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

homeopathy

They say, one has to try everything at least once – except line-dancing and incest. So, when I was invited to co-organize a petition, I considered it and thought: WHY NOT?

Here is the text (as translated by myself) of our petition to the German Medical Association:

 

 

Dear President Dr Reinhardt,

Dear Ms Lundershausen,

Mrs Held,

Dear Ms Johna,

We, the undersigned doctors, would like to draw your attention to the insistence of individual state medical associations on preserving “homeopathy” as a component of continuing medical education. We hope that you, by virtue of your office, will ensure a nationwide regulation so that this form of sham treatment [1], as has already happened in other European countries, can no longer call itself part of medicine.

We justify our request by the following facts:

  1. After the landmark vote in Bremen in September 2019 to remove “homeopathy” from the medical training regulations, 10 other state medical associations have so far followed Bremen’s example. For reasons of credibility and transparency, it would be desirable if the main features of the training content taught were not coordinated locally in the future, but centrally and uniformly across the country so that there is no “training tourism”. Because changes to a state’s own regulations of postgraduate training are only binding for the examination committee of the respective state, this does not affect national regulations but is reduced to only a symbolic character without sufficient effects on the portfolio of medical education nationwide.
  2. Medicine always works through the combination of a specifically effective part and non-specific placebo effects. By insisting on a pseudo-medical methodology – as is “homeopathy” represents in our opinion – patients are deprived of the specific effective part and often unnecessarily deprived of therapy appropriate to the indication. Tragically, it happens again and again that the “therapeutic window of opportunity” for an appropriate therapy is missed, tumors can grow to inoperable size, etc.
  3. Due to the insistence of individual state medical associations on the “homeopathic doctrine of healing” as part of the medical profession, we are increasingly exposed to the blanket accusation that, by tolerating this doctrine, we are supporting and promoting ways of thinking and world views that are detached from science. This is a dangerous situation, which in times of a pandemic manifests itself in misguided aggression reflected not just in vaccination skepticism and vaccination refusal, but also in unacceptable personal attacks and assaults on vaccinating colleagues in private practice.
[1] Homöopathie – die Fakten [unverdünnt] eBook : Ernst, Edzard, Bretthauer, Jutta: Amazon.de: Kindle-Shop

Responsible:

Dr. med. Dent. Hans-Werner Bertelsen

Prof. Dr. med. Edzard Ernst

George A. Rausche

You can sign the petition here:

Petition an die Bundesärztekammer › Sachverständiger kriminalistische Forensik, Foto- Videoforensik, digitale Forensik und der Identifikation lebender Personen nach Bildern (rauscher.xyz)

 

Prior research has generated inconsistent results regarding vaccination rates among patients using so-called alternative medicine (SCAM). Given that SCAM includes a wide range of therapies – about 400 different treatments have been counted – variable vaccination patterns may occur within consultations with different types of SCAM practitioners.

A recent analysis aimed to evaluate differences between categories of SCAM regarding vaccination behavior among US adults.

Data from the 2017 National Health Interview Survey (NHIS; n = 26,742; response rate 80.7%) were used. Prevalences of flu vaccination, consultations with SCAM practitioners in the past 12 months, and their potential interactions were examined. 42.7% of participants had received the flu vaccination in the past 12 months, 32.4% had seen one or more SCAM practitioners. Users of any type of SCAM were as likely as non-users to have received a flu vaccination (44.8% users versus 41.7% non-users; p = 0,862; adjusted odds ratio [AOR] = 1.01, 95% confidence interval [CI] = 0.95–1.07).

Regarding specific SCAM types,

  • individuals consulting with naturopaths (p < 0.001; AOR = 0.67, 95 %CI = 0.54–0.82),
  • homeopaths (p < 0.001; AOR = 0.55; 95 %CI = 0.44–0.69)
  • chiropractors (p = 0.016; AOR = 0.9, 95 %CI = 0.83–0.98)

were less likely to be vaccinated. Other SCAMs showed no significant association with flu vaccination behavior. Independent predictors for a flu shot were prior diabetes, cancer, current asthma, kidney disease, overweight and current pregnancy. As well, higher educational level, age, ethnicity, health insurance coverage, and having seen a general physician or medical specialist in the past 12 months were also associated with a higher vaccination rate.

