conflict of interest
The aim of this study was to establish an international consensus regarding the use of spinal manipulation and mobilisation among infants, children, and adolescents among expert international physiotherapists. Twenty-six international expert physiotherapists in manual therapy and paediatrics voluntarily participated in a 3-Round Delphi survey to reach a consensus via direct electronic mail solicitation using Qualtrics®. Consensus was defined a-priori as ≥75% agreement on all items with the same ranking of agreement or disagreement. Round 1 identified impairments and conditions where spinal mobilisation and manipulation might be utilised. In Rounds 2 and 3, panelists agreed or disagreed using a 4-point Likert scale.
Eleven physiotherapists from seven countries representing five continents completed all three Delphi rounds. Consensus regarding spinal mobilisation or manipulation included:
● Manipulation is not recommended: (1) for infants across all conditions, impairments, and
spinal levels; and (2) for children and adolescents across most conditions and spinal levels.
● Manipulation may be recommended for adolescents to treat spinal region-specific joint
hypomobility (thoracic, lumbar), and pain (thoracic).
● Mobilisation may be recommended for children and adolescents with hypomobility, joint
pain, muscle/myofascial pain, or stiffness at all spinal levels.
The authors of this paper concluded that consensus revealed spinal manipulation should not be performed on infants regardless of condition, impairment, or spinal level. Additionally, the panel agreed that manipulation may be recommended only for adolescents to treat joint pain and joint hypomobility (limited to thoracic and/or lumbar levels). Spinal mobilisation may be recommended for joint hypomobility, joint pain, muscle/myofascial pain, and muscle/myofascial stiffness at all spinal levels among children and adolescents.
Various forms of spinal manipulations are the hallmark therapy of chiropractors. Almost 100% of their patients recieve these interventions. So, what will our friends, the chiros, say about the consensus? Might it be this:
- Physiotherapists are not the experts on spinal manipulation.
- Only chiropractors can do them properly.
- And when WE do them, they are very good*!
(* for our income)
This study aims to assess the feasibility of a pragmatic prospective study aiming to report the immediate and delayed (48-hours post-treatment) AEs associated with manual therapies in children aged 5 or younger and to report preliminary data on AEs frequency.
Between July 2021 and March 2022, chiropractors were recruited through purposive sampling and via a dedicated Facebook group for Quebec chiropractors interested in pediatrics. Legal guardians of patients aged 5 or younger were invited to fill out an online information and consent form. AEs were collected using the SafetyNET reporting system, which had been previously translated by the research team. Immediate AEs were collected through a questionnaire filled out by the legal guardian immediately after the treatment, while delayed AEs were collected through a questionnaire sent by email to the legal guardian 48 h after the treatment. Feasibility was assessed qualitatively through feedback from chiropractors and quantitatively through recruitment data.
Overall, a total of 28 chiropractors expressed interest following the Facebook publication, and 5 participated. An additional two chiropractors were enrolled through purposive sampling. In total, 80 legal guardians consented to their child’s participation, and data from 73 children were included for the analysis of AEs. At least one AE was reported in 30% of children (22/73), and AEs were mainly observed immediately following the treatment (16/22). The most common AEs were irritability/crying (11 children) or fatigue/tiredness (11 children). Feasibility analysis demonstrated that regular communication between the research team and clinicians, as well as targeting clinicians who showed great interest in pediatrics, were key factors for successful research.
The authors concluded that their results suggest that it is feasible to conduct a prospective pragmatic study evaluating AEs associated with manual therapies in private practices. Direct communication with the clinicians, a strategic clinicians’ recruitment plan, and the resulting administrative burden should be considered in future studies. A larger study is required to confirm the frequency of AEs reported in the current study.
It is hardly surprising that such a study is ‘feasible’. I could have told the authors that and saved them the trouble of doing the study. What is surprising, in my view, that chiropractors, after ~120 years of existence of the profession, ask whether it is feasible.
I suggest to do the definitive study on a much larger sample, extend the observation period, and recruit a representative rather than self-selected sample of chiros … or – much better – forget about the study and establich a functioning post-marketing surveillance system.
