In Five Years, the Society of Homeopaths Have Learnt Nothing

Hat tip to the Quackometer on BBC Newsnight…

 

Before they reconsider their damning response. here it is… with annotations in red

 

Society of Homeopaths does not endorse “preventative” treatment in serious tropical diseases

The Society of Homeopaths, the UK’s largest register of homeopaths with 1,500 members, does not endorse the use of homeopathic remedies with a view to preventing serious tropical diseases such as malaria and yellow fever.

This is a very misleading statement as it implies that the Society is critical of such practices. The truth is that the Society does not ‘endorse’ any particular mode of treatment within the world of homeopathy. However, the Society quite happily organises conferences on such things as the treatment of HIV and malaria with homeopathy and it supports charities which do such work in Africa. Homeopaths routinely offer dangerous advice and the Society has done nothing about it. Indeed, its statements about such matters have been deeply questionable and misleading.

The evidence to support the use of homeopathic prophylactics, that is, using homeopathic remedies as a preventative treatment, is currently largely anecdotal and therefore the use of this method is speculative.

Again a misleading statement as all forms of homeopathy could, at best, be described as ‘speculative’. Homeopathy cannot be shown to be clinically effective for any condition – and evidence for success is mostly based on anecdotal evidence. The Society tries to make out that malaria prevention is somehow a special case. It is not. Indeed the first homeopathic cure devised by the founder was for malaria.

This is entirely different from treatment by a registered homeopath in the UK. Although more research is welcomed, the balance of evidence already shows that treatment by a homeopath is clinically effective1, cost-effective2 and safe.3

This is simply untrue. The overwhelming scientific evidence is that homeopathy is an inert treatment with no specific effects. The Spence trial referenced here to show clinical effectiveness did no such thing. It was a survey of patient satisfaction at the Bristol Homeopathy clinic without control groups. Such a study is incapable of  showing effectiveness. This has been pointed out to homeopaths many times. They keep misleading people with this minor study as if it is solid evidence.  The Witt study again suffers from lacking controls and not being randomised. The third paper is meaningless as all agree that sugar pills can be safe. The dangers of homeopathy come from using ineffective treatments against serious diseases – the central point of this Newsnight programme which the Society is refusing to address

By the end of 2009, 142 Randomised Controlled Trials of homeopathy had been published in peer-reviewed journals.4 In terms of statistically significant results, 74 of these trials were able to draw firm conclusions:  63 were positive (patients given a homeopathic medicine improved significantly more than the comparison group given either an inactive placebo or established conventional treatment) and 11 were negative (no significant difference was seen between the action of the homeopathic medicine and the comparison group).

Systematic reviews of the trials of homeopathy consistently show that most trials are of poor quality and therefore are likely to mislead. Furthermore, several analyses have clearly shown that the higher quality the trial of homeopathy the more likely it is to show a negative result – entirely consistent with homeopathy being an inert treatment. Again, this is continuously pointed out to homeopaths – and they ignore it- instead trying to bamboozle with the ‘most are positive’ gambit. This is deeply misleading.

Further, 75 per cent of in vitro experiments have found that substances as dilute as homeopathic medicines have specific effects.5 For example, [h]omeopathically-prepared thyroxine can slow down metamorphosis of tadpoles into frogs.6These results were replicated by five separate laboratories in Austria and confirmed by the results of similar experiments carried out by an independent team in Brazil.7 The homeopathic thyroxine used was so highly diluted that you would not expect any molecules to be present.

This is classic cherry picking of anomalous results. Why bring up this study? Clearly one set of anomalous results does not turn over classic chemistry. Much higher standards of evidence would be required.

It is recommended that anyone interested in homeopathic treatment consults a member of the Society (they will have RSHom after their name), who has completed three or four years of training and has agreed to abide by a strict code of ethics and practice.

I would suggest people do the exact opposite of this. If you want to understand what homeopathy can do for you, do not consult a homeopath as it is quite clear that they are incapable of appraising their own capabilities.

