The most common claim from homeopaths is that they have all the evidence they need that homeopathy works and that Ernst and Singh are not trained enough, too biased or have not done their research.
It looks like the two are now putting their money where there mouth is and asking homeopaths to show that their assessment of homeopathy is wrong.
Their challenge is as follows:
We challenge homeopaths to demonstrate that homeopathy is effective by showing that the Cochrane Collaboration has published a review that is strongly and conclusively positive about high dilution homeopathic remedies for any human condition.
Or, we challenge homeopaths to have such a review published within 12 months of the first publication of extracts from “Trick or Treatment?” (8 April, 2009).
The Prize will be £10,000 – it will be paid by Ernst and Singh out of their own pockets to the first person or persons to present such evidence.
Despite the challenge only being a day or two old since the Daily Mail broke the story, the excuses for ignoring the challenge are already being discussed on homeopathic sites and message boards. Of course, James Randi has for many years offered a much bigger prize to anyone who can demonstrate real homeopathic effects. This challenge it rather different. It is directly asking homeopaths to show that Ernst’s research is incomplete or wrong and that his summary of this research with Simon Singh is incomplete, cherry picked or misleading. Put up or shut up.
What we can expect now from homeopaths, based on recent form, is a whole range of bluster, insults and excuses. I would like to try to tackle some of the excuses homeopaths will use to ignore this challenge based on their responses to both Randi’s challenge and the new Ernst and Singh challenge.
1. Homeopathy has been used successfully for 200 years. We have no need to prove anything.
Has it? The evidence for this is very weak, based mainly on anecdotal evidence. There is anecdotal evidence that bloodletting and voodoo dolls work too. A modern society with a publicly funded healthcare system should expect a little more.
2. Trials have show that it works for animals and babies who cannot experience the placebo effect?
Have they? Where are the high quality trials on animals and babies that show this? There are many poor quality trials that do not blind practitioners and animal owners and so reporting biases can easily creep in. The placebo effect is not the only way you can be fooled into thinking a treatment works.
3. Conventional trials are not suitable for the ‘individualised’ approach of homeopathy.
That is not true. Many individualised trials have been conducted, e,g, see Linde 1998.
4. Critics cherry pick negative trials and ignore positive ones.
Well that is what this trial is about. If you can show this to be true, then the prize is yours. Critics do not ‘ignore’ positive trials, they ignore poor quality trials – which just happen to be positive more often than not. Poor quality trials provide highly unreliable evidence.
5. ‘What is needed is more investment in homeopathy research, not facile enticements by scientists who should know better.’ (Robert Mathie, of the BHA)
There have been over 200 trials of homeopathy to date. The results are not good as Ernst and Singh show. What would you expect more research to show?
6. Homeopaths do not have the money to conduct trials.
An hour browsing Cochrane could prove Ernst wrong. Failing that, any of the academic homeopaths out there could do their own literature review and publish it. The challenge does not ask you to conduct vast, expensive trials – just show how the current evidence supports homeopathy.
7. Yes but, homeopaths do not have the money to conduct good trials.
But many trials have been done. In most cases, simple changes could have vastly improved their quality. And lots of homeopathic money is out there. Boiron is a half a billion dollar company. It spends 18.5 times as much on advertising as it does on research. (Pharmaceutical companies, on average, have a 2 to 1 ratio). Boiron’s absolute research budget is near non existent. Budget is not the factor – it is the will to do good tests that is lacking.
As a side note, my own challenge would only cost around £50 and after six months, all I have had is excuses.
8. Why the Cochrane review? Aren’t they biased towards pharmaceuticals?
The Cochrane Collaboration is completely independent of any pharmaceutical company and forbids contributors from accepting payments. Its reputation rests on its integrity and high standards. Cochrane does publish reviews of homeopathy, e.g. asthma.
