homeopathy
This study aimed to evaluate whether individualized homeopathic medicines have a greater adjunctive effect than adjunctive placebos in the treatment of moderate and severe cases of coronavirus disease 2019 (COVID-19). It was designed as a randomized, single-blind, placebo-controlled trial set in the clinical context of standard care. Patients admitted in a tertiary care hospital, suffering from moderate or severe COVID-19 and above 18 years of age were included. In total, 150 patients were randomly divided into two groups to receive either:
- individualized homeopathic medicines
- or placebos.
Both options were administered in addition to the standard treatment of COVID-19.
The primary outcome was time taken to achieve RT-PCR-confirmed virus clearance for COVID-19. Secondary outcomes were changes in the Clinical Ordinal Outcomes Scale (COOS) of the World Health Organization, the patient-reported MYMOP2 scale, and several biochemical parameters. Parametric data were analyzed using unpaired t-test. Non-parametric data were analyzed using the Wilcoxon signed rank test. Categorical data were analyzed using Chi-square test.
In total, 72 participants of the add-on homeopathy (AoH) group showed conversion of RT-PCR status to negative, in an average time of 7.53 ± 4.76 days (mean ± SD), as compared with 11.65 ± 9.54 days in the add-on placebo (AoP) group (p = 0.001). The mean COOS score decreased from 4.26 ± 0.44 to 3.64 ± 1.50 and from 4.3 ± 0.46 to 4.07 ± 1.8 in the AoH and AoP groups respectively (p = 0.130). The mortality rate for the AoH group was 9.7% compared with 17.3% in the AoP group. The MYMOP2 scores between the two groups differed significantly (p = 0.001), in favor of AoH. Inter-group differences in the pre- and post- mean values of C-reactive protein, fibrinogen, total leukocyte count, platelet count and alkaline phosphatase were each found to be statistically significant (p <0.05), favoring AoH; six other biochemical parameters showed no statistically significant differences.
The authors concluded that the study suggests homeopathy may be an effective adjunct to standard care for treating moderate and severe COVID-19 patients. More rigorous, including double-blinded, studies should be performed to confirm or refute these initial findings.
I do agree with the authors that more rigorous studies are needed before we can accept these findings. As it stands, this study seems to have multiple flaws:
- I fail to understand why they did not design their trial as a double-blind study. The reason given by the authors makes little sense to me.
- I also have my doubts that the study was even single-blind. If I understand it correctly, the placebo group was did not benefit from the detailed homeopathic history taking that is necessary to find the optimal homeopathic remedy. If that is so, unblinding of patients is inevitable.
- The authors themselves point out that the relevance of many outcome measures is questionable
Generally speaking, I find the results suspicious, implausible, and frankly too good to be true. I might also point out that the authors’ afilitation do not inspire much trust in their objectivity:
- 1Central Council for Research in Homoeopathy, New Delhi, India.
- 2Central Council for Research in Homoeopathy, Ministry of AYUSH, Govt. of India, New Delhi, India.
- 3Rejoice Health Foundation, New Delhi, India.
- 4Department of Onco-Anaesthesia and Palliative Medicine, Dr. B.R. Ambedkar Institute Rotary Cancer Hospital and National Cancer Institute, All India Institute of Medical Sciences, Ministry of Health and Family Welfare, New Delhi, India.
- 5Department of Onco-Anaesthesia and Palliative Medicine, All India Institute of Medical Sciences, Ministry of Health and Family Welfare, New Delhi, India.
Neither do these statements:
Funding
The study was funded by the Central Council for Research in Homoeopathy, Ministry of AYUSH, Government of India. The funder approved the study through its review committees, delegated/recruited staff for conducting the study, and facilitated all collaborative procedures.
Conflict of Interest
None declared.
Lastly, I do wonder why the authors published their study in the 3rd class journal ‘Homeopathy’. Surely, such findings – if true – deserve to be published in a journal of a decent reputation!
‘Chiropractic Economics‘ focuses on “bridging the gap between what doctors of chiropractic learn about healthcare and what they need to know as entrepreneurs who command successful, thriving practices. We are the top-rated resource for chiropractic news, marketing, consulting, financial planning, attracting and retaining patients, and motivating and managing employees. We provide information for practicing chiropractors, with a focus on office management, patient relations, personal development, financial planning, legal, clinical and research data, and wellness and nutrition.”
The magazine recently published an article that is so wonderfully overflowing with BS that I cannot resist showing you a few hilarious excerpts from it:
HOMEOPATHY IS A NATURAL FOR CHIROPRACTORS — because it works with innate intelligence. Each tiny pellet of a homeopathic remedy is like a flash drive full of information that “reinstalls the software,” i.e., it reminds the body that “you know how to have a healthy nervous system” or strong and healthy bones or muscles.
