Homeopathy4health

29 June 2013

Why hounding homeopaths is both batty and arrogant.

“Ultimately what Nightingale is attacking is the intelligence and judgement of people who are trying to find an effective way to heal themselves. If homeopathy, which even its most virulent critics cannot claim is remotely likely to be harmful, works for you, then someone needs to combine serious arrogance with real battiness to believe they have the right to stand in the way.”

 Body of Evidence

There is no shortage of villains in the world. Psychopaths – domestic and national – whalers, toxic waste dumpers, global eavesdroppers, billionaire tax avoiders and their army of accountants –  all well worth campaigning against with the aim of getting them banged up or forced to cough up.

There is also an infinite supply of people who are mildly irritating who misplace apostrophes, wear Croc shoes, do crochet, litter their sentences with “you know” and text using their middle finger.

However most of us can tell the difference. In fact mixing the two categories up is a pretty reliable indicator of a serious level of battiness . Picketing shops that sell Crocs or campaigning to forbid the sale of mobiles to clumsy texters puts you firmly in the mild-to-fairly-irritating and definitely-a-bit -potty class.

Step forward the Nightingale Collaboration, earnest and self-styled defender of rationalism, whose seriously potty members have got…

View original post 986 more words

23 July 2010

Observations on Homeopathy Evidence Check

(my emphases)

Observations on the report Evidence Check 2: Homeopathy by the House
of Commons Science and Technology Committee, February 2010

1. Background

1.1. The report Evidence Check 2: Homeopathy was the second to be produced with
the purpose of examining how the UK Government uses evidence to
formulate and review its policies
. It was not an inquiry into homeopathy as
such
. The House of Commons Committee asked two principal questions:
What is the Government’s policy? And on what evidence is that policy
based?
The point was whether the scientific evidence supported the provision
of homeopathy by the NHS and the licensing of homeopathic products
by the MHRA.

1.2. The report received much publicity because of its firm rejection of evidence
for homeopathy’s efficacy on its way to answering these questions. The aim
of this paper is to focus on this one aspect of the Committee’s work, in view of
doubts voiced about the validity of its findings
. Sections 2 – 5 below address
this question.

1.3. The author served on the House of Lords Science and Technology Sub-
Committee which in 1999-2000 inquired into complementary and alternative
medicine (CAM). He was Co-Chairman of what used to be called the Parliamentary
Group for Alternative and Complementary Medicine during the
1990s, and also served on the advisory board to the systematic review of water
fluoridation which was conducted in 1999-2000 by the NHS Centre for
Reviews and Dissemination (CRD) at the University of York. As a user of
homeopathy he has failed to derive much benefit from it, but has supported
its use and development in the UK.

2. The scientific evidence for efficacy

2.1. There have been a number of systematic reviews and meta-analyses in this
field, which as the Committee states are the best sources of evidence. The
most recent review of substance is that by Shang et al in 2005, which it
considered “the most comprehensive to date” and which compared 110
placebo-controlled trials of homoeopathy [authors’ spelling] with 110 trials of
conventional medicine matched for disorder and type of outcome. The
Committee cited a conclusion by the authors [paragraph 69] that “when
analyses were restricted to large trials of higher quality there was no convincing
evidence that homeopathy [sic] was superior to placebo”. They did not
also cite the authors’ interpretation which followed these findings in the
Lancet summary, which stated: “When account was taken for these biases
[common to trials of both homoeopathy and conventional medicine], there
was weak evidence for a specific effect of homoeopathic remedies
, but strong
evidence for specific effects of conventional interventions. This finding is
compatible with the notion that the clinical effects of homoeopathy are
placebo effects.”

2.2. This was no endorsement of homeopathy. But it was some way removed
from the Committee’s conclusion in paragraph 70 of their report, “In our view,
the systematic reviews and meta-analyses conclusively demonstrate that
homeopathic products perform no better than placebos.” It also provides
little support for that part of Professor Ernst’s evidence to the Committee
where he “pointed out that: . . . Shang et al very clearly arrived at a
devastatingly negative overall conclusion
” [67].

2.3. The exaggeration by the Committee of Shang’s conclusions is worrying. It is
difficult to see how a weakly supported positive effect, for which one
explanation (possibly well-founded) is a placebo effect, can be translated into
a conclusive demonstration of this effect, with a “devastatingly” negative
finding
. No such firm claims can be found in Shang, who writes of finding
“no strong” evidence, or “little” evidence, and who ends his paper with
cautions about methodology and about the difficulty of detecting bias in
studies, as well as the role of possible “context effects” in homeopathy.

