable patients from charlatans: a story of superb teamwork
  8. What motivates a doctor to work as an integrative medical practitioner?
  9. Beyond the headlines: an analysis of 22 articles from ‘THE DAILY EXPRESS’
  10. The ‘golden rules’ of so-called alternative medicine (SCAM)
  11. Comments by a chiropractor: insights into quasi-religious zeal
  12. Chiropractic spinal manipulation is not safe!
  13. Prince Charles’ advocacy of quackery is by no means harmless
  14. Anti-vax arguments used by proponents of SCAM are stupid, or wrong, or both

Is there a common denominator between the two sets of posts (other than SCAM)? Not really! This probably is because I try to cover many diverse topics under the umbrella of SCAM (and very occasionally also beyond it). If there is anything at all that most posts might have in common, it must be the fact that I often make a conscious effort to educate the public about SCAM and try to counter-balance the uncritical hype the subject enjoys almost everywhere else.

Comparing the two sets of posts, the most striking observation might be that the 1st one mainly relates to defined SCAM interventions, while the 2nd set of posts tends to be about general issues related to SCAM. Another finding might also be relevant: posts that I feel are amongst my ‘best’ are clearly not the ones that generate the most comments. This, of course, begs the question as to what I define as ‘best’ in the context of this blog. I have to admit that I find this is far from easy. ‘Best’, I suppose, means informative/relevant/well-researched/most thoughtful.

I kept the most important issue emerging from all this to the last. As the year 2022 ends, I have the urge to thank all of you, the folks that read my posts and sometimes even provide comments to them. Some are supportive, others are the opposite; some are informative, others are infuriating; some are correct, others are not. But all have one thing in common: they are the lifeblood of my blog!

Let me use the occasion of the last post of 2022 to thank you all for your interest in my work.

See you next year.

 

 

Animals cannot consent to the treatments they are given when ill. This renders the promotion and use of SCAM in animals a tricky issue. This systematic review assessed the evidence for the clinical efficacy of 24 so-called alternative medicines (SCAMs) used in cats, dogs, and horses.

A bibliographic search, restricted to studies in cats, dogs, and horses, was performed on Web of Science Core Collection, CABI, and PubMed. Relevant articles were assessed for scientific quality, and information was extracted on study characteristics, species, type of treatment, indication, and treatment effects.

Of 982 unique publications screened, 42 were eligible for inclusion, representing 9 different SCAM therapies, which were

  • aromatherapy,
  • gold therapy,
  • homeopathy,
  • leeches (hirudotherapy),
  • mesotherapy,
  • mud,
  • neural therapy,
  • sound (music) therapy,
  • vibration therapy.

For 15 predefined therapies, no study was identified. The risk of bias was assessed as high in 17 studies, moderate to high in 10, moderate in 10, low to moderate in four, and low in one study. In those studies where the risk of bias was low to moderate, there was considerable heterogeneity in reported treatment effects.

The authors concluded that the present systematic review has revealed significant gaps in scientific knowledge regarding the effects of a number of “miscellaneous” SCAM methods used in cats, dogs, and horses. For the majority of the therapies, no relevant scientific articles were retrieved. For nine therapies, some research documentation was available. However, due to small sample sizes, a lack of control groups, and other methodological limitations, few articles with a low risk of bias were identified. Where beneficial results were reported, they were not replicated in other independent studies. Many of the articles were in the lower levels of the evidence pyramid, emphasising the need for more high-quality research using precise methodologies to evaluate the potential therapeutic effects of these therapies. Of the publications that met the inclusion criteria, the majority did not have any scientific documentation of sufficient quality to draw any conclusion regarding their effect. Several of our observations may be translated into lessons on how to improve the scientific support for SCAM therapies. Crucial efforts include (a) a focus on the evaluation of therapies with an explanatory model for a mechanism of action accepted by the scientific community at large, (b) the use of appropriate control animals and treatments, preferably in randomized controlled trials, (c) high-quality observational studies with emphasis on control for confounding factors, (d) sufficient statistical power; to achieve this, large-scale multicenter trials may be needed, (e) blinded evaluations, and (f) replication studies of therapies that have shown promising results in single studies.