A remedy for patient malady
Homeopathic remedies have much to offer your patients:
- Fast-acting: Some patients will actually feel the effects as soon as they ingest the remedy; it works faster than herbs or vitamins
- Easily available in health food stores, some drug stores and online
- Inexpensive: pennies per dose
- No rebound or withdrawal: Your patient can discontinue it without symptoms recurring
- No drug interactions: It can work well alongside meds and supplements
- Safe: Reactions are rare and serious side effects are unknown.1
Practitioners will benefit as well from recommending homeopathy as this unusual modality will set the chiropractor apart and patients will be grateful for the relief they feel. Homeopathy is available as single remedies, plus more unusual ones are also blended into combination formulas which chiropractors may choose to stock in their office, just as they stock nutritional supplement and glandular formulas.
…
How does it work?
Homeopathy is totally safe because there is nothing in it — not even one molecule of its original starting substance — yet it is powerful and fast-acting. How can we make these contradictory claims? Because it is information technology.
The manufacturing process imprints the healing information onto water like recording onto a flash drive. The process takes the starting substance through many stages of dilution (making it safe) and potentizes or energizes it at each step (making it powerful). Water behaves differently at these very high dilutions, becoming coherent or structured, as explained by the newly emerging field of ultra-high dilution physics. Two Nobel laureates have testified that their studies explain how homeopathy works.2
Now let’s look at some specific remedies.
Hypericum for the nervous system
Hypericum is almost a universal remedy for nerve-related symptoms: tingling and numbness, pain shooting along a nerve, and trauma to nerve-rich areas (like hitting a finger with a hammer or slamming it in a car door):
- Arnica for soft tissue trauma: homeopathy’s best-known remedy, Arnica is good for sore muscles, pulled muscles, sports injuries, sprains and strains, and bruising.
- Symphytum for fractures: This is the well-known herbal remedy comfrey, known traditionally as “knit-bone,” used to speed the healing of fractures and reduce bone pain.
- Bryonia for joints that hurt to move. When your patient is splinting or guarding, think bryonia, for a bruised rib that makes it painful to laugh or cough or sneeze, or knees that hurt from walking that make the patient take cautious steps.
- Rhus tox for “rusty gate” joints: This is for your patient who needs to limber up when first getting out of bed, or who needs to swing their leg a few times to loosen it up before getting up from a chair.
- Ruta grav. for connective tissue, cartilage and joints in general: sprains and strains, cracking joints, torn tendons and ligaments, and fascia. It has a special affinity for the knee, like the knee that goes out from under someone and for Baker’s cysts.
Three homeopathically-energized minerals to strengthen and heal bone need to be given in a special 6x potency and are known as cell salts or tissue salts:
- Calcarea fluorica (Calc. fluor.) 6x to soften and dissolve: This remedy can help dissolve bone spurs and hardened or condensed tissues like cataracts.
- Calcarea phosphorica (Calc. phos.) 6x to deposit minerals in the bones: This provides the template to send calcium and other minerals to bones and not deposit them elsewhere in the body.
- Silicea 6x strengthens bone as well as hair, skin and nails; you know silica as a supplement, and as a homeopathic remedy it provides the instructions for silica the mineral to go where it is needed. However, Silica 30c (full strength) can push foreign objects out of the body and should not be given to patients with a rod or plate and screws.
…
What could possibly go wrong?
Not much — an “overdose” in homeopathy is not harmful in the long run — in fact, too much of a remedy is pushing the patient too fast in the direction of cure and the long-term result can be positive. It can be uncomfortable in the short run, though.
The body can only process so much of the remedy’s information at once, and if the body is presented with more than it can handle, it pushes back in the form of increased symptoms, the same symptoms the remedy was intended to treat. This is called an “aggravation” in homeopathy. It’s often said that “You have to get worse before you get better” in homeopathy and this is absolutely not true as long as mild to moderate doses are used (the typical 30c dose in health food stores) and the patient is told to stop if the remedy starts to feel too intense. When in doubt, it’s always safe to stop the remedy and start again later.
The bottom line
Start by recommending these few remedies and you are likely to get good feedback from your patients. Or consider stocking combination remedies that include even more unusual remedies.
They may give even better results and keep patients coming back to you for more, since they are only available through professionals. And if you’re feeling exhausted beyond repair, try some Sepia for yourself.
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END OF QUOTE
Yes, this is what a ‘top rated’ chiropractic resource mistakes for information on ‘clinical and research data, and wellness and nutrition’!
I didn’t promise too much, did I?
We discussed the 2015 Australian NHMRC report on homeopathy many times before, e.g.:
- Homeopathy: the 2015 NHMRC report and its criticism re-analysed
- HOMEOPATHY: the NHMRC report revisited
- Ombudsman investigates ‘flawed’ homeopathic study
- The final verdict on homeopathy: it’s a placebo
In a nutshell, the report was an hugely influential analysis of the effectiveness of homeopathy which came to squarely negative conclusions. Thus it was celebrated as a thorough and conclusive piece evidence demonstrating the madness of homeopathy. Unsurprisingly, homeopaths did not like it at all and produced various criticisms claiming that it was neither thorough nor conclusive.
