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

methodology

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Yesterday, I received the email below. I almost deleted it because, at first glance, it looked like spam. Then I started reading it – perhaps you should do so too.

Dear Edzard Ernst,

We’d like to inform you that Research.com, a leading academic platform for researchers, has just released the 2024 Edition of our Ranking of Best Scientists in the field of Medicine.

We are sure you will be very happy to learn that you have ranked #819 in the world ranking and #86 in United Kingdom. You have also been recognized with our Medicine Leader Award for 2024. Congratulations!

The ranking is based on D-index (Discipline H-index) metric, which only includes papers and citation values for an examined discipline. The ranking includes only leading scientists with D-index of at least 70 for academic publications made in the area of Medicine.

The full world ranking is available here: https://www.research.com/scientists-rankings/medicine
The full ranking for United Kingdom is available here: https://www.research.com/scientists-rankings/medicine/gb

Feel free to also read an article summarizing the statistics and trends from our ranking here: https://research.com/careers/world-online-ranking-of-best-medicine-scientists-2024-report

Please accept our sincere congratulations. Being present in our ranking is definitely a great achievement for you and your university or research institution. Feel free to share and publicize your accomplishment in any way you see fit.

With Best Regards…

________________________

I am not sure how significant this all is. Nonetheless, I thought I share the email with my small fan club from my blog.

This prospective cohort study examined the effects of fish oil supplements on the clinical course of cardiovascular disease, from a healthy state to atrial fibrillation, major adverse cardiovascular events, and subsequently death.

The analysis is based on the UK Biobank study (1 January 2006 to 31 December 2010, with follow-up to 31 March 2021 (median follow-up 11.9 years)) including 415 737 participants, aged 40-69 years. Incident cases of atrial fibrillation, major adverse cardiovascular events, and death, identified by linkage to hospital inpatient records and death registries. Role of fish oil supplements in different progressive stages of cardiovascular diseases, from healthy status (primary stage), to atrial fibrillation (secondary stage), major adverse cardiovascular events (tertiary stage), and death (end stage).

Among 415 737 participants free of cardiovascular diseases, 18 367 patients with incident atrial fibrillation, 22 636 with major adverse cardiovascular events, and 22 140 deaths during follow-up were identified. Regular use of fish oil supplements had different roles in the transitions from healthy status to atrial fibrillation, to major adverse cardiovascular events, and then to death:

  • For people without cardiovascular disease, hazard ratios were 1.13 (95% confidence interval 1.10 to 1.17) for the transition from healthy status to atrial fibrillation and 1.05 (1.00 to 1.11) from healthy status to stroke.
  • For participants with a diagnosis of a known cardiovascular disease, regular use of fish oil supplements was beneficial for transitions from atrial fibrillation to major adverse cardiovascular events (hazard ratio 0.92, 0.87 to 0.98), atrial fibrillation to myocardial infarction (0.85, 0.76 to 0.96), and heart failure to death (0.91, 0.84 to 0.99).

The authors concluded that regular use of fish oil supplements might be a risk factor for atrial fibrillation and stroke among the general population but could be beneficial for progression of cardiovascular disease from atrial fibrillation to major adverse cardiovascular events, and from atrial fibrillation to death. Further studies are needed to determine the precise mechanisms for the development and prognosis of cardiovascular disease events with regular use of fish oil supplements.

I must admit that I am slightly puzzled by this study and its findings. The authors clearly speak of the ‘role’ regular use of fish oil supplements has. This language implies a casual impact. Yet, what we have here are associations, and every 1st year medical student knows that

correlation is not causation.

Other things to note are that:

  • the associations are only very weak;
  • they go in opposite directions depending on the subpopulation that is examined,
  • there is no plausible mechanism of action to explain all this.

Collectively, these facts suggest to me that we are indeed more likely dealing here with a non-causal association and not a causal link. All the more surprising then that the (UK) press took up this paper in a major and occasionally alarmist fashion (the headline in THE TELEGRAPH was Revealed: How cod liver oil could be bad for your health). I learned of it by listening to the BBC headline news.

 

Many forms of so-called alternative medicine (SCAM) involve touch, and touch is of critical importance: many studies have shown that it promotes mental and physical well-being.