The authors concluded that SCAM users were equally likely to receive an influenza vaccination compared with non-users. Different SCAM therapies showed varied associations with vaccination behavior. Further analyses may be needed to distinguish influencing factors among patients’ vaccination behavior.

This survey confirms what we have discussed repeatedly on this blog (see, for instance here, here, here, here, and here). The reason why consumers who consult naturopaths, homeopaths, or chiropractors get vaccinated less regularly is presumably that these practitioners tend to advise against vaccinations. And why do they do that?

  • Naturopaths claim that vaccines are toxic and their therapeutic options protect against infections.
  • Homeopaths claim that vaccines are toxic and their therapeutic options protect against infections.
  • Chiropractors claim that vaccines are toxic and their therapeutic options protect against infections.

Do these ‘therapeutic options’ – detox, nosodes, spinal manipulation – have anything in common?

Yes, they are bogus!

Conclusion:

Many naturopaths, homeopaths, and chiropractors seem to be a risk to public health.

I was alerted to this announcement by the Faculty of Homeopathy:

Faculty of Homeopathy Accredited Education

The role of Dentistry in Integrative Medicine and Homeopathy

Dentistry appears to be the Cinderella of healthcare and the importance of good oral health is hugely underestimated. The mouth is the portal into the rest of our bodies. There is increasing evidence proving that health of the oral cavity has strong links with the health of the rest of the body especially increasing risk of heart disease, low birth weight babies and type 2 diabetes. The aim of this webinar is to highlight the vital importance of dentistry and oral health in integrative medicine and why healthcare professionals need to work closely with dentists. It will also cover how, as homeopaths, we can appreciate symptoms in the mouth as indications of general health or disease and manage dental conditions.

THE TICKETS FOR THIS WEBINAR ARE LIMITED THEREFORE, PLEASE REGISTER NOW TO ENSURE ACCESS.

Some splendid platitudes there:

  • the Cinderella of healthcare
  • The mouth is the portal into the rest of our bodies
  • health of the oral cavity has strong links with the health of the rest of the body…

But what about the importance of dentistry in integrative medicine? The importance of dentistry in medicine is fairly clear to me. However, what is the importance of dentistry in integrative medicine?

Even more puzzling seems the ‘role of dentistry in homeopathy’? What on earth do they mean by that? Perhaps they meant the ‘role of homeopathy in dentistry’?

And what is the role of homeopathy in dentistry? The British Homeopathic Dental Association should know, shouldn’t they? On their website, they explain that they are a group of dentists and dental care professionals that have an interest in using homeopathy alongside our dentistry.

On the basis of what evidence, you ask? They kindly provide an answer to that question:

In dentistry there is limited research though studies have shown improved bone healing around implants with Symphytum and reduced discomfort and improved healing time with ulcers and beneficial in oral lichen planus. These studies have small numbers and are not generally acepted as stong evidence.

Are they trying to tell us that there is no good evidence? Looks like it, doesn’t it? In this case, the above Webinar seems rather superfluous.

For those of you who want to save the money for the tickets, here is a full and evidence-based summary of all the conditions where homeopathy might be helpful in dentistry:

THE END

 

We have covered urine therapy several times already (see for instance here, and here). Essentially it is ineffective but harmless …

except…

CTV reported that a mother in Canada has temporarily lost her right to unsupervised parenting over allegations she made her young son drink his own urine as part of a controversial so-called alternative medicine (SCAM). Specifically, she had fed the eight-year-old boy smoothies made with his own urine.