Now the final evaluation of what has been going on was finally published (ISSUED BY THE COMMONWEALTH OMBUDSMAN, IAIN ANDERSON, ON 4 AUGUST 2023):
The Office of the Commonwealth Ombudsman (the Office) has finalised an investigation relating to the National Health and Medical Research Council’s (NHMRC) review of the evidence for the effectiveness of homeopathy, conducted between 2010 and 2015. We commenced this investigation in September 2017 in response to concerns raised with us about how the NHMRC review had proceeded.
The Office conducts its investigations in private, and the Ombudsman generally does not make a public statement in the absence of a formal report. In the circumstances of this matter, including that the then-Ombudsman released a public statement on 4 June 2021 which acknowledged the Office was investigating, we believe it is important to share publicly the information we can, now that the investigation is complete.
Our investigation was finalised in July 2023. We acknowledge the length of time the investigation has taken. This is in part due to the extensive efforts the Office made to source independent scientific expertise to advise us on some detailed and specific questions of scientific methodology that were raised with our Office, including some that were only brought to our attention as our investigation progressed. Despite our best efforts, it was not possible to engage an expert (or experts) to provide independent advice to our Office on this subject. In the absence of independent, expert scientific expertise we have not been able to conclusively determine those matters of scientific methodology. This did not prevent our Office from forming a view on other aspects of the matter.
Our investigation did not result in any adverse findings about the review or the NHMRC. When finalising investigations, we may offer comments and suggestions to an agency about areas for future improvement. In this instance, we offered comments and suggestions to the NHMRC about how it records and publicly explains decisions about its activities. The NHMRC also independently made several improvements to its processes during the course of our investigation.
________________
In essence, this means that the conclusions of the report stand:
Homeopathy should not be used to treat health conditions that are chronic, serious, or could become serious. People who choose homeopathy may put their health at risk if they reject or delay treatments for which there is good evidence for safety and effectiveness. People who are considering whether to use homeopathy should first get advice from a registered health practitioner. Those who use homeopathy should tell their health practitioner and should keep taking any prescribed treatments.
Thus the matter is closed – that is closed for rational thinkers. For irrationalists, the matter will no doubt continue to be a stone of contention. No, homeopath will be able to accept these conclusions simply because a member of a cult ceases to be a cultist once he/she accepts the criticism agaist the cult.
Charles has a well-documented weakness for so-called alternative medicine (SCAM) – not just any SCAM but predominantly the type of SCAM that is both implausible and ineffective. Therefore, nobody can be all that surprised to read in THE TIMES that he has decided to use SCAM for helping women who have difficulties getting pregnant.
If one really wanted to employ SCAM for this aim one is spoilt for choice. In fact, there are only few SCAMs that don’t claim to be useful for this purpose.
A recent review, for instance, suggested that some supplements might be helpful. Other authors advocate SCAMs such as acupuncture, moxibustion, Chinese herbal medicine, psychological intervention, biosimilar electrical stimulation, homeopathy, or hyperbaric oxygen therapy.
Yes, I know! The evidence for these treatments is lousy, and I would never issue a recommendation based on such flimsy evidence.
Yet, the SCAM project at Dumfries House, the Scottish stately home Charles restored in 2007, offers acupuncture, reflexology, massage, yoga, and hypnotherapy for infertile women.
REFLEXOLOGY for female infertility?
Reflexology, also called zone therapy, is a manual treatment where pressure is applied usually to the sole of the patient’s foot and sometimes also to other areas such as the hands or ears. According to its proponents, foot reflexology is more than a simple foot massage that makes no therapeutic claims beyond relaxation. It is based on the idea that the human body is divided into 10 zones each of which is represented on the sole of the foot. Reflexologists employ maps of the sole of the foot where the body’s organs are depicted. By massaging specific zones which are assumed to be connected to specific organs, reflexologists believe to positively influence the function of these organs. While reflexology is mostly used as a therapy, some therapists also claim they can diagnose health problems through feeling tender or gritty areas on the sole of the foot which, they claim, correspond to specific organs.
Reflexology is not merely implausible as a treatment for infertility, it also boasts of some fairly rigorous trial evidence. A clinical trial (perhaps even the most rigorous of all the trials of SCAM for female fertility problems) testing whether foot reflexology might have a positive effect on the induction of ovulation stated that “the results suggest that any effect on ovulation would not be clinically relevant”.
So, as so often before in the realm of SCAM, Charles has demonstrated that his lack of critical thinking leads him to the least promising options.
Well done, Your Majesty!
This review assessed the role of homoeopathy in the therapeutic management of substance use disorders (SUD) through a systematic web-based literature search. A comprehensive search was conducted online and manually to identify homoeopathic research studies published between 1993 and 2022 on SUD in international databases and the Central Council of Research in Homoeopathy library. Relevant studies were categorised and assessed in terms of study designs, number of participants, evidence grades and clinical outcome parameters. A total of 21 full-text studies were screened and evaluated. Risk of bias (RoB) was assessed for all studies and model validity was appraised for the included RCTs’.