What the authors revealed in relation to homeopathy was particularly interesting, in my view. The included studies, with moderate risk of bias, such as homeopathic hypotensive treatment in dogs with early, stage two heart failure and the study on cats with hyperthyroidism, showed no differences between treated and non-treated animals. An RCT with osteoarthritic dogs showed a difference in three of the six variables (veterinary-assessed mobility, two force plate variables, an owner-assessed chronic pain index, and pain and movement visually analogous scales).

The results on homeopathy are supported by another systematic review of 18 RCTs, representing four species (including two dog studies) and 11 indications. The authors excluded generalized conclusions about the effect of certain homeopathic remedies or the effect of individualized homeopathy on a given medical condition in animals. In addition, a meta-analysis of nine homeopathy trials with a high risk of bias, and two studies with a lower risk of bias, concluded that there is very limited evidence that clinical intervention in animals using homeopathic remedies can be distinguished from similar placebo interventions.

In essence, this review confirms what I have been pointing out numerous times: SCAM for animals is not evidence-based, and this includes in particular homeopathy. It follows that its use in animals as an alternative to treatments with proven effectiveness borders on animal abuse.

 

On Sunday, December 18, 2022, the General Assembly of the European Humanist Federation (EHF)met for the very last time. It was decided that, from 2023, there will be only one international humanist organization and resources will be concentrated there, namely with the Humanists International. It was felt that this is the best way to strengthen the humanist network in Europe as well as in the world. The EHF has thus stopped its own activities and the liquidation surplus will go to Humanists International.

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Humanists International (HI) is the global representative body of the humanist movement, uniting a diverse community of non-religious organizations and individuals. On their website, the organization states the following:

Inspired by humanist values, we are optimistic for a world where everyone can have a dignified and fulfilling life. We build, support and represent the global humanist movement and work to champion human rights and secularism.

What we do

We campaign on humanist issues. We defend humanists at risk of persecution and violence. We lobby for humanist values at international institutions, including the United Nations. And we work to build the humanist movement around the world. Find out more about the work we do on behalf of the global humanist community.

Our members and supporters

Our Members and Associates include humanist, rationalist, secular, ethical culture, atheist and freethought organisations from all over the world. Our community also includes many individual supporters who share our vision and values.

Find out more about our member organizations around the world. If you represent a humanist or secular organization you can find out more and apply for membership here. If you are interested in supporting us as an individual, you can sign up here.

Below, you can read more about our history, our strategy and how our organization is managed and governed.


Our history

Humanists International was founded in Amsterdam in 1952. Originally five Humanist organizations — the American Ethical Union, American Humanist Association, British Ethical Union (later the British Humanist Association and now Humanists UK), Vienna Ethical Society and the Dutch Humanist league — hosted our inaugural congress in Amsterdam, 22–27 August 1952, founding the organization that was then called the International Humanist and Ethical Union (IHEU). On the last day of the congress five resolutions were passed, which included a statement of the fundamentals of “modern, ethical Humanism”, a resolution which would come to be known as the Amsterdam Declaration.

Now registered in New York, USA, the main administrative headquarters are in London, United Kingdom, Humanists International is an international non-governmental organisation (NGO) with representation on various United Nations committees and other international bodies. We seek to influence international policy through representation and information, to build the humanist network, and let the world know about the worldview of Humanism.

___________________________

Humanism focuses on living ethically and thinking rationally while refusing to rely on supernatural sources. The humanist movement aims at making the world a better place. I consider myself a humanist (without being a member of an organization) and believe the world could do with more of us.

Is so-called alternative medicine (SCAM) compatible with Christian beliefs? This is not a question that often robs me of my sleep, yet it seems an interesting issue to explore during the Christmas holiday. So, I did a few searches and – would you believe it? – found a ‘Christian Checklist’ as applied to SCAM Since it is by no means long, let me present it to you in full:

  1. Taking into consideration the lack of scientific evidence available, can it be recommended with integrity?
  2. What are its roots? Is there an eastern religious basis (Taoism or Hinduism)? Is it based on life force or vitalism?
  3. Are there any specific spiritual dangers involved? Does its method of diagnosis or practice include occult practices, all forms of which are strictly forbidden in Scripture.