In recent weeks and months, I have been thinking quite a lot about the various types of scientists. This is partly due to me finishing a book entitled:
1. SCIENTIST
Scientists gather information through observation and experimentation, formulate hypothesis, and then test them. They work in vastly different areas but have certain attitudes or qualities in common, e.g. critial thinking and an open mind. As scientists tend to publish their findings, a very simple (but not fool-proof) way to identify a scinetist is to look him/her up, for example by finding his/her H-Index. (The H-Index is defined as the maximum value of h such that the given author/journal has published at least h papers that have each been cited at least h times. For instance, if someone has 10 papers that were cited 10 times, his H-Index would be 10. If another scientist has 50 papers that were cited 50 times, his H-Index would be 50.)
2. PSEUDO-SCIENTIST
Pseudo-scientists are people who pretend to produce science but, in fact, they generate pseudoscience. The demarkation of pseudo-science from science is sometimes difficult, as we have seen several times on this blog, e.g.:
- Characteristics of pseudoscience
- Science or Pseudoscience?
- Is acupuncture pseudoscience?
- The techniques of pseudoscience
- Pseudoscience revisited
- Tolerance towards pseudo-science?
- How to become a charlatan
The pseudo-scientist does have no or just a few publications in the peer-reviewed literature and no H-Index to speak of.
3. WOULD-BE SCIENTIST
The term ‘would-be scientist’ is not one that is commonly used, nor is it one that has an accepted definition. The way I see it, would-be scientists are aspiring to become scientist. They are on the way to become a scientist but have not quite arrived yet. To the would-be scientist I say: good luck to you; I hope you make it and I look forward to reading about your scientific achievements. The would-be scientist is, however, not the topic of my post.
4. THE PREDEND-SCIENTIST
The predent-scientist (PS) is the one who I want to focus on here. He – yes, the PS is usually male – talks a lot about science; so much so that outsiders would get the impression that he actually is a scientist. Crucially, the PS himself has managed to delude himself to the point where believes to be a scientist.
While scientists tend to be media-shy, the PS enjoys the limelight to generate the impression of being a scientist. He talks eloquently and at length about science. Much of what he says or writes might even be correct. The PS is often quite well-versed and knows (most of) his stuff.
The crucial difference between the PS and the scientist is that the PS produces no or very little science; neither does he intend to. To identify the PS, an easy (but not fool-proof) method is to him look up. Typically, he has published several articles in the popoular press or books for the lay public, but – as he does not conduct scientific research – he does not generate papers in the peer-reviewed scientific literature. This void, however, has never stopped the PS from appearing in the media speaking about science, nor from occupying prominent positions in the world of science, nor from avidly rubbing shoulders with scientists. Few people see anything wrong with that, mainly because the PS has convinced them (most importantly himself) that he actually is a scientist. While the scientist is trained in doing science, the PS is trained in talking about science.
Don’t get me wrong, the PS can have his merits. He often presents science to the public more or less accurately and frequently is rhetorically superior to the scientist. I nevertheless have reservations about the PS (and the recent pandemic has shown us how dangerous PSs can beome). The questions to ask ourselves are the following:
- Does PS have a truly open mind?
- Can he set aside ideologies?
- Will he change his opinion vis a vis new evidence?
- Is he prepared to consider criticism?
- Does he avoid ‘black and white’ thinking?
- Is he sufficiently humble?
- Is he honest with himself and others?
These questions refer to important attitudes that scientists learn – often the hard way – while doing science. If someone lacks this experience, such attitudes are likely to be under-developed. Perhaps, it all boils down to honesty: if a man who has never done any amount of science to speak of has convinced himself to be a scientist, he arguably is dishonest with himself and the public.
In order to make my points as clearly as possible, I admittedly caricaturized the extremes of a wider spectrum; my appologies for that. In reality, the different types of scientists rarely exist as entirely pure forms. Frequently, people are mixtures of two types, either because they did different things during different periods of their lives, or because they simply are hybrids.
To provide a few examples, let me show you 14 H-Indices (according to ‘Google Scholar’) of people (in alphabetical order) who you might have heard of, for instance, because they have featured on my blog. I leave it up to you to decide how well they fit in any of my three categories and who might qualify to be a PS.
