Zeno's Blog

The random thoughts of a sceptical activist.

That ‘neutral’ Swiss homeopathy report

Wednesday 09 May 2012 Edit

What does the Swiss Government really think about homeopathy?

By Sven Rudloff and Zeno

Jump to Postscript

A lot has been made by homeopaths about the ‘neutral’ Swiss Government’s report and its unequivocal support of homeopathy. It’s been lauded by the luminaries of the homeopathic world as further proof — as if any was needed, of course — that homeopathic ‘medicines’ are superior in every way to those dangerous and expensive pharmaceutical drugs.

Arch proponent of homeopathy, Dana Ullman, proclaimed:

The Swiss government’s exceedingly positive report on homeopathic medicine

The Swiss government has a long and widely-respected history of neutrality, and therefore, reports from this government on controversial subjects need to be taken more seriously than other reports from countries that are more strongly influenced by present economic and political constituencies.

…

In late 2011, the Swiss government’s report on homeopathic medicine represents the most comprehensive evaluation of homeopathic medicine ever written by a government and was just published in book form in English (Bornhoft and Matthiessen, 2011). This breakthrough report affirmed that homeopathic treatment is both effective and cost-effective and that homeopathic treatment should be reimbursed by Switzerland’s national health insurance program.

…

The provisional reimbursement for these alternative treatments ended in 2005, but as a result of this new study, the Swiss government’s health insurance program once again began to reimburse for homeopathy and select alternative treatments. (Source, cached)

Ullman again:

this report from the Swiss government has confirmed the efficacy and cost-effectiveness of homeopathic treatment. (Source, cached)

The Society of Homeopaths:

Swiss scientists endorse homeopathy evidence

Report says homeopathic medicine is clinically effective

A comprehensive and authoritative research study by Swiss scientists has offered an unambiguous endorsement of the evidence base for homeopathy as a clinically effective system of medicine.

Their report, part of a Swiss government evaluation of complementary and alternative medicines, gives a massive boost to the growing body of research underpinning the therapeutic effects of homeopathic medicine. (Source, cached)

The Faculty of Homeopathy and the British Homeopathic Association:

Evidence for homeopathy builds

Long-awaited English translation of Swiss study endorses evidence for homeopathy

This important report addresses the evidence for the effectiveness of homeopathic therapy in everyday use (i.e. the real world), its safety and its cost-effectiveness.

The authors, Doctor Gudrun Bornhöft and Professor Peter Matthiessen, state: “There is sufficient evidence for the preclinical effectiveness and the clinical efficacy of homeopathy and for its safety and economy compared with conventional treatment.”

Following on from the initial publication of this report, a public referendum in Switzerland in 2009 supported the inclusion of homeopathy and other complementary and alternative medicines in the Swiss national health insurance, with 67% of the people voting in favour. Earlier this month, the Swiss government passed legislation to enact the referendum’s conclusion. (Source, cached and source, cached)

GP and homeopath Dr Andrew Sikorski:

In 2009 a Swiss national referendum voted in favour of complementary medicine being part of the public health service which is now covered by the obligatory public health insurance system. This decision was partly informed by the findings of the 2006 Health Technology Assessment report commissioned by the Swiss Government on the effectiveness, safety and cost-effectiveness of homeopathy in general practice. (Source, cached)

Many other websites have echoed these sentiments, with many taking their lead from Ullman’s article and possibly placing far too much reliance on what he had to say, eg Swiss Government finds homeopathy effective and cost efficient (cached).

You’d think from all this that the ‘neutral’ Swiss Government had taken to homeopathy like the proverbial quacking duck to water.

Of course, to state in this context that the Swiss Government has a ‘widely-respected history of neutrality’ is to conflate political neutrality with scientific objectivity.

As usual, research of truly homeopathic proportions, misrepresentation and cherry picking are the order of the day.

Health Technology Assessment

Background

Even less skeptical academic doctors will regard many interpretations [of the HTA] as very optimistic and not scientifically convincing.

To understand this report properly, we need to look at its context, its purpose and what it led to.

Switzerland has a universal compulsory private health insurance scheme, regulated by the Federal Health Insurance Act of 1994 (Krankenversicherungsgesetz — KVG). The KVG details the treatments for which the treatment provider will be reimbursed.

In 1998, the Swiss Department for the Interior (Eidgenössische Departement des Inneren — EDI) and the Federal Service Commission (Eidgenössische Leistungskommission — ELK) decided to allow insurance companies to be reimbursed for five alternative therapies: homeopathy, anthroposophic medicine, neural therapy, phytotherapy (herbal) and Traditional Chinese herbal therapy (TCM). This was a temporary measure that expired in June 2005.

These therapies were provisionally included in the reimbursement scheme while evidence was sought for their efficacy, appropriateness and cost-benefit so that a decision could be made in 2005 whether to end the reimbursement or add it permanently to the insurance scheme.

For this, an elaborate Complementary Medicine Evaluation Program (Programm Evaluation Komplementärmedizin — PEK) was set up, eventually costing the Swiss taxpayer six million Francs (~£4 million).

The PEK issued three different kinds of reports to inform a comprehensive evaluation:

  • Health Technology Assessments (HTAs) for all five therapies

Qualitative reviews of existing literature on indicators for effectiveness, security, utilisation, and cost-effectiveness.

The HTAs were all written by specialists and proponents for the respective therapies. They were coordinated by the PANMEDION Trust (Switzerland), founded in 2001 to promote complementary medicine, and prepared in cooperation with the Chair for Medical Theory and Complementary Medicine (Lehrstuhl für Medizintheorie und Komplementärmedizin) of the Witten-Herdeck University (Germany) and the Institute for Applied Epistemology and Medical Methodology (Institut für angewandte Erkenntnistheorie und medizinische Methodologie e.V. — IFAEMM), a registered anthroposophic organisation in Freiburg (Germany).

Witten-Herdecke University was founded by anthroposophic doctor Gerhard Kienle, who was also key in establishing special legal status for homeopathic, herbal and anthroposophic therapies in the German public health system in the 1970s. Gerhard Kienle’s daughter Gunver Kienle is senior scientist at IFAEMM and authored the PEK HTA on anthroposophic medicine.

  • Meta-analyses for three therapies (homeopathy, phytotherapy, TCM)

Quantitative reviews of existing clinical studies, specifically on the efficacy of the therapies compared to placebo.

No meta-analyses were done for anthroposophic medicine and neural therapy because the researchers did not find sufficient usable studies.

All meta-analyses were prepared by the Institute for Social and Preventive Medicine (Institut für Sozial- und Präventivmedizin — ISPM) of the University of Bern (Switzerland), specialised on research on public health issues.

  • Original PEK studies

A series of surveys amongst doctors and hospitals, to gauge the extent to which the five therapies are used in Switzerland (utilisation), what the typical patient and conditions look like, and the therapies’ safety and patient satisfaction, as subjectively perceived by the practitioners.

This was complemented by health economy studies, estimating the costs of the therapies in comparison to conventional treatments. PEK originally aspired to also commission original clinical studies on the efficacy of the five therapies, but this approach was eventually scrapped for time, cost and ethical reasons.

The original reports prepared for the PEK have not been made public as part of the process itself. However, their respective authors were allowed to properly publish their work in scientific papers or books after conclusion of the PEK. On homeopathy, this includes the HTA, written by Bornhöft et al., and the meta-analysis, famously known as Shang et al.

 

Homeopathy HTA (Bornhöft et al.)

The many positive results of smaller homeopathy studies can also be explained through biases, therefore an efficacy for homeopathy cannot be seen as proven.

A summary of the homeopathy HTA was first published in 2006 as an article in “Forschung zur Komplementärmedizin”, a German CAM journal. In the same year, authors Bornhöft et al. published a German book version, which was then extended and published in English in 2011.

It is this eventual book that the English-speaking homeopathy world is so unjustifiably ecstatic about.