A team of researchers conducted a pre-registered (PROSPERO: CRD42022304281) systematic review and multilevel meta-analysis encompassing 137 studies in the meta-analysis and 75 additional studies in the systematic review (n = 12,966 individuals, search via Google Scholar, PubMed and Web of Science until 1 October 2022) to identify critical factors moderating touch intervention efficacy.

Included studies always featured a touch versus no touch control intervention with diverse health outcomes as dependent variables. Risk of bias was assessed via small study, randomization, sequencing, performance and attrition bias.

The results show that touch interventions were especially effective in:

  • regulating cortisol levels (Hedges’ g = 0.78, 95% confidence interval (CI) 0.24 to 1.31),
  • increasing weight (0.65, 95% CI 0.37 to 0.94) in newborns,
  • reducing pain (0.69, 95% CI 0.48 to 0.89),
  • reducing feelings of depression (0.59, 95% CI 0.40 to 0.78),
  • reducing state (0.64, 95% CI 0.44 to 0.84) or trait anxiety (0.59, 95% CI 0.40 to 0.77) for adults.

Comparing touch interventions involving objects or robots resulted in similar physical (0.56, 95% CI 0.24 to 0.88 versus 0.51, 95% CI 0.38 to 0.64) but lower mental health benefits (0.34, 95% CI 0.19 to 0.49 versus 0.58, 95% CI 0.43 to 0.73). Adult clinical cohorts profited more strongly in mental health domains compared with healthy individuals (0.63, 95% CI 0.46 to 0.80 versus 0.37, 95% CI 0.20 to 0.55).

The authors found no difference in health benefits in adults when comparing touch applied by a familiar person or a health care professional (0.51, 95% CI 0.29 to 0.73 versus 0.50, 95% CI 0.38 to 0.61), but parental touch was more beneficial in newborns (0.69, 95% CI 0.50 to 0.88 versus 0.39, 95% CI 0.18 to 0.61). Small but significant small study bias and the impossibility to blind experimental conditions need to be considered.

The authors concluded that leveraging factors that influence touch intervention efficacy will help maximize the benefits of future interventions and focus research in this field.

It seems obvious to me that these findings are relevant to several SCAMs, e.g.:

  • acupuncture,
  • Alexander technique,
  • applied kinesiology,
  • aromatherapy,
  • Bowen technique,
  • chiropractic,
  • craniosacral therapy,
  • cupping,
  • Dorn method,
  • Feldenkrais method,
  • gua sha,
  • kinesiology taping,
  • lymph drainage,
  • massage in all its variations,
  • naprapathy,
  • osteopathy,
  • rebirthing,
  • reflexology,
  • Rolfing,
  • shiatsu,
  • slapping therapy,
  • therapeutic touch.

This also means that the effects of these SCAMs will be at least to some extend non-specific, i.e. not related to the treatment per se but to touch. Finally, it means that clinical trials testing these SCAMs need to be designed such that the touch element is adequately accounted for.

This randomized controlled, pretest-post-test intervention study examined the effect of distance reiki on state test anxiety and test performance.
First-year nursing students (n = 71) were randomized into two groups. One week before the examination,

  • the intervention group participants received reiki remotely for 20 minutes for 4 consecutive days,
  • the control group participants received no intervention.
The intervention group had lower posttest cognitive and psychosocial subscale scores than pretest scores (p > .05). The control group had a significantly higher mean posttest physiological subscale score than pretest score (p < .05). Final grade point averages were not significantly different between the intervention and control groups (p > .05). One quarter of the intervention group participants noted reiki reduced their stress and helped them perform better on the examination.The authors concluded that Reiki is a safe and easy-to-practice method to help students cope with test anxiety.What a conclusion!What a study!

A controlled clinical trial has the purpose of comparing outcomes of two or more treatments. Therefore, intra-group changes are utterly irrelevant. The only thing of interest is the comparison between the intervention and control groups. In the present study, this did not show a significant difference. In other words, distant Reiki had no effect.

This means that the bit in the conclusion telling us that Reiki helps students cope with test anxiety is quite simply not true.

This leaves us with the first part of the conclusion: Reiki is a safe and easy-to-practice method. This may well be true – yet it is meaningless. Apart from the fact that the study was not aimed at assessing safety or ease of practice, the statement is true for far too many things to be meaningful, e.g.:

  • Not having Reiki (the control group) is a safe and easy-to-practice method.
  • Going for a walk is a safe and easy-to-practice method.
  • Cooking a plate of spagetti is a safe and easy-to-practice method.
  • Having a nap is a safe and easy-to-practice method.
  • Reading a book is a safe and easy-to-practice method.