10 studies were included:
- 3 Randomised Controlled Trials,
- 3 Observational studies,
- 1 Pilot study,
- 1 observational comparative study,
- 1 retrospective cohort study,
- 1 case series.
Three studies have a level of evidence of 1b with an ‘A’ grade of recommendation, which consists of the RCTs only. The most commonly prescribed medicines identified were:
- Arsenic album,
- Nux vomica,
- Lycopodium,
- Pulsatilla,
- Sulphur,
- Staphysagria,
- Belladonna,
- Ipecac,
- Chamomilla,
- Rhustox,
- Phosphorus,
- Lachesis.
A high risk of bias was elicited in most of the observational studies accentuating the need for more robust methodological studies.
The authors concluded that the majority of the studies have a small number of recruitments. Pragmatic studies with larger sample sizes and validated outcome measures may be designed further to validate the
promising role of homoeopathic medicines in SUDs and generate quality evidence.
The paper is surprising! Most of the studies are not RCTs and thus cannot come even near suggesting a causal effect of homeopathy. The three RCTs are the following:
- Manchanda RK, Janardanan Nair KR, Varanasi R, Oberai P, Bhuvaneswari R, Bhalerao R, et al. A randomised comparative trial in the management of alcohol dependence: Individualised homoeopathy versus standard allopathic treatment. Indian J Res Homoeopathy; 2016.
- Adler UC, Acorinte AC, Calzavara FO, et al. Double-blind evaluation of homeopathy on cocaine craving: A randomised controlled pilot study. J Integr Med. 2018; 16(3):178-184.
- Grover A, Bhushan B, Goel R. Double-blind placebo-controlled trial of homoeopathic medicines in the
management of withdrawal symptoms in opium addicts and its alkaloid derivatives dependents. Indian J Res Homoeopathy. 2009;3:41-4.
All of these 3 studies were assessed by the review authors as having major flaws. Only one is available on Medline:
Background: Brazil is among the nations with the greatest rates of annual cocaine usage. Pharmacological treatment of cocaine addiction is still limited, opening space for nonconventional interventions. Homeopathic Q-potencies of opium and Erythroxylum coca have been tested in the integrative treatment of cocaine craving among homeless addicts, but this setting had not proven feasible, due to insufficient recruitment.
Objective: This study investigates the effectiveness and tolerability of homeopathic Q-potencies of opium and E. coca in the integrative treatment of cocaine craving in a community-based psychosocial rehabilitation setting.
Design, setting, participants, and interventions: A randomized, double-blind, placebo-controlled, parallel-group, eight-week pilot trial was performed at the Psychosocial Attention Center for Alcohol and Other Drugs (CAPS-AD), Sao Carlos/SP, Brazil. Eligible subjects included CAPS-AD patients between 18 and 65 years of age, with an International Classification of Diseases-10 diagnosis of cocaine dependence (F14.2). The patients were randomly assigned to two treatment groups: psychosocial rehabilitation plus homeopathic Q-potencies of opium and E. coca (homeopathy group), and psychosocial rehabilitation plus indistinguishable placebo (placebo group).
Main outcome measures: The main outcome measure was the percentage of cocaine-using days. Secondary measures were the Minnesota Cocaine Craving Scale and 12-Item Short-Form Health Survey scores. Adverse events were reported in both groups.
Results: The study population comprised 54 patients who attended at least one post-baseline assessment, out of the 104 subjects initially enrolled. The mean percentage of cocaine-using days in the homeopathy group was 18.1% (standard deviation (SD): 22.3%), compared to 29.8% (SD: 30.6%) in the placebo group (P < 0.01). Analysis of the Minnesota Cocaine Craving Scale scores showed no between-group differences in the intensity of cravings, but results significantly favored homeopathy over placebo in the proportion of weeks without craving episodes and the patients’ appraisal of treatment efficacy for reduction of cravings. Analysis of 12-Item Short-Form Health Survey scores found no significant differences. Few adverse events were reported: 0.57 adverse events/patient in the homeopathy group compared to 0.69 adverse events/patient in the placebo group (P = 0.41).
Conclusions: A psychosocial rehabilitation setting improved recruitment but was not sufficient to decrease dropout frequency among Brazilian cocaine treatment seekers. Psychosocial rehabilitation plus homeopathic Q-potencies of opium and E. coca were more effective than psychosocial rehabilitation alone in reducing cocaine cravings. Due to high dropout rate and risk of bias, further research is required to confirm our findings, with specific focus on strategies to increase patient retention.
This study can hardly be said to show convincing evidence for homeopathy.
This paper is all the more surprising if we consider the affiliations of the authors:
- Clinical Research Unit (H), Aizawl under Central Council for Research in Homoeopathy, Ministry of AYUSH, Govt. of India, India.
- All India Institute of Ayurveda, New Delhi, India.
- Department of Materia Medica, Madhav Homoeopathic Medical College and Hospital, Madhav Hills,
Opposite Banas River, Abu Road, Rajasthan, India.