9. This is a fraud / stunt / Ernst will never pay out.
The easiest way to prove this is true is to claim the prize and make it public. If your claim matches the simple conditions then homeopathy wins. If Ernst and Singh fail to pay then you will be vindicated and their reputations diminished.
10. Ernst should be promoting homeopathy, not knocking it.
Ernst is a Professor of Complementary Medicine and is paid to critically appraise the evidence for homeopathy and other practices. He is not paid to uncritically promote such things.
11. “The real problem here is Ernst’s and Singh’s attempt to use a tool of conventional medicine to study alternative medicine.” (Lynne McTaggart)
Meta analyses and randomised and double blind trials are not tools of ‘conventional medicine’. These are general experimental and statistical techniques that make no assumptions about what they are applied too. Indeed, the medical profession fought for many years against the imposition of such techniques on their authority. Homeopaths still do so.
12. Most trials of homeopathy show a positive result.
You are doing your own mini meta analysis here. But your technique (counting positive trials) ignores the negative trials and fails to weight each trial according to its quality. When you do this, you see that poor quality trials tend to come out in favour and high quality trials do not – exactly what we would expect if homeopathy were a placebo therapy. If you can show that high quality trials consistently show positive and strong effects for homeopathy then you bag the money.
13. £10,000 is not a persuasive amount for me to bother.
I am glad you do not think so. Homeopathy must be very lucrative. An hour’s work could win the prize.
14. “We have nothing to prove…” (Steve Scrutton of the Alliance of Registered Homeopaths)
And yet you feel it is OK to provide a health care role to people who may be very ill and you are prepared to offer advice to people who may face serious health risks. Frankly, attitudes like that make we want the government to ban unlicensed medical practitioners and I am not one for heavy handed legislation.
15. “…especially to people with closed minds” (Steve Scrutton of the Alliance of Registered Homeopaths)
I am not sure what is closed minded about asking people for evidence. Real close mindedness is displayed by homeopaths who cannot contemplate being wrong.
I will add more as they come forth…
Homeopathic treatments could easily be subject to a double-blind randomised trial which would not affect the homeopaths connection with their patients.
When there’s lack of will there’s lack of way I guess.
Excellent. I think this could prove to be a useful resource.
To ellazimm: indeed. In fact, such trials have been carried out.
Don’t forget the original pv homeopathy challenge: Give one incontrovertible example, with references, of a non-self-limiting condition being cured by homeopathic treatment.
Under point number 4, I think you meant to write that critics do not ignore *positive* studies.
Thanks Linda – corrected.
“Trials have show that it works for animals and babies who cannot experience the placebo effect”
Neither can they report that their condition has improved. On the other hand administering a placebo will probably make their owners or parents feel better about their condition.
OK OK!!!!!!An energy healer in Wexford, Ireland has cured many people in one session…FACT!!!Including 50 students from one local school in Kilkenny!! I will personally drive you to Wexford and you can see the results for yourself….10,000 sterling please???
Don’t you just love FACTS!!!!
Also, regarding point 2, don’t forget the “mummy kiss it better” effect.
Regarding the placebo effect in veterinary homoeopathy, here’s an interesting comment from Lionel Milgrom:
“If that is the case, then perhaps you have to consider the owner and the animal as an entangled entity. Ergo if you gave the remedy to the owner, would it have the same effect? I was giving a talk down in the South West recently and apparently there is a vet down there who works in that way, which I find absolutely fascinating. I would love to talk to that person.”
As long as the owner believes that taking a remedy themselves will improve the animal’s condition, the placebo effect will come into play here.
Addendum: by which I mean that the owner will tend to feel better about the animal’s condition, of course, not that the animal itself will benefit from the placebo effect.
Good post. On the topic of placebo response and animals, some researchers argue that a placebo response can be the result of classical conditioning.
Classical conditioning was famously demonstrated by Pavlov and his salivating dogs. Later, other researchers apparantly exploited the fact that dogs naturally salivate after receiving morphine; after a few morphine injections the dogs became conditioned to the needle and salivated from any injection. This is, of course, very similar to a classic human placebo: saline injection.