Now, let me try to answer the questions that the checklist poses:

  1. No! – particularly not, if the SCAM endangers the health of the person who uses it (which, as we have discussed so often can occur in multiple ways).
  2. Most SCAMs have their roots in eastern religions, life force, or vitalism. Very few are based on Christian ideas or assumptions.
  3. If we define ‘occult’ as anything that is hidden or mysterious, we are bound to see that almost all SCAMs are occult.

What surprises me with the ‘Christian Checklist’ is that it makes no mention of ethics. I would have thought that this might be an important issue for Christians. Am I mistaken? I have often pointed out that the practice of SCAM nearly invariably violates fundamental rules of ethics.

In any case, the checklist makes one thing quite clear: by and large, SCAM is nothing that Christians should ever contemplate employing. This article (which I have quoted before) seems to confirm my point:

The Vatican’s top exorcist has spoken out in condemnation of yoga … , branding [it] as “Satanic” acts that lead[s] to “demonic possession”. Father Cesare Truqui has warned that the Catholic Church has seen a recent spike in worldwide reports of people becoming possessed by demons and that the reason for the sudden uptick is the rise in popularity of pastimes such as watching Harry Potter movies and practicing Vinyasa.

Professor Giuseppe Ferrari … says that … activities such as yoga, “summon satanic spirits” … Monsignor Luigi Negri, the archbishop of Ferrara-Comacchio, who also attended the Vatican crisis meeting, claimed that homosexuality is “another sign” that “Satan is in the Vatican”. The Independent reports: Father Cesare says he’s seen many an individual speaking in tongues and exhibiting unearthly strength, two attributes that his religion says indicate the possibility of evil spirits inhabiting a person’s body. “There are those who try to turn people into vampires and make them drink other people’s blood, or encourage them to have special sexual relations to obtain special powers,” stated Professor Ferrari at the meeting. “These groups are attracted by the so-called beautiful young vampires that we’ve seen so much of in recent years.”

You might take such statements not all that seriously – the scorn of the vatican does not concern you?

Yet, the ‘Christian Checklist’ also raises worries much closer to home. King Charles is the head of the Anglican Church. Undeniably, he also is a long-term, enthusiastic supporter of many of those ‘quasi-satanic’ SCAMs. How are we supposed to reconsile these contradictions, tensions, and conflicts?

Please advise!

Hypericum perforatum (St John’s wort) is often recommended as a remedy to relieve pain caused by nerve damage. This trial investigated whether homeopathic Hypericum leads to a reduction in postoperative pain and a decrease in pain medication compared with placebo.

The study was designed as a randomized double-blind, monocentric, placebo-controlled clinical trial with inpatients undergoing surgery for lumbar sequestrectomy. Homeopathic treatment was compared to placebo, both in addition to usual pain management. The primary endpoint was pain relief measured with a visual analog scale. Secondary endpoints were the reduction of inpatient postoperative analgesic medication and change in sensory and affective pain perception.

The results show that the change in pain perception between baseline and day 3 did not significantly differ between the study arms. With respect to pain medication, total morphine equivalent doses did not differ significantly. However, a statistical trend and a moderate effect (d = 0.432) in the decrease of pain medication consumption in favor of the Hypericum group was observed.

The authors concluded that this is the first trial of homeopathy that evaluated the efficacy of Hypericum C200 after lumbar monosegmental spinal sequestrectomy. Although no significant differences between the groups could be shown, we found that patients who took potentiated Hypericum in addition to usual pain management showed lower consumption of analgesics. Further investigations, especially with regard to pain medication, should follow to better classify the described analgesic reduction.

For a number of reasons, this is a remarkably mysterious and quite hilarious study:

  1. Hypericum is recommended as an analgesic for neuropathic pain.
  2. According to the ‘like cures like’ axiom of homeopathy, it therefore must increase pain in such situations.
  3. Yet, the authors of this trial mounted an RCT to see whether it reduces pain.
  4. Thus they either do not understand homeopathy or wanted to sabotage it.
  5. As they are well-known pro-homeopathy researchers affiliated with a university that promotes homeopathy (Witten/Herdecke University, Herdecke, Germany), both explanations are highly implausible.
  6. The facts that the paper was published in a pro-SCAM journal (J Integr Complement Med), and the study was sponsored by the largest German firm of homeopathics (Deutsche Homoeopathische Union) renders all this even more puzzling.
  7. However, these biases do explain that the authors do their very best to mislead us by including some unwarranted ‘positive’ findings in their overall conclusions.