It is time, I think, that Indian officials and researchers learn some critical thinking and formulate the conclusions of reviews based on the evidence they produced. This would be a start:
Our review has not generated convincing evidence to suggest that homeopathy is effective in treating SUDs.
Guest post by Norbert Aust, Udo Endruscheit, and Edzard Ernst
How do we know whether a treatment is reasonable or just some so-called alternative medicine (SCAM) that is at best useless? A simple answer is that the former is evidence-based, while the latter is not. But how can we tell the difference? High-quality studies, with independent replications or even a systematic review, are the sort of things we are usually looking for. But there is an underlying assumption, namely that, in science, bogus studies are prevented from polluting the scientific database or, if such trials have emerged, there are ways to identify and eliminate them.
And what if this assumption is wrong?
What if respectable universities and research organizations venture into the realm of pseudoscience either knowingly or because it had slipped their attention?
What if the editorial board of a top journal passes bogus studies to peer review?
What if such a paper is eventually reviewed by a proponent of the implausible therapy?
What if the readers of the article, once it is published, are too lethargic to object and do not write letters to the editor in protest?
And what if skeptics do formulate a protest but the journal editor refuses to publish it?
Well, if all the checks that should prevent faulty results from entering the scientific knowledge fail, we have fake evidence: a study that looks like sound science but that, in fact, is invalid. It is not hard to imagine what would happen if SCAM therapies are supported by seemingly respectable studies published in top journals. The fake evidence would accumulate as part of the body of evidence and eventually enter mainstream clinical practice, education, politics, etc., etc. Thus the reputation of bogus therapies would grow unjustifiably.
If you think this cannot happen, you are in the wrong. After the infamous study by Frass et al about homeopathy as an add-on treatment for lung cancer, another homeopathy paper was published in 2022 by Gaertner et al. in Pediatric Research (PR), a Medline-indexed journal with a two-year impact factor of 3.95 belonging to the nature-group of journals. According to this meta-analysis ‘individualized homeopathy showed a clinically relevant and statistically robust effect in the treatment of ADHD’. Shortly after the publication of this paper, we sent a letter to the editor to point out the shortcomings of this study. Here it is:
Sir,
with this letter we like to comment on the systematic review and meta-analysis on childhood ADHD by Gaertner et al. recently published in your journal.
First off, we are surprised, that your journal that is connected to nature does publish a paper on a treatment that has no a-priory probability at all and thus can only contain false positives if any. And this review is no exception as will be seen presently.
Our concerns are:
Out of the six studies included three were mere pilot trials (Fibert_2019, Jacobs_2005, Oberai_2013, ) which cannot provide any evidence for the shortcomings involved in pilots. Three of the six trials show severe issues in blinding (Fibert_2016, Fibert_2019, Oberai_2013), with two of them concerning both of the participants and the test personnel. This usually leads to massive bias in favour of the treatment [Zitat Cochrane Handbook].
Then we compared data from two trials with the data reported in the review and found some major misrepresentations:
(1) Jacobs et al. report an improvement in the T-score of their main outcome (CGI-P) of 4.1 for homeopathy and 9.1 for controls, that is placebo outperformed the homeopathic intervention. But the authors give an effect size of 0.272 in favour of homeopathy which is the opposite of the findings in the trial.
(2) Oberai et al. report effect sizes for their three main outcomes of 0.22, 0.59 and 0.54 (CPRS-R, CGISS, CGIIS repectively). There is no way that this yields a pooled effect size of 1.436 as given in the review.
We conclude that the positive result obtained by the authors is due to a combination of the inclusion of biased trials unsuitable to build evidence together with some major misreporting of study outcomes.
Our recommendation would be that the authors reconsider their review and improve their report. Maybe the editors would like to add a caution-notice to the paper – if not to withdraw it completely.
In June 2023, a full year after our submission, we were informed that Pediatric Research would not publish our criticism because the priority given to it was not sufficient to justify publication. But we were assured, that the journal would take the matter seriously, that they will investigate this matter and take appropriate editorial action. But as of today (End of June 2023) no expression of concern has been published.
Did the journal receive other comments or criticisms related to the paper in question? No, apparently there were none, at least none was published and the paper remains unchallenged to this day. This means that it might be taken for reliable evidence on the effectiveness of homeopathy and mislead patients, carers, practitioners, decision-makers, etc.
We feel this is unacceptable and therefore again wrote to the editors asking to reconsider their decision. Here is our letter:
Dear …
together with my co-authors we would like to comment your decision about our letter to the editor about an extremely faulty and misleading paper that may well create harm to patients. In fact we find it very hard to accept your decision not to publish our comment.
We understand that Pediatric Research is a high impact journal with a 2-year IF of nearly 4. Your journal is member of COPE and is indexed with quite a few first rank institutions. By all standards, any reader will be convinced that a paper published in Pediatric Research is based on solid research and the results are derived by rigorous methodology and are as reliable as can be. Especially if this paper remains unchallenged by any reader’s comments for a full year after publication. This is your responsibility to the scientific community. And to the children that might receive treatment based on knowledge spread through your journal.