- Fabrizio Benedetti – H-Index = 83
- David Colquhoun – H-Index = 78
- Ian Chalmers – H-Index = 84
- Michael Dixon – H-Index = 0
- David Gorski – H-Index = 30
- Holm Hümmler – H-Index = 0
- Ted Kaptchuk – H-Index = 103
- Jos Kleinjen – H-Index = 104
- Andreas Michalsen – H-Index = 0
- Michael Mosely – H-Index = 0
- Dana Ullman – H-Index = 0
- Dale Thompson (alias DC) – H-Index = 0
- Chris van Tulleken – H-Index = 0
- Harald Walach – H-Index = 9
My conclusion: the PS, a person who presents himself as a scientist without having done any meaningful amount of science himself, is a man who is not entirely honest. The H-Index can be helpful for identifying PSs. An index of zero, for instance, seems to send out a fairly clear message. In the case low indices, it is advisable to go one step further and study the actual articles That mede up the index. However, the H-Index tells us nothing about whether someone presents himself as a scientist; this information must be gleaned from the person him(her)self.
A recent article about ayurvedic medicine caught my eye. Here are a few excerpts:
Imagine if there were a magic pill to ward off COVID-19. Or if you could cure diabetes with vegetable juices and herbal pills instead of controlling it with insulin medication. Or if yoga and breathing exercises were all you need to do to get rid of asthma. These are all claims made by Patanjali Ayurved, one of India’s biggest manufacturers of traditional ayurvedic products…
Many scientists have expressed concerns over the lack of research into the safety and efficacy of ayurvedic products… Nonetheless, Ayurveda enjoys widespread acceptance among Indians. And under India’s Hindu-nationalist government that took power in 2014, ayurveda and other alternative systems of medicine have received unprecedented government support. India’s ministry of alternative medicine gets nearly $500 million a year. The government also promotes ayurveda through its international trade and diplomatic channels. All this set Patanjali’s fortunes soaring.
But now the Supreme Court of India has temporarily banned Patanjali – named after a Hindu mystic best known for his writings on yoga – from advertising some of its products… “The entire country has been taken for a ride,” Ahsanuddin Amanullah, one of the two judges conducting the court hearing, told the lawyer representing the government… The Indian Medical Association had brought the case to court in August 2022, claiming that Patanjali and its brand ambassador Baba Ramdev made a series of false claims against evidence-backed modern medicine and its practitioners, and spread misinformation about COVID-19 vaccines. Their petition also referred to instances where Ramdev lambasted modern medicine as a “stupid and bankrupt science” at a yoga session. The trigger was a series of Patanjali advertisements in Indian newspapers in July 2022 claiming that ayurvedic products could cure chronic conditions like diabetes, high blood pressure, heart diseases and autoimmune conditions. The Indian Medical Association’s petition alleged that such claims were in violation of India’s Drugs and Magic Remedies (Objectionable Advertisements) Act.
…The company’s public face – yoga guru Baba Ramdev – is a vocal supporter of India’s ruling party, the BJP, and Prime Minister Narendra Modi. Modi even inaugurated Patanjali’s ayurvedic research facility in 2017… Some scientists have accused their government of promoting these alternative medicines at the expense of modern medicine, partly as a way to glorify India’s culture and history. “One of the political ideas of this government is to glorify the Hindu tradition,” says Dhrubajyoti Mukherjee, president of the Breakthrough Science Society, an organization that promotes scientific thinking. “But in the name of our glorious past, the government is propagating obscure, unscientific ideas.”
… A few months after the outbreak of the COVID-19 pandemic in 2020, India’s health minister at the time, Harsh Vardhan participated in the company’s launch of pills, where Ramdev, the yoga guru, claimed the pills showed “100 percent favorable results” during clinical trials on patients. Despite experts flagging the lack of evidence, the company said it sold 2.5 million kits in six months, consisting of the tablets to ward off COVID-19 and bottled oils that would allegedly boost immunity. And the company is making an enormous amount of money: Its income was over $1.3 billion in the financial year 2021-22, with profits of $74 million before taxes.
Addressing the overall impact of misinformation about ayurvedic treatments, Dr. Jayesh Lele, vice president of the Indian Medical Association, says “Our worry is people are being misguided. We have got people who’ve left our treatment saying their kidneys will be able to function properly [using ayurvedic medicines] and ended up with renal failure. The same happened with patients suffering from hepatitis, who’ve got the wrong medicine and ended up with further problems. And if you say every day that modern medicine is bad, that is not acceptable.”