In the end, none of this matters, because the results of the study reveal that firstly the homeopathic ‘law of similars’ is nonsense, and secondly one homeopathic placebo (i.e. Hypericum C200) produces exactly the same outcomes as another, non-homeopathic placebo.

It’s again the season for nine lessons, I suppose. So, on the occasion of Christmas Eve, let me rephrase the nine lessons I once gave (with my tongue firmly lodged in my cheek) to those who want to make a pseudo-scientific career in so-called alternative medicine (SCAM) research.

  1. Throw yourself into qualitative research. For instance, focus groups are a safe bet. They are not difficult to do: you gather 5 -10 people, let them express their opinions, record them, extract from the diversity of views what you recognize as your own opinion and call it a ‘common theme’, and write the whole thing up, and – BINGO! – you have a publication. The beauty of this approach is manifold:
    • you can repeat this exercise ad nauseam until your publication list is of respectable length;
    • there are plenty of SCAM journals that will publish your articles;
    • you can manipulate your findings at will;
    • you will never produce a paper that displeases the likes of King Charles;
    • you might even increase your chances of obtaining funding for future research.
  1. Conduct surveys. They are very popular and highly respected/publishable projects in SCAM. Do not get deterred by the fact that thousands of similar investigations are already available. If, for instance, there already is one describing the SCAM usage by leg-amputated policemen in North Devon, you can conduct a survey of leg-amputated policemen in North Devon with a medical history of diabetes. As long as you conclude that your participants used a lot of SCAMs, were very satisfied with it, did not experience any adverse effects, thought it was value for money, and would recommend it to their neighbour, you have secured another publication in a SCAM journal.
  2. In case this does not appeal to you, how about taking a sociological, anthropological or psychological approach? How about studying, for example, the differences in worldviews, the different belief systems, the different ways of knowing, the different concepts about illness, the different expectations, the unique spiritual dimensions, the amazing views on holism – all in different cultures, settings or countries? Invariably, you must, of course, conclude that one truth is at least as good as the next. This will make you popular with all the post-modernists who use SCAM as a playground for enlarging their publication lists. This approach also has the advantage to allow you to travel extensively and generally have a good time.
  3. If, eventually, your boss demands that you start doing what (in his narrow mind) constitutes ‘real science’, do not despair! There are plenty of possibilities to remain true to your pseudo-scientific principles. Study the safety of your favourite SCAM with a survey of its users. You simply evaluate their experiences and opinions regarding adverse effects. But be careful, you are on thin ice here; you don’t want to upset anyone by generating alarming findings. Make sure your sample is small enough for a false negative result, and that all participants are well-pleased with their SCAM. This might be merely a question of selecting your patients wisely. The main thing is that your conclusions do not reveal any risks.
  4. If your boss insists you tackle the daunting issue of SCAM’s efficacy, you must find patients who happened to have recovered spectacularly well from a life-threatening disease after receiving your favourite form of SCAM. Once you have identified such a person, you detail her experience and publish this as a ‘case report’. It requires a little skill to brush over the fact that the patient also had lots of conventional treatments, or that her diagnosis was never properly verified. As a pseudo-scientist, you will have to learn how to discretely make such details vanish so that, in the final paper, they are no longer recognisable.
  5. Your boss might eventually point out that case reports are not really very conclusive. The antidote to this argument is simple: you do a large case series along the same lines. Here you can even show off your excellent statistical skills by calculating the statistical significance of the difference between the severity of the condition before the treatment and the one after it. As long as this reveals marked improvements, ignores all the many other factors involved in the outcome and concludes that these changes are the result of the treatment, all should be tickety-boo.
  6. Your boss might one day insist you conduct what he narrow-mindedly calls a ‘proper’ study; in other words, you might be forced to bite the bullet and learn how to do an RCT. As your particular SCAM is not really effective, this could lead to serious embarrassment in the form of a negative result, something that must be avoided at all costs. I, therefore, recommend you join for a few months a research group that has a proven track record in doing RCTs of utterly useless treatments without ever failing to conclude that it is highly effective. In other words, join a member of my ALTERNATIVE MEDICINE HALL OF FAME. They will teach you how to incorporate all the right design features into your study without the slightest risk of generating a negative result. A particularly popular solution is to conduct a ‘pragmatic’ trial that never fails to produce anything but cheerfully positive findings.
  7. But even the most cunningly designed study of your SCAM might one day deliver a negative result. In such a case, I recommend taking your data and running as many different statistical tests as you can find; chances are that one of them will produce something vaguely positive. If even this method fails (and it hardly ever does), you can always focus your paper on the fact that, in your study, not a single patient died. Who would be able to dispute that this is a positive outcome?
  8. Now that you have grown into an experienced pseudo-scientist who has published several misleading papers, you may want to publish irrefutable evidence of your SCAM. For this purpose run the same RCT over again, and again, and again. Eventually, you want a meta-analysis of all RCTs ever published (see examples here and here). As you are the only person who conducted studies on the SCAM in question, this should be quite easy: you pool the data of all your dodgy trials and, bob’s your uncle: a nice little summary of the totality of the data that shows beyond doubt that your SCAM works and is safe.

