As promised, I emailed the authors of that Cochrane Review of homeopathy for reducing the side effects of cancer treatment. I asked them to clarify why they had included the Pommier et al trial of Calendula ointment - a decision which attracted some criticism. Their (very prompt) response included this statement:
"...We contacted the manufacturer of the calendula ointment and they confirmed that it had been prepared in accordance with the German Homeopathic Pharmacopoeia, therefore the trial met our inclusion criteria..."Which is a reference to the inclusion criteria as set out in their paper, i.e.:
Homeopathy (also spelt homoeopathy) was defined, for the purpose of this review, as the use of homeopathic medicines prepared in accordance with officially recognised homeopathic pharmacopoeias. Where there was doubt about the classification of the medicine, we contacted authors or the product manufactures for confirmation. Any homeopathic prescribing strategy was included (pp. 3-4).So it looks like the debate over the inclusion of this trial boils down to a difference of opinion over the definition of "homeopathy". Critics (myself included) who questioned the inclusion of this trial did so because we hold a rather narrower concept of "homeopathy" than the authors do. Of course, there is no right or wrong definition of homeopathy - no-one holds a trademark on the term - so I think that this is where the debate is going to have to rest.
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18 comments:
There is a fundamental point here though that is important and that is that homeopaths themselves cannot agree what homeopathy is. There are various schools and methods that are quite in opposition to each other. For example, the mouth wash used in this study is a combination remedy which is distinctly 'unclassical' and frowned upon in some quarters. Importantly, it is also not 'individualised' which is a corner-stone to many.
This is not a trivial point because it demonstrates that homeopathy is a pseudoscience because there is no mechanism for resolving which of these various views is correct. Standards of evidence are non-existent. You will not see homeopaths changing their prescribing methodology because of this review. Evidence is only for sceptics of homeopathy. Real homeopaths 'know' what works.
And this is the deceitful thing about this Cochrane review. No-one - sceptics or homeopaths - would claim that dilute homeopathic remedies (as the vast majority practice) can cause side effects (the stated purpose of the review). The real purpose of this review was not to show evidence for this, but to put homeopathy in the news - especially good for the Royal London Homeopathic Hospital, whose staff conducted this review, because their very existence is under threat. The inclusion of very un-homeopathic like creams looks like a classic 'bait-and-switch'. Put a cream in that may well work and then allow people to draw the conclusion that the 'methods' of homeopathy actually work. Deceitful nonsense.
I would love to research exactly by what process "homeopathic" calendula ointment is made, unfortunately the German Homeopathic Pharmacopoeia is outside my budget (>$400) for casual inquiry.
I now see the failure of the alchemists. It was not that they could not turn lead into gold, it was that they failed to create international standards for the process. Anyone knows that if there is a international standard for something, then it must be true.
LCN: No argument there. But this kind of thing is not really that unusual, I think. In this case the author's financial and professional interests in making the review give the "right" conclusions were especially obvious. But few people would commit the time and energy to doing a Cochrane review if they didn't have some such interests. It's hard work. An important lesson of this affair is that meta-analyses are no more "scientific" than any other study. They can be as biased as anything else. I think there's a tendency to overlook that by EBM fans.
Interestingly, with regard to "contacting the manufacturer" being included in the review criteria:
"Differences between protocol and review
...
Where there was doubt about the classification of the medicine, we contacted authors or the product manufactures for confirmation."
http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD004845/sect0.html
Well spotted, Mojo. It's always worth reading to the very end of papers.
That doesn't look good, does it?
Someone has managed to track down the protocol as at January 29th:
http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/rel0001/CD004845/pdf_fs.html
On page 3: "Homeopathy (also spelt homoeopathy) is defined, for the purposes of this review, as the use of homeopathic medicines prepared in accordance with nationally recognised pharmacopoeias. Where trials do not report this information, we will contact authors for confirmation. any homeopathic prescribing strategy will be included."
So it's just the words "or the product manufacturers" that were added for the actual review. Possibly the authors couldn't be contacted for some reason? It would be interesting to know - I'm sure it's more usual to contact the authors of a paper.
That's unlikely. I mean a large team of researchers (Pommier et al was 6 people) don't just disappear and become uncontactable. Not even in France.
I suspect it's more likely that they were uncooperative. Remember that Pommier et al made no mention of homeopathy in their paper. They probably wouldn't have been very keen on a Cochrane review which refers to their study as a homeopathy trial!
Homeopathy cures even when Conventional Allopathic Medicine (CAM) fails
Yes! I've finally been visited by the famous Nancy Malik, who has posted that exact comment to dozens, maybe hundreds of sites!
Homeopathy is the evidence based modern medicine for the 21st century
http://www.hpathy.com/papersnew/milgrom-homeopathy-fundamentalism.asp
Thanks Nancy. But Dr Milgrom does not appear to be fully familiar with the English language. He writes "New Fundamentalism’s hallmarks include the denial of evidence for the efficacy of any therapeutic modality that cannot be consistently “proven” using double-blind, randomized controlled trials."
I think by "New Fundamentalism" he means "Science". The connotations in English are slightly different. If you know Dr Milgrom I'd be happy to provide English-language proofreading services for his future papers, free of charge.
Evidence-based modern homeopathy is the scientific revolution (fastest growing medicine in the world) in the 21st century
Homeopathy is non-toxic system of medical science originated in Germany by Dr. Friedrich Samuel Hahnemann (1755-1843) (the founder and father of homeopathy). He was M.D. in conventional medicine. The term “homoeopathy” was coined in 1807.
The four fundamental principles of Homeopathy are: -
1. Law of similars/Like cures like (1796): Disease can be cured by a medicinal substance given in micro doses that produces similar symptoms in health people when given in large doses.
2. Law of minimum dose (1801): Since the homoeopathic medicines act at a dynamic level, only a minute quantity of the medicine is administered which is enough/sufficient to stimulate the dynamically deranged vital force/innate healing powers to bring about the necessary curative change in a patient
3. Law of simplex (1810): At any given time, only one remedy can be the exact similar to the presenting disease condition of the patient. So a single remedy (one remedy at a time) is given based upon their constitution/totality of the symptoms which includes physical, mental, and emotional aspects/symptoms.
4. Hering’s law of five directions of cure (1845): Cure progresses from above downwards, from within outwards, ceter to periphery, from more important organ to less important one, in reverse order of coming of the symptoms
It's "homeopathy" not "homoeopathy", Nancy.
You can buy Homeopathic medicines online at Boots UK http://www.boots.com/en/Pharmacy-Health/Complementary-Therapies/Homeopathy/
So, Nancy, you agree then that the controvecially "homeopathic" product described in the article isn't actually homeopathic?
If so, I am amazed, because it means we are in agreement about something!
130+ studies in support of homeopathy medicine published in 45+ peer-reviewed international journals
Medicines for specific disease conditions, Ultra-molecular dilutions, Structure & Memory of Water, Animal Studies, Plant Studies
http://knol.google.com/k/dr-nancy-malik-bhms/scientific-research-in-homeopathy/pocy7w49ru14/2#
Will you ever stop?
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