The random thoughts of a sceptical activist

Let’s be aware. Very aware.

This is Homeopathy Awareness Week. The triumvirate of Lewith, Dixon and Fisher are on the attack against those silly people who think there is no evidence for homeopathy.

In a letter published in yesterday’s Guardian, they proclaimed there is, after all, positive evidence for the efficacy of homeopathy:

Positives about homeopathy

The apparent success of homeopathy for many patients is puzzling. But Dr Evan Harris MP is wrong to say it is “known not to be effective” (£12m spend on homeopathy hard to swallow, Society, 10 June). In fact, out of six reviews of the scientific evidence carried out by the independent and respected Cochrane Collaboration, two are cautiously positive and four inconclusive. There is also some evidence to say that homeopathy may be effective in the long term for chronic intractable problems. Inconvenient for those who oppose integrated healthcare perhaps, but very different from demonstrating homeopathy is “ineffective”.

If the NHS were to withdraw access to homeopathy, it would not save the £4m a year it currently spends. Patients now receiving homeopathy would still need treatment, almost certainly at a higher cost and with greater risk of side effects from treatment. The mistake made by Dr Harris and Professor Edzard Ernst is to assume that we have effective treatments for all conditions and all patients. We don’t. Some patients cannot tolerate existing treatments, often those with multiple morbidity – suffering from several conditions, each needing different treatment. For some conditions, we have no effective treatment at all. Is it morally acceptable to deny patients access to a well-established treatment they find effective when no conventional treatment is available? We would suggest not.

Professor George Lewith
Professor of health research, University of Southampton

Dr Michael Dixon
Medical director, Prince’s Foundation for Integrated Health

Dr Peter Fisher
Clinical director, Royal London Homoeopathic Hospital

Let’s see what they are saying:

The apparent success of homeopathy for many patients is puzzling.

No it’s not! The apparent success is due to the placebo effect, making people feel listened to, making people feel as if something is being done just for them, personalised. This is well described elsewhere and shouldn’t be a surprise to anyone.

They then go on to tell us about the two reviews that the Cochrane Collaboration found to be ‘cautiously positive’ and the other four that were inconclusive. No references, of course, but I suppose this is just the Guardian.

So that’s it, then. Proof that homeopathy is efficacious. There can be no more criticism. All us sceptics can pack their bags and move onto, say, looking into bogus claims of chiroquacktic.

Hold on. Wait a minute, there!

Just two reviews that were ‘cautiously positive’? Is that the best they can do?

…currently 15% of the population of Britain trust it.

The over-the-counter market in homeopathy currently stands at around £40million in the UK, based on the last market figures published by Mintel, which estimated in 2007 it was worth £38million but projected to reach £46million in 2012.

There has been a 60% growth in the homeopathic market in Europe over 10 years (1995-2005); from €590million to €930million. 90% of homeopathic products are consumed by France, Germany, Netherlands, Spain, Belgium, UK and Poland. Relative to population, France and Germany have highest consumption – 59%

(Source: British Homeopathic Association)

In India, homeoquackery is rampant:

At present there are nearly 186 homeopathic medical college in India. Approximately 35 are government colleges, rest are managed by private bodies. Homeopathy is the third most popular method of treatment in India, after Allopathy and Ayurveda. It is estimated that there are about quarter million homeopaths in India. Nearly 10,000 new ones add to this number every year. The legal status of homeopathy in India is very much at par with the conventional medicine.

(Source: Hpathy.com)

And all they’ve got are just two reviews that are:

…cautiously positive

FFS!

You’d have thought they’d be able to come up with just a bit more than that?

If the NHS were to withdraw access to homeopathy, it would not save the £4m a year it currently spends. Patients now receiving homeopathy would still need treatment, almost certainly at a higher cost and with greater risk of side effects from treatment.

There may well be a greater risk of side-effects (but these are invariably grossly overstated by homeoquacks), but there is also a greater risk of people being made better by conventional medicine! (There’s no risk of anyone being cured by homeopathy.) Bear in mind as well, most conditions homeopaths treat are minor and self-limiting.

For some conditions, we have no effective treatment at all.

There are no effective homeopathic potions at all! They are all placebo sugar pills.

Is it morally acceptable to deny patients access to a well-established treatment they find effective when no conventional treatment is available?

Is it morally acceptable to lie to patients and tell them that there is good evidence for the efficacy of homeopathy? No, after two hundred years, they are still struggling to invent any evidence whatsoever.

This is Homeopathy Awareness Week. Be aware. Be very aware.

Further information:

Homeopathy Awareness Week. Like tobacco companies, discredited at home, homeopaths exploit poor countries

the quackometer: Homeopathy Awareness Week, 14 – 21st June 2009

Homeopathy Awareness Week and hay fever « A canna’ change the laws of physics

Oh goody. Homeopathy awareness week begins : Respectful Insolence

8 Responses to Let’s be aware. Very aware.

  • The NHS isn't made up of complete idiots (I hope). At a wild party over the weekend, I was debating the placebo effect in homeopathy with someone who would recommend it to others, and he was quite happy to admit that it is plausible for homeopathy to be no more than a placebo.