(I think you get my gist)

To make the irony complete, let me tell you that this trial was published in Journal of Nursing Education. On the website, the journal states: The Journal of Nursing Education is a monthly, peer-reviewed journal publishing original articles and new ideas for nurse educators in various types and levels of nursing programs for over 60 years. The Journal enhances the teaching-learning process, promotes curriculum development, and stimulates creative innovation and research in nursing education.

I suggest that the journal urgently embarks on a program of educating its editors, reviewers, contributors and readers about science, pseudoscience, minimal standards, scientific rigor, and medical ethics.

 

 

In the realm of so-called alternative medicine (SCAM), dental amalgam is a big topic. Therefore, we have discussed it several times before, e.g.:

This study evaluated the changes of health complaints after removal of amalgam restorations in patients with health complaints attributed to dental amalgam fillings.

Patients with medically unexplained physical symptoms (MUPS) attributed to dental amalgam (Amalgam cohort) had all their amalgam fillings removed. The participants indicated an intensity of 11 local and 12 general health complaints on numeric rating scales before the treatment and at follow-up after 1 and 5 years.

The comparison groups comprising

  1. a group of healthy individuals
  2. a group of patients with MUPS without symptom attribution to dental amalgam

did not have their amalgam restorations removed.

In the Amalgam cohort, mean symptom intensity was lower for all 23 health complaints at follow-up at 1 year compared to baseline. Statistically significant changes were observed for specific health complaints with effect sizes between 0.36 and 0.68. At the 5-year follow-up, the intensity of symptoms remained consistently lower compared to before the amalgam removal. In the comparison groups, no significant changes of intensity of symptoms of health complaints were observed.

The authors concluded that, after removal of all amalgam restorations, both local and general health complaints were reduced. Since blinding of the treatment was not possible, specific and non-specific treatment effects cannot be separated.

This is an interesting study with a particularly long follow-up. Unfortunately, due to the study’s design, its results tell us very little about causality. The results are perfectly consistent with two entirely different explanations:

  1. Amalgam was the cause of MUPS and therefore removal of amalgam cured the problem permanently.
  2. Amalgam was not the cause of MUPS but the knowledge that the evil substance had finally been removed sufficed for MUPS to disappear.

It is to the credit of the authors that they consider both options.

A word of caution: amalgam removal can lead to a spike in Hg levels in the body!

I know, I have mentioned my concerns before about research into so-called alternative medicine (SCAM) from China, e.g.:

In 2018, China became the country that produces more scientific papers than any other. At present, China’s output stands at over one million articles per year. Yes, I do find this worrying!

On 2/4/2024, I did a few very simple Medline searches. I feel that the findings are remarkable.

Clinical trials of TCM

Between 2000 and 2023 ~ 8000

2000 = 8

2010 = 157

2020 = 1 192

Systematic reviews of TCM

2000 = 1

2010 = 26

2020 = 1 222

This near explosive rate of growth could, of course, be good news. But it isn’t because – as shown here so often before – the findings of Chinese research are worringly unreliable.

As if to confirm my point about the dominance of China, this paper has just been published:

Background: Neuropathic pain (NP) is a common type of pain in clinic. Due to the limited effect of drug treatment, many patients with NP are still troubled by this disease. In recent years, complementary and alternative therapy (CAT) has shown good efficacy in the treatment of NP. As the interest in CAT for NP continues to grow, we conducted a bibliometric study of publications on CAT treatment for NP. The aim of this study is to analyze the development overview, research hotspots and future trends in the field of CAT and NP through bibliometric methodology, so as to provide a reference for subsequent researchers.

Methods: Publications on CAT in the treatment of NP from 2002 to 2022 were retrieved from the Web of Science Core Collection. Relevant countries, institutions, authors, journals, keywords, and references were analyzed bibliometrically using Microsoft Excel 2021, bibliometric platform, VOSviewer, and CiteSpace.