The HTA looked at various studies, including existing meta-analyses (no new clinical studies or meta-analyses were conducted). Summary tables of the assessment were given in an appendix, included with the summary HTA.

It is interesting to note how many of the original studies’ conclusions the HTA ‘re-interpreted’ to be more favourable towards homeopathy, and their attempted justification for doing so.

We will leave others to look closely at the detail of the HTA itself, but, unsurprisingly, it disparages randomised controlled trials as being unsuitable for homeopathy and is awash with special pleadings.

Even then, the HTA only looked specifically at evidence for upper respiratory tract infections and allergic reactions, so even if their conclusions were valid, they cannot be extrapolated to the homeopathic treatment of any other condition.

Finally, whether homeopathy was cost-effective was also partially addressed by the HTA. They cautiously indicated potential positive cost effects of homeopathy. However, the HTA authors themselves also recognised that they had found only a few and very diverse studies to form a conclusion on the subject, leading them to make the final statement:

Further well-designed studies and analyses of existing databases for homeopathy are encouraged in order to support informed decisions in European health-care systems.

We will come back to this topic further below in the wider PEK context.

 

Homeopathy meta-analysis (Shang et al.)

In parallel to the original HTA, the PEK commissioned meta-analyses to look at the quantitative evidence on the efficacy of the therapies against placebo. For homeopathy, the respective Shang et al. meta-analysis was eventually published in The Lancet in August 2005.

Shang matched 110 homeopathy trials and 110 conventional-medicine trials and concluded:

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.

This was yet another damning blow to homeopathy.

Since this analysis was done in parallel to the original HTA, the 2006 German publications by Bornhöft et al. do not mention it. However, their 2011 book has been extended with a critique of Shang et al.

They attempt to re-interpret the findings and we look at this matching below.

Neutrality? What neutrality?

As shown by the quotes at the beginning, the HTAs has been hailed by homeopaths as vindication of homeopathy because it was a Swiss Government report, and who could be more neutral than the Swiss?

The report was certainly commissioned by a Swiss Government department, but it was written by alternative therapy apologists. We cannot be certain who were involved in the original HTA on homeopathy, but the summary report published in 2006 was written by:

  • Gudrun Bornhöft and Peter Matthiessen: Chair in Medical Theory and Complementary Medicine, University of Witten/Herdecke, Germany and PanMedion Foundation, Zurich
  • Ursula Wolf: Institute for Complementary Medicine (KIKOM), Inselspital, University of Berne and PanMedion Foundation, Zurich
  • Klaus von Ammon, Stephan Baumgartner and André Thurneysen: Institute for Complementary Medicine (KIKOM), Inselspital, University of Berne
  • Marco Righetti: Medical Practice, Zurich
  • Stefanie Maxion-Bergemann: PanMedion Foundation, Zurich

No wonder homeopaths think the HTA was a good report — it was written by supporters of alternative therapies.

Verdict of the PEK report

All individual reports were submitted to the PEK office by early 2005 and summarised in a final report by a review panel. This panel consisted of the two lawyers tasked with running the PEK, a health economist, one (some sources say two) medical doctors of the Federal Health Office (Bundesamt für Gesundheit — BAG), and Dieter Melchart, Professor of Naturopathy and Complementary Medicine (in Zürich at the time, now mainly in Munich).

It can be said, then, that it is the PEK report that more accurately reflects the view of the Swiss Government, not the HTA.

So what does the PEK report actually say about the HTA and homeopathy in general?

Here is the PEK report’s summary of results (Table 18 in the original report), translated into English:

Click to enlarge

In the following, we will focus on the key question of efficacy. That CAM therapies are in high demand (utilisation), that patients subjectively like them (satisfaction) and that many of them are relatively safe and cheap is quite obvious. The question is whether they actually consistently work better than alternatives.

As you can see, homeopathy was in a unique situation, as its efficacy was seen as very positive in the HTA (but downgraded by the PEK review panel) and very negative by the meta-analysis (but upgraded by the review panel). What’s behind this?

Here is what the PEK report says about the HTAs:

For all five assessments, it is very obvious that all or some of the authors have a positive attitude towards the treatments in question or are convinced about their efficacy. Unquestionably, strict proponents of the usual hierarchy of evidence will regard the presented evaluations as scientifically untenable and unreasonably positive (except for some specific aspects of phytotherapy). Even less skeptical academic doctors will regard many interpretations as very optimistic and not scientifically convincing.

This is why the review panel downgraded all the HTAs in their view on efficacy, as shown in the table above.

Specifically, on the homeopathy HTA, the report concludes:

The positive interpretation of the current evidence seems understandable, as long as one does not require especially high evidence standards, given the low plausibility of homeopathy in the light of established scientific knowledge. Very skeptical people will regard the reviewed evidence as not very convincing.

Somehow Bornhöft, Matthiessen and the fans of their HTA fail to mention this part of the Swiss Government’s report.

Cost-effectiveness

Although the HTA noted that the authors believed that homeopathy had positive cost effects, the PEK had more to say.

The PEK had also commissioned economic studies and used these to inform their final conclusions about cost-effectiveness.

On cost factors, only a very limited number of studies is available. High-quality cost-benefit analyses in connection with pragmatic randomised trials are not available at all. Since again the original data obtained by the PEK studies is much more relevant than the few studies found in the literature by the HTAs, we only briefly summarise the key results: […]

Similarly [to anthroposophic medicine], there are a few studies on homeopathy, indicating that potentially higher direct costs through [longer] consultation may at least be compensated by lower lab and technical costs as well as positive effects on sick leave. […]

The PEK review panel concluded:

Due to insufficient data, no reliable statements on the cost-effectiveness of the 5 complementary therapies are possible based on the HTAs.

So, although the writers of the HTA might have thought homeopathy could be cost-effective, the PEK, even with much more data, was nowhere near as positive.

However, this still misses the fundamental point: a useless treatment is just as useless whatever it costs.

Like for like?

“But wait”, homeopathists may say, “the Shang et al. meta-analysis has also been criticized! And it showed that homeopathy studies are of higher quality than conventional studies!”

Well, yes and no.

From the summary of the meta-analyses in the PEK report:

Included in the analyses were 110 studies on homeopathic interventions […] and 110 conventional interventions, matched regarding condition and target criterion. […] The methodological quality of both homeopathic and conventional studies was similar for most criteria, though overall somewhat higher for the homeopathy studies: 19% of homeopathy studies and 8% of conventional studies were classified as of ‘higher quality’.

So, yes, the proportion of higher quality studies was higher for homeopathy. This is actually to be expected if you first find 110 homeopathy studies and then have to find 110 roughly comparable conventional studies that match the homeopathic studies regarding condition and target criteria.

In any case, a higher proportion of higher quality studies doesn’t seem to have helped homeopathy at all:

When the results of the eight large, methodologically better homeopathy studies were pooled, no significant effect above placebo could be found. […] However, for the six large, methodological better studies for conventional interventions a significant effect was found. […] The authors conclude that the current results support the hypothesis that the clinical effects of homeopathy — compared to effects of conventional medicine — are unspecific placebo or context effects.

The review panel criticised the meta-analysis, but effectively for this last sentence only:

Due to the basic methodological issues, the results of the meta-analyses should be interpreted conservatively. However, in the light of their depth and high technical quality, several conclusions can likely be derived reliably: […]

The issue of potentially overestimating effect sizes due to biases [like small sample size] appears especially large for homeopathy studies. […]

When looking only at large studies with higher methodological quality, the effects compared to placebo remain statistically significant for phytotherapy and most conventional treatments, but not for homeopathy. This supports general efficacy for the first two, whereby the many positive results of smaller homeopathy studies can also be explained through biases, therefore an efficacy for homeopathy cannot be seen as proven.