Apparently, the mother began pursuing a fringe “natural and holistic” lifestyle about three years ago. “It has created significant distrust by the (father) as to the respondent’s judgment in ensuring that the child is safe in her care, which came to a head when the allegation that she was imposing urine therapy on the child arose,” the judge wrote.

The mom’s interest in alternative medicine previously resulted in her seeking unsupported remedies such as homeopathy to treat her breast cancer – all of which failed, ultimately leaving her with no choice but to undergo surgery. Eventually, that inclination also brought her to urine therapy, described in the decision as “a centuries-old practice of drinking one’s own urine and massaging it into one’s skin.”

The mother admitted in court that she started drinking her own urine last January, and even that she appeared on an obscure podcast called “Healing Powers of Urine Therapy,” but denied forcing her son to take part in the practice. The father recounted an after-school incident in which the child approached him looking confused and guilty and said, “I have a secret, you have to promise me not to tell mom. Mom made me pee in a jar, then she put the pee into my fruit smoothie.” The boy later repeated the allegations during an appointment alone with their family doctor. The child said he “didn’t want to do it, told his mom he didn’t want to but she encouraged him to.”

There were also concerns raised about the mother’s fasting, which the father said went on for days on end and left her physically incapable of caring for their son. The judge wasn’t convinced that foregoing food left the mom unable to parent, but ultimately said she agreed with the father’s assessment that, while his former partner loves their son, her “judgment and health are questionable at this time.” The judge ruled that the mother can have parenting time from Sunday mornings to Wednesday evenings, but only with supervision from a professional or a third party agreed upon by both parents.

_________________

The case shows that, once a gullible consumer falls under the influence of the SCAM cult and goes ‘off the rails’, there are no limits. This woman started by treating her cancer with homeopathy and, even though this was not successful, she continued to slide down the slippery SCAM slope until, finally, she experimented with urine therapy on her own son. This indicates to me that we might have to add another risk to the many dangers of homeopathy: it can serve as a gateway drug for all sorts of other SCAMs.

Diabetic polyneuropathy is a prevalent, potentially disabling condition. Evidence-based treatments include specific anticonvulsants and antidepressants for pain management. All current guidelines advise a personalized approach with a low-dose start that is tailored to the maximum response having the least side effects or adverse events. Homeopathy has not been shown to be effective, but it is nevertheless promoted by many homeopaths as an effective therapy.

This study assessed the efficacy of individualized homeopathic medicines in the management of diabetic polyneuropathy. A multi-centric double-blind, placebo-controlled, randomized clinical trial was conducted by the Indian Central Council for Research in Homoeopathy at six centers with a sample size of 84. Based on earlier observational studies and repertorial anamnesis of DDSP symptoms 15 homeopathic medicines were shortlisted and validated scales were used for evaluating the outcomes post-intervention. The primary outcome measure was a change in Neuropathy Total Symptom Score-6 (NTSS-6) from baseline to 12 months. Secondary outcomes included changes in peripheral nerve conduction study (NCS), World Health Organization Quality of Life BREF (WHOQOL-BREF) and Diabetic Neuropathy Examination (DNE) score at 12 months.

Data of 68 enrolled cases were considered for data analysis. A statistically significant difference (p<0.014) was found in NTSS-6 post-intervention in the Verum group. A positive trend was noted for the Verum group as per the graph plotted for DNE score and assessment done for NCS. No significant difference was found between the groups for WHOQOL-Bref. Out of 15 pre-identified homeopathic medicines, 11 medicines were prescribed in potencies in ascending order from 6C to 1M.

The authors refrain from drawing conclusions about the efficacy of their homeopathic treatment (which is more than a little odd, as their stated aim was to assess the efficacy of individualized homeopathic medicines in the management of diabetic polyneuropathy). So, please allow me to do it for them:

The findings of this study confirm that homeopathy is a useless treatment.

Homeopaths believe that their remedies work for every condition imaginable and that naturally includes irritable bowel syndrome (IBS). But what does the evidence show?