2.4. The Committee’s overstatement is not helped by claiming Government support
for its interpretation in paragraph 70, based on the Minister’s concession
of no “credible” evidence that homeopathy works beyond placebo. If he
meant persuasive evidence – and his guarded support for further research [75]
supports this – that shows a confusion by the Committee between absence of
evidence and evidence of absence
. If however he was saying that all evidence
was negative, this as Prof. Harper correctly stated [71] runs counter to the
message from most reviews up to and including Shang, which is one of primary
studies of insufficient quantity, rigour, size, homogeneity and power to
give clear-cut answers.

2.5. It is the absence of reliable evidence that remains the problem, and this
includes evidence of an absence of specific effects
(while acknowledging the
problem in proving a negative, an obstacle which did not deflect the
Committee from its conclusive verdict in 70). The Committee itself writes in
69 of no “convincing” evidence from Shang, from higher-quality trials, which
is not consistent with a claim of conclusive (dis)proof. Care with words can
be as important as with figures, and can just as easily mislead.

2.6. In a search for best evidence in the early 2000s this author relied on the bulletin
on homeopathy produced by the NHS CRD at York in 2002, one of an
Effective Health Care series on “the effectiveness of health service
interventions for decision makers”. This bulletin made a systematic
assessment of the evidence to date. It advised “caution” in interpreting this
evidence, and warned that many of the areas researched were “not
representative of the conditions that homeopathic practitioners usually treat”,
and that “the methodological problems of the research” should be considered.
It found “insufficient evidence of effectiveness . . to recommend homeopathy
for any specific condition”. At the same time it could not conclude that
homeopathy performed no better than placebo.

2.7. That was eight years ago. But it is notable that the more recent review by
Shang, on which the Committee relied quite heavily, cited no reference to any
placebo-controlled trial (i.e. of reasonable quality) subsequent to the CRD’s
bulletin, in arriving at a suggestion, but not a conclusion, of a placebo effect.

The House of Commons Committee’s verdict in 70 stands on its own in going
beyond what either review found from the evidence before it.

2.8. In seeking an up-to-date assessment from the NHS CRD, this author was referred
to the German researcher Klaus Linde as among the best of the
objective sources of current evidence on homeopathy. Linde, who was the
lead author of a major review in 1997 cited by the Committee, in turn
recommended the statistician Rainer Lüdtke as an expert with a good
overview of the current literature. Correspondence ensued with both
researchers, who were aware of the Committee’s recent report.

2.9. Both Linde and Lüdtke hold that the Committee’s conclusion in 70 that
reviews “conclusively demonstrate” a placebo effect is overstated and
unsustainable on present evidence. They have further criticisms of the way in
which evidence has been addressed.

2.10. Both are critical of Prof. Ernst’s evidence to the Committee as highlighted in
67. Prof. Linde confirms that his own 1999 re-analysis weakened the findings
of his 1997 review and probably “at least overestimated the effects of
homeopathic treatments”, but that his paper was “not ‘negative’” as stated by
Ernst
. He writes that “A more accurate interpretation is that the ‘re-analyses’
[by himself and 5 others, referred to by Ernst] show that the (positive)
evidence is not fool-proof. This applies still today (for example, to the Shang
analysis)”. Lüdtke draws attention to his own paper in 2002 which criticised
many statistical errors in Ernst’s 2000 re-analysis in the same journal, vitiating
Ernst’s negative conclusion, a published criticism which received no mention
in Ernst’s own evidence to the Committee
. Ernst was correct to state in
evidence elsewhere that the re-analyses of Linde came to a “less than positive”
conclusion, and that further reviews “failed to conclude that homeopathy is
effective”. The Committee, while adopting Ernst’s more absolute
conclusions, has not resolved the contradiction between his statements.

2.11. Lüdtke, like Shang, has also drawn attention to the pitfalls in research into
homeopathy, in a chapter in ‘New directions in homeopathy research’ (Witt C,
Albrecht H, eds.) published in 2009. He counsels against including all types
of homeopathy trials of reasonable quality in one review (such reviews tend to
suggest that homeopathic medicines are not efficacious), since the pooling of
so many different kinds of trial and type of homeopathy makes findings
unreliable
. He advocates restricting systematic reviews to clearly defined
health conditions or to single homeopathic medicines, concluding that “the
heterogeneity of trials is high and the meta-analysis results are not robust
against small changes in study design or statistical analysis”. In a paper
published in 2008 he has argued that Shang’s conclusions do not hold when
slightly different selection criteria are applied, e.g. by redefining how large is a
“large” study, or by including treatment trials but excluding prevention trials.
Size is not the only factor in arriving at robust conclusions.

2.12. Context effects may play a part, according to both Shang and Lüdtke.
Shang’s “powerful alliances” between patient and carer, based on “shared
strong beliefs”, may not be as distinctive or as peculiar to homeopathy as the
nature of the homeopathic consultation, with its wider range of questions than
are addressed in a conventional context, and the lifestyle recommendations
referred to by Lüdtke that often flow from it. There is overlap here with the
placebo effect (see 4 below); but homeopathy as “a complex medical system
of its own” may be responsible for some broader effects.