The review panel however regards as too extensive the [meta-analysis’ authors’] conclusion that the lack of a significant effect in the larger, high quality homeopathy studies and the meta-regression indicate that the clinical effects of homeopathy are placebo effects.

This is why the review panel upgraded the meta-analysis rating for homeopathy — even though to a still negative rating.

Mostly harmless

Overall, the review panel concluded on homeopathy:

From a conventional, scientific perspective, there is no plausible mechanism for homeopathy. […]

The efficacy analysed in the literature leads to a negative result in the meta-analysis of placebo controlled studies, and to a positive result in the HTA when other feedback is considered. The demand for homeopathy in Switzerland is rather high. The clinical potential for damage caused by this special drug therapy in the hands of medical basic care providers is negligible. The customer base is broad, but children with their typical conditions as well as women with psychological conditions, pregnancy or post-menstrual conditions form key groups.

For these indications often there is no conventional alternative or only pharmacological treatments with a significantly higher risk potential than for homeopathic remedies.

According to some sources, in an early draft the review panel recommended the continued reimbursement of homeopathy (and for two other therapies), but the respective passages were removed from the final version. Looking at wording of the summary above, this actually looks quite likely. The summary essentially says: there is demand; people like it; it rarely hurts; it’s not clear whether it really works; but it’s cheap so what the hell.

Excluded

Following the final report, the ELK decided — on the basis of the HTA and the subsequent PEK report — to not include the five alternative therapies in the statutory reimbursement after June 2005 (except for some herbal drugs that were put on a speciality list).

A predictable outcry by the alternative medicine community ensued.

There was a lot of discussion about the cumbersome PEK process — in the beginning caused by prolonged controversy between conventional and alternative medical practitioners and methodologists about the ‘correct’ study designs — the PEK’s seemingly rushed final stages, and the apparent dislike of alternative medicine by the Swiss Health Secretary in office at the time.

Referendum

Based on the popularity of CAM, the campaign Yes to complementary medicine (Ja zur Komplementärmedizin) gained traction in the following years, seeking to include consideration of CAM in the Swiss constitution. The Swiss parliament made a somewhat softened counter-proposal to the campaign’s phrasing, and in 2009 a public referendum endorsed it by a two to one majority.

After the referendum, the organisations for the five therapies officially requested reimbursement again from the BAG in 2010. The BAG reviewed their applications, and asked the Union of Swiss CAM Organisations  (Union der Komplementärmedizinischen Ärztegesellschaften) to name experts for each therapy that could be further questioned.

the clinical effects of homeopathy — compared to effects of conventional medicine — are unspecific placebo or context effects.

The application material plus the experts’ statements were then sent by the BAG to a commission for a recommendation to the EDI. This commission, the Federal Commission for General Services and Policy Issues (Eidgenössische Kommission für allgemeine Leistungen und Grundsatzfragen — ELGK) consisted of 20 representatives of Swiss doctors (including a CAM one, following the referendum), pharmacists, health insurance companies, patients, Swiss cantons, as well as experts on lab analytics and ethics and which advises the EDI on what to reimburse.

Their recommendation was that, even when considering new studies, none of the five therapies complied with the criteria of efficacy, appropriateness and cost-effectiveness.

According to their verdict, there was nothing new that would merit overturning the decision from 2005. The commission felt that covering the five therapies would require a change of the law.

Because these therapies did not meet the established criteria for full and permanent inclusion for reimbursement, they ended up with the new, temporary solution again with reimbursement from 2012 until 2017, with the obligation to finally prove compliance of these therapies with the key criteria of efficacy, appropriateness and cost-effectiveness by end of 2015.

This will be done via:

  • Re-evaluation of existing material, led by the Union of Swiss CAM Organisations and coordinated by Prof. André Busato and the Institute for Complementary Medicine (Kollegiale Instanz für Komplementärmedizin — KIKOM) at the University of Bern. Both were already involved in the PEK.
  • A new comprehensive HTA, prepared by an internationally recognised research institute outside Switzerland, which has yet to be appointed by the BAG.

Another bite of the cherry

So, the proponents of homeopathy, etc get yet another chance.

They tried and failed miserably in 2005 to convince the Swiss Government because of the lack of good evidence for their pet therapies.

They failed again in 2010.

It’ll be interesting to see if they can come up with anything better — and more objective — in the next few years.

Homeopaths can praise the HTA under the PEK if they want. But in the eyes of the PEK review panel and the Swiss Government it was biased and overly optimistic, and taking everything else into account, they decided that homeopathy was quite likely ineffective but harmless.

Hardly something homeopaths can be proud of and not quite the story they want us to believe.

Postscript

01 November 2013

Some six months after we published this and after more articles by homeopathists lauding this ‘Swiss Government Report’ as the last word on the scientific evidence for homeopathy, an official of the Swiss Government wrote to the Swiss Medical Weekly to correct many of their errors.

It was then that we realised that we couldn’t trust homeopaths to even get the title of the report correct. As Felix Gurtner of the Federal Office of Public Health FOPH, Health and Accident Insurance Directorate in Bern, Switzerland, had to point out:

This review was declared to be an HTA by the authors (the final PEK [5] report does not classify the literature reviews as HTA reports) and published later as a book [7] under their responsibility without any consent of the Swiss government or administration. [Original reference numbers]

So now we know: their ‘book’ wasn’t an HTA after all, just a biased and limited ‘literature review’ that was not even published by the Swiss Government or with their permission.

Of course, homeopaths have now corrected themselves and no longer misrepresent this as an authoritative ‘Swiss Government HTA’.

Don’t be silly; of course they haven’t.

References and further reading

1. Swiss Health Office page with all relevant documents: Programm Evaluation Komplementärmedizin (PEK) — Publikationen

2. The final PEK report: Schlussbericht PEK, April 2005.

3. Shang et al. (2005) in The Lancet: Are the clinical effects of homoeopathy placebo effects?

4. Bornhöft et al. (2006), their first publication on the homeopathy HTA, a summary article in Forschende Komplemtärmedizin (Research in Complementary Medicine), with a summary in English (the article itself requires registration).

5. Swiss Government page on the 2009 referendum, with referendum results and link to the referendum wording (including background).

6. Swiss Health Office press release on the new 2012–2017 trial period.

 

Acknowledgements

Thanks to Sven Rudloff for translating large sections of the various reports and for writing the majority of this blog post.

Thanks to Mojo for pointing out the PEK report that got us looking into this.

But thanks mostly to homeopath Nancy Malik for highlighting the existence of the PEK report in the first place. Her contribution to the understanding of science and the continued lack of scientific evidence for homeopathy is duly noted.

Categories

AltMed, Government, Science
Comments (86)

86 thoughts on “That ‘neutral’ Swiss homeopathy report”

  2. Excellent analysis, many thanks to all involved, especially Nancy Malik whose tireless devotion to demonstrating homeopathy’s inability to understand the scientific method is unequalled by anyone other than perhaps Dullman himself.

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  3. Excellent work, gentlemen.

    Who would have guessed that something hailed by DUllman et al as being neutral and scientifically rigourous turns out to be almost the exact opposite.

    I for one am shocked beyond belief.

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  4. Thanks for the post. I’m now looking forward to Ullman, Malik et al diluting their enthusiasm for the Swiss Report.

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  5. good work chaps – detailed rebuttals of this nature are really important so that skeptics have on record a way of countering the “but look, the neutral Swiss government say homeopathy works!” type argument.

    ta

    P

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  6. Wow, that is a very thorough piece of work. Kudos to you for putting the effort in!

    This is a great illustration that bloggers can sometimes knock traditional media into a cocked hat when it comes to in-depth and thorough reporting.

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  7. Thanks for the thorough summing up of this complicatedly simply thicket of distortions.

    This is an important point:

    “…so even if their conclusions were valid, they cannot be extrapolated to the homeopathic treatment of any other condition.”