The aim of this pilot study was to evaluate the efficacy of individualized homeopathic treatment in patients with IBS. The study was carried out at the National Homeopathic Hospital of the Secretary of Health, Mexico City, Mexico and included 41 patients: 3 men and 38 women, mean age 54 ± 14.89 years, diagnosed with IBS as defined by the Rome IV Diagnostic criteria. Single individualized homeopathics were prescribed for each patient, taking into account all presenting symptoms, clinical history, and personality via repertorization using RADAR Homeopathic Software. The homeopathic remedies were used at the fifty-millesimal (LM) potency per the Mexican Homeopathic Pharmacopoeia starting with 0/1 and increasing every month (0/2, 0/3, 0/6). Severity scales were applied at the beginning of treatment and every month for 4 months of treatment. The evaluation was based on comparing symptom severity scales during treatment.

The results demonstrated that 100% of patients showed some improvement and 63% showed major improvement or were cured. The study showed a significant decrease in the severity of symptom scores 3 months after the treatment, with the pain score showing a decrease already one month after treatment.

The authors state that the results highlight the importance of individualized medicine regimens using LM potency, although the early decrease in pain observed could also be due to the fact that Lycopodium clavatum and Nux vomica were the main homeopathic medicine prescribed, and these medicines contain many types of alkaloids, which have shown significant analgesic effects on pain caused by physical and chemical stimulation.

The authors concluded that this pilot study suggests that individualized homeopathic treatment using LM potencies benefits patients with IBS.

Where to begin?

Let me mention just a few rather obvious points:

  1. A pilot study is not for evaluating the efficacy, but for testing the feasibility of a definitive trial.
  2. The study has no control group, therefore the outcome cannot be attributed to the treatment but is most likely due to a mixture of placebo effects, regression towards the mean, and natural history of IBS.
  3. The conclusions are not warranted.
  4. The paper was published in the infamous Altern Ther Health Med.

Just to make sure that nobody is fooled into believing that homeopathy might nonetheless be effective for IBS. Here is what the Cochrane review on this subject tells us: no firm conclusions regarding the effectiveness and safety of homeopathy for the treatment of IBS can be drawn. Further high quality, adequately powered RCTs are required to assess the efficacy and safety of clinical and individualised homeopathy for IBS compared to placebo or usual care.

In my view, even the conclusion of the Cochrane review is odd and slightly misleading. The correct conclusion would have been something more to the point:

THE CURRENT TRIAL EVIDENCE FAILS TO INDICATE THAT HOMEOPATHY IS AN EFFECTIVE TREATMENT FOR IBS.

This study aimed to assess the feasibility of a future definitive trial, with a preliminary assessment of differences between effects of individualized homeopathic (IH) medicines and placebos in the treatment of cutaneous warts.

A double-blind, randomized, placebo-controlled trial (n = 60) was conducted at the dermatology outpatient department of the Homoeopathic Medical College and Hospital, West Bengal. Patients were randomized to receive either IH (n = 30) or identical-looking placebos (n = 30). The primary outcome measures were numbers and sizes of warts; the secondary outcome measure was the Dermatology Life Quality Index (DLQI) questionnaire measured at baseline, and every month up to 3 months. Group differences and effect sizes were calculated on the intention-to-treat sample.

Attrition rate was 11.6% (IH, 3; placebo, 4). Intra-group changes were significantly greater in the IH group than in the placebo group. Inter-group differences were statistically non-significant (all > 0.05, Mann-Whitney U tests) with small effect sizes, both in the primary outcomes (number of warts after 3 months: IH median [interquartile range; IQR] 1 [1, 3] vs. placebo 1 [1, 2]; p = 0.741; size of warts after 3 months: IH 5.6 mm [2.6, 40.2] vs. placebo 6.3 [0.8, 16.7]; p = 0.515) and in the secondary outcomes (DLQI total after 3 months: IH 4.5 [2, 6.2] vs. placebo 4.5 [2.5, 8]; p = 0.935). Thuja occidentalis (28.3%), Natrum muriaticum (10%), and Sulphur (8.3%) were the most frequently prescribed medicines. No homeopathic aggravations or serious adverse events were reported.