2.13. Linde writes that the “undecided fraction” to which he belongs is confused by
“the notorious lack of predictable reproducibility” on the one side, and by
“too many anomalous results in high quality studies to rule out a relevant
phenomenon”
on the other.

3. Other evidential considerations

3.1 A conventional argument against CAM treatments is often that they are risky
because they deny or delay a proper diagnosis and the adoption of tried and
tested conventional treatments [105; 108; Ev 26-27]. But this is not an
argument about (as here) homeopathy per se, and its side-effects which at such
high dilutions are as implausible as its efficacy is claimed to be. The potential
for harm however is real enough: but only if patients have not been in contact
with their own doctors, which happens in a minority of cases; if homeopaths
are not adequately trained to recognise ‘red flags’, and give bad advice; and if
conventional treatment is likely to be successful and/or acceptably risk-free in
the particular case, and indeed more successful than a homeopathic approach
.

3.2. The argument for adopting one kind of treatment and not the other relates
therefore to issues of practice, communication and training as well as of
comparative efficacy (for patient choice see 6.1 below). These are highly
important; but it is not legitimate to deploy the argument as the Committee
did as a factor in the intrinsic risk/benefit ratio of a therapy
, which it is not,
adducing it as an additional negative element instead of as part of an efficacy
argument which has already been addressed. (Suppose high-quality trials
establish homeopathy’s superiority over conventional treatment for a
condition: this, with homeopathy’s negligible side-effects, would make the
conventional option the risky one.)

3.3. Nor is the argument even-handed if examination of true side-effects in homeopathic
and conventional treatment is not addressed when discussing the
comparative merits of the two approaches, patient satisfaction, and
government policy. Shang et al gave “the exclusive focus on beneficial effects”
as one of several limitations of their study. The extent of adverse
clinical effects is as much a part of the evidence base as is benefit. If the
Committee had looked at these it might have cast a different light on policy
towards homeopathy in the NHS, and would almost certainly have highlighted
public disquiet about some of the more aggressive conventional treatments
as a reason for many patients preferring a CAM approach. This is a
significant omission.

3.4. There may be no good conventional treatment for a condition. Alternatively,
the standard treatment may be contraindicated. The Committee has not
considered these reasons why some patients may welcome the continued
provision of homeopathy.

4. The placebo effect

4.1. The placebo effect, addressed at some length by the Committee (30–40), is not
in dispute. Yet much about it is unknown
. It may be premature to assume
that patient expectations of modern medicine, with its erudition, structures,
scientific approach and rituals which give it the intellectual and moral high
ground in Western society, are of lesser force than those of a treatment which
is commonly thought of as “implausible”, and not only by scientists. Belief in
white coats is not weak
. Furthermore patients are likely to resort to CAM on
grounds of principle or safety as well as efficacy. The placebo as an
explanation is sometimes reached for too readily off the shelf, when its applicability
to the relevant condition, treatment and patient population is poorly
understood. This gap in argument has not been closed by the Committee.
The placebo effect in homeopathy needs more work before conclusions can be
confidently drawn.

4.2. Empathy in a consultation is more than a matter of time given [81]: it also involves
personality and training. This author has on occasion felt better heard
in a ten-minute GP consultation than in an hour with a CAM therapist,
although the latter have generally shown up well. The better comparator in
CAM situations is probably the specialist consultation, since most patients will
have initially visited their GPs. Nor is it always the fluctuating or selflimiting
conditions [43, 81], as the Committee suggests, that send patients to
unconventional providers; claimed relief from chronic complaints after a long
period of failure with conventional treatment is not uncommon
.

4.3. The surveys of homeopathic patients referred to in 80 suggest that selfreported
benefit was not only at a high level but persisted beyond the limits of
any placebo effect which, as the Committee states, is usually short-lived
.

5. The Committee’s witnesses

5.1. The Committee in two sessions called twelve witnesses to give oral evidence,
all but one with relevant affiliations. Selection of witnesses can affect
outcomes in the same way as selection of written evidence
. It is therefore
legitimate to examine the choices made.