_______________
The sad thing, in my view, is that (as discussed previously) ayurvedic medicine has not just taken India for a ride:
- King Charles’ “Ayurvedic Centre of Excellence” turns out to be an embarrassing failure
- Dr Michael Dixon seems to support homeopathy as a treatment for cancer
- PRINCE CHARLES: the ‘immense value’ of alternative diagnostic methods
- Will the UK ‘ROYAL COLLEGE OF GENERAL PRACTITIONERS’ soon become a ‘ROYAL COLLEGE OF QUACKERY’?
And perhaps even more disappointing is the notion that, while in India they take action in order to prevent harm, I can see no such developments in the UK.
Looking at some ancient papers of mine, I came across a short BMJ paper from 1994. Here is a passage from it:
… A standard letter (on departmental letterhead) was written (in German) to all 189 firms that we identified as marketing herbal drugs in Germany. It asked (among other questions) for reprints of articles reporting controlled clinical trials on the company’s product(s).
Only 19 replies had reached us six weeks later. Four of these included at least one reprint. Twelve respondents regretted not knowing of clinical trials on their drug(s). In three cases we had written to a wrong address (one
instance) or to a firm which did not market phytomedicines (two instances).
These data, though far from conclusive, do not give the impression that research is in proportion to either prevalence or financial tumover of herbal remedies…
I wonder what the results would be, if we repeated this little excercise today, 30 years afteer the original investigation. I fear that the findings would be much the same or perhaps even worse. I also suspect that they would be similar regardless of the country we chose. Those who sell herbal remedies have very little incentive to do expensive clinical trials to test whether the products they earn their money with actually work. They may be doing well without it and ask themselves, why spend money on research that might not show what we hope and could easily turn out to jeopardize our financial success?
But the problem is by no means confined to herbal manufacturers (who would arguably have an important share to initiate and sponsor research). Even though fundamental questions remain unanswered, research into herbal medicine is scarce across the board.
To see whether this statement is true, I did a very quick Medline search. It showed that, in 2023, just over 13 000 papers on herbal medicine emerged. Of those, just 460 were listed as clinical trials. The latter figure is almost certainly considerably smaller than the true amount because Medline is over-generous in classifying papers as clinical trials. I thus estimate that only around 200 clinical trials of herbal medicine are conducted each year. Considering that we are dealing with thousands of herbs and ten thousands of herbal products, this figure is an embarrassment for the sector – which, as we have seen just days ago, is doing extremely well in finacial terms.
According to its authors, this study‘s objective was to demonstrate that acupuncture is beneficial for decreasing the risk of ischaemic stroke in patients with rheumatoid arthritis (RA).
The investigation was designed as a propensity score-matched cohort nationwide population-based study. Patients with RA diagnosed between 1 January 1997 and 31 December 2010, through the National Health Insurance Research Database in Taiwan. Patients who were administered acupuncture therapy from the initial date of RA diagnosis to 31 December 2010 were included in the acupuncture cohort. Patients who did not receive acupuncture treatment during the same time interval constituted the no-acupuncture cohort. A Cox regression model was used to adjust for age, sex, comorbidities, and types of drugs used. The researchers compared the subhazard ratios (SHRs) of ischaemic stroke between these two cohorts through competing-risks regression models.
After 1:1 propensity score matching, a total of 23 226 patients with newly diagnosed RA were equally subgrouped into acupuncture cohort or no-acupuncture cohort according to their use of acupuncture. The basic characteristics of these patients were similar. A lower cumulative incidence of ischaemic stroke was found in the acupuncture cohort (log-rank test, p<0.001; immortal time (period from initial diagnosis of RA to index date) 1065 days; mean number of acupuncture visits 9.83. In the end, 341 patients in the acupuncture cohort (5.95 per 1000 person-years) and 605 patients in the no-acupuncture cohort (12.4 per 1000 person-years) experienced ischaemic stroke (adjusted SHR 0.57, 95% CI 0.50 to 0.65). The advantage of lowering ischaemic stroke incidence through acupuncture therapy in RA patients was independent of sex, age, types of drugs used, and comorbidities.