How then can it be, that an article about homeopathy, a thoroughly implausible lore, in the treatment of ADHD is published in Pediatric Research, where the authors come to the conclusion “that individualized homeopathy showed a clinically relevant and statistically robust effect in the treatment of ADHD”?
In our comment we point out that the authors made a lot of errors – to say it mildly. They deny the doubtful quality of the studies they included in their meta-analysis, they did not stick to their own exclusion criteria, the data the authors report do not resemble the findings of the studies they were allegedly taken from, the one study setting the results is a mere pilot study.
The reason you give for our letter not being published is that it was not given enough priority to justify publication. We would like to know: Which issues can conceivably receive higher priority than the fact that a paper in your journal is downright wrong and misleading?
What do you need to deem a comment important? Up to now the paper is unchallenged by any reader’s comments, so apparently there was no other letter to the editor that might be given higher priority than ours.
We ask you to review your decision, or better still, consider a retraction of the paper altogether. If so, an expression of concern should be issued at once. After all, the COPE-guidelines for retraction state “clear evidence, that the findings are unreliable, either as a result of major error (…), or as a result of fabrication (…) or faslification (…)’ as a reason to consider retraction.
Otherwise the malpractice of homeopathy will have a first class evidence that will be helpful to promote homeopathy to parents and their children.
Watch this space!
It has been reported that a GP has been erased from the medical register after a disciplinary tribunal concluded yesterday that her statements on vaccines amounted to misconduct.
Dr Jayne Donegan, who no longer works as an NHS GP, was found by the tribunal to have ‘encouraged parents to mislead healthcare professionals about their children’s diet or immunization history’. The UK General Medical Council (GMC) brought several allegations against Dr Donegan, about statements made between 2019 and 2020, however, the determination of impaired fitness to practise (FTP) and subsequent erasure was based solely on her suggestions to parents.
The tribunal determined that her misconduct ‘posed an ongoing risk to patient safety given her lack of insight and lack of remediation’ and that ‘public confidence would be undermined’ if such a doctor was allowed to remain in practice. An immediate order of suspension was imposed, which the tribunal determined necessary for the ‘protection of the public’. Other GMC allegations, such as Dr. Donegan’s statements failing to ‘give balanced information on the risks and benefits of immunization’, were proved true by the tribunal but were not determined to be serious misconduct.
Dr. Donegan works as a homeopathic and naturopathic practitioner and has been ‘researching disease ecology and vaccination since 1994’, according to her website. The tribunal considered statements made by Dr. Donegan in a consultation with an undercover reporter and during her lectures on vaccination. She had said that the historical decline in deaths from whooping cough was because of sanitation and surgeons, not vaccinations. She had also suggested to audiences at her lectures that they could avoid answering questions from healthcare professionals about their child’s immunization history. When asked by an audience member about this, Dr. Donegan had said: ‘I thought what am I going to do because if I were you, I could just forge something but I can’t do that because I am a doctor and I would get struck off and I really would get struck off. What can I do? I thought maybe I can do something homeopathic because they are not having it. In the meantime, I wrote “Yes, I’ll get it done” thinking what will I do and they never came back to me, so when the next one went I just said “yes. The main thing is, don’t stick your head above the parapet because you make it difficult for them. If you say they are not vaccinated, they say they can’t go on the trip or they say “They could but the insurers won’t insure us”, so just keep saying “yes” but don’t say I said that.’
The tribunal concluded that comments like this made it clear Dr. Donegan was aware this was a ‘serious matter that could result in her being struck off’, despite her defense that she was simply ‘making people laugh’. The MPTS tribunal chair Mr Julian Weinberg said: ‘The Tribunal considered that honest and accurate communication of an individual’s medical history forms an essential part of ongoing patient healthcare and that any attempt to undermine this risks the safety of patients. It noted that whilst no dishonesty was found against Dr. Donegan, the Tribunal has found that she encouraged parents to be dishonest with healthcare professionals by, for example, forging medical documents/records, thereby undermined this essential quality of the doctor/patient relationship.’ Mr Weinberg highlighted that the tribunal’s findings did not concern ‘the rights or wrongs of her views on immunization’ but rather her encouragement to parents to mislead healthcare professionals.
Dr. Donegan said in response to the decision: ‘I boycotted the GMC’s political show trial against me which ended today. Serious irregularities include bogus dishonesty charges and bogus accusations that I put newborns at risk of serious harm.’ She added: ‘Being struck off by a corrupt GMC is a small price to pay for taking a lawful ethical stand for the safety of British children.’
Apparently, Dr. Donegan even claimed that she is delighted to be struck off the register of medical practitioners – and so, I presume, are many of us reading this post!