References:

  • 1. Spence D, Thompson E and Barron S. Homeopathic treatment for chronic disease: A 6-Year, university-hospital outpatient observational study. J Altern Complement Med 2005; 5: 793-8.
  • 2. Witt C, Keil T, Selim D, et al. Outcome and costs of homeopathic and conventional treatment strategies: a comparative cohort study in patients with chronic disorders. Complement Ther Med, 2005; 13: 79-86
  • 3. Dantas F, Rampes H. Do homeopathic medicines provoke adverse effects? A systematic review. Br Homeopath J 2000; 89: 535–8
  • 4.Mathie, R. The Research Evidence Base for Homeopathy. British Homeopathic Association, 2009.www.britishhomeopathic.org/export/sites/bha_site/research/evidencesummarymay09.pdf

5. Witt CM, Bluth M, Albrecht H, et al. The in vitro evidence for an effect of high homeopathic potencies – a systematic review of the literature. Complement Ther Med, 2007; 15: 128–138

6. Endler PC, Heckmann C, Lauppert E, et al. The metamorphosis of amphibians and information of           thyroxine. In: Schulte J, Endler PC (eds). Fundamental Research in Ultra High Dilution and Homoeopathy. Dordrecht: Kluwer Academic Publishers, 1998

7. Guedes JR, Ferreira CM, Guimaraes HM et al. Homeopathically prepared dilution of Rana catesbeiana thyroid glands modifies its rate of metamorphosis. Homeopathy, 2004; 93(3):132–7

43 comments for “In Five Years, the Society of Homeopaths Have Learnt Nothing

  1. January 5, 2011 at 12:40 pm

    Reference 4 does not exist.
    I found this:
    http://www.facultyofhomeopathy.org/export/sites/faculty_site/research/evidencesummary.pdf

    Would the black duck like to give us a review of the references 1-5 cited from peer-review journals such as BMJ and Lancet? I note that the negative review (reference 5) has the most recent publication date. I haven’t time to read them myself but I should b grateful if the duck would give an opinion.

    • Mojo
      January 7, 2011 at 12:37 am

      References 1-4 were debunked several times in this (very long) thread on the Guardian website. In particular see comments by GuyInEdinburgh (15 July 2010 1:15PM), westcoaster (15 July 2010 1:16PM), Voodoo (15 July 2010 1:55PM), and apgaylard (15 July 2010 8:06PM).

      • Mojo
        January 7, 2011 at 12:39 am

        Or perhaps I should say that the interpretation of them as “positive” was debunked.

  2. Badly Shaved Monkey
    January 5, 2011 at 12:55 pm

    Posted something on this here;

    http://forums.randi.org/showthread.php?t=196687

    I loved the way Dymitr squirmed. Kirsty Wark didn’t quite hit the nail on the head as squarely as she should have done, but I think Dymitr’s body language spoke volumes.

    With respect to the SoH press release, they have managed to mangle the Fac Hom’s own version of what the literature says. In their weird world a “negative” study means one in which hom patients do less well than the controls. The SoH have this completely wrong. Mathie is quite insistent on this interpretation. What the SoH have done just looks like ignorant copying and pasting without even understanding their own party-line.

  3. Bob
    January 5, 2011 at 1:25 pm

    I wish the US still had journalists of the same calibre and tenacity as displayed here by the BBC. That said, the video turned my stomach. Apparently the professional ethics of the SoH are as watered down and undetectable as are their supposed remedies.

  4. January 5, 2011 at 1:41 pm

    Simon Singh: “The BBC are the only people regulating homeopathy at the moment because the SOH seems to be obvlivious to its responsibility.”

    Nicely put. Well done, Newsnight and Simon for another exposee of the criminal irresponsibility of the Society of Homeopaths.

  5. Greta
    January 5, 2011 at 2:19 pm

    Only had one eye on Newsnight and now confused. Simon Singh seemed to be implying that malaria cannot be contracted if you take anti malaria drugs butI have read several reports that state the opposite.There is an article at BBC News Magazine 6 July 2010 that is revealing.Didn’t Cheryl Cole take anti malaria drugs?

  6. @skepticmedic
    January 5, 2011 at 2:31 pm

    Excellent post. I wish SoH allowed comments on their site :).

