‘New evidence for homeopathy’

[Blue Wode]

See here:
http://www.cybermed.it/index.php?option=com_content&task=view&id=19995&It emid=134

And also here:

A press release by the Faculty of Homeopathy today shows that the ‘conclusions’ of a paper in the Lancet entitled ‘The End of Homeopathy’ have been called into serious doubt. As Dr Peter Fisher puts it: they cast ‘serious doubts on the review, showing that it was based on a series of hidden judgments unfavourable to homeopathy’. No space for the detail but here are the references:

Read on…
http://drkaplanarticles.blogspot.com/2008/11/tide-is-turning.html

However, there’s currently no sign of the press release on the Faculty of Homeopathy’s News Items and Press Releases page:
http://www.trusthomeopathy.org/index.html

Does anyone have a copy of it?

[Matt]

That's a misleading headline if ever I saw one. No new evidence is presented at all, just kvetching over someone else's critique.

If I found a flaw in a general relativity paper would that be new evidence for creationism? I think not.

[Mojo]

If I found a flaw in a general relativity paper would that be new evidence for creationism? I think not.

Well, considering that "creation science" and intelligent design entirely define themselves in terms of alleged flaws in other theories, I suspect that it would certainly be claimed as such.

I've had problems finding BHA/FoH press releases before. For example, Fisher has mentioned a meta-analysis carried out at the end of 2005. The only other reference to it I managed to find was in what seemed to be a BHA press release, but I couldn't find anything on their website.

[JJM]

Is this what you are looking for?
http://www.eurekalert.org/pub_releas...-nef110308.php

[Trinoc]

Is this what you are looking for?
http://www.eurekalert.org/pub_releas...-nef110308.php

I would call this not "New evidence for homeopathy" so much as "Doubts about evidence presented against homeopathy". It doesn't appear to give evidence for homeopathy at all.

It seems to be an example of something I have criticised on another forum ... lazy science on the part of skeptics who regard the invalidity of alternative medicine as a foregone conclusion, rather than testing it with the same rigour as required of other medicine. Rather than cherry-picking good results, as supporters of alternative medicine often do, the Lancet paper appears to have muck-raked for bad results, which of course is just as invalid.

Lazy skepticism is bad science, and will get thrown back in our faces by the supporters of woo.

[JJM]

{snip} It seems to be an example of something I have criticised on another forum ... lazy science on the part of skeptics who regard the invalidity of alternative medicine as a foregone conclusion, rather than testing it with the same rigour as required of other medicine. Rather than cherry-picking good results, as supporters of alternative medicine often do, the Lancet paper appears to have muck-raked for bad results, which of course is just as invalid.

Lazy skepticism is bad science, and will get thrown back in our faces by the supporters of woo.

Perhaps I should have been more specific, Blue Wode asked if there is a new press-release, and I thought that may be what BW was looking for.

I have no idea what you mean by lazy skepticism. If you presume to lecture me about science, you are more than 40 years late. As for thinking "the invalidity of alternative medicine as a foregone conclusion" that is a legitimate approach, search for "prior probability" at this blog http://www.sciencebasedmedicine.org/

You should also study R. Barker Bausell's new book "Snake Oil Science."

Since there is a good discussion of this topic, I should also cite http://www.theness.com/neurologicablog/?p=411 as the source for link to the press release.

[Trinoc]

I have no idea what you mean by lazy skepticism. If you presume to lecture me about science, you are more than 40 years late. As for thinking "the invalidity of alternative medicine as a foregone conclusion" that is a legitimate approach, search for "prior probability" at this blog http://www.sciencebasedmedicine.org/

Hey, I wasn't accusing you of lazy skepticism! I was referring to the authors of the paper criticised in The Lancet, who appeared to have been less than rigorous in their meta-analysis claiming to disprove homeopathy, in particular by negative cherry picking of the studies least helpful to the homeopathy cause.

[JJM]

Hey, I wasn't accusing you of lazy skepticism! I was referring to the authors of the paper criticised in The Lancet, who appeared to have been less than rigorous in their meta-analysis claiming to disprove homeopathy, in particular by negative cherry picking of the studies least helpful to the homeopathy cause.

Okay, sorry.

I've been reading about this elsewhere. The homeopaths are claiming that certain studies were omitted in an earlier paper; whereas that paper set-out their criteria for inclusion, and those studies were legitimately excluded. I will try to find some citations. Maybe Blue Wode remembers.

[Trinoc]

Okay, sorry.

I've been reading about this elsewhere. The homeopaths are claiming that certain studies were omitted in an earlier paper; whereas that paper set-out their criteria for inclusion, and those studies were legitimately excluded. I will try to find some citations. Maybe Blue Wode remembers.

That's OK. It may well turn out that the "good" studies were omitted for good reason, but I could only go by the claims of the Lancet paper. I suppose I may be making the mistake of assuming reliability on the basis of the Lancet's authority. I found the claim that a lot of homeopathy trials had positive results to be particularly unlikely.

I think my point about skeptics sometimes getting lazy still stands - I sometimes cut corners myself - but it does not necessarily apply in this case.

[Matt]

The suspicion is that a biased researcher may first choose the papers which back their hypothesis and then tailor their inclusion criteria to suit.

[Pebble]

The problem here is a failure to understand the methodology of the meta-analysis performed. What the 'new studies' have done is to cherry pick from the 110 initially chosen and concluded that there were positive trials from a homeopathy standpoint. This is nonsense from a statistical view point. The methodology is very clear, so either you show that the methodology was in itself flawed or biased, or you show that it was inappropriately applied.