The authors concluded that this study showed the beneficial effect of acupuncture in reducing the incidence of ischaemic stroke in patients with RA.
It seems obvious that the editors of ‘BMJ Open’, the peer reviewers of the study and the authors are unaware of the fact that the objective of such an investigeation is not to to demonstrate that acupuncture is beneficial but to test whether acupuncture is beneficial. Starting a study with the intention to to show that my pet therapy works is akin to saying: “I am intending to mislead you about the value of my intervention”.
One needs therefore not be surprised that the authors of the present study draw very definitive conclusions, such as “acupuncture therapy is beneficial for ischaemic stroke prevention”. But every 1st year medical or science student should know that correlation is not the same as causation. What the study does, in fact, show is an association between acupuncture and stroke. This association might be due to dozens of factors that the ‘propensity score matching’ could not control. To conclude that the results prove a cause effect relationship is naive bordering on scientific misconduct. I find it most disappointing that such a paper can pass all the hurdles to get published in what pretends to be a respectable journal.
Personally, I intend to use this study as a good example for drawing the wrong conclusions on seemingly rigorous research.
Acute Otitis Media (AOM) is one of the most common acute infections in children and often injudiciously treated by antibiotics. Homeopathy has been claimed to work but is it really effective?
This open label, randomized, controlled, parallel arm trial was conducted on children (aged 0–12 years), suffering from AOM. The primary outcome was changes in Tympanic Membrane Examination scale (TMES) and Acute Otitis Media-Severity of Symptoms (AOM-SOS) scale, time to improvement in pain through Facial Pain Scale-Revised (FPS-R) over 10 days. The need for antibiotics in both groups and the recurrence of subsequent episodes of AOM over 12 months were also compared.
Intention-to-treat analysis was performed on 222 children; Homeopathy (n = 117) (H-group), Allopathy (A-group) (n = 105). There was a statistically significant reduction of scores in H-group compared with A-group at each time point: at day 3 (mean diff. ± sd: 1.71 ± 0.19; 95% CI: 1.34 to 2.07; p = 0.0001), at day 7 (mean diff. ± sd: 1.29 ± 0.24; 95% CI: 0.82 to 1.76; p = 0.0001) and at day 10 (mean diff. ± sd: 1.23 ± 0.25; 95% CI = 0.74 to 1.71; p = 0.0001) favoring homeopathy. Clinical failure by the third day of treatment was observed in 11% and 24% of children in H-group vs A-group (OR: 0.03; 95% CI: 0.001 to 0.52; p = 0.03). None of the children in the H-group required antibiotics, whereas 14 children in the A-group did.
The authors concluded that both therapies seemed to produce comparable effects and appeared safe. The study consolidated the findings observed during a pilot study, i.e., homeopathy is non-inferior to allopathy in managing AOM in children and antibiotics in children can be avoided.
This study was published in the journal ‘Homeopathy’ and originates from the Central Council for Research in Homeopathy, New Delhi, India. Sadly, I do not have the full text of the paper and cannot therefore scrutinize it adequately.
Let me just mention these three facts:
- The journal ‘Homeopathy’ never publishes negative results.
- Indian researchers of homeopathy publish as good as no negative results.
- As far as I can see, the Central Council for Research in Homeopathy, New Delhi, has never published a negative result.
These points do, of course, not necessarily mean that the study is false-positive, but they do not inspire me with confidence. In any case, it seems wise to insist on better evidence. To render it credible, we would need:
- Several rigorous RCTs that test homeopathy for AOM against placebo.
- If (and only then) they show that homeopathy is better than placebo, at least one independent replication of the present study.
As the biological plausibility of all this is close to zero, the chances that this will happen are also zero.
I have left the German skeptics organisation , GWUP, two days ago. This led to many questions and confusion. I therefore feel that I owe it to those skeptics who I may have upset or unsettled to offer a few clarifications (I do appologise, if this does not make much sense to those readers who were unable to follow the various disputes and discussions that took place, mostly in German, on Twitter).