Results: A total of 898 articles from 46 countries were published in 324 journals, and they were contributed by 4455 authors from 1102 institutions. The most influential country and institution are China (n = 445) and Kyung Hee University (n = 63), respectively. Fang JQ (n = 27) and Evidence-Based Complementary and Alternative Medicine (n = 63) are the author and journal with the most publications in this field. The clinical efficacy, molecular biological mechanisms and safety of CAT for NP are currently hot directions. Low back pain, postherpetic neuralgia, acupuncture, and herbal are the hot topics in CAT and NP in recent years.

Conclusion: This study reveals the current status and hotspots of CAT for NP. The study also indicates that the effectiveness and effect mechanism of acupuncture or herbs for treating emotional problems caused by low back pain or postherpetic neuralgia may be a trend for future research.

China is increasingly dominating SCAM research and we all know – or should know by now (see above) – that the results of this research are misleading. I cannot understand why so few people seem to think this is alarming.

 

 

This study sought to identify if an Neonatal Intensive Care Unit (NICU) integrating complementary medicine has low antibiotic prescribing.

The researchers conducted a retrospective analysis at the level-2 NICU of the Filderklinik, an integrative medicine hospital in Southern Germany, to compare antibiotic use locally and internationally; to compare neonates with suspected infection, managed with and without antibiotics; and to describe use and safety of complementary medicinal products.

Among 7778 live births, 1086 neonates were hospitalized between 2014 and 2017. Two hundred forty-six were diagnosed with suspected or confirmed infection, their median gestational age was 40.3 weeks (range 29-42), 3.25% had a birthweight <2500 g, 176 were treated with antibiotics for a median duration of 4 days, 6 had culture-proven infection (0.77 per 1000 live births), and 2.26% of live births were started on antibiotics. A total of 866 antibiotic treatment days corresponded to 111 antibiotic days per 1000 live births and 8.8 antibiotic days per 100 hospital days. Neonates managed with antibiotics more often had fever and abnormal laboratory parameters than those managed without. Complementary medicinal products comprising 71 different natural substances were used, no side effect or adverse event were described. A subanalysis using the inclusion criteria of a recent analysis of 13 networks in Europe, North America, and Australia confirmed this cohort to be among the lowest prescribing networks.

The authors concluded that antibiotic use was low in this NICU in both local and international comparison, while the disease burden was in the mid-range, confirming an association between integrative medicine practice and low antibiotic prescribing in newborns. Complementary medicinal products were widely used and well tolerated.

I have often suggested that somone does a study to assess the usage of meat products in a vegetarian restaurant. I am sure it would generate resuts that are at least as meaningful as the ones reported by the team of anthroposophic geniuses responsible for this paper. Here are their affiliations:

  • 1ARCIM Institute, Filderstadt, Germany.
  • 2Department of Pediatrics, Filderklinik, Filderstadt, Germany.
  • 3Department of Neonatology, University Hospital Tübingen, Tübingen, Germany.
  • 4Center for Integrative Pediatrics, Fribourg Cantonal Hospital, Fribourg, Switzerland.
  • 5Department of Community Health, Fribourg University, Fribourg, Switzerland.
  • 6Institute of Precision Medicine, University Furtwangen, Furtwangen, Germany.

Say no more!

This systematic review and meta-analysis investigated the effectiveness and safety of manual therapy (MT) interventions compared to oral or topical pain medications in the management of neck pain.
The investigators searched from inception to March 2023, in Cochrane Central Register of Controller Trials (CENTRAL), MEDLINE, EMBASE, Allied and Complementary Medicine (AMED) and Cumulative Index to Nursing and Allied Health Literature (CINAHL; EBSCO) for randomized controlled trials that examined the effect of manual therapy interventions for neck pain when compared to oral or topical medication in adults with self-reported neck pain, irrespective of radicular findings, specific cause, and associated cervicogenic headaches. Trials with usual care arms were also included if they prescribed medication as part of the usual care and they did not include a manual therapy component. The authors used the Cochrane Risk of Bias 2 tool to assess the potential risk of bias in the included studies, and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach to grade the quality of the evidence.

Nine trials  with a total of 779 participants were included in the meta-analysis.

  • low certainty of evidence was found that MT interventions may be more effective than oral pain medication in pain reduction in the short-term (Standardized Mean Difference: -0.39; 95% CI -0.66 to -0.11; 8 trials, 676 participants),
  • moderate certainty of evidence was found that MT interventions may be more effective than oral pain medication in pain reduction in the long-term (Standardized Mean Difference: −0.36; 95% CI −0.55 to −0.17; 6 trials, 567 participants),
  • low certainty evidence that the risk of adverse events may be lower for patients who received MT compared to the ones that received oral pain medication (Risk Ratio: 0.59; 95% CI 0.43 to 0.79; 5 trials, 426 participants).