    With this in mind, do you think it's possible that the NHS are spending £12million on researching the placebo effect?

  • Carmenego

    They aren't doing any research into homeopathy (nor should they): they are just spending £12 million on potions that have been shown to have no effect over placebo.

    Now, there is certainly a debate to be had over the use of placebo, but that is separate from the wasted £12 million.

  • Good post. If you read what the Cochrane reviews actually say, the letter looks less than honest. It's hard to categorise outcomes at times – but there is nothing to justify actually using these treatments on patients.

    Here's my summary:

    NEGATIVE

    "Overall the results of this review found no evidence of effectiveness for homeopathy for the global symptoms, core symptoms or related outcomes of attention deficit/hyperactivity disorder."

    Heirs M, Dean ME. Homeopathy for attention deficit/hyperactivity disorder or hyperkinetic disorder. Cochrane Database of Systematic Reviews 2007, Issue 4. Art. No.: CD005648. DOI: 10.1002/14651858.CD005648.pub2.

    "The review of trials found […] that no strong evidence existed that usual forms of homeopathy for asthma are effective […] Until stronger evidence exists for the use of homeopathy in the treatment of asthma, we are unable to make recommendations about homeopathic treatment."

    McCarney RW, Linde K, Lasserson TJ. Homeopathy for chronic asthma. Cochrane Database of Systematic Reviews 2004, Issue 1. Art. No.: CD000353. DOI: 10.1002/14651858.CD000353.pub2

    INSUFFICIENT EVIDENCE

    "The researchers did not find any good quality trials and so cannot say whether it is or is not effective for treating this condition. As no information is available on how much homeopathy is used for dementia, it is difficult to say whether it is important to conduct more trials."

    McCarney RW, Warner J, Fisher P, van Haselen R. Homeopathy for dementia. Cochrane Database of Systematic Reviews 2003, Issue 1. Art. No.: CD003803. DOI: 10.1002/14651858.CD003803

    "[…] there were no trials including homeopathy […]"

    Glazener CMA, Evans JHC, Cheuk DKL. Complementary and miscellaneous interventions for nocturnal enuresis in children. Cochrane Database of Systematic Reviews 2005, Issue 2. Art. No.: CD005230. DOI: 10.1002/14651858.CD005230

    "[…] trials demonstrated no differences in any primary or secondary outcome between the treatment and control group […] there was not enough evidence to show the effect of a homoeopathy as a method of induction […]"

    Smith CA. Homoeopathy for induction of labour. Cochrane Database of Systematic Reviews 2003, Issue 4. Art. No.: CD003399. DOI: 10.1002/14651858.CD003399.

    INCONCLUSIVE

    "[…] Trials do not show that homoeopathic Oscillococcinum can prevent influenza. However, taking homoeopathic Oscillococcinum once you have influenza might shorten the illness, but more research is needed […]"

    Vickers A, Smith C. Homoeopathic Oscillococcinum for preventing and treating influenza and influenza-like syndromes. Cochrane Database of Systematic Reviews 2006, Issue 3. Art. No.: CD001957. DOI: 10.1002/14651858.CD001957.pub3

    One of the other problems here is generalising. At best, it might help shave a few hours off a flu-like episode (more likely, the result is just an artefact of bias). This is the best support that Cochrane provides. Yet, I'm sure that Fisher's hospital treats more than the 'flu …

  • Thanks apg! I didn't really have the time to go through them (although I know others have already done so).

  • Homeopathy cures even when Conventional Allopathic Medicine (CAM) fails

  • No, Nancy, homeopathy does absolutely nothing. It is useless. And because it is useless, it is dangerous when you lie to perhaps desperate and vulnerable people and mislead them into thinking you can cure all manner of serious medical conditions. This gives them false hope and delays them from getting proper medical help and sometimes this kills them.

    Homeopathy has been shown to be useless many times. Your ridiculous assertions about it working and your continual spamming of blogs with your comment will persuade no one.

    I’m sure you couldn’t have looked very closely at this blog or you would have realised that you already knew what I’m about to say to you:

    We’re STILL waiting for you at Think Humanism so we can do the test of a homeopathic potion you promised you’d do (and which you claimed you could pass).

    Are you EVER going to keep your promise – or do you now think you can’t tell the difference between a homeopathic potion and water?

  • Its funny, the “arguments” is a really extrange. Zenon abuse for the pseudo refutation technic. The pseudoskeptik philosophy is really amazing, a one caravan of Novella, Goldgrace, Dawkins, Edzard, Randi, and the bloggers (i.e. Apylagard and Lewis), yes! the bloggers and bosses for the science.
    It most easy ignore positive evidence and reivindicated negative evidence Yes! ist most easy usea and abuse of opinions and pseudo refutation for the explicate a complex phenomenon. Its most easy “argument” for explanation of homeopathy its a placebo effect, and ignore the real practice. Yes the pseudoskeptik philosophy a modern producto of Sagan and Co. (in coproduction of massive internet and abuse of “its a fallacy argument….”)..

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