5.2. It is not easy to see why a journalist doctor was invited to appear in preference
to some other non-representative contributors to the inquiry. The written
submission by Dr. Goldacre [Ev. 8] was notably short on supporting evidence,
but contained unqualified statements on the ineffectiveness of homeopathy,
forcefully expressed (“extreme quackery” was mentioned)
. By contrast, the
submission by the Complementary Medicine Research Group from the
Department of Health Sciences at the University of York presented a wellargued
summary with 68 references [Ev. 143]. In this appears the statement
“To date there are eight systematic reviews that provide evidence that the
effects of homeopathy are beyond placebo when used as a treatment for [five
childhood conditions]”
. This claim from a mainstream academic centre, rated
joint first nationally for health services research in the latest Research
Assessment Exercise, stands in stark contradiction to Prof. Ernst’s referenced
claims, noted above, and to Dr. Goldacre’s unreferenced statements
. It would
have been illuminating if the Committee had probed the Group about this,
face to face as a witness, and attempted some resolution before agreeing in
unequivocal terms with the two witnesses who were invited to appear and
were quoted favourably. The Committee criticised the supporters of homeopathy for their “selective
approaches” to evidence [73]. They could fairly be accused of the same.

Unfortunately they did not (presumably) have the scope to solicit the views of
Dr. Linde from Germany, which would have differed from those of Prof. Ernst
with regard to the evidence.

5.3. Only one Primary Care Trust submitted a paper, and it was invited to give
oral evidence on its decision that homeopathy did not provide value for
money. Given the number of PCTs countrywide this is rather surprising. It
might be wondered if some form of publication bias was in play, with the
many PCTs who were happy with provision of homeopathy seeing no need to
defend the status quo
. At least one writer complained of the short timescale
for submissions [Ev. 128]. It would have been interesting to know what steps
the Committee took to obtain a range of views about the evidence
, and
whether West Kent was the only PCT to have done an assessment of the kind
referred to in Ev. 134. Only a negative PCT view was recorded; and despite
the Committee’s unequivocal conclusion even West Kent conceded “limited
evidence in favour of homeopathy”.

6. Societal questions

6.1. Since doctors exist for patients and not the other way round it is not selfevident
that scientific evidence, important as it is, should be the sole
determinant of what is provided to the public.
If the patient is ultimately in
the driving seat (s)he might wish on broader grounds than proven efficacy to
finance this type of treatment rather than that (or in addition to that) from the
public purse. This gives scope for political judgements which can set a
government at odds with its medical advisers. This should be no surprise to
a parliamentary scientific committee which sits at the border of these two
worlds.

6.2. In the purely scientific field it is interesting that the present Committee should
feel “troubled” [71] by two senior government scientists coming to different
conclusions about the weight of homeopathic evidence. Such disagreement
in interpretation is quite common in scientific debate, although life is
undoubtedly easier where there is consensus. Premature consensus,
however, has its own dangers, as is generally recognised. The Committee
appears to require the scientists metaphorically to retire to a jury room and
not come out until they agree [64, 72], presumably with the Committee’s view.
This seems a step too far.

6.3. Pre-existing structures have some de facto claims. It is reasonable to decide
that if something were not in existence one would not call it into being, but if
it is already there one would not abolish it. While theoreticians might debate
this, society as a whole can accept it. It is more easy to accept where the
institution claims a minuscule proportion of the health and research budgets,
which must be the case with homeopathy whatever precise figure the
government comes to at the Committee’s request.

7. Conclusion

7.1. The evidence for homeopathy is not impressive, except possibly in terms of
lack of adverse effects. The Committee however has been less than rigorous
in its approach to this evidence.
Its choice of witnesses favoured a medical
media opponent of homeopathy over a research centre of excellence. It was
unwise to rely heavily on the interpretations of one professor of CAM, some
of whose statements are unsound or in conflict with other statements of his,
and who is not without his critics in the worlds of research and academia
whose views were given less prominence.
The 2005 review by Shang et al has
been inaccurately represented as ruling out specific effects of homeopathy, in
a summary statement by the Committee that goes beyond present evidence.
The Committee’s own statements show confusion between unconvincing
evidence of a specific effect and disproof of it
. The true risk profile of
homeopathy, compared with conventional treatment, was not considered.

7.2. These limitations make the Committee’s report an unreliable source of
evidence about homeopathy.
The jury must still be regarded as out on its
efficacy and risk/ benefit ratio. Whether more research should be done, and
of what kind, is another question. But there can be no ethical objection to it
since the principal questions have not, as the Committee claimed, “been
settled already” [78].

Earl Baldwin of Bewdley.
June 2010.

26 April 2009

Singh and Ernst’s book ‘Trick or Treatment?’ “has no validity as a scientific examination of alternative medicine.”

From H:MC21: ‘Halloween Science’

A critique of Trick or Treatment? by Simon Singh and Edzard Ernst written by William Alderson on behalf of H:MC21 (Homeopathy: Medicine for the 21st Century); March 2009.