    The fact is easily obscured, that homeopaths aren’t just quibbling over the odd “positive” review for a cough remedy. They see such trivial results as justifying their entire system, as well as proving the poverty of evil and materialistic “allopathic” medicine. They use this to leap straight into: “The Swiss Government confirms we have discovered a cure for cancer, dengue fever, small pox, leprosy” etc.

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  8. I think you need to get out more!

    To spend so much time trying to discredit a relatively harmless complementary therapy that many people want to use and believe does them good, suggests to me that you need to see a doctor.

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  9. John

    Thank you for trying to tell me what I should do in my spare time and for being concerned for my mental health.

    Homeopathy discredits itself, of course, but what I object to is the misrepresentation and spin that has been put on the HTA by homeopaths and their supporters. This is misleading and might leave those not familiar with it to think that homeopathy is a real medicine when the evidence shows otherwise. I hope you will share those concerns.

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  10. John

    In addition to Zeno’s comment, I also find it remarkable that governments are repeatedly (!) forced to undertake such evaluations, costing millions of Francs / Euros / Pounds, just to make the scientifically already well established point that these ‘therapies’ are ineffective, and that if people want them anyway, they should pay them out of their own pocket.

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  11. In addition to Zeno’s comment, I also find it remarkable that governments are repeatedly (!) forced to undertake such evaluations, costing millions of Francs / Euros / Pounds, just to make the scientifically already well established point that these ‘therapies’ are ineffective…

    Especially when you look at the recent research. According to figures from the BHA, who put these figures on their website in a document that is periodically updated, as of 2005 there had been 119 RCTs of homoeopathy, of which 58 were positive, 57 “inconclusive” (by which they mean there was no significant difference between homoeopathy and placebo) and 4 negative (bt which they mean that homoeopathy actually performed significantly worse than placebo or some other comparator). Their current figures, up to the end of 2010, are 156 RCTs, of which 64 were positive, 81 “not statistically conclusive” and 11 negative. That means that since 2005, the year in which the original PEK decision was made, there have been 37 new trials, of which only 6 could be described as “positive”.

    Homoeopaths often describe homoeopathy as having a “growing evidence base”, but it doesn’t seem to be growing in the direction they imply. On the positive side, maybe they are getting better at designing and conducting RCTs.

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  12. Mojo

    Good point. In addition, always remember (as shown by Shang et al. and cited in the blog post) that the absolute number of “positive” vs. “negative / inconclusive” trials is also heavily biased to overestimate the importance of “positive” trials, since they tend to be the smaller and less rigorous ones.

    The issue of potentially overestimating effect sizes due to biases [like small sample size] appears especially large for homeopathy studies.

    This is exactly why meta-analyses are needed: To give the best estimate of the actual effect, across all available studies.

    And here homeopathy always looses out. Reliably.

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  13. I have to keep saying this. In spite of the RCTs (and however shoddy or dubious the “positive” ones are), there are no actual cases to demonstrate any claimed effectiveness. In every branch of real medicine there are detailed recorded cases to study, that anyone can question, replicate or disprove. With homeopathy there is no such thing. After more than 200 years there should be millions, yet homeopaths can’t produce a single incontrovertible, verifiable example. Anecdote and fantasies, yes, by the score. Real examples, not millions, not even one.

    It is all demonstrably marketing, smoke and mirrors, involving misrepresentation, word games and often downright lying. It is first and foremost a business, and a fraudulent one at that. And it is presented as if it were religion, with which it shares almost every significant characteristic. Absolute and unquestionable, incapable of error, and relying on religious like stories and rituals. It even has its own bible, god, theology and various sects.

    Homeopathy is demonstrably ignorance and gullibility writ large. And, to continue the religious theme, I think it’s not too outrageous to suggest that the reasons people want to become homeopaths are the same as for wanting to become a priest or vicar.

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  14. Did ya find out WHICH 8 trials were analysed by Shang?- Why doesn’t anyone want to divulge this information? Not got anything to hide, or………………

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  15. Andrew

    The list of those eight trials is freely available on the Internet to anyone capable of using a search engine.

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  16. Zeno thanks for a good article. However, until such time that homeopathic potion pushers (I mean expensive bottled water marketers) provide a logical and plausible mechanism that doesn’t violate every basic fact of physics and chemistry, I’m not even going to worry about Dana Ullman and his delusions and lies. And any homeopath that is capable of reading (so far, obviously Sikorski is incapable of that), spare me the Argument from Ignorance that the absence of evidence is not evidence of absence.

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  17. D’jaa have the 8 trials or not- bet you can’t answer my request except with a snide side-swipe- innit!?
    Mike- if it works why do you need to know a logical and plausible mechanism? Do you take Paracetamol? What happened in the nanoseconds before the ‘big bang’ and yet you are alive and breathing- take a deep breath, brother, love you hugely!!

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  19. I was sad to see that by politics in the teeth of the evidence, the assorted quacks got public funding in Switzerland from 1998-2005 and 2012-2017, with no reason to expect them to accept reality in 2017.

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  20. Thank you for a comprehensive and very logical exposition of the report and its history. This will be a reference for anyone interested in the facts of homeopathy.

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  21. I know for a fact Ullman never read the report. On another forum he was in a discussion about it, but as soon as he was asked about certain sections and the wording of parts of the report on particular pages, he stopped posting immediately.

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  22. Andew Sikorski, you said:

    if it works why do you need to know a logical and plausible mechanism? Do you take Paracetamol?

    The inference is that conventional science has neither a “logical or plausible” mechanism for the analgesic action of paracetamol. This is quite untrue, as you should know. You are a doctor, aren’t you? Do you not have to undergo educational updates on relevant issues, or do CPD? Or do you just acquire those homeopathically by walking past the medical library occasionally?

    Hint – check up COX-2 and COX-3 inhibitors, and TRPA1. Google will do, if you can’t find your way to PubMed, like other doctors do.

    It is sad to see someone like you resporting to the worst of logical fallacies to debate this issue. Oh, and have you found those 8 studies from Shang yet?

    Reply
  23. Pingback: Skeptics with a K – Episode #072 « The Merseyside Skeptics Society

  24. You folks are in such sweet denial…and it is fun to watch you spin this and spin that.

    As for DeeTee’s assertion that I have not read the report, he is speaking out of ignorance or just plain being deceitful (I’m not surprised). I own a copy of the Swiss report…and in fact, my company now sells this report published by Springer.

    I also could not help but notice that you chose to not mention that 67% (!) of the Swiss public voted to include homeopathy, herbology, acupuncture, Anthroposophical medicine, and prolotherapy into the Swiss government’s national health insurance plan. How can you spin and misinterpret this one? It will be fun to watch you spin in the wind on this one…

    It is also fun to watch you folks talk about Shang without mentioning any of its serious flaws, while taking out the electron microscope to your analysis of any trial or review of homeopathy that has had a positive result. The lack of a good or health “scientific attitude” is palpable. My sincere condolences to you…

    Reply

  25. Dana Ullman said:

    You folks are in such sweet denial…and it is fun to watch you spin this and spin that.

    If you spot any factual errors, please do let us know.

    As for DeeTee’s assertion that I have not read the report, he is speaking out of ignorance or just plain being deceitful (I’m not surprised). I own a copy of the Swiss report…and in fact, my company now sells this report published by Springer.

    Good for you and thanks for declaring your conflict of interest.

    Perhaps you’d now like to read our blog post properly? You said:

    I also could not help but notice that you chose to not mention that 67% (!) of the Swiss public voted to include homeopathy, herbology, acupuncture, Anthroposophical medicine, and prolotherapy into the Swiss government’s national health insurance plan.

    We said:

    The Swiss parliament made a somewhat softened counter-proposal to the campaign’s phrasing, and in 2009 a public referendum endorsed it by a two to one majority.

    Just in case your maths isn’t up to it, that is saying that 67% of those who voted, voted in favour of the proposition.