This article by a Postgraduate Trainee (Dept. of Case Taking and Repertory, National Institute of Homoeopathy, Govt. of India) an Assistant Professor (Dept. of Surgery, National Institute of Homoeopathy Govt. of India) and another Assistant Professor (Dept. of Obstetrics & Gynaecology, Midnapore Homoeopathic Medical College & Hospital, Govt. of West Bengal) might not be available online (Clinical Medicine and Health Research Journal, Volume 03, Issue 03, May – June 2023 Page No. 444-446) but it is I think worth discussing. Here is its abstract:
Warts are one of the common dermatological disorders caused by human papilloma viruses encountered in our day to day life. These are cutaneous or mucosal infection needs proper care and treatment to prevent its transmission and complete healing. Although mostly warts are dealt with the therapeutic approach, i.e. on the basis of its peculiar type and location but it can even be successfully treated by constitutional approach. This article is regarding a case of warts treated successfully with Rhus Tox followed by Ferrum Met selected as the simillimum and proved its effectiveness in a short period of time.
As the abstract is not very informative, let me show you also some sections from the paper itself:
The patient presented with warts on right wrist for 1 year. There were plane warts at back of wrist, which was smooth, slightly elevated and skin coloured. There was no history of warts or other benign skin disease in the family. This case treated with individualized homoeopathic medicine showed complete resolution of the warts. There is no cure for wart in conventional medicine except removal of them with various methods. Although it does not rule out the chance of recurrence, later on may deep organic disease. That is why a substantial number of warts patients resort to Complementary and Alternative Medicine (CAM), especially homoeopathy.
In this case, Ferrum Metallicum 0/1 was selected as a ‘similimum’ based on totality of symptoms, repertorial analysis and consultation with Homoeopathic Materia Medica, which was given more priority in this case. After seeing improvement, succeeding potency was prescribed. After Ferrum Met 0/4 all her complaints including warts disappeared. Thus, the outcome of this case of Plane Warts of the lady shows the success of individualized homoeopathic medicine in treatment of wart.
Conclusion:
This case report suggests homoeopathic treatment as a promising complementary or alternative therapy and emphasizes the need of repertorisation in individualized homoeopathic prescription. This case shows a positive role of homoeopathic in treating Warts. However, this is a single case study and requires well designed studies which may be taken up for future scientific validation.
This case report reminded me of an exciting and quite lovely story: at Exeter, we once conducted a wart study. It was a placebo-controlled, double-blind trial where the verum group received distant healing and the controls nothing at all. After planning the study, I was no longer involved in its running. As I happened to have a wart at the time, I offered myself to my team as a patient. They checked me out and admitted me into the study. For the next weeks, I either received the distant healing energy or nothing; neither I nor my team knew which. My wart was photographed and measured regularly.
And then it happened: shortly after the treatment period was over, my wart had gone. Everyone was excited, especially the UK healing scene. But we had to wait until the trial was finished, the results were calculated, and the random code was opened. The result: no difference between verum and placebo! We concluded that distant healing from experienced healers had no effect on the number or size of patients’ warts.
And my own, very personal wart?
It had disappeared spontaneously – I had been in the control group!
I know Indian homeopaths have a thing about healing warts (we discussed this before) but I am afraid the conclusions of this new paper ought to be re-written:
This case report does not suggest that homeopathic treatment is a promising complementary or alternative therapy. It shows the natural history of the condition in the disappearance of warts.
At first glance, the article entitled ‘Homeopathy: A State of the Science Review With Recommendations for Practical Therapies in Midwifery Practice‘ looks interesting and fairly solid; it was published in a mainstream, peer-reviewed midwifery journal; it is lengthy and thus seems thorough; it cites 125 references; and its two American authors have respectable affiliations (Art of Nursing Care Inc., Playa del Ray, California. Sonoran University of Health Sciences, Tempe, Arizona.). Yet, it does not take long to discover that ‘solid’ is not the term to describe it accurately. In fact, the paper is one of the worst examples of pseudo-science that I have ever come across. Let me just show you its conclusions:
This state of the science review has explored the history of homeopathy, its evidence base, manufacturing, regulation, and licensure. We have examined some of the controversies between homeopathy and conventional medicine in an effort to provide an overview and understanding of homeopathic science. Suggestions for practical therapies for use in midwifery practice have been given.
Despite misperceptions, homeopathy has become a well-established global practice with a growing body of research to support its benefits. Homeopathic medicines provide a comprehensive treatment approach to the myriad of conditions encountered in the midwifery practice model of care. With homeopathy’s generally accepted safety profile, low risk of side effects, few drug interactions, and low risk of overdose, midwives educated in homeopathic science can be confident that homeopathy provides a satisfactory complement for patients seeking alternative practices.
Increased opportunities for clinical research of homeopathic medicines by large funding organizations is recommended to advance patient care, understanding, and acceptance of the whole person and inform future health policy. Researchers around the world have begun to investigate the unanswered questions verifying the safety and efficacy of homeopathic treatment and the future of homeopathic research is promising. As homeopathic science continues to evolve, many health care professionals, including midwives, now seem open to adding homeopathy to complement their system of care for the whole person.