Trick or Treatment? by Simon Singh and Edzard Ernst claims to “examine the various alternative therapies in a scrupulous manner” (p.3). This critique assesses the validity of this claim, both in general and specifically in respect of homeopathy, by analysing the authors’ own arguments and evidence for accuracy, consistency and reliability. Where information is lacking in Trick or Treatment?, the critique incorporates evidence from other primary sources (where possible) or reputable secondary sources. Some conclusions reached on the basis of Ernst and Singh’s own statements are also supported by reference to other sources. All sources are referenced.
RESULTS: We have identified nineteen major faults in the case presented by this book

Evidence: (1) The authors frequently rely on figures, trials, events, quotations, statements, opinions and explanations which are unsupported by reference to sources. (2) This evidence is frequently misleading as a result of being presented out of context. (3) The authors use different criteria when assessing the validity of evidence, depending on whether the evidence supports their views or not.

Science: (4) The authors commit the common fallacy of confusing absence of proof with proof of absence. (5) The importance of theory is minimized or even ignored, when discussing both science in general and individual alternative therapies. (6) The authors assume that orthodox medicine is scientific, but offer no justification for this position. (7) There is evidence that the authors do not understand the principles and practice of orthodox medicine.

Definitions: (8) Alternative medicine is defined in four different ways in the course of the book. (9) Other significant terms, such as ‘science’, ‘disease’, ‘cure’, ‘effectiveness’ and ‘orthodox medicine’ are undefined. (10) This allows arguments to be built on vague preconceptions rather than on clearly defined principles. (11) The differences between orthodox medical and alternative medical definitions is not taken into account, despite their impact on the design of trials. (12) The authors fail to present the ideas of evidence-based medicine accurately. (13) The authors fail to present the nature and development of homeopathy accurately, raising doubts about their presentation of the other therapies. (14) They also call into question the principles of orthodox drug therapy, despite the fact that the tests used by this therapy underpin much of their argument.

Analytical tools: (15) The authors fail to prove that their main tool, the randomised controlled trial (RCT), is valid for testing curative interventions, while presenting evidence that there are serious problems with using it for this purpose. (16) They show that a tool derived from these trials, the meta-analysis, is prone to lack of objectivity, yet they rely on this for some of their conclusions. (17) Their conclusions are also dependent on the concept of the placebo effect, but they make it clear that this effect has no scientific basis and is so unpredictable as to have questionable scientific validity in this context. (18) They acknowledge the importance of individuality in the curative process, but deny its significance for the design of analytical tools. (19) They fail to take into account the need for analysis of evidence from clinical practice.

CONCLUSIONS: Ernst and Singh have failed to provide a secure theoretical or evidential base for their argument, and have used analytical tools inadequate (in this context) for achieving objective and reliable conclusions. The result of these weaknesses is that their argument relies heavily on preconceptions, variable definitions and opinion, a problem exacerbated by a tendency to confirmation bias on the authors’ part. As a result, Trick or Treatment? has no validity as a scientific examination of alternative medicine.

Full report here

2 April 2008

Homoeoprophylaxis – a Proven Alternative to Vaccination by Dr Isaac Golden

Visit Nourishedmagazine for the full report of a doctor’s analysis of data on the use of homeopathic remedies to build up immunity to specific diseases:

By Dr Isaac Golden

“I prepared my first formal program of homoeopathic remedies to prevent infectious diseases in 19861. In the following 20+ years, tens of thousands of Australian children have been immunised homoeopathically – a method called homoeoprophylaxis (HP) – using programs from myself as well as other practitioners across the country. The method itself is over 200 years old, and has considerable clinical and research experience to support its claims.

In 2004, I integrated 18 years of data collection from parents of children using my program with 4 years of doctoral research at Swinburne University in Melbourne. The purpose of this article is to share with you the findings of this and other research into the effectiveness and safety of HP.

He concludes:

The Safety of Homoeoprophylaxis

Homoeopathic medicines are usually prepared using a series of dilutions and succussions (firm striking of the container holding the liquid remedy against a firm surface). The remedies are called “potencies” because at each stage they become energetically stronger. After the 12c potency, no molecules of the original substance remain, yet the remedy is energetically stronger. Pharmaceutical advocates cannot understand this, because their paradigm forces them to believe that as the number of molecules of a substance decreases in a medicine, the medicine becomes weaker. This is true if the kinetic energy of the succussion is not correctly applied, and a simple dilution only is prepared. But we are making much more than a simple dilution.

Doctors agree that homoeopathic potencies cannot be toxic, and so physical safety is not an issue. However, some homoeopaths have expressed concerns over the years as to whether the long-term use of the remedies in my HP program is energetically safe. Many people who are not bound to the pharmaceutical paradigm understand that energy can produce real and tangible effects, and if misused can cause problems. One important part of my research at Swinburne was to check the long-term safety of HP.

This was done by examining 5 markers of overall wellbeing in children aged between 4 and 12 years of age – asthma, eczema, ear/hearing problems, allergies and behavioural problems. These were compared to a range of early childhood markers, including breastfeeding status, birthweight, APGAR scores, as well as to 4 possible immunisation methods – vaccination, HP, general/constitutional prevention, and no prevention at all. That gave 20 (5 x 4) possible combinations of health conditions and immunisation methods. The data was processed using Odds Ratios and Chi Squared Probability tests.