When I conduct my regular literature searches, I am invariably delighted to find a paper that shows the effectiveness of a so-called alternative medicine (SCAM). Contrary to the impression that I might give to some, I like positive results as much as the next person. So, today you find me pleased to yet again report about one of my favorite SCAMs.

The purpose of this systematic review was to evaluate the effectiveness of manual lymphatic drainage (MLD) in breast cancer-related lymphedema (BCRL) patients.

In total, 11 RCTs involving 1564 patients could be included, and 10 trials were deemed viable for inclusion in the meta-analysis. Due to the effects of MLD for BCRL, statistically significant improvements were found on the incidence of lymphedema (RR = 0.58, 95% CI [0.37, 0.93], P =.02) and pain intensity (SMD = -0.72, 95% CI [-1.34, -0.09], P = .02). Besides, the meta-analysis carried out implied that the effects that MLD had on volumetric changes of lymphedema and quality of life, were not statistically significant.

The authors concluded that the current evidence based on the RCTs shows that pain of BCRL patients undergoing MLD is significantly improved, while our findings do not support the use of MLD in improving volumetric of lymphedema and quality of life. Note that the effect of MLD for preventing BCRL is worthy of discussion.

Lymph drainage is so well-established in cancer care that most people would probably consider it a conventional treatment. If, however, you read for which conditions its inventor, Emil Vodder, used to promote it, they might change their minds. Vodder saw it as a cure for most illnesses, even those for which there is no plausibility or good evidence.

As far as I can see, lymph drainage works well for reducing lymph edema but, for all other conditions, it is not evidence-based. And this is the reason why I still categorize it as a SCAM.

The purpose of this review was to

  • identify and map the available evidence regarding the effectiveness and harms of spinal manipulation and mobilisation for infants, children and adolescents with a broad range of conditions;
  • identify and synthesise policies, regulations, position statements and practice guidelines informing their clinical use.

Two reviewers independently screened and selected the studies, extracted key findings and assessed the methodological quality of included papers. A descriptive synthesis of reported findings was undertaken using a level-of-evidence approach.

Eighty-seven articles were included. Their methodological quality varied. Spinal manipulation and mobilisation are being utilised clinically by a variety of health professionals to manage paediatric populations with

  • adolescent idiopathic scoliosis (AIS),
  • asthma,
  • attention deficit hyperactivity disorder (ADHD),
  • autism spectrum disorder (ASD),
  • back/neck pain,
  • breastfeeding difficulties,
  • cerebral palsy (CP),
  • dysfunctional voiding,
  • excessive crying,
  • headaches,
  • infantile colic,
  • kinetic imbalances due to suboccipital strain (KISS),
  • nocturnal enuresis,
  • otitis media,
  • torticollis,
  • plagiocephaly.