    Has anyone looked at the “63 were positive (patients given a homeopathic medicine improved significantly more than the comparison group given either an inactive placebo or established conventional treatment) and 11 were negative (no significant difference was seen between the action of the homeopathic medicine and the comparison group).” claim and annotated each one of these as to the quality, size and design?

    I am sure someone must have done it. I would love to link it and tweet it before this systematic misleading gets more established.

    Thanks

    • January 5, 2011 at 9:32 pm

      I had a bit of a go at this in late 1997. I should really re-visit some time.

      • January 6, 2011 at 12:33 am

        I had a go at the claim that homeopathy is supported by “more than 150 placebo controlled studies” a few months ago. It’s basically the same old list.
        http://bit.ly/fxqVqp

        Disclaimer: I’m not medically trained
        Disclaimer#2: That doesn’t matter so much because being able to read was sufficient qualification.
        Disclaimer#3: It was Dana Ullman who made the original claim, so instead of reading my post about it just bang your head on the table a few times for the same effect.

  7. BillyJoe
    January 5, 2011 at 2:50 pm

    Greta,

    Actually, Simon Singh did not even mention anti-malarial drugs so I’m not sure how you concluded that he was implying anything at all about them.
    ON the other hand, the host did say “proven drugs” at one point, but all that implies is that anti-malarial drugs have been proven to be effective in preventing malaria. Which is correct. I don’t know how you could have read that as implying that malaria cannot be contracted if you take anti malaria drugs.

  8. DT_1975
    January 5, 2011 at 3:08 pm

    Its true that taking anti-malarial drugs don’t guarantee that you won’t get malaria, but taking the right one for the region you are in will greatly reduce the risk of getting malaria.

    Its like wearing a seatbelt doesn’t actually guarantee that you won’t be injured in an car accident, but does greatly reduce the risk of serious injury when compared to not wearing one at all.

    The problem with homeopathic anti-malarials is that they are “Emperor’s New Clothes” equivalent of a seatbelt. You’re not actually wearing a seatbelt, so exposing yourself a significantly greater risk of serious injury. And likewise you’re not actually taking an anti-malarial, so significantly increasing the risk of catching malaria.

  9. January 5, 2011 at 3:46 pm

    Congratulations Andy, another great post. Concerning the “patients making a choice” argument: This implies that homeopathy endorses free will. Well, free will is only truly when one is exposed to information that is unbiased and evidence based. The propaganda of homeopathy is quite the opposite.

    • January 5, 2011 at 4:21 pm

      The idea of “patient choice” conjures up images of a doctor offering three bottles of pills: one which makes the patient better, one which makes the patient worse and one which does absolutely nothing at all. The doctor then shuffles them around and the patient has to pick one.

      But (very importantly) because the patient was the one who chose, that’s ok. That’s “patient choice”.

      • Richard Rawlins (FRCS)
        January 5, 2011 at 11:27 pm

        I very much like this idea.

        I will use it when explaining to well meaning folk (including my MP Dr Sarah Wollaston) how unacceptable the idea of “patient choice” is when dealing with NHS funded health care.

        Actually, an ethical doctor should not offer any pill which might make matters worse.

        Two choices would do:

        “Please choose pills in a bottle with a blue label, or one with a red label. One contains drugs known to be pharmacologically active and which I recommend. One, pure water. Your choice. Even I don’t know what is in each bottle, but I have a code which we can open later when you are better. Or worse.”

        There are actually doctors who behave like that when they refer patients to homeopaths, or practice homeopathy on their own account. Except they tell the patient the inert bottle “might” (even “will”) help them and lay on the placebo inducing effects for all their worth. (Dressing up as doctors, consulting in a “clinic”, even a “hospital”, claiming support from celebrities – never mentioning the many thousands of celebrities who do not approve etc. etc.)

        And what does the GMC do about it? Nothing.

        So don’t expect SoH to regulate its practitioners any better than the GMC regulates doctors.

  10. January 5, 2011 at 3:47 pm

    correction :” is only truly free when one..”