    However, since the turnout was only 38.3% of the eligible Swiss public, you are wrong to try to assert that 67% of the Swiss public voted for it. Numbers are important, aren’t they?

    How can you spin and misinterpret this one? It will be fun to watch you spin in the wind on this one…

    Foot. Mouth. It’s the homeopathists who have been trying to spin this one, I’m afraid, by misrepresenting a report written by homeopaths as being endorsed by the Swiss Government. You did read the bit where the PEK had to revise (downwards) the homeopaths’ over-optimistic conclusions because they were biased, didn’t you?

    It is also fun to watch you folks talk about Shang without mentioning any of its serious flaws, while taking out the electron microscope to your analysis of any trial or review of homeopathy that has had a positive result. The lack of a good or health “scientific attitude” is palpable. My sincere condolences to you…

    I’ll leave it to readers of this blog to decide who it is who is doing all the spinning.

    Reply

  26. Dana really seems to have missed the point that the HTA was written by people with an interest in CAM & in many ways was akin to the submission by homeopaths to the UK HoC Evidence Check on homeopathy. It failed as well.

    Reply

  27. Does DUllman’s telling us that he OWNS a copy of the Swiss report, and sells it, per se mean he has READ it? I’d have said not. In fact, a person whose intellectual vanity far exceeds their knowledge might well also be the kind of person who would buy a book and sit it prominently on their shelves so more impressionable people might THINK they had read it.

    And, needless to say, even reading something is not the same as ‘processing, understanding and critique-ing’ it. A process which tends to depend on whether you have any idea what you are talking about in the first place.

    Reply

  28. Irrespective of the report, which Dullman clearly has neither read nor understands, the substantive issue is that neither Dullman nor any other homeopath can produce a single case where homeopathy has incontrovertibly cured anything at all – not self-limiting and particularly not non-self-limiting. Blusterers and shysters all of them.

    Dullman argues by weight of anecdote and volume of dubious authority. He is a fact-free zone. There is no point in arguing with him because he’s like the Black Knight of the Holy Grail. Reality isn’t his thing (not in public at any rate) because his bank balance depends on his apparent belief in the homeopathic fantasy. The epitome of a homeopathic brain, infinitely diluted, he would claim that confers on him more a powerful intellect.
    Engaging him in an argument about the Swiss Government’s attitude towards homeopathy is ultimately as pointless as trying to convince the Black Knight he has no limbs, or the Emperor he has no clothes.

    The only choice to make regarding Dullman and every other homeopath is whether they are in reality quite deluded, or simply unprincipled frauds.

    Reply

  29. What exasperates me is the professional envy of obviously bonkers Homeopaths and their pathetic rivalry with medical professionals that can rely on much more clinically significant data sets for their ongoing practice. If Homeopathy, and Homeopathists were less ambitious and pompous I think we could all accept such therapies as Placebo medicine, although the problem with Placebo is that it relies on people “believing” in something that might otherwise have little or no effect. The research on Placebo medicine is quite good, good enough to enable a Homeopath to claim that Homeopathy can be effective, but too frequently they overstep the important theoretical and practical boundaries between faith, magic, medicine and science. Mostly it is about hijacking good work done in good faith, co-opting the findings to reInforce their own, petite-bourgeoise CAM enterprise (which is of course about making sure that people believe in Homeopathy, in order for the Placebo to be as affective as possible and not for clients to understand it or come even close to explaining it). There is no right or wrong here, just shades of wonk and provided that individuals are directed to the most appropriate source of help for whatever health issue they are concerned about, there is enough medicine in the world for more than just scientifically proven medicine, but to even try to suggest that Homeopathy falls within this latter group I think is what one might call a category error?

    Reply

  30. @Matt

    Placebo therapies are all very well if used on patients who aren’t really ill, but homoeopaths don’t restrict themselves to these.

    One of the complaints they most often claim to be able to treat is asthma. This is a condition that kills over a thousand people each year in this country. Treating asthma with a placebo may make the patient feel better about it, but it doesn’t actually have any significant effect on the flow of air into their lungs. This is dangerous because it will make them less likely to seek proper medical care, and make them more likely to reduce any medication that they are already taking.

    If patients seek placebo therapy for their symptoms they will pretty much inevitably delay seeking proper medical care, and there are all sort of conditions for which this delay can make the eventual outcome worse.

    Reply
  32. Pingback: Where Switzerland did not endorse homeopathy

  33. Lol………… What an amount of fear running out there !!!!!!!!!!!!!!!!!!!!
    Once again homeopaths resort to anecdotes masquerading as evidence. Anecdotes (partial or otherwise) do not = clinical case.
    Anyway there should be shed loads of clinical cases (millions of them), but in reality there are none. Stories from deluded wannabe doctors making dodgy diagnoses and fantasising results do not count. Hpathy.com could be renamed Bollox-r-us, and no-one would notice.

    Reply

  34. When you read the words of someone charismatic like Dana Ullman, they appear at first to convey, simple, honest, resolute truth. Then you read something like this –thorough, appraising, deep and broad — and it becomes a wonder that Ullman’s simplistic appeals to authority ever hold sway.

    Reply

  36. In the words of the Great Prophet Zarquon, “Er, Hello everybody, sorry I’m late. ”

    Only just read Zeno’s analysis and I’m glad to see DUllman has turned up.

    As for DeeTee’s assertion that I have not read the report, he is speaking out of ignorance or just plain being deceitful (I’m not surprised). I own a copy of the Swiss report…and in fact, my company now sells this report published by Springer.

     My first reaction to his post was exactly that of Dr Aust;

    Does DUllman’s telling us that he OWNS a copy of the Swiss report, and sells it, per se mean he has READ it? I’d have said not. In fact, a person whose intellectual vanity far exceeds their knowledge might well also be the kind of person who would buy a book and sit it prominently on their shelves so more impressionable people might THINK they had read it.

    What follows is obviously pure speculation, a thought experiment if you like.

    Suppose there was an unscrupulous bullshitter who makes a living by playing fast and loose with the truth whose income depends in applying maximum hyperbole. But also suppose that deep down, there is a little nugget of honesty that prevents this person telling an absolute outright lie. If that person was accused of not having read a certain book and they had not, but they had in their possession copy of it and indeed even made money selling copies, might they make a big play of owning it and marketing it and just hope that no one asked flat out whether they had actually read it in its entirety because that would leave only two options, either snap that final thread of personal honesty or reveal the extent of the bullshitting and the careful word games that had been played. 

    Obviously, I’m just speculating. 

    In other news, DUllman, have you read the entirety of the Swiss report (apparently published by Springer) that is the subject of Zeno’s analysis?

    A nice clear answer would be excellent. 

    Reply

  37. I’m never sure what it takes to bring DUllman down upon us.

    Is it repetition of his name?
    Dana Ullman
    Dana Ullman
    Dana Ullman

    Or do I have to get a hard-boiled egg and paint bright beady eyes then stick pins in it to awaken his demonic majesty?

    Yikes!!

    Reply

  38. Hello BSM – fancy finding you here. Making perfect sense as usual.

    Your explanation of bullshit is a very neat précis of Harry Frankfurts “On Bullshit” and Stephen Law’s “Believing Bullshit”. I doubt if you are a stranger to either of them, but just in case.

    You just have to avoid the lie. How you do it is down to you and your hyperbolic creative ability. Having spent the last 30 years in IT sales I speak as an expert.

    I would not say Dana Ullman three times in front of a mirror. Like The Candyman he might suddenly materialise and homeopathetic you to death.

    Reply

  39. I posted this at Quackometer first, but I thought I’d spread its antibody goodness here.

    DUllman appears like a virus on various sceptic websites. Posts and runs.