Once again, the full results are reported in detail elsewhere8, but the main findings are as follows:

  1. In 19 of the 20 possible measures of health, vaccinated children were less healthy than other children, usually by a significant amount (the 1 measure favouring vaccination was not statistically significant). The most dramatic single finding was that vaccinated children have a 15 times greater chance of becoming asthmatic than children using HP, with P>99%, a highly statistically significant finding.
  2. Children using HP were generally at least as healthy (and often more healthy) as children who used constitutional/general immunisation or no immunisation at all. The HP group were not exclusively from people who were extremely health conscious. Regularly, parents using my HP program say that it is their first introduction to homoeopathy and to natural medicine in general.
  3. Parental estimates of general wellbeing were very high in the HP group – at least as high as in other groups.
  4. Not all HP programs give consistent results. When comparing children using my HP program to those using other HP programs, the levels of both effectiveness and safety were lower in the group using other programs. So it is advisable to check the basis of a HP program before committing to it. Programs using daily doses of low potencies provide less effective long-term prevention than programs using infrequent doses of (appropriately selected) high potencies.

We may conclude from the parts of my data which were statistically significant (P?95%), that HP is associated with an improvement in general health, compared to other immunisation methods (as well as no immunisation at all), and that this figure is significantly better when compared to vaccinated children. Therefore we may conclude that the evidence suggests that the use of an appropriate long-term HP program does not lessen the health of children, and evidence suggests that it may in fact assist the maturation of the immune system by gently challenging the system in the first 5-6 years of life.”

27 March 2008

Flu abating, did homeopathy help you?

I notice that my ‘Treating flu symptoms with homeopathy’ post is not getting as many hits from people searching for ‘flu symptoms’ in the US states and cities mentioned in it, so I hope that the epidemic is abating there and that some of the viewers found the post helpful.  So far it has had 283 views.

Sceptics would like us to believe that it is ‘just placebo’ but has anyone ever tried to treat full blown flu with placebo? References please.

14 March 2008

Consumer attitudes towards alternative therapies and homeopathy around the world

Global TGI Barometer January 2008 Issue 33

A combination of reduced faith in conventional treatments and the growth in availability of alternative remedies has led to a rise in the popularity of alternative medicine around the world. 

Using the latest research from Global TGI, we investigate consumer attitudes towards alternative therapies in different parts of the world.

Divergent attitudes

The results of the studies suggest that acceptance of alternative therapies varies a good deal from country to country. This is likely to be caused by a combination of cultural factors and variance in the regulation of its use.

Focusing on the proportion of consumers in each country who say that they ‘trust homeopathic medicine’, we see a considerable divergence of opinion. Almost two thirds of consumers in India** say that they trust homeopathy compared with less than a fifth in the US and Great Britain.

Homeopathy supporters…

In India, alternative treatments are a well established means of combating illness, with an impressive 94% of people saying that they have faith in alternative remedies. Homeopathy is integrated into the general system of health care in India and our study shows that one in ten consumers have consulted a homeopath in the last year.

Other strong supporters of homeopathy can be found in Latin America and the Middle East. Around half of the population in Brazil, Chile, Saudi Arabia and United Arab Emirates say that they trust homeopathic medicine.

…and cynics

In many countries, particularly in Europe, consumers are less convinced. At 15% agreement, Britons are the least trusting of homeopathy, and only 1 in 10 say that they prefer alternative medicine. Even in Germany, the birth place of homeopathy, just 27% of people trust this kind of treatment. France is the European market in which people are most trusting of homeopathy.

Why go alternative?

There are many reasons why many consumers are increasingly turning to alternative remedies to complement more conventional medicine. One theory is that consumers are choosing more and more to take responsibility for their own health and well-being. The internet has had a large impact in this respect, with consumers being given access to unlimited health information online. In the US for example, where we have seen a slow but steady increase in the proportion of people who say that they ‘prefer alternative medicine to standard medicine’ over the past five years, a third of the population now gathers healthcare information on the internet.

At the same time, people are becoming increasingly health-conscious. Taking Brazil as an example, 9 out of 10 people who trust homeopathic medicine say that they would pay anything where health is concerned, and one third claim that friends ask for their advice on health and nutrition matters. In Germany and Great Britain, half of those who trust homeopathic medicine believe that they should do more about their health.

Who uses alternative medicine?

According to Global TGI research, people aged 35 and over are generally more likely than their younger counterparts to turn to alternative medicine, and acceptance of the practice appears to increase with age. In Germany for example, 30% of 45-54 year olds say that they trust homeopathic medicine, compared with just 20% of 18-24 year olds. The research also shows a clear gender divide, with women generally more in favour of alternative medicine than men. In Chile for example, women are 24% more likely than men to say that they trust homeopathic medicine.