  11. Greta
    January 5, 2011 at 4:21 pm

    BillyJoe

    Fair enough, I wasn’t concentrating.It appears that there is nothing one can do to guarantee a malaria free trip which is what I originally thought.The threat of malaria is actually putting me off re visiting Africa and ‘proven effective’ but you can still get it seems illogical.

    • BillyJoe
      January 6, 2011 at 2:16 pm

      If she had said “proven 100% effective” I would agree, but she didn’t, she said “proven effective” and it has been “proven effective” in the prevention of malaria.

  12. Tim
    January 5, 2011 at 4:39 pm

    SoH endorses choice.
    Well, OK, maybe, for adults but what if adults are making such choices for children or infants travelling to disease riven places.

    Could one argue that the parents are responsible for at least negligent behaviour if the child falls ill. In analogous situations, parents have been prosecuted for ignoring or refusing medical advice.

    It would be interesting to see such a case with the parents and the SoH person in the dock for manslaughter.

    • January 6, 2011 at 12:14 am

      The ethics of treating children with homeopathy is something that the Society of Homeopaths has virtually no grasp of. It is important to remember that homeopathy enjoys no legal recognition as a medical practice. It is not, in the eyes of the law, “appropriate medical aid”.

      Yes, parents whose child was killed/harmed by reliance on homeopathy as primary care could be prosecuted for neglect or even manslaughter. I’m aware of several UK cases – google Nakhira Harris. But it is unlikely that a homeopathy would face criminal proceedings, however culpable – it would be a matter for the civil courts.

      Many of these “homeopathic vaccines” are unlicensed medicines – it largely depends on who manufactures them. Certainly, if Ainsworths manufacture the ones they sell, they are unlicensed medicines. There are all sorts of regulatory issues with unlicensed medicines. If a customer is killed/harmed as the direct result of a unlicensed medicine provided by a pharmacist, there are liability and professional conduct issues.

      Both are complex subjects.

  13. January 5, 2011 at 6:08 pm

    @Greta

    To say that ‘anti-malarial drugs have been proven to be effective in preventing malaria but you can still get it’ isn’t “illogical”. It just means they’re not 100% effective.

    I’m sure if you do some research using reputable sources – rather than picking up things you thought people implied from programmes you weren’t concentrating on – you’ll find the information you need to enable you to make an informed decision.

    Just avoid any quack websites.

  14. Pod3
    January 5, 2011 at 9:10 pm

    I lived in W Africa for over 10 years as a child. I took both a daily and a weekly anti-malarial prophylactic.
    Although I SUFFERED several times from malaria it never killed me (which it probably would have done otherwise).
    Thank God my parents (missionaries) didn’t rely only on the power of prayer (or homeopathy) for our protection.

  15. Exdoc
    January 6, 2011 at 1:17 pm

    Have I read this correctly? They report that there have only been 150 RCT in homeopathy in peer review journals.

    It has been around for 200 years. What have they been doing all this time?

    If I was running the SoH I would be ashamed by this lack of interest shown by homeopaths to do research in their own field. I certainly would not publicise it.

  16. January 6, 2011 at 1:40 pm

    As Le Canard Noir has just pointed out on Twitter, the SoH have changed their statement ever so slightly…

    Original version (as above)

    Changed version

  17. January 6, 2011 at 2:07 pm

    I notice that the revised statement cites the Cuban Leptospirosis study, where homeopathy plus basic prevention advice was doled out and the situation got better.

    Orac kicked this into touch pretty conclusively back in November. http://bit.ly/forJz2

    • Mojo
      January 6, 2011 at 5:06 pm

      Not forgetting, of course, the conventional medication that was targeted at hugh-risk groups.

      Apgaylard also covered it rather well here.

      • Badly Shaved Monkey
        January 6, 2011 at 10:45 pm

        I’ve emailed the SoH asking some simple questions in relation to their new press release.

        I can get to be quite annoying if people don’t reply in a timely and professional manner.

        I’ll let you know what, if anything, they say.