    In this context, I wonder whether things like this link would serve as antibodies to be deployed as soon as he appears. You never know, one day he might choose to engage meaningfully with the problems he creates for himself.

    http://apgaylard.wordpress.com/2008/08/26/making-your-own-reality-part-2/

    Reply

  42. Energy can neither be created nor destroyed.1 drops of Homoeopathic medicine is added in 1/4th glass of water… Medicinal parts still disperse into the water.

    Reply

  43. Energy can neither be created nor destroyed.

    Yes, that is a major problem for a system of medicine that claims that you can dilute its remedies indefinitely without running out of the starting material.

    Reply

  44. Although I read this fantastic takedown of the HTA report by Zeno et al., I did not comment because I couldn’t add anything substantive to this magnificent effort. But by Toutatis, it is incredibly strange and irritating that odd homeoquackery proponents are still popping up here and there, and referring to this report as ‘evidence’ for. A Kurt Robinson dropped by an old blog post of mine on an awful water memory video that was doing the rounds then; in the comments, what does he flash as evidence of studies proving ‘efficacy’ of homeopathy? The friggin’ HTA report. Gaaah!!

    1 drops (sic) of Homoeopathic medicine is added in 1/4th glass of water… Medicinal parts still disperse into the water

    Ain’t no ‘medicinal parts’ in homeopathic ‘medicine’. Go back and revisit your high school chemistry textbooks, Fambol.

    Reply

  45. This blog is written by people who have no understanding of medical science. They write out exotic names (like above or quackometer, whatstheharm etc.) and are in business of deriding homeopathy- a subject they have no clue about.

    They continue to quote high school science to prove their point indicating the level of their academic achievements and understanding.

    They write under pseudo names, write at many sites and cross reference these sites to prove invalid points.

    To support themselves, they find a set of people who sing in unison at all these sites and write out personal insults to anyone who disagrees to an extent that he/she leaves the site disgusted by the approach. The blogger would even moderate what is written against the blog under ” I have to protect my honor”.

    Interesting business model.

    Reply

  46. Homeopathy is derided as a belief – it is not evidence based.

    Let us look at what doctors have to say about evidence based medicine?

    David Eddy, the former cardiovascular surgeon at Stanford turned Duke University mathematics PhD, who has devised a new computer model called ARCHIMEDES which has shown him that most, if not all, treatments for chronic diseases like diabetes and high blood pressure do more harm than good.

    During his long and controversial career proving that the practice of medicine is more guesswork than science, Eddy showed that the annual chest X-ray (routine check up) was worthless, over the objections of doctors who made money off the regular visit. He proved that doctors had little clue about the success rate of procedures such as surgery for enlarged prostates. He traced one common practice — preventing women from giving birth vaginally if they had previously had a cesarean — to the recommendation of one lone doctor. Eddy liked to cite a figure that only 15% of what doctors did was backed by hard evidence.

    That was 1986. Now move on to 2006:

    Eddy showed that the conventional approach to treating diabetes did little to prevent the heart attacks and strokes that are complications of the disease.

    In his career, he has never been afraid to take a difficult path or an unpopular stand. “Evidence-based” is a term he coined in the early 1980s, and it has since become a rallying cry among medical reformers. The goal of this movement is to pierce the fog that envelops the practice of medicine — a state of ignorance for which doctors cannot really be blamed. “The limitation is the human mind,” Eddy says.

    Where does the human mind figure in the RCT for drugs?

    http://www.businessweek.com/stories/2006-05-28/medical-guesswork

    Reply

  47. Avijit said:

    This blog is written by people who have no understanding of medical science.

    Thanks for your (wrong) opinion.

    They write out exotic names (like above or quackometer, whatstheharm etc.)

    What other call their blogs is none of my concern nor did they ask me to help them choose a name. However, I’m fascinated to learn that you think names like whatstheharm are ‘exotic’. It’s irrelevant, of course.

    and are in business of deriding homeopathy- a subject they have no clue about.

    Homeopathy can be derided by anyone with even a basic understanding of physics, chemistry and biology. However, if you ever spot an error in my blog, please feel free to let me know.

    They continue to quote high school science to prove their point indicating the level of their academic achievements and understanding.

    High school science is all it takes to show homeopathy is nonsense.

    They write under pseudo names

    My name as the author and owner of this site is clearly given.

    write at many sites and cross reference these sites to prove invalid points.

    I only write blog posts here (although I comment on many others – as you do), but if you spot any invalid points, please feel free to point them out. I notice you’ve not done that yet.

    To support themselves, they find a set of people who sing in unison at all these sites and write out personal insults to anyone who disagrees to an extent that he/she leaves the site disgusted by the approach. The blogger would even moderate what is written against the blog under ” I have to protect my honor”.

    I have found no such people. All are free to comment if they want (as you have done), of course, as long as they abide by the rules (as you have not done). In fact many detractors do come on here (we’ve even have the great Dana Ullman making an idiotic comment, but he never returned after I corrected his wrong assertions).

    Interesting business model.

    This is not a business. I pay for this out of my own pocket and receive no inome from it or for it – even not a penny from any pharmaceutical company.

    Now, perhaps you’d like to stick to the topic of this blog post?

    Reply

  48. Avijit said:

    Homeopathy is derided as a belief – it is not evidence based.

    It’s homeopathy that’s a belief and certainly not based on robust evidence. If you have any robust scientific evidence for homeopathy, you might like to pass it on to the Swiss Government so you can save homeopathy there.

    Let us look at what doctors have to say about evidence based medicine?

    Why? What has that got to do with the topic of this blog: the Swiss Government’s decision about homeopathy?

    You then go on to copy and paste from an article in a business magezine website…

    David Eddy, the former cardiovascular surgeon at Stanford turned Duke University mathematics PhD, who has devised a new computer model called ARCHIMEDES which has shown him that most, if not all, treatments for chronic diseases like diabetes and high blood pressure do more harm than good.

    During his long and controversial career proving that the practice of medicine is more guesswork than science, Eddy showed that the annual chest X-ray (routine check up) was worthless, over the objections of doctors who made money off the regular visit. He proved that doctors had little clue about the success rate of procedures such as surgery for enlarged prostates. He traced one common practice — preventing women from giving birth vaginally if they had previously had a cesarean — to the recommendation of one lone doctor. Eddy liked to cite a figure that only 15% of what doctors did was backed by hard evidence.

    The figure of 15% is utterly wrong, of course. The figure of 15% comes from a small survey of GPs in the north of England in 1961 – half a century ago. Fortunately for us, much has changed in the last 50 years.

    But this survey was never intended to assess the degree to which GPs were evidence-based, but rather was looking at controlling prescribing costs in terms of generic versus proprietary drugs.

    Utterly irrelevant to the subject of the Swiss Government and homeopathy.

    That was 1986. Now move on to 2006:

    Eddy showed that the conventional approach to treating diabetes did little to prevent the heart attacks and strokes that are complications of the disease.

    In his career, he has never been afraid to take a difficult path or an unpopular stand. “Evidence-based” is a term he coined in the early 1980s, and it has since become a rallying cry among medical reformers. The goal of this movement is to pierce the fog that envelops the practice of medicine — a state of ignorance for which doctors cannot really be blamed. “The limitation is the human mind,” Eddy says.

    Where does the human mind figure in the RCT for drugs?

    http://www.businessweek.com/stories/2006-05-28/medical-guesswork

    But Eddy was an advocate of EBM and he used the best evidence he could find to challenge the status quo and pointed out when the evidence was weak or non-existent. That is what science does and what EBM is all about (and what homeopathy completely ignores), so I have no idea what point you think you were making.

    For anyone interested, Avijit has recently commented on the Quackometer article on the Swiss report and I (and several others) have replied to him, so his comments here really follows on from there.

    Avijit, if you choose to comment further, I remind you of the rules for comments, particularly the first one. If you post off-topic comments (ie ones like your two here that have nothing to do with the Swiss Government’s decision to withdraw reimbursement for homeopathy in 2017), I may delete them.