An alternative cure

Homeopathy is typically used to treat chronic or recurrent conditions and our research shows that people who have faith homeopathic remedies are generally more likely to have suffered from such complaints. In the US for example, homeopathy supporters are 57% more likely than average to suffer from eczema or psoriasis, 29% more likely to have asthma and 22% more likely to suffer from allergies or hay fever. In France, people who have suffered the same ailments were found to be 50% more likely than average to have consulted an alternative health practitioner in the last 12 months.

Base: Individuals aged 18+

* Respondents from urban areas only

** Respondents from ABC socio-economic groups in urban areas

19 February 2008

Homeopathic ‘placebo’: much more effective than conventional medicine’s placebo

Laughing my socks off’s comment on blog entry ‘Socking hypocrisy in anti-cam campaign’ :

GSK’s Allen Roses says 90% of pharmaceutical drugs are only effective in 30-50% of cases. BMJ Clinical Evidence says only somewhere between 26-34% of 2,500 commonly used treatments have some proven benefit. The Bristol study [Bristol Homeopathic Hospital] concluded 70%+ of patients reported some improvement with homeopathic treatment. The Berlin study came up with similar percentages and concluded that patients using homeopathy had better outcomes than patients using conventional medicine. Glasgow Homeopathic Hospital’s ongoing audits of patient response return similar percentages.

It’s worth emphasising that while controls might be absent in these studies, the patient cohorts tend to have a high percentage (80%+) of chronic complaints of which an equally high percentage (80%+) have failed to respond to conventional treatment. If they failed to respond to conventional treatment, in which the placebo effect is likely to be considerably stronger than in homeopathy, then it’s reasonable to suggest that these are patients who are not particularly susceptible to placebo response. If they failed to respond to conventional treatment, then it’s reasonable to suggest that for these patients, homeopathy proved to be the more effective option.”

13 January 2008

Structures of liquids are easily and regularly changed and homeopathic remedies exhibit biological activity

Homeopathy – Quackery or a Key to the Future of Medicine?

Debate between Dr Steven Novella, Dr Rustum Roy, Dr Donald Marcus, Dr Iris Bell, Dr Nadav Davidovitch, Dr Andre Saine.

Rustum Roy: ‘There are three vectors in the homeopathic process which can change structure which are well established in materials science:

1. Pressure during succussion

2. Epitaxy on each remedy’s structure

3. Nanobubbles formed by succussion.” (Slide 57)

“There have been excellent papers using physio chemical methods to show that homeopathically processed lab samples are measurably different from the original waters.  Especially the several papers by Elia et al flux calorimetry, conductivity, pH, electrode potentials and by Rey using standard thermo luminescence.” (Slide 53)

Differences in spectrometry between homeopathic Natrum Muriaticum and Nux Vomica (Slide 54)

Dr Iris Bell: Histamine Dilutions Modulate Basophil Activation Non-linearly Multicentre Study (Belon et al) (Slide 88)

Thrombogenic effects of Ultra-High Dilution Aspirin (ASA): a Nonlinear Dose-Response Relationship (Slide 89) “we see a reversal of what we usually anticipate aspirin to do at the toxic level.”

Animal studies demonstrate biological effects of homeopathic remedies (Slide 90)

What you see is an 70-80% rate of favourable outcome for the people in the real world who have found their way to homeopathic treatment across a large range of chronic and acute illnesses.” (Slide 95)

[The full write up of the debate is in the article in the Journal of Alternative and Complementary Medicine January 1, 2008, 14(1): 9-15]

3 January 2008

Malignant tumour cases regressed with homeopathy

Homeopathy is gaining acceptance in large economies such as India and France  and Indian medicine is starting to integrate modern diagnostic techniques with homeopathic treatment.  This report is by Prasanta Banerji and Pratip Banerji of the PBH Research Foundation.

http://www.virtualtrials.com/ruta/ruta2007.cfm

Presented 6/7/2007 at the Central NJ Brain Tumor Support Group

“In this lecture I have presented only seven proved malignant tumor cases who were regressed following treatment with specific homeopathic medicines – Kali Carbonicum and Ferrum Phosphoricum for bronchogenic carcinoma, Condurango for oesophageal carcinoma, Ruta and Calcarea Phosphorica for brain tumors and Symphytum for the Osteogenic Sarcoma.

Most of these cases were followed up and found normal even after five years. We have studied thousands of similar cases and promising results have been obtained in many instances.