  18. notarealdoctor
    January 7, 2011 at 1:09 pm

    Comment on “freedom of choice”. It is a common trick of quacks to emphasize the consumers right to choose, as if it would free the provider of the service or product from any responsibility. What they really are protecting is the freedom to sell services that do not work as promised or are possibly even harmful. On a sidenote, the alcohol and tobacco industry is granted the same privilege, and their products are taxed for it.

    I can make a choice between jeans and khakis, but certainly can’t choose which treatment is best for a illness. That’s why we have real doctors. Homeopaths are pretending to be doctors handing out prescriptions, and you get the homeopathic remedy from the same place as you would get a real medicine. It is all about the freedom to mislead the consumer, not freedom of choice.

    • pv
      January 15, 2011 at 1:23 am

      You can choose between two boxes labelled “cornflakes” – one that actually contains cornflakes, and one that contains nothing. But you aren’t allowed to know which is which before you purchase.

      The choice as far as homeopaths go is similar. Medicine that actually contains medicine, and “medicine” that contains nothing at all.

      Of course the cornflake choice becomes apparent after you’ve opened the box. The homeopathic one is simply deceitful.

      • JimR
        January 15, 2011 at 3:31 am

        Another view is a homeopathic med is like the box with Schrödinger’s cat (http://en.wikipedia.org/wiki/Schr%C3%B6dinger%27s_cat). That experiment is a thought experiment, so the choice is I will get well or I won’t get well, but you have no a priori knowledge, which you would if you use a system based on evidence. If the NHS pays for your experiment then you are not out any money for the experiment, just prolonged illness, or death in some of the more egregious cases such as Africa.

        Our philosophy is foundation based. It requires a basis for an assertion. Absent that, I cannot even communicate with you about anything and will ignore claims that are hollow. The entire structure of alt med is hollow, without a foundation.

        There is a great piece in the NYTimes about the common misapplication of statistical significance. (http://www.nytimes.com/2011/01/11/science/11esp.html?_r=3) I suspect even the few near “proofs” of alt med will fail if subjected to a proper Bayesian look see. So “poof” all the “Proof” becomes more of the smoke in this smoke and mirrors game.

  19. January 9, 2011 at 1:56 am

    Returning the title of this blogpost… I suspect that someone did a follow up on this in a couple of years time nothing would have changed. The homeopathic trade associations are not amenable to change.

  20. Dusty
    January 11, 2011 at 8:56 am

    I have always been sceptical about the claims of homeopathy,not that Ive thought about it much or done any in depth study.However my dentist gave me homeopathic pain relief recently & it worked a treat.Now, even though I have never visited a homeopath before I am considering giving it a go for my hayfever which is mild but annoying at times.Any advice appreciated.

  21. Richard Rawlins (FRCS)
    January 11, 2011 at 3:36 pm

    I have just waved my hands in your direction and the etheric vibrations of the occult force are even now entering you and stimulating your immune response to react to allergens , but less so. You will be better by next summer.

    No charge, but you must report the outcome please, preferably by a Lickert questionnaire which I append below.

    “Dr Rawlins Etheric Vibrations have benefited me.”

    Agree whole heartedly: 5
    Agree: 4
    Neither agree nor disagree: 3
    Do not agree: 2
    Totally disagree: 1

    Thank you, and may the vibrations be ever with you.

    Dr Richard Rawlins
    Consultant Charlatan
    Specialist in the care of the Gullible

    • Mojo
      January 11, 2011 at 6:55 pm

      You have too many options in your questionnaire; it should look like this:

      “Dr Rawlins Etheric Vibrations worked for me.”

      Yes: 1

  22. Dusty
    January 12, 2011 at 12:17 am

    Thanks Dr Rawlins(FRCS) for your kind wishes & generous ministrations.Even though far away in Australia I feel the benefit,& it is immediate – wont have to wait till next summer at all.Yea! All fixed! By the way,as a snide aside (oh poetry!)do they actually have summers in England?Ha ha.
    Just a bit of fun there.Please people at Quackometer get a life! Why so obsessed with homeopaths?Is modern orthodox medicine the only’true’ medicine just as Christianity is the only ‘true’ religion?Come on theres room for all beliefs & philosophies in this world.As I said I am not particularly convinced about homeopathy but have an open mind & will give it a go.If my condition is cured or even mollified(yes I will be happy with mollification)this will be a good outcome.
    I must say Prince Charles is a particular favourite of mine,even though I am an Antipodean Republican.He looks great for his age,doesnt he.So does the Queen.Yes they do have good genes as well.