The descriptive synthesis revealed: no evidence to explicitly support the effectiveness of spinal manipulation or mobilisation for any condition in paediatric populations. Mild transient symptoms were commonly described in randomised controlled trials and on occasion, moderate-to-severe adverse events were reported in systematic reviews of randomised controlled trials and other lower-quality studies. There was strong to very strong evidence for ‘no significant effect’ of spinal manipulation for managing

  • asthma (pulmonary function),
  • headache,
  • nocturnal enuresis.

There was inconclusive or insufficient evidence for all other conditions explored. There is insufficient evidence to draw conclusions regarding spinal mobilisation to treat paediatric populations with any condition.

The authors concluded that, whilst some individual high-quality studies demonstrate positive results for some conditions, our descriptive synthesis of the collective findings does not provide support for spinal manipulation or mobilisation in paediatric populations for any condition. Increased reporting of adverse events is required to determine true risks. Randomised controlled trials examining effectiveness of spinal manipulation and mobilisation in paediatric populations are warranted.

Perhaps the most important findings of this review relate to safety. They confirm (yet again) that there is only limited reporting of adverse events in this body of research. Six reviews, eight RCTs and five other studies made no mention of adverse events or harms associated with spinal manipulation. This, in my view, amounts to scientific misconduct. Four systematic reviews focused specifically on adverse events and harms. They revealed that adverse events ranged from mild to severe and even death.

In terms of therapeutic benefit, the review confirms the findings from the previous research, e.g.:

  • Green et al (Green S, McDonald S, Murano M, Miyoung C, Brennan S. Systematic review of spinal manipulation in children: review prepared by Cochrane Australia for Safer Care Victoria. Melbourne, Victoria: Victorian Government 2019. p. 1–67.) explored the effectiveness and safety of spinal manipulation and showed that spinal manipulation should – due to a lack of evidence and potential risk of harm – be recommended as a treatment of headache, asthma, otitis media, cerebral palsy, hyperactivity disorders or torticollis.
  • Cote et al showed that evidence is lacking to support the use of spinal manipulation to treat non-musculoskeletal disorders.

In terms of risk/benefit balance, the conclusion could thus not be clearer: no matter whether chiropractors, osteopaths, physiotherapists, or any other healthcare professionals propose to manipulate the spine of your child, DON’T LET THEM DO IT!

The year 2022 is drawing to a close, and I am reminded of my ‘WORST PAPER OF 2022 COMPETITION’. As a prize, I am offering the winner (that is the lead author of the winning paper) one of my books that best fits his/her subject. I am sure this will overjoy him or her. I hope to identify about 10 candidates for the prize, and towards the end of the year, I let my readers decide democratically on who should be the winner. In this spirit of democratic voting, let me suggest to you entry No 10 entitled ‘Conventional Homeopathic Medicine and Its Relevance to Modern Medicine‘. Here is the unadulterated abstract:

Context: Homeopathic medicine can be explained as a symptoms-based method of treatment, and it can act as an alternative treatment strategy against allopathy by focusing on the symptoms of illness, as opposed to causative agents as allopathic medicine does. Also, homeopathic medicines are extracted from nature rather than being chemically synthesized as western drugs are.

Objective: The review intended to briefly describe the concept of homeopathic medicine, its emergence from a historical point of view, and its broader healing properties, providing examples of key homeopathic drugs and comparing them to modern medicines.

Design: The research team performed a narrative review by searching databases like Pubmed, Google Scholar, and other national search engines. The search used the keywords homeopathic medicine, alternate medicine, materia medica, allium cepa, Zingiber officinale, penicillium, Agaricus muscaria, Botulinum toxin.

Setting: Dr. D.Y. Patil Homoeopathic Medical College and Research Centre, Dr. D.Y. Patil Vidyapeeth (Deemed to be University), Pimpri, Pune.

Results: This review highlights the rich sources homoeopathic drugs and their corelation with modern medicine. The current review focuses on the significance of the Homeopathic Materia Medica and on notable remedies in homeopathy that align with allopathy in addressing different pathological conditions, including treatments that the two types of medicine have in in common and that are effective in homeopathy.

Conclusions: Many studies are being conducted to prove the mechanism of action of homoeopathic medicines. Droplet Evaporating Method (DEM), Raman, UltraViolet-Visible (UV-VIS) spectroscopy and Transmission Electron Microscopy (TEM) are commonly used methods to characterize homeopathic medicines at ultra-low concentration and many such studies will surely indicate how homoeopathic medicines act. Such research results may subsequently lead to the betterment of treatment procedures and the integration of homeopathic principles into mainstream medical practices.