There is also evidence for the placebo supression of the immune system in mice.
Aside from the effect of treatment on owners, the single blinding that is often seen in animal woo studies; the assumption that animals themselves don’t have a (conditioned) placebo response is highly questionable.
[Source: Bausell, R.B. Snake Oil Science – The Truth About Complementary and Alternative Medicine pp. 130-135]
“If that is the case, then perhaps you have to consider the owner and the animal as an entangled entity. Ergo if you gave the remedy to the owner, would it have the same effect?”
If this is the case it makes me wonder why all homeopaths don’t work this way – just get ‘entagled’ (ahem) with the ‘patient’ and take the ‘remedy’ on the patient’s behalf? More ad hocery from the Master.
More genius from milgrom.
Does he get up early so that he can practice believing impossible things before breakfast?
Having said that – my bastard cat has such long hair, I am in a constant state of entanglement with it – and so is my furniture, clothes and carpet.
I can’t believe Milgrom is serious about that – I look forward to reading about this idea in his next paper.
But it just occurred to me, regarding Anonymous’s “energy healer in Wexford!!!!!”: since when was homeopathy anything to do with energy healing? The only thing they have in common is that neither of them actually work.
WHY IS THE TREATMENT OF ANIMALS BOTH BY HOMEOPATHY AND RADIONICS SO SUCCESSFUL.ASK ANY LEADING HORSE TRAINER IF THEY USE THESE METHODS.
See above, and note that there are very few published RDBPC trials of veterinary homoeopathy, and none that show that it works.
Oh, and press the caps lock key on your keyboard (once only) before posting again.
shpalman: “But it just occurred to me, regarding Anonymous’s “energy healer in Wexford!!!!!”: since when was homeopathy anything to do with energy healing?”
Homoeopathy is often claimed to be “energy medicine” (when it’s not being “quantum” or “memory of water”, or whatever). See an example (RSHom, by the way) from the first page of a Google search:
Of course, the term “energy medicine” doesn’t really mean anything…
Thankyou Mojo,very enlightening,I shall pass it on.(caps unlocked)
Just about everybody in the UK must now have heard the relentless placebo arguement against homeopathy. If it is just placebo then surely homeopathy will now rapidly decline? If after all this adverse publicity homeopathy continues to be used by millions then maybe there is more to this placebo story.
Perhaps not – I think it has been demonstrated before that the placebo effect seems to work even if the receiver of the bogus intervention is aware that the treatment contains no active substance or useful methodology (can anyone remember that study?)
But I’ve heard it is true that an outright negative attitude to a treatment can seem to have the opposite effect to placebo, i.e. reduce the interventions effectiveness.
*maybe there is more to this placebo story*
well, astrology has been debunked consistently for years and yet remains popular…their argument being that a negative result proves nothing, because what they do is ‘beyond science’…. I suspect the same mechanism might keep homeopathy going for a while longer…
Over 20 years ago I was seriously into astrology and I was doing a horoscope for a work collegue, Whilst I was doing the chart, she had an accident and ended up in a wheelchair. There was nothing in her chart to indicate anything like happening at all. I consulted with some other astrologers and none of them seemed bothered by this and one of the explanations given to me by another astrologer was that “the stars may not choose to alwyas reveal their secrets”. I pointed out to him that rather undermines all of astrology, as how could you be sure about anything? I concentrated on astronomy which is much more interesting.
Homeopathy on animals: The placebo effect is still at work but not on the dumb animal. Bill.
Please read http://www.ncbi.nlm.nih.gov/pubmed/12963976
Also Read NIH articles: http://www.ncbi.nlm.nih.gov/pubmed?term=Banerji%20P%5BAuthor%5D&cauthor=true&cauthor_uid=12963976
And what is it about those you find convincing?