    If you want to express your opinions about the medical miracle that is homeopathy, start your own blog.

    Reply

  49. ….Thanks for your (wrong) opinion……..

    What is wrong about the opinion? Are you a doctor in medicine?

    …..What other call their blogs is none of my concern nor did they ask me to help them choose a name. However, I’m fascinated to learn that you think names like whatstheharm are ‘exotic’. It’s irrelevant, of course…..

    For a change you are right. The contents make them irrelevant.

    ….Homeopathy can be derided by anyone with even a basic understanding of physics, chemistry and biology. However, if you ever spot an error in my blog, please feel free to let me know. High school science is all it takes to show homeopathy is nonsense…….

    ERROR? You have no clue what you are writing. Justifying high school science to run down medical science? You are not serious. Hold it. I believe you are serious.

    It would be good if you met a second year student at a medical college and compared your high school science with his medical science. Do come back and tell everyone what the look he gave you was.

    ….I only write blog posts here (although I comment on many others – as you do), but if you spot any invalid points, please feel free to point them out. I notice you’ve not done that yet……..

    Let us get the basic rules corrected then you will see the answers.

    ….In fact many detractors do come on here (we’ve even have the great Dana Ullman making an idiotic comment, but he never returned after I corrected his wrong assertions)………..

    There you go: idiotic comment- he did not return because he would have been disgusted with the idiotic responses from a dozen stupid high school science students.

    ………It’s homeopathy that’s a belief and certainly not based on robust evidence. If you have any robust scientific evidence for homeopathy, you might like to pass it on to the Swiss Government so you can save homeopathy there……..

    I have to write about the “scientific medicine system” because this is the reference you use to run down homeopathy. So first we find out the robustness of the reference system. If the reference system is irrelevant then what is your reason to challenge homeopathy?

    ……You then go on to copy and paste from an article in a business magazine website…

    Have you forgotten that medical science spawns a large business area and is therefore of immense interest to business magazines. How can YOU be so dumb to this fact? You are in the same area.

    ………The figure of 15% is utterly wrong, of course. The figure of 15% comes from a small survey of GPs in the north of England in 1961 – half a century ago. Fortunately for us, much has changed in the last 50 years. But this survey was never intended to assess the degree to which GPs were evidence-based, but rather was looking at controlling prescribing costs in terms of generic versus proprietary drugs…………

    Why do you report incorrect facts? Go to http://en.wikipedia.org/wiki/David_M._Eddy and correct your reference. 50 years later nothing has changed.

    1987

    “ At the time, Kaiser was prescribing to its patients what was then a relatively new cholesterol-lowering drug, Mevacor, from Merck (MRK). “We were treating everyone who walked in the door,” recalls Dr. James Dudl, diabetes expert at the Kaiser Permanente Care Management Institute. “We thought the drug would do spectacular things.”

    Then read the 2009 document: http://www.wired.com/magazine/2009/11/ff_archimedes/all/1

    ………But Eddy was an advocate of EBM and he used the best evidence he could find to challenge the status quo and pointed out when the evidence was weak or non-existent. That is what science does and what EBM is all about (and what homeopathy completely ignores), so I have no idea what point you think you were making…….

    You as usual have avoided what Dr. Eddy is saying- The goal of this movement is to pierce the fog that envelops the practice of medicine — a state of ignorance for which doctors cannot really be blamed. “The limitation is the human mind,” Eddy says.

    Eddy had built his model following a revelation. He had spent long years promoting clinical trials as the “gold standard” of medical research. But although it is better for doctors to make decisions based on clinical trial data than on instinct, trials are expensive and time-consuming. They’re also constrained by the requirement that medications be tested on carefully selected, highly specific populations (for example, diabetics who are overweight but not obese, with no past history of heart disease). Because of this, Eddy realized, trials could never fully meet the needs of policymakers who have to make sweeping decisions about patient care. Ideally, before recommending treatment protocols, you’d like to test different combinations of therapies in a variety of patients.

    So what is evidence based? In Dr. Eddy’s words: the scientific medical world is still in the prescientific medical days.

    I also saw the message where Iqbal presented negative audit results of cardiac surgery and you ask “ Don’t be silly, Mojo. If bypass ops and angioplasty don’t work, why are they so popular? Eh?” This lays out your ignorance (or double standards) about medical science.

    Let us first work out the correct reference and then we discuss your stupidity in the blog.

    Reply

  50. Avijit said:

    What is wrong about the opinion? Are you a doctor in medicine?

    My qualificationa are irrelevant, as are yours. What does matter is whether assertions are substantiated by evidence and whether arguments are valid and sound.

    …..What other call their blogs is none of my concern nor did they ask me to help them choose a name. However, I’m fascinated to learn that you think names like whatstheharm are ‘exotic’. It’s irrelevant, of course…..
    For a change you are right. The contents make them irrelevant.

    If they are irrelevant, why bother to mention them in the first place. But I’m glad you agree what someone chose to call their blog is irrelevant.

    ….Homeopathy can be derided by anyone with even a basic understanding of physics, chemistry and biology. However, if you ever spot an error in my blog, please feel free to let me know. High school science is all it takes to show homeopathy is nonsense…….
    ERROR? You have no clue what you are writing. Justifying high school science to run down medical science? You are not serious. Hold it. I believe you are serious.

    I’ll repeat: if you spot any error, please highlight it rather than waste time with lots of hand-waving insulting rhetoric about me being ignorant.

    It would be good if you met a second year student at a medical college and compared your high school science with his medical science. Do come back and tell everyone what the look he gave you was.

    I’m really not concerned what you might personally find amusing, nor does what he or she thinks of my medical knowledge relevant to the either to what the Swiss Government report says about homeopathy or, indeed, the lack of robust scientific evidence for homeopathy.

    ….I only write blog posts here (although I comment on many others – as you do), but if you spot any invalid points, please feel free to point them out. I notice you’ve not done that yet……..
    Let us get the basic rules corrected then you will see the answers.

    Yes, it’s always a good idea to get the basic rules corrected – but what rules are you talking about? You’ve not mentioned any so far.

    ….In fact many detractors do come on here (we’ve even have the great Dana Ullman making an idiotic comment, but he never returned after I corrected his wrong assertions)………..
    There you go: idiotic comment- he did not return because he would have been disgusted with the idiotic responses from a dozen stupid high school science students.

    I’m not sure why you think you know what was in the mind of Ullman or what the tone of any further comments would be. Nor am I sure why you keep trying to assert – without any evidence – that everyone only has high school science knowledge. Please try to be more specific.

    ………It’s homeopathy that’s a belief and certainly not based on robust evidence. If you have any robust scientific evidence for homeopathy, you might like to pass it on to the Swiss Government so you can save homeopathy there……..
    I have to write about the “scientific medicine system” because this is the reference you use to run down homeopathy. So first we find out the robustness of the reference system. If the reference system is irrelevant then what is your reason to challenge homeopathy?

    No. Homeopathy can be run down without reference to evidence-based medicine – it stands (or rather, it falls) on its own through the lack of any robust scientific evidence that it works and through the lack of a plausible mechanism of action. Do you have robust scientific evidence for homeopathy and have you passed it to the Swiss Government yet?

    ……You then go on to copy and paste from an article in a business magazine website…
    Have you forgotten that medical science spawns a large business area and is therefore of immense interest to business magazines. How can YOU be so dumb to this fact? You are in the same area.

    I will ask you to abide by the rules here and stop the insults.

    The automobile industry spawns a large business area and is therefore of immense interest to a business magazine, but that tells us nothing about how that business conducts itself. Nor does it tell us anything about homeopathy or the Swiss report.