1. Clarification – accusation of antisemitism: This accusation is completely absurd! In my opinion, the 1st re-Tweet that Bartoschek is using is not anti-Semitic. I have posted thousands of tweets, many of which are the opposite of anti-Semitic, as anyone can verify. Moreover, I have worked for the last 30 years to fight antisemitism and can probably show more results of this endeavor than my accuser.
2. Clarification – I can’t find the 2nd re-tweet that Bartoschek exhibits. No idea who found it and where! I can’t remember the text (but I do vaguely remember the graphic), and I certainly didn’t delete anything. I would delete if, if I could find it and be open about it. If it turns out that I am nevertheless at fault, I can only apologise.
3. Clarification – peer-review publications by Hirsch, Huemmler, Bartoschek (who I sarcastically called ‘the GWUP-elite’). After watching a long video of these gentlemen, I began to doubt whether they are true scientists (or even skeptics) at all. Hence my legitimate question. The answer seems to be largely negative.
4. Clarification – Bartoschek claims “Prof Ernst is on the side of the “anti-woke”. However, I have repeatedly emphasised that I do not believe in and even detest both ‘woke’ and ‘anti-woke’.
5. Clarification – Mr Hirsch is the ‘social media manager’ of the GWUP commissioned by Huemmler, the current chair of the GWUP. The fact that he spreads aggressive nonsense in this role under the pseudonym ‘Endgegner der Kommentarspalten’ is inadmissible.
6. Clarification – I have not gained the impression that the current division of the GWUP is primarily idiological in nature (both sides are not far apart in this respect), but believe that it is a rather ridiculous power struggle on a personal level.
7. Clarification – I have left the GWUP because I am sure that I can do my work better without it, because the current tone amongst GWUP members is unacceptable, because the GWUP is currently not converting its membership fees (I estimate ~200 000 per year) into meaningful activities, because the current GWUP ‘elite’ behaves neither as genuine sceptics nor as true scientists, and because I fear that things will only get worse after the AGM in May.
_________________________
My hope is that this is the last time I have to mention this sorry story here on my blog.
The 29th of February is an unusual date, and I will do something fittingly unusual today – something that I have never done before: I will with a heavy heart resign from an organisation of skeptics.
After I had observed the self-destructive debates within the GWUP for almost one year without saying a single word about it (hoping they would soon dissolve into thin air), I published a comment a few days ago. Soon after, I was aggressed, defamed, wrongly denounced as an anti-Semite, and blackmailed by leading members of that organisation.
Confronted with these events, it was inevitable that I would have doubts about my previous plan to remain a member until the upcoming general assembly in May. While I was contemplating, I received a Tweet on 27/2/2024 from someone under the pseudonym Endgegner der Kommentarspalten; it included this sentence:
Einer der verschwörungsideologischen Clowns, die seit gut einem Jahr Kulturkrieg in der GWUP mit rechtsextremen Talking Points spielen und Märchen von einem “woken Putsch” herbeiphantasieren?
My translation:
One of the conspiracy ideological clowns who have been playing culture war in the GWUP for a good year with right-wing extremist talking points and fantasising about a “woke coup”?
Next, I watched a long discussion on youtube between the new chair of the GWUP, my accuser (Bartoschek) and Sebastian Hirsch. There I learnt that the latter is, in fact, nobody else than Endgegner der Kommentarspalten. He was recently put in charge of Twitter account for GWUP by the chair.
At this point, I lost the hope that the GWUP might be saved. It seems to be in the hand of thugs who call not me personally but their opponents ‘ideological clowns who have been playing culture war’. They claim that they want to keep politics out of the GWUP, yet almost all they do is engaging in politics.
Since the former formidable chair, Amardeo Sarma, left and the rift started, the GWUP has done nothing wothwhile, as far as I can see. On the GWUP website, we are told that (my translation):
- The GWUP aims at promoting science and scientific thinking.
- The GWUP investigates parascientific theories according to the current state of scientific knowledge and reports publicly and comprehensibly on its findings.
- The GWUP aims to disseminate scientific and critical thinking and scientific methods, explain them in a generally understandable way and clearly distinguish real science from parascience. The GWUP thus wants to contribute to reducing society’s susceptibility to parascientific ideas and promises.
- The GWUP is an internationally orientated society. It is happy to work with like-minded individuals, organisations and institutions.