The authors conluded that MT may be more effective for people with neck pain in both short and long-term with a better safety profile regarding adverse events when compared to patients receiving oral pain medications. However, we advise caution when interpreting our safety results due to the different level of reporting strategies in place for MT and medication-induced adverse events. Future MT trials should create and adhere to strict reporting strategies with regards to adverse events to help gain a better understanding on the nature of potential MT-induced adverse events and to ensure patient safety.

Let’s have a look at the primary studies. Here they are with their conclusions (and, where appropriate, my comments in capital letters):

  1. For participants with acute and subacute neck pain, spinal manipulative therapy (SMT) was more effective than medication in both the short and long term. However, a few instructional sessions of home exercise with (HEA) resulted in similar outcomes at most time points. EXERCISE WAS AS EFFECTIVE AS SMT
  2.  Oral ibuprofen (OI) pharmacologic treatment may reduce pain intensity and disability with respect to neural mobilization (MNNM and CLG) in patients with CP during six weeks. Nevertheless, the non-existence of between-groups ROM differences and possible OI adverse effects should be considered. MEDICATION WAS BETTER THAN MT
  3. It appears that both treatment strategies (usual care + MT vs usual care) can have equivalent positive influences on headache complaints. Additional studies with larger study populations are needed to draw firm conclusions. Recommendations to increase patient inflow in primary care trials, such as the use of an extended network of participating physicians and of clinical alert software applications, are discussed. MT DOES NOT IMPROVE OUTCOMES
  4. The consistency of the results provides, in spite of several discussed shortcomings of this pilot study, evidence that in patients with chronic spinal pain syndromes spinal manipulation, if not contraindicated, results in greater improvement than acupuncture and medicine. THIS IS A PILOT STUDY, A TRIAL TESTING FEASIBILITY, NOT EFFECTIVENESS
  5. The consistency of the results provides, despite some discussed shortcomings of this study, evidence that in patients with chronic spinal pain, manipulation, if not contraindicated, results in greater short-term improvement than acupuncture or medication. However, the data do not strongly support the use of only manipulation, only acupuncture, or only nonsteroidal antiinflammatory drugs for the treatment of chronic spinal pain. The results from this exploratory study need confirmation from future larger studies.
  6. In daily practice, manual therapy is a favorable treatment option for patients with neck pain compared with physical therapy or continued care by a general practitioner.
  7. Short-term results (at 7 weeks) have shown that MT speeded recovery compared with GP care and, to a lesser extent, also compared with PT. In the long-term, GP treatment and PT caught up with MT, and differences between the three treatment groups decreased and lost statistical significance at the 13-week and 52-week follow-up. MT IS NOT SUPERIOR [SAME TRIAL AS No 6]
  8. In this randomized clinical trial, for patients with chronic neck pain, Chuna manual therapy was more effective than usual care in terms of pain and functional recovery at 5 weeks and 1 year after randomization. These results support the need to consider recommending manual therapies as primary care treatments for chronic neck pain.
  9. In patients with chronic spinal pain syndromes, spinal manipulation, if not contraindicated, may be the only treatment modality of the assessed regimens that provides broad and significant long-term benefit. SAME TRIAL AS No 5
  10. An impairment-based manual physical therapy and exercise (MTE) program resulted in clinically and statistically significant short- and long-term improvements in pain, disability, and patient-perceived recovery in patients with mechanical neck pain when compared to a program comprising advice, a mobility exercise, and subtherapeutic ultrasound. THIS STUDY DID NOT TEST MT ALONE AND SHOULD NOT HAVE BEEN INCLUDED

I cannot bring myself to characterising this as an overall positive result for MT; anyone who can is guilty of wishful thinking, in my view. The small differences in favor of MT that (some of) the trials report have little to do with the effectiveness of MT itself. They are almost certainly due to the fact that none of these studies were placebo-controlled and double blind (even though this would clearly be possible). In contrast to popping a pill, MT involves extra attention, physical touch, empathy, etc. These factors easily suffice to bring about the small differences that some studies report.