    ………The figure of 15% is utterly wrong, of course. The figure of 15% comes from a small survey of GPs in the north of England in 1961 – half a century ago. Fortunately for us, much has changed in the last 50 years. But this survey was never intended to assess the degree to which GPs were evidence-based, but rather was looking at controlling prescribing costs in terms of generic versus proprietary drugs…………
    Why do you report incorrect facts? Go to http://en.wikipedia.org/wiki/David_M._Eddy and correct your reference. 50 years later nothing has changed.

    What incorrect facts? And where did your assertion that ‘Eddy liked to cite a figure that only 15% of what doctors did was backed by hard evidence’? It’s not in the article you cited or in the Wikipedia article, so where did you get it from. Do you believe it is correct and why?

    1987
    “ At the time, Kaiser was prescribing to its patients what was then a relatively new cholesterol-lowering drug, Mevacor, from Merck (MRK). “We were treating everyone who walked in the door,” recalls Dr. James Dudl, diabetes expert at the Kaiser Permanente Care Management Institute. “We thought the drug would do spectacular things.”
    Then read the 2009 document: http://www.wired.com/magazine/2009/11/ff_archimedes/all/1

    Again, that quote is not from that article, so I don’t know what game you’re playing at here.

    ………But Eddy was an advocate of EBM and he used the best evidence he could find to challenge the status quo and pointed out when the evidence was weak or non-existent. That is what science does and what EBM is all about (and what homeopathy completely ignores), so I have no idea what point you think you were making…….
    You as usual have avoided what Dr. Eddy is saying- The goal of this movement is to pierce the fog that envelops the practice of medicine — a state of ignorance for which doctors cannot really be blamed. “The limitation is the human mind,” Eddy says.
    Eddy had built his model following a revelation. He had spent long years promoting clinical trials as the “gold standard” of medical research. But although it is better for doctors to make decisions based on clinical trial data than on instinct, trials are expensive and time-consuming. They’re also constrained by the requirement that medications be tested on carefully selected, highly specific populations (for example, diabetics who are overweight but not obese, with no past history of heart disease). Because of this, Eddy realized, trials could never fully meet the needs of policymakers who have to make sweeping decisions about patient care. Ideally, before recommending treatment protocols, you’d like to test different combinations of therapies in a variety of patients.
    So what is evidence based? In Dr. Eddy’s words: the scientific medical world is still in the prescientific medical days.

    I don’t know why you’re wasting your time on this straw man. No one has said that medical knowledge has reached any kind of dizzy heights of infalibility or that it should stop. However, it has moved on leaps and bounds, particularly in the last few decades. Homeopathy on the other hand, has barely changed in 200 years and is still entrenched in the pre-scientific ignorance of the Georgian Era.

    I also saw the message where Iqbal presented negative audit results of cardiac surgery and you ask “ Don’t be silly, Mojo. If bypass ops and angioplasty don’t work, why are they so popular? Eh?” This lays out your ignorance (or double standards) about medical science.

    Methinks you completely missed my point of parody.

    Let us first work out the correct reference and then we discuss your stupidity in the blog.

    Avijit: This blog post is about the Swiss homeopathy HTA, the PEK and the actions taken by the Swiss Government. If you can spot any mistakes I’ve made, then please be specific and point them out – I will be happy to correct them, assuming they are backed up by robust evidence.

    One final warning: stick to the topic of this blog post and stop the insults.

    Reply

  51. Hi Gents,

    Thanks a lot for this very informative and highly inspirational article. Special thanks to Herr Rudloff for doing this vast job with all the analyze and documentation.
    I just “slammed” the original report in the head of a highly regarded danish homeopath (not highly regarded by me). Thereafter he completely lost the debate. Also it gave me an extraordinary chance to report the Danish Homoepathic Society to the Danish consumer-ombudsmand due to fraudulent claims on their homepage.
    Ill let you know if the ombudsmand “bites the hook”.

    By the way, this argument seems to present a dilemma for a lot of hmpts(yes, I am lazy).

    There we are: a bloke lies on the floor intoxicated by a lethal overdose of heroin, thus suffering from respiratory insufficiens that will strangle him from within. We have three remedies at our disposal of which we are only allowed to use two of them. One syringe, one bottle of Naloxone (that is proven to cure heroinoverdosis´) and one bottle of , say, 12C dilution of heroin.
    Which two remedies should we use?
    Any hmpt answering Syringe and Naloxone should then be questioned why we do not use the 12C, as it is curing like with like – and of cause why hmpt. is thus demonstrating a lack of trust in the 12C.
    Oh, hmpt might reply, we havent done the personalityassesment yet.
    Well – say the patient would have such a personality (as seen in his journal), why not the 12C then…

    And if the statement is 12C bottle:call the person a quack.

    I think you are all smart enough to find other harsh questions yourselves.

    Anyway – I am a verrrrrryyyyyy big fan of James Randi…just as I have now become a very big fan of Zeno for keeping this page “on air”.

    Oh – I am an openminded scientist, You know. Recently I decided to treat myself with a homoepathic remedy against a bout with high-strung stress.
    Yesterday, though, I forgot to take the medication – which almost instantly killed me by an overdose.

    Best Regards

    Michael Edahl, B.Sc., B.A.(merit)

    Reply
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  53. “But thanks mostly to homeopath Nancy Malik for highlighting the existence of the PEK report in the first place. Her contribution to the understanding of science and the continued lack of scientific evidence for homeopathy is duly noted.”

    Brilliant!

    Reply

  54. Mr. Michael Edahl

    ….There we are: a bloke lies on the floor intoxicated by a lethal overdose of heroin, thus suffering from respiratory insufficiens that will strangle him from within. We have three remedies at our disposal of which we are only allowed to use two of them. One syringe, one bottle of Naloxone (that is proven to cure heroinoverdosis´) and one bottle of , say, 12C dilution of heroin.
    Which two remedies should we use?…….

    In this case you start with Nux Vomica Q 10 drops in half cup of water.

    Reply

  57. Yes.

    Now, what do you think of the situation in Switzerland and what are homeopaths doing about the 2015 deadline?

    PS There’s really no need to use both my real name and my pseudonym – just the one will do.

    Reply

  59. Schulthess Klinik Zurich said:

    The Homeopathic ‘medicines’ is ever green because it has very less side defect rather than English medicine.

    1. There is no such thing as ‘English medicine’.

    2. Homeopathic products are not medicines because they have no medicinal action.

    3. Homeopathic products have no side effects because they have no medicinal action.

    Reply
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  73. Wow…are we (you…) out to bash everything and anything that is cam….? The answer is quite obvious. Have you tried anything other than chemicals to heal. I have and have done so for others…Don’t bash something unless you have proved it yourself…Which I am beyond confident you have not!

    Reply
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  78. Many thousands of board certified homeopathic physicians work throughout the world curing ailments that allopathy can still only dream of. In France a doctor needs to complete regular medical school and then study for 3-4 years extra to learn homeopathy. Homeopathic doctors understand and are trained in both allopathy and homeopathy. During the many plagues of the 19th centlury homeopathy saved many lives, all of which is documented. All that aside, any housewife and mother who has treated her children for an acute ailment knows that homeopathy works. The ONLY reason you are still debating it, is because YOU have never tried it. Since you believe it is placebo, you have no excuse for not trying it. It’s only pennies a dose. If you are a true skeptic and not just a homeopathy basher, try it and see for yourself.

    Considering that over 500 million people have used and benefitted from homeopathy, degating it’s validity is like arguing whether the the combustion engine is feasible, while there are millions of cars on the road.

    Reply

  79. If only you could provide good evidence for your claims without fallacious appeals to authority, popularity, etc, etc.

    But perhaps you’d also like to comment on the topic of this post: the Swiss homeopathy report?

    Reply
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  86. Some Homeopathy products are originated from natural substances like plants and minerals but others are not. It is very safe can cause harms if not sufficiently diluted or it is improperly manufactured and causes no side effects up to and including death.

    [Comment corrected by Admin]
    [Link to commenter’s website deleted to prevent harm.]

    Reply

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