The authors concluded that, as regards efficacy, the preliminary study was inconclusive, with a statistically non-significant direction of effect favoring homeopathy. The trial succeeded in showing that an adequately powered definitive trial is both feasible and warranted.

Partly the same group of authors recently published another trial of homeopathy with similar findings. At the time, I commented as follows:

We have come across this terminology before; homeopaths seem to like it. It prevents them from calling a negative trial by its proper name: A NEGATIVE TRIAL. In their view

  • a positive trial is a study where homeopathy yields better results than placebo,
  • a negative trial is a study where placebo yields better results than homeopathy,
  • an inconclusive trial is a study where homeopathy yields results that are not significantly different from placebo.

Is this silly?

Yes, it is completely bonkers!

Is it dishonest?

Yes, in my view, it is.

Why is it done nonetheless?

Perhaps a glance at the affiliations of the authors provides an answer. And here is the list of the affiliations of the trialists of the present cutaneous wart study:

  • 1Department of Repertory, D.N. De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India.
  • 2D.N. De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India.
  • 3Department of Organon of Medicine and Homoeopathic Philosophy, The Calcutta Homoeopathic Medical College and Hospital, Kolkata, West Bengal, India.
  • 4Department of Practice of Medicine, The Calcutta Homoeopathic Medical College and Hospital, Kolkata, West Bengal, India.
  • 5Department of Repertory, National Institute of Homoeopathy, Ministry of AYUSH, Govt. of India, Kolkata, West Bengal, India.
  • 6Department of Organon of Medicine and Homoeopathic Philosophy, D.N. De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India.
  • 7Department of Pediatrics, National Institute of Homoeopathy, Ministry of AYUSH, Govt. of India, Salt Lake, Kolkata, West Bengal, India.
  • 8Department of Organon of Medicine and Homoeopathic Philosophy, State National Homoeopathic Medical College and Hospital, Lucknow, Uttar Pradesh.
  • 9Independent Researcher; Champsara, Baidyabati, Hooghly, West Bengal, India.
  • 10Independent Researcher, Shibpur, Howrah, West Bengal, India.

And, as before, this paper also contains this statement:

Conflict of interest statement

None declared.

Pre-hypertension, or stage 1 hypertension as it is also called, is usually defined as a systolic pressure reading between 120 mmHg and 139 mmHg, or a diastolic reading between 80 mmHg and 89 mmHg. It remains a significant public health challenge and appropriate intervention is required to stop its progression to hypertension and cardiovascular diseases.

This double-blind, randomized, two parallel arms, placebo-controlled study tested the effects of individualized homeopathic medicines (IH) against placebo in intervening with the progression of pre-hypertension to hypertension.

Ninety-two patients with pre-hypertension were randomized to receive either IH (n = 46) or identical-looking placebo (n = 46). Both IH or placebo were applied in the mutual context of lifestyle modification (LSM) advice including dietary approaches to stop hypertension (DASH) and brisk exercises.

The primary endpoints were systolic and diastolic blood pressures (SBP and DBP); secondary endpoints were Measure Yourself Medical Outcome Profile version 2.0 (MYMOP-2) scores. All endpoints were measured at baseline, and every month, up to 3 months.

After 3 months of intervention, the number of patients having progression from pre-hypertension to hypertension between groups was similar without any significant differences in between the groups. Reduction in BP and MYMOP-2 scores were also not significantly different. Lycopodium clavatum, Thuja occidentalis and Natrum muriaticum were the most frequently prescribed medicines. No serious adverse events were reported from either group.

The authors concluded that there was a small, but non-significant direction of effect favoring homeopathy, which ultimately rendered the trial as inconclusive.