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In the article, we find two short paragraphs dealing with the effectiveness of homeopathy:
Essential to these debates are questions surrounding theories of homeopathy, such as the Law of Minimum Dose, like cures like, nonstandardized dosing, and symptom evaluation in a manner different from that of conventional medicine. It has been argued that the homeopathic paradigm is different from conventional scientific concepts associated with evidence-based medicine such as independent replication, confirmation of findings, measurement, and interpretation of results based on homeopathy’s reliance on individualized treatments and it basic tenets of the Principle of Similars and Law of Minimum Dose.69, 68 Conventional medicine practitioners find it counterintuitive that further dilution of a substance is believed to enhance its healing power when compared with a less dilute substance.65 For example, if the level of dilution is unmeasurable, how can the active ingredient be found, and is it even there?22 Recent research using nanopharmacology is beginning to uncover, identify, and characterize these ingredients in ultradiluted remedies and may help to answer these questions.39, 70 Debates arise concerning why individuals with similar symptoms often receive different treatments.22 Others ask whether homeopathic remedies perhaps inadvertently lead consumers to forgo conventional treatments that have been proven to work.5, 21, 22, 65
Interestingly, studies examining placebo therapies have appeared in scientific literature with increasing frequency, and some have compared the effectiveness of placebos with homeopathic remedies.68, 71–73 Multiple studies that have examined homeopathic treatments have found them equivalent to or no more effective than placebo,65, 68 whereas other studies found either measurable success or that patients perceived their outcomes as improved following homeopathic treatment.26, 75, 74 Mathie et al conducted a systematic review and meta-analysis focused on randomized controlled trials of nonindividualized homeopathic treatments. Authors reported that the quality of evidence was too low to determine whether homeopathic treatment results were distinguishable from those of placebo.72 These issues cited above represent some of the inconsistencies surrounding the theoretical basis and effectiveness of homeopathic therapies.
WHY WOULD ANY RESPECTABLE AUTHOR WRITE SUCH MISLEADING NONSENSE?
WHY WOULD ANY RESPECTABLE JOURNAL PUBLISH IT?
The answers to these questions might be found at the end of the paper:
Support for this supplement has been provided by Boiron USA. Boiron representatives provided no input into the article content.
Sharon Bond, CNM, PhD, who was an Associate Editor of the Journal of Midwifery & Women’s Health during the initial drafting of the manuscript, received compensation from Boiron USA for the assistance she provided the authors with editing and proofreading of the manuscript. Dr. Bond was not involved in the editorial review of or decision to publish this article.
The findings and conclusions in this supplement are those of the authors and do not necessarily reflect the official position of the host organizations, the American College of Nurse-Midwives, John Wiley & Sons, Inc., or the opinions of the journal editors.
I would argue that publishing such an article is unethical and amounts to scientific misconduct!
The COVID-19 pandemic has posed an unprecedented challenge to global health. Classical homeopathy may, according to homeopaths, have a role to play in alleviating this burden. The objective of this study was to curate data on the treatment effect of classical homeopathy for COVID-19 in a real-world scenario to guide future scientific investigations.
Classical homeopaths from the International Academy of Classical Homeopathy (IACH) were asked to provide details on cases they treated by filling out a standardized questionnaire. COVID-19 cases were defined according to World Health Organization (WHO) criteria as suspected/probable/confirmed cases, with intervention provided being either stand-alone classical homeopathy or combined with conventional therapy for COVID-19. Cases were followed up with main outcomes being ‘improved’, ‘not improved’, or ‘progressed’ post-treatment. Details of the homeopathic remedies used and the main symptoms at the presentation were gathered. Factors associated with main outcomes were investigated with correlational and regression analyses.
367 patients (male 166, female 201) met eligibility criteria (mean age 42.75 years). The mean follow-up period was 6.5 (standard deviation, SD=5.3) days. 255 were confirmed COVID-19 cases, with 61 probable and 51 suspected cases, respectively. The most used remedy was Arsenicum album. Over 73% of COVID-19 patients (and about 79% of severe cases) improved under classical homeopathic treatment. The number of remedies required per individual was negatively correlated to improvement (P< 0.01). Fever, the most common symptom at presentation (74.4%), was associated with an increased likelihood of improvement (P<0.01). Improvement was negatively associated with advanced age, but not associated with sex (P<0.01).
The authors conclude that this study suggests that classical homeopathy was associated with improvement in COVID-19, including severe cases. Despite limitations from study design and data sources, our findings should prompt further studies on the role of classical homeopathy in the management of COVID-19.
I BEG TO DIFFER!
These cases suggest nothing of the sort. If anything, these highly selected cases suggest that about 27% of the exemplary patients did not improve, perhaps they even died. This implies to me that classical homeopathy worsens the prognosis of patients infected with COVID-19.
The ‘International Academy of Classical Homeopathy‘ is led by the ‘Ueber-Homeopath’, George Vithoulkas. His vision is that this Academy will become a center of real knowledge which will provide an education that will far exceed the technical and strictly “medical” aspect of one’s learning. One might ask what fanatics like he truly want to achieve – is it perhaps the promotion of ‘euthanasia homoeopathica’?