It follows that the main conclusion of the authors of the review should be modified:

There is no compelling evidence to show that MT is more effective for people with neck pain in both short and long-term when compared to patients receiving oral pain medications.

 

Acute tonsillitis, which includes tonsillopharyngitis, is a common condition, particularly in childhood. It is mostly caused by a viral infection. Symptomatic treatment is of high importance. But which treatment is effective and which isn’t?

For this expert consensus, 53 physicians from Germany, Spain, Netherlands, Switzerland, Austria, and Hungary with at least one year of experience in anthroposophic paediatric medicine were invited to participate in an online Delphi process. The process comprised 5 survey rounds starting with open-ended questions and ending with final statements, which need 75% agreement of experts to reach consensus. Expert answers were evaluated by two independent reviewers using MAXQDA and Excel.

Response rate was between 28% and 45%. The developed recommendation included 15 subtopics. These covered clinical, diagnostic, therapeutic and psychosocial aspects of acute tonsillitis. Six subtopics achieved a high consensus (>90%) and nine subtopics achieved consensus (75-90%). The panel felt that AM was an adequate therapy for acute tonsillitis.

The authors of this paper concluded that the clinical recommendation for acute tonsillitis in children aims to simplify everyday patient care and provide decision-making support when considering and prescribing anthroposophic therapies. Moreover, the recommendation makes AM more transparent for physicians, parents, and maybe political stakeholders as well.

I found it hard to decide whether to cry or to laugh while reading this paper.

Experience in anthroposophic paediatric medicine does not make anyone an expert in anything other than BS.

Expert consensus and clinical guidelines are not conducted by assembling a few people who all are in favour of a certain therapy while ignoring the scientific evidence.

AM for acute tonsillitis in children is nonsense, whatever these pseudo-experts claim.

Imagine we run a Delphi process with a few long-standing members of ‘the flat earth society’ and ask them to tell us about the shape of the earth …

…I rest my case.

The Academy of Homeopathy Education is a US-based accredited teaching institution offering homeopathy education services to professional and medically licensed homeopathy students. This study reports on clinical outcomes from the teaching clinic from 2020 to 2021.

Data were collected using the patient-generated outcome measure, the Measure Yourself Concerns and Wellbeing (MYCaW). Mean MYCaW values for initial and subsequent consultations were analyzed for the degree of change across the intervention period in 38 clients. Each client listed up to two complaints. MYCaW scores between initial and subsequent consultations were analyzed for the degree of change (delta) across the intervention period.

A total of 95 body system-related symptoms were analyzed for change in intensity following the homeopathic intervention. Statistically significant improvements in the intensity of main symptoms were observed between initial and subsequent follow-ups. The main symptom scores showed a mean change in intensity (delta MYCaW) of −0.79 points (95% confidence interval (CI), −1.29 to −0.29; p = 0.003) at first follow-up, a mean change of −1.67 points (95% CI, −2.34 to −0.99; p = 0.001) at second follow-up compared with the initial visit, and a mean change of −1.93 points (95% CI, −3.0 to −0.86; p = 0.008) at third follow-up compared with the initial visit. For clients with four or more follow-ups, the mean delta MYCaW was −1.57 points (95% CI, −2.86 to −0.28; p = 0.039).

The authors concluded that statistically significant improvements as well as some clinically meaningful changes in symptom intensity were found across a diverse group of individuals with a variety of long-term chronic conditions. The improvement was evident across different body systems and different levels of chronicity. There are limitations to the generalizability of the study due to the research design. Further research and investigation are warranted given the promising results of this work.

There are, of course, not just limits to the generalizability of this study! I’d say there are limits to the interpretation of any of its findings.

What was the cause of the improvements?

Here are just a few questions that I asked myself while reading this paper:

  • Are the guys from the Academy of Homeopathy Education not aware of the fact that even chronic conditions often get better by themselves?
  • Have they heard of the placebo effect?
  • Are they trying to tell us that the patients did not also use conventional treatments for their chronic conditions?
  • What about regression towards the mean?
  • What about social desirability?
  • Why do they think that further research is needed?
  • Are these really results that look ‘promising for homeopathy?

To answer just the last question: No, these findings are in perfect agreement with the fact that highly diluted homeopathic remedies are pure placebos (to be honest, they would even be in agreement with such remedies being mildly harmful).

 

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