The premise was that only large scale double blind trials could be regarded as providing positive evidence for efficacy. Using this approach conventional medicine works, homeopathy does not. What this does not show is that homeopathy does not work, rather that there is no body of high quality evidence to consistently demonstrate such an effect.

This approach allows for the fact that no one knows which conditions it might be effective in, but makes the reasonable assumption that where researchers have gone to the trouble of setting up large scale high quality trials, this should select those areas where there was the greatest apriori probability of success based on previous trial work.

The arguments about trial matching are irrelevant in the setting of this meta-analysis, the issue here was trial quality and insisting on matching at every level would have created bias one way or the other.

The arguments about not providing the reference detail is further obfuscation.

In essence this is simply 'straw-man' arguments in another guise.






Shang A, Huwiler-Müntener K, Nartey L, Jüni P, Dörig S, Sterne JA, Pewsner D, Egger M.
Department of Social and Preventive Medicine, University of Berne, Berne, Switzerland.

Lancet 2005; 366: 726

BACKGROUND: Homoeopathy is widely used, but specific effects of homoeopathic remedies seem implausible. Bias in the conduct and reporting of trials is a possible explanation for positive findings of trials of both homoeopathy and conventional medicine. We analysed trials of homoeopathy and conventional medicine and estimated treatment effects in trials least likely to be affected by bias. METHODS: Placebo-controlled trials of homoeopathy were identified by a comprehensive literature search, which covered 19 electronic databases, reference lists of relevant papers, and contacts with experts. Trials in conventional medicine matched to homoeopathy trials for disorder and type of outcome were randomly selected from the Cochrane Controlled Trials Register (issue 1, 2003). Data were extracted in duplicate and outcomes coded so that odds ratios below 1 indicated benefit. Trials described as double-blind, with adequate randomisation, were assumed to be of higher methodological quality. Bias effects were examined in funnel plots and meta-regression models. FINDINGS: 110 homoeopathy trials and 110 matched conventional-medicine trials were analysed. The median study size was 65 participants (range ten to 1573). 21 homoeopathy trials (19&#37 and nine (8%) conventional-medicine trials were of higher quality. In both groups, smaller trials and those of lower quality showed more beneficial treatment effects than larger and higher-quality trials. When the analysis was restricted to large trials of higher quality, the odds ratio was 0.88 (95% CI 0.65-1.19) for homoeopathy (eight trials) and 0.58 (0.39-0.85) for conventional medicine (six trials). INTERPRETATION: Biases are present in placebo-controlled trials of both homoeopathy and conventional medicine. When account was taken for these biases in the analysis, 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

[Trinoc]

I remember hearing a talk a few years ago from a medical researcher who was advocating triple-blind studies. That is, neither the patients nor the experimenters know who is getting active or placebo, but also that the reviewers of the data do not know what the data is setting out to prove, and so will not be tempted to cherry-pick data which fit with their existing beliefs.

The problems in achieving this are probably great, and I don't know whether anyone has actually attempted it. I think, though, that it would be advantageous in this case. If the homeopaths didn't know which studies supported homeopathy, and the critics did not know which ones did not support it, then there could be no accusation of bias (deliberate or otherwise) in choosing which studies to include ... they would be included strictly on the basis of the quality of the data, before it is revealed what the data actually represent.

Trying to figure out how you might achieve this is giving me a headache, but I think something like this has to be done if we are not going to have a constant ping-pong game with proponents of both sides arguing over which trials are valid and which are not.

[Mojo]

The problem homoeopaths have with the Shang paper is that its final analysis omitted some positive trials. The reason it did this was that they didn't fit the parameters that had been decided upon before the analysis was conducted. It was not done on the basis of the outcomes of the trials, because the specific studies weren't considered when deciding upon the parameters.

What the homoeopaths are objecting to, essentially, is that Shang et al. didn't cherry-pick the studies they considered.

[Blue Wode]

Is this what you are looking for?
http://www.eurekalert.org/pub_releas...-nef110308.php

Yes, that’s it. Thanks, JJM. I see that the Faculty of Homeopathy has now published it as well:
http://www.trusthomeopathy.org/csArticles/articles/000001/000198.htm

I don’t know from what source Brian Kaplan (Harley Street MD and homeopath) found the following quote from Dr Peter Fisher…

As Dr Peter Fisher puts it: they cast ‘serious doubts on the review, showing that it was based on a series of hidden judgments unfavourable to homeopathy’.

http://drkaplanarticles.blogspot.com/2008/11/tide-is-turning.html

…but it’s interesting to read David Colquhoun’s recent thoughts about Dr Fisher:

UCL homeopathy debate

…The main opposer was my old friend Peter Fisher, homeopathic physician to the Queen. It was a pleasure to show the video of Fisher agreeing with me that there is not enough science in homeopathy to justify a BSc degree in it. Fisher, in his papers, strikes me as one of the most honest of homeopaths. He was “very angry” when homeopaths were caught out recommending their sugar pills to prevent malaria. But is his speech, he struck me as less than honest. He cherry-picked the evidence quite shamelessly as usual. And his suggestion that there was an analogy between the ‘memory of water’ and a DVD was disposed of ably by a physics student who spoke from the floor.

http://dcscience.net/?p=282#hom

[Mojo]

I don’t know from what source Brian Kaplan (Harley Street MD and homeopath) found the following quote from Dr Peter Fisher…

It appears in the EurekAlert piece, and in the version on the FoH site in a slightly different form, although it isn't attributed in either.

Could it perhaps be from Fisher's editorial immediately preceding the Rutten/Stolper paper in the October 2008 issue of Homeopathy (Fisher: Bayes, bias and plausibility, Homeopathy, Volume 97, Issue 4, October 2008, Pages 167-168)? I don't have access to the text.