I find it quite an ‘achievement’ to put so much nonsense into such a short abstract. My ‘favorite’ statement is this one: “many such studies will surely indicate how homoeopathic medicines act.” Since he published this paper, the first author has done another article; it is entitled “Breast Abscess Healing with Homoeopathy: A Case Report” and would be a further contender for my award.

But let’s not give him an unfair chance to win the competition!

 

PS

The next time I post about this will be about deciding on this year’s winner. So, you might want to give it some consideration.

This Cochrane review assessed the effectiveness and safety of oral homeopathic medicinal products compared with placebo or conventional therapy to prevent and treat acute respiratory tract infections (ARTIs) in children.

The researchers included double‐blind randomized clinical trials (RCTs) or double‐blind cluster‐RCTs comparing oral homeopathy medicinal products with placebo or self‐selected conventional treatments to prevent or treat ARTIs in children aged 0 to 16 years.

In this 2022 update, the researchers identified three new RCTs involving 251 children, for a total of 11 included RCTs with 1813 children receiving oral homeopathic medicinal products or a control treatment for ARTIs. All studies focused on upper respiratory tract infections (URTIs), with only one study including some lower respiratory tract infections (LRTIs). Six RCTs examined the effect on URTI recovery, and five RCTs investigated the effect on preventing URTIs after one to four months of treatment. Two treatment and three prevention studies involved homeopaths individualizing treatment. The other studies used predetermined, non-individualized remedies. All studies involved highly diluted homeopathic medicinal products, with dilutions ranging from 1 x 10‐4 to 1 x 10‐200.

Several limitations to the included studies were identified, in particular methodological inconsistencies and high attrition rates, failure to conduct intention‐to‐treat analysis, selective reporting, and apparent protocol deviations. Three studies were classified as at high risk of bias in at least one domain, and many studies had additional domains with unclear risk of bias. Four studies received funding from homeopathy manufacturers; one study support from a non‐government organization; two studies government support; one study was co‐sponsored by a university; and three studies did not report funding support.

Methodological inconsistencies and significant clinical and statistical heterogeneity precluded robust quantitative meta‐analysis. Only four outcome variables were common to more than one study and could be combined for analysis. Odds ratios (OR) were generally small with wide confidence intervals (CI), and the contributing studies found conflicting effects, so there was little certainty that the efficacy of the intervention could be ascertained. All studies assessed as at low risk of bias showed no benefit from oral homeopathic medicinal products, whilst trials at unclear or high risk of bias reported beneficial effects. For the comparison of individualized homeopathy versus placebo or usual care for the prevention of ARTIs, two trials reported on disease severity; due to heterogeneity the data were not combined, but neither study demonstrated a clinically significant difference. For the comparison of non-individualized homeopathy versus placebo or usual care for the prevention of ARTIs, only the outcome recurrence of ARTI was reported by more than one trial. For the comparison of both individualized and non-individualized homeopathy versus placebo or usual care for the treatment of ARTIs, two studies provided data on short‐term cure (OR 1.31, 95% CI 0.09 to 19.54) and long‐term cure (OR 1.01, 95% CI 0.10 to 9.96; very low‐certainty evidence). The studies demonstrated an opposite direction of effect for both outcomes. Six studies reported on disease severity but were not combined as they used different scoring systems and scales. Three studies reported adverse events (OR 0.79, 95% CI 0.16 to 4.03; low‐certainty evidence).

The authors concluded that the “pooling of five prevention and six treatment studies did not show any consistent benefit of homeopathic medicinal products compared to placebo on ARTI recurrence or cure rates in children. We assessed the certainty of the evidence as low to very low for the majority of outcomes. We found no evidence to support the efficacy of homeopathic medicinal products for ARTIs in children. Adverse events were poorly reported, and we could not draw conclusions regarding safety.”

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These findings are hardly surprising. Will they change the behavior of homeopaths who feel that

  1. children respond particularly well to homeopathy,
  2. ARTIs are conditions for which homeopathy is particularly effective?

I would not hold my breath!

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