We have come across this terminology before; homeopaths seem to like it. It prevents them from calling a negative trial by its proper name: A NEGATIVE TRIAL. In their view

  • a positive trial is a study where homeopathy yields better results than placebo,
  • a negative trial is a study where placebo yields better results than homeopathy,
  • an inconclusive trial is a study where homeopathy yields results that are not significantly different from placebo.

Is this silly?

Yes, it is completely bonkers!

Is it dishonest?

Yes, in my view, it is.

Why is it done nonetheless?

Perhaps a glance at the affiliations of the authors provides an answer:

  • 1Dept. of Organon of Medicine and Homoeopathic Philosophy, D. N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India. Electronic address: drsouvikdutta@gmail.com.
  • 2Dept. of Organon of Medicine and Homoeopathic Philosophy, D. N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India.
  • 3Principal and Administrator D. N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India.
  • 4Dept. of Practice of Medicine, D. N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India.
  • 5Dept. of Practice of Medicine, Mahesh Bhattacharyya Homoeopathic Medical College and Hospital, Howrah, Govt. of West Bengal, affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India.
  • 6Dept. of Organon of Medicine and Homoeopathic Philosophy, National Institute of Homoeopathy, Block GE, Sector III, Salt Lake, Kolkata 700106, West Bengal, India; affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India.
  • 7Dept. of Organon of Medicine and Homoeopathic Philosophy, State National Homoeopathic Medical College and Hospital, Lucknow, Govt. of Uttar Pradesh, affiliated to Dr. Bhimrao Ramji Ambedkar University, Agra, Govt. of Uttar Pradesh), India.
  • 8Dept. of Repertory, D. N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India.

Despite these multiple conflicts of interest, the article carries this note:

“Declaration of Competing Interest: None declared.”

During the last few days, we were entertained by one of the more fanatical specimen of the lunatic fringe. From the outset, ‘ASTRO’ was out to provoke, insult, and foremost state utter nonsense. Within just a few hours ‘ASTRO’ posted dozens of comments, one more hilarious than the next.

As always, I let it pass for a while because this sort of thing usually is very amusing and mildly instructive. Then, when my fun was over, I told him or her that my conversation with him or her was finished, thereafter I sent ‘ASTRO’ my usual hint to indicate that my patience was wearing thin (an overdose of nonsense, fun, and hilarity might be toxic) and now I have blocked ‘ASTRO’.

This little incident is a mere triviality, of course. Yet, it is also a most welcome reminder to demonstrate what is needed to get blocked by me. Here are a few selected ‘bon mots’ posted by ‘ASTRO’ which all contributed to his or her dismissal from this blog:

  • Lenny is an intellectual terrorist
  • you manipulate data
  • you are nobody in the scientific world
  • I’m very sorry for your lack of education
  • I don’t hate you for lying, I pity you
  • With all sincerity, and seeing that you don’t have a single scientific publication, I recommend that mounts a business for atheists resentful and sell cheap products with the face of Carl Sagan or James Randi in a coffe cup or pins, I assure you that the media will make of your business, earn some money and you’ll be able to publish a book trash like Ben Goldacre, with his “Bad science” or the Steven Novella. Poor quality is a typical sign of skeptical pseudoscientists.
  • your “letter to the editor” is based on manipulating data and making false accusations, everything
  • you only have an opinion based on your belief and denial that may well be a projection of your lack of knowledge
  • I’m disappointed that you have very superficial knowledge, no wonder Mathie will ignore you
  • Your comments again reflect that you haven’t the slightest idea
  • your lack of reading comprehension is evident
  • You are very ignorant
  • your aggressiveness and lack of empathy tell a lot about your profile of atheist resentful of life
  •  these” verdicts ” that Ernst quotes in his pamphlets are at best a fraud
  • in reality you, Grams and the team of the anti-homeopathy propaganda network have no idea what you’re talking about
  • Ernst,” friend, ” you’re still pretty aggressive, maybe you need some joy in your life. Now I understand why the pseudoscientific skeptical atheist community is so childish and so toxic
  • anyone who questions Edzar’s sacred dogmas is a troll
  • Thank you for confirming that you are a sectarian
  • your obsessive behavior borders on harassment
  • Magazines like Skepter are very popular with immature gentlemen who believe they are the world or with teenagers who are just out of college who believe that science is done with whims
  • don’t be like Lenny and try to grow up
  • real science is in the objective pursuit and not in harassment campaigns orchestrated by a few clowns who believe James Randi is unquestionable
  • every time I read your entries I feel sorry that your level of logic is so low and lousy
  •  Your naivety and superficial knowledge in philosophy of science (and that of most of those who follow you) is very pitiful
  • you are the example of a pseudo-sceptic, a rude and cowardly skeptic who can’t tolerate criticism
  • your friends are a sect, possibly a group based on coertion
  • it doesn’t look like “Lenny” has a single scientific article published, not to mention your colleagues in the “About” section that the few who look like scientists are mediocre in their fields, the rest are small-time activists. No wonder, so much envy, so much anger, so much hatred, that’s what leaves fanatical atheism. They’re talibans of science, not scientists
  • you with your age presume a lot and I only see you being interviewed by mainstream media that talk nonsense against homeopathy
  • You had to control that aggressiveness, you feel more nervous and angry, maybe you’re a relative of the troll Lenny
  • The obsessive behavior of Aust trying to refute Frass already looks like that of a stalker, similar of the journalist Christian Kreil who invented a whole string of nonsense in a German public media trying to link Frass to a questionable company, the media does not even mention Frass’s refutation to Kreil

One thing we cannot accuse ‘ASTRO’ of is that he or she was not industrious. You might ask why I did not stop his aggressive stupidity earlier after it had stopped being funny. Perhaps I should have – but, to be honest, these trolls do amuse me a great deal. More importantly, they might teach us important lessons:

  • The fun one can have with fanatics is usually short-lasted.
  • Some weirdos are very well misinformed, i.e. they read a lot and misunderstand even more.
  • The minds of heavily deluded people are beyond productive discussions.
  • Any hope to educate them will be disappointed.
  • If we allow them to, they swiftly make themselves ridiculous.
  • Their pseudo-arguments are strikingly similar.
  • Their aggressiveness can be considerable.

And finally, the little ‘ASTRO’ interlude tells you something else:

It really does need a lot to get banned from my blog.

Guest post by Norbert Aust and Viktor Weisshäupl

Imagine you recently published an excellent and rigorous trial providing solid evidence that a certain therapy is able to help patients suffering from some inevitably fatal condition. You proved that your therapy is able to significantly prolong the patients’ lifetime, much longer than with the current state-of-the-art therapeutic approach. But the patients not only live considerably longer, but they also do so with a much better quality of life (QoL) and subjective well-being. In short: this therapy marks some progress that would otherwise take years or decades of scientific effort.

And then someone comes forward and points out your data apparently were manipulated. Essential parameters of this trial were modified sometime after data collection was completed, with the patients’ outcome and first analyses available. Thus the results were biased in a certain direction and the critics show that the results as published in your study show characteristics that such manipulations would evoke. After all, this holds an implication of scientific misconduct that could, if verified, ruin your academic reputation more or less completely.

What would you do?

Ignore the preposterous concerns because you know your methods and performance were rigorous and solid? After all, anytime some real academic criticism arises you are ready to prove your findings are well-founded results of accepted scientific methods. Or would you publish data or documents that your critics were too ignorant to find or to understand, and thus to stop such rumours once and for all? Maybe you could even clarify some of the issues raised by those critics, maybe add some follow-up information or data to ensure no more misunderstandings occur. Or would you try to find some clues for a libel lawsuit?