The National Institutes of Health (NIH), USA, was very interested in our research into various types of cancers and had asked us to produce records of our successes. This we had done by submitting a “Best Case Series” on Cancer to the National Center for Complementary and Alternative Medicine (NCCAM) and the National Cancer Institute (NCI) at the NIH. On acceptance of our series, we were invited to present the same before the Cancer Advisory Panel for Complementary and Alternative Medicines in July 1999. As a result of our presentation, the NCI, USA, is at present devising a “Practice Outcomes Monitoring and Evaluation Systems Study for Bronchogenic Carcinoma” at our clinic in Kolkata, India, with a view to arrive at a protocol for treatment of these cases at institutions in the US. Therefore, scientific progress demands that we continuously carry on more and more experiments and keep observational records.

Along with the Professor of Cell Biology and Genetics, at the University of Texas MD Anderson Cancer Center, Houston, one paper has been published entitled “Ruta 6 selectively induces cell death in brain cancer cells but proliferation in normal peripheral blood lymphocytes: A novel treatment for human brain cancer” in the International Journal of Oncology in October 2003 where our method of treatment with Ruta and Calcarea Phosphorica was followed with excellent results.

Of interest in this context is the fact that the brain tumor community in the US has shown an immense response to this protocol of treatment. We all know that patients suffering from serious diseases often acquire a good deal of knowledge about their diseases. Lately, we have been receiving 60 to 70 mails a day from patients all over the world who have found the paper on Ruta and in an uncontrolled manner have started taking the medicines themselves. When after 3 to 4 months of treatment, they find that their tumor has regressed or become static, they contact us to fine tune the treatment for them.

Some have even gone so far as to set up user groups on the internet which are showing remarkable results. One such group is run by Mr. Alex Fidelibus and can be accessed on the projected URL: “http://health.groups.yahoo.com/group/Ruta6/

We have treated thousands of cancer patients in the last four decades. Here we now highlight some outcome of our treatment in the recent past.

This Graph shows general outcome of treatment of 17,324 cancer patients from 1990 to 2005 at our clinics. In 19% cases the malignant tumors were completely regressed which appeared to us very significant. In 21% cases they were static or improved after treatment. Over the last two years, there has been a spurt in the number of cancer cases visiting our clinics. It may be mentioned here that the above in-house figure is mainly based on those cases with complete documentation such as scan plates, biopsy slides and such, and the actual number of cancer cases under our treatment exceeds this figure. On an average about 1000 new cancer cases are registered in our clinics every month and in December 2006 we have treated 1136 new such cases.

Thus presently it appears from all these findings that our new method of treatment with homeopathic medicines may be regarded as the future drug for cancer research and treatment for the benefit of mankind. ”

The presentation includes diagnostic slides, scans and x-rays.

20 December 2007

Homeopathic dilutions and plant growth, there is an effect and no placebo.

Karger ‘Forschender Komplementarmedezin’ Research in Complementary Medicine’:  Vol 12 No 5 2005

This study replicates the findings of a previous study on the growth of wheat seedlings that have been stressed by exposure to arsenic trioxide.  The wheat seedlings were treated with various potentised ultradilutions of arsenic trioxide, various potentised ultradilutions of water or various dilutions of arsenic trioxide (non-potentised).  Significant increases in growth were indicated in the groups treated with arsenic trioxide to the potency 45x and with water 45x.  Plants are not subject to the placebo effect. 

It is interesting that effects were noticed at the 45X potency, this is not a potency commonly used to treat people.  The X scale of potency is less commonly used in the UK but may have been used in this experiment as it is much quicker to generate potency scale increases in the scale of 1:10 rather than 1:100 (the C potency scale).  It is really interesting that simliar results were found for H20 45X which causes me to wonder whether the substance is key or the potency. Update: or whether this is an entanglement effect.

 “Summary:

Plant-based bioassays are suitable for basic research – lacking the placebo effect and ensuring large data samples for structured statistical analyses.

The aim of the study was to reproduce a previous experiment on the effects of arsenic trioxide (As2O3) high dilutions on wheat seedling growth in order to verify whether the same significant results could be obtained working in a different place and with a different experimental team. A further goal was to investigate high dilution effects on variability.

 A structured experiment was performed blind over 9 weeks, using wheat seeds previously stressed with a sublethal dose of As2O3. The seeds were then treated with either potentized As2O3 (5x, 15x, 25x, 35x, 45x), potentized water (equivalent potencies) or diluted As2O3 (10-5, 10-15, 10-25, 10-35, 10-45).

The working variable was the stem length, measured after 4, 5, 6 and 7 days.

Results: Some potencies (As2O3 45x and H2O 45x) induced a relevant increase in seedling growth and/or a variability decrease. Diluted As2O3 did not induce any significant results.

Conclusions: Confirmation of a significant stimulating effect on seedling growth and a significant decrease of variability was obtained with ultra-high dilutions at the 45x potency. The model of wheat germination and growth has been confirmed to be a good tool for basic research in homeopathy.”

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