  23. Le Canard Noir
    January 12, 2011 at 12:59 am

    Hello Dusty

    Indeed, there is room in this world for many beliefs and philosophies, although, when it comes to health care I would suggest that it is prudent to ensure your beliefs correspond closely with reality. Otherwise, you are likely to make very bad choices.

    And there are many sorts of medicines too. But homeopathy is not one one of them – it is a pseudomedicine based on superstitious thinking, and when people chose it over real medicine, they may well harm themselves. That is why it is worth debating the issues and raising awareness.

    • Richard Rawlins (FRCS)
      January 12, 2011 at 10:13 am

      1. Minds should not be so open that their owners’ brains fall out.

      2. Yes we do have summers in England. This year it is expected on July 13th! Let’s hope it lasts all day.

      3. If you “give it a go” and your hayfever is “cured or mollified”, how are you going to know that it was the homeopathic remedy wot done it, rather than “Dr Rawlins Vibrations” which have already been sent to you? (Gratis).

      4. As for HRH PC and HM the Q: How much healthier would they be if they shared the scepticisim of most readers of the Quackometer?

      In the UK, Homeopathy presents a particular problem in that its proponents press for public funds and resources from the NHS to be used for their particular brand of non-scientific ‘medicine’. Thus wasting scarce NHS resources, indulging the whims and fancies of folk who clearly do not understand the role of evidence based medicine, and misleading many patients who do not fully appreciate the principles behind Homeopathy. Homeopathy is valuable as an alternative for those folk who want an alternative (to rational medicine), but the tax payer should not have to pay for it. (BMA policy 2010).

      • Dusty
        January 13, 2011 at 2:00 am

        Thanks black duck and Dr Rawlins for your replies and for the time you both took to offer your advice.
        Integrative medicine is the system I would support so Im not sure we are on the same wavelength but, no matter, we all just want the best outcomes possible.
        Was not aware of how UK NHS works but in OZ I think private health insurance covers alternative therapies.I dont think public monies are allocated to other than mainstream medicine.
        Just a comment re your banner heading for your site.Do you really want to cure all known nonsense? I love nonsense! What about the Goons,Little Britain,The Vicar of Dibley.I could go on forever.Britain was built on a love of nonsense.Nonsense verse made me giggle uncontrollably as a child.Laughter is the ‘best’ medicine after all.

      • Badly Shaved Monkey
        January 15, 2011 at 11:56 am

        Dusty, if I was an Australian healthcare user, why should I have my insurance premium inflated by those who are insured by the same company and who contract to use batshit insane therapies like homeopathy?

  24. pv
    January 15, 2011 at 1:43 am

    Wot is “integrative” medicine, if not a weasel expression. Integrating what, exactly?
    I do feel also the word “alternative” has been shitted on to death by what are really promoters of alternative reality reality. An alternative implies something of equal efficacy and value which isn’t what is actually being provided.

    There are some maladies where the alternative to real medicine is death. There are others where the alternative is crippling disablement. These illnesses are called non-self-limiting because without medical intervention the patient tends not to recover. Homeopathy is precisely useless in this case and there isn’t a single recorded incontrovertible case on homeopathy curing a non-self-limiting illness. Not in 200 years of “meticulous” homeopathic record keeping. I would suggest in fact that as medical records go homeopathic records are much like homeopathic medicine – totslly devoid of any meaningful substance.

    There are still others though where doing nothing is a reasonable alternative to medicine, and these are called self-limiting illnesses. These are the ones where alternative reality therapies and “medicine” score well, because no intervention is required and no intervention is actually performed. Homeopathy is an expensive way of doing nothing.

    Homeopaths = deluded fools and charlatans.

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