GWUP stands for ‘Gesellschaft zur wissenschaftlichen Untersuchung von Parawissenschaften’ (Society for the Scientific Investigation of Parasciences). The people currently in charge claim to be scientists but most of them are not (talking about science or publishing books for the lay reader about it does not, in my view, make you a scientist!). The leadership of the GWUP, it seems to me, is currently dominated by small-minded inward-looking guys with no international perspective who are in the middle of a mega-ego trip.
Instead of fighting parascience, they feel entitled to fight their colleagues. Instead of doing their job, they open the door to parascience. Instead of being scientists, they are using skepticism as an excuse for their machinations. Instead of running a scientific organisation, they turned it into a veritable kindergarden. In a nutshell: to the utmost delight of German parascientists, they have completely lost the plot.
I do not believe that the general assembly can turn things around. More likely, matters will get worse and it will come to a complete split. Personally, I cannot – not even until May – remain a member of an organisation where the man officially put in charge of the Twitter account feels entitled to collectively call his opponents ‘ideological clowns who have been playing culture war’. This remark in itself might not be all that significant but, for me, it is the ‘last straw’ and a symptom of a deep and irreversible rot.
So, I have come to the conclusion that I can do my work better without any further GWUP-hindrance. Therefore, I will now email my resignation as a member of the GWUP.
Jennifer Jacobs started publishing peer-reviewed papers on homeopathy in the early 1990s. This happens to be around the same time as I did. So, we both have about 30 years of research into homeopathy behind us.
Jennifer just authored a paper entitled “Thirty Years of Homeopathic Research – Lessons Learned“. Here is its abstract:
Conducting double-blind randomized controlled trials is difficult, even in the allopathic medical system. Doing so within the paradigm of classical homeopathy is even more challenging. More than thirty years of experience in carrying out such trials has taught me much about the pitfalls to avoid as well as the factors that can lead to success. The initial steps of putting together a research protocol, securing funding, and obtaining human subjects’ approval can be daunting. After that comes developing questionnaires and surveys, hiring study personnel, and recruitment of subjects. The actual implementation of the research comes with its own set of possible missteps. Sample size determination, entry criteria, as well as type, frequency and duration of treatment are all crucial. Finally, statistical analysis must be performed to a high standard and a manuscript prepared to submit for publication. Even then there can be one or more manuscript revisions to make, based on feedback from reviewers, before a study is actually published. The entire process can take at least two years and is usually much longer.
Mistakes at any one of these steps can damage the outcome, as well as the impact of the study. With examples from my body of research, I will discuss some of the things that I wish I had done differently, as well as those that turned out to be correct. Homeopathic research is held to a much higher standard than conventional trials. Any flaws in study design, implementation, and analysis can be used by critics to negate the results. I am hopeful that the next generation of homeopathic researchers will learn from my experiences and carry on with great success.
Jennifer’s example motivated me to follow suit and contribute some very brief thoughts about my 30 years of homeopathy research and the lessons I have learnt:
Conducting double-blind randomized controlled trials is difficult in any area of medicine. Yet these types of studies are by far the best way to find out which treatments work and which don’t. Therefore, they need doing, regardless of the obstacles they may pose.
In homeopathy, we now have a large body of such trials. Sadly, not all of them are reliable. Those that are, according to accepted criteria, tend to fail to show that homeopathy works better than a placebo. Understandably, homeopaths are disappointed with this overall result and have made numerous attempts to invalidate it.
The main problem with research into homeopathy is not the research methodology. It is well established for clinical trials and can be easily modified to fit all the demands made by individualised treatment or other pecularities that may apply to homeopathy. The main problem is the homeopath who finds it impossible to accept the truth, namely that highly diluted homeopathic remedies are pure placebos and any observed benefits of homeopathy are due to non-specific effects such as the empathetic encounter or a placebo response.
The lesson to be learned from the past is that, in medicine, even the most obsessive belief, conviction or wishful thinking will eventually have to give way to the scientific evidence. In the case of homeopathy, this process has taken an extraordinary amount of time and effort but, finally, we are almost there and the writing is on the wall for everyone to see.
Two resumes of 30 years of work, research and experience!
And what a difference between them!
Who do you think gets closer to the truth,
Jennifer or I?