Well, we thought some of the above would happen after we contacted the authors of the recent study on adjunct homeopathy in non-small cell lung cancer. On that date, we forwarded our detailed analysis to the lead author and all the co-authors.

Of course, we even considered the possibility, not very likely though, that we would receive some explanation for the numerous exclusion criteria while other serious conditions that coincide with advanced age did not preclude enrollment. Or an updated CONSORT diagram accounting for the patients excluded. Or some explanation just why the numerous amendments to the protocol were necessary but not important enough to mention them in the published paper.

But nothing of this happened as yet (July 2021). Instead on June 14 and 16, 2021, not two weeks after our messages to the authors, the registration data at ClinicalTrials were updated once again and a new version of the protocol was uploaded [3]. And this update looks pretty much like it is meant to cover up and blur the former data that we based our analysis on. Of course, these data and the former version of the protocol are available still – just one layer further down, and you have to scroll to the bottom of the page to find the small link “history of changes”. Maybe not many visitors will do that.

In contrast to the versions before, now the uploaded data are in line with the study as published, namely, they include a full list of the exclusion criteria and the reduced observation time for QoL, which was the primary outcome. Note: throughout the trial until the end of data assessment those parameters were set with pregnancy as the only exclusion criterion and two years follow up time, only to be amended in the protocol uploaded two months after data collection was complete and analysis presumably was well underway.

In addition, there is a new version of the study protocol, this one dated Feb. 6, 2014. Of course, this protocol is fairly new, in spite of the date it carries. Why would the older version allegedly from January 2011 be uploaded to the register in September 2019, if this more actual version already had existed and was available?

Contrary to the prior version all the clues are removed that would indicate that this document was finished at a much later point in time than given in its date: References to some future software versions that were released years after the protocol was allegedly compiled are dropped. And this strange literature reference “25” that corresponds to the reference list in the final study as published but is pointless in the protocol without any reference list, is removed too. And of course, again contrary to the prior version, the exclusion criteria are identical with the final study as is the shortened follow-up time for QoL.

New to the protocol is a section “Bringing in the patient’s voice”, where the authors disclose how they want to “systematically research the ethical, legal, socio-political, and science theoretical dimensions of homeopathy as in the case of lung cancer (non-small-cell lung carcinoma) exemplified” in some “integral social scientific study”, where some “focus groups” of 4 to 10 participants together with their relatives, friends and caregivers included should be used to study “interactions between individuals, collectively shared and uncontested assumptions, and the emergence of collective meaning”.

But from all of this more or less meaningless but very sciency sounding socio-speak, not a single word found its way into the study. Nothing. So it is pointless to try to figure out what the content of this part of the investigation is all about.

Why then was this chapter added? This “integral social scientific study” was to start after the “third or fourth homeopathic treatment” (But why should patients not be included in this “research” from the very first beginning?). Is it perhaps to give some rationale why the follow-up time for QoL was to end after the third homeopathic treatment?

So what we see, when we look up the study at ClinicalTrials now, is a perfectly matching set of data and a protocol that corresponds to the study as published and looks as if it was published at a time where the trial was underway and the patients were still blinded. If you do not look very closely everything now appears to be perfect.

And here we would like to forward some critique to the register: The purpose of the study register is to prevent not only publication bias but misleading manipulation from happening as well. They do quite a good job in preserving former versions of data and documents and keeping them available to the public. Many national study registers do not offer this service. But you must be of a suspicious mind and of some persistence to actively search and find and check the history of modifications. Thus, a cover-up like the one we are witnessing here might well prove successful. We, therefore, propose to improve the presentation of the registration: If vital amendments occurred that may affect the outcomes – such as protocol changes, extensions of exclusion criteria, modifications of follow-up time – this should be indicated upfront in the study’s record instead of some small hint to “history of changes” at the very bottom of the page.

In conclusion, there appears to be no proof that the results of the study were produced using rigorous scientific methods. And the issues we raised in our report to the authors remain unresolved.

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