{"id":799,"date":"2007-11-08T18:30:00","date_gmt":"2007-11-08T18:30:00","guid":{"rendered":"http:\/\/www.quackometer.net\/wpblog\/2007\/11\/dr-elaine-weatherley-jones-you-and-yours-and-me.html"},"modified":"2007-11-08T18:30:00","modified_gmt":"2007-11-08T18:30:00","slug":"dr-elaine-weatherley-jones-you-and","status":"publish","type":"post","link":"https:\/\/www.quackometer.net\/blog\/2007\/11\/dr-elaine-weatherley-jones-you-and.html","title":{"rendered":"Dr Elaine Weatherley-Jones: You and Yours and ME"},"content":{"rendered":"

\"\"<\/a>Radio 4’s You and Yours<\/em> programme has been running a series<\/a> on Chronic Fatigue Syndrome\/ME. Today saw the last in the series and concentrated on ‘alternative treatments’ for patients who do not get ‘satisfaction’ from their GP.<\/p>\n

ME is a quack’s dream. It does not have a specific set of diagnostic criteria – it is what left when all other possibilities have been ruled out – follows a cyclical pattern of symptoms, and tends to get better on its own. Kerching. As such, the Radio 4 programme explored the full zoology of quack therapies for ME, including reflexology, nutritional therapy, mickel therapy and, of course, homeopathy.<\/p>\n

The first homeopath to be interviewed was Dr Susie Rockwell, who is an NHS GP, but also runs her own private homeopathy clinic<\/a>. She points out on her website the rather confusing contradiction,<\/p>\n

I advise on management and treatment according to NICE guidance. This guidance does not support the use of complementary therapies in CFS\/ME as there is currently insufficient evidence for their use. However a wide range of complementary therapies have been tried in CFS\/ME and I can advise about which may be useful and how to access them.<\/p><\/blockquote>\n

<\/p>\n

Given their is insufficient evidence to support homeopathy for ME, one has to wonder how the doctor is able to offer ‘useful’ advice. However, Dr Rockwell charges \u00a3110 for a session, and then, as she says on the BBC interview, waits two or three weeks for the customer’s symptoms to improve. Everyone can then go home happy that the ‘subtle effects’ are due to her intervention.<\/p>\n

Now as most ME sufferers will seek alternative help like this at one of their lower points in their illness, ‘subtle effects’ towards improvement may well take place over a few weeks. It’s called regression to the mean<\/em>. Dr Rockwell’s assertion that she sees her patients getting better is no evidence that it is anything to do with homeopathy.<\/p>\n

One person who has made an honest attempt to improve the evidence base for homeopathic treatment for ME is Shefield University psychologist Dr Elaine Weatherley-Jones. <\/p><\/div>\n

Dr W-J appears on the programme to discuss the results of trials into homeopathy as a treatment for ME. She appears somewhat more upbeat than she has done writing about this elsewhere. By all accounts, it was a well conducted trial that was properly blinded and conducted with a rigorous statistical analysis, albeit on a relatively small number of patients.<\/p>\n

Dr Weatherley-Jones obviously had high expectations of the trial as she ‘aimed to find a strong clinically significant effect’. Unfortunately, the trial did not yield a strong significant effect. On most measures<\/a>, there was no significant difference between the placebo group and the homeopathicly treated group. Overall though, “there is weak but equivocal evidence that the effects of homeopathic medicine are superior to placebo. ” Hardly, the ringing endorsement the researchers were looking for. And as DR W-J admits, “further studies are needed to determine whether these differences hold in larger samples. ” It is highly likely that this is just a statistical anomaly.<\/p>\n

But, given the very disappointing nature of the trial, does Dr Weatherley-Jones admit that homeopathy may not be the wonder treatment for ME? Of course not, its the trial that was the problem. I think her words<\/a> speak for themselves, (it is worth quoting at length)<\/div>\n

\n

Since completing and reporting on this study, I have reflected on and researched the relevance and appropriateness of the design of this study for investigating homeopathic treatment. (…) At the time of designing this trial, I believed the triple\/double-blind placebo randomized controlled trial fit these criteria. <\/p>\n

In retrospect, however, it is clear that the presence of a placebo arm in a study of homeopathic treatment can compromise the practice of homeopathy. In a further paper, colleagues and I conclude that \u201cIt is not reasonable to assume that the specific effects of homeopathic medicine and the non-specific effects of consultations are independent of each other\u2014specific effects of the medicine (as manifested by patients\u2019 reactions) may influence the nature of subsequent consultations and the non-specific effects of the consultation may enhance or diminish the effects of the medicine.\u201d and that \u201cFor clinical trials of homeopathy to be accurate representations of practice, we need modified designs that take into account the complexity of the homeopathic intervention.\u201d. <\/p>\n

It is probably the case that the results of the CFS\/ME homeopathic treatment trial were influenced by the existence of a placebo arm in the study. (…) They are also a possible explanation why only small effects are seen in placebo-controlled trials of homeopathy. <\/p>\n

Whilst placebo-controlled trials of specific homeopathic remedies are valid, it is time to halt the misguided task of conducting placebo-controlled RCTs to test efficacy of individualized treatments; to redirect our energies to analyses of whole-systems health care and to design more relevant and meaningful pragmatic studies of comparative effectiveness, where untested treatments are compared to those where there is evidence of effectiveness.\u201d <\/p>\n<\/blockquote>\n

Now, quite what this means, I am not sure. Somehow, having a placebo buggers up the positive effects of the homeopathy. How, I do not know. From her writings, I am not sure that Dr W-J knows either. What I do not understand is that Dr Weatherley-Jones appears to have questioned <\/a>the randomised controlled trial as a method before the ME trial was published. Why take part in a trial if you think the method is ineffective? What would she have said if the trial had been positive?<\/div>\n

<\/p>\n

<\/div>\n

<\/p>\n

For Dr Weatherley-Jones, the ‘truth’ that homeopathy works appears to override all else. When the science fails to show this, it must be the scientific method itself that is wrong. There is no hint of questioning whether homeopathy might not be anything other than a placebo. Now I wouldn’t mind too much – ME is not fatal, and although debilitating, most people do get better. If people want to see a homeopath when they are low then fair enough. It is the denial of evidence that worries me, and the contorted and strange relationship that homeopaths have with science. If this had been a trial of homeopathic treatment for something like AIDS then I would have been much more alarmed. <\/div>\n

<\/p>\n

And alarmingly, Dr Weatherley-Jones has been involved with treating AIDS patients with sugar pills<\/a>. The Maun Homeopathy Project in Botswana has said that the “clinical results that we achieve in the clinics here are nothing short of miraculous”. I wonder how they know, given that trials are not to be trusted?<\/div>\n

<\/p>\n

<\/div>\n

<\/p>\n

Postscript<\/strong><\/div>\n
For a thorough review of the homeopaths’ attitude to evidence and trials…<\/div>\n
<\/div>\n
I wish I had written it…<\/div>\n
<\/div>\n
http:\/\/apgaylard.wordpress.com\/2007\/11\/08\/its-evidence-jim-but-not-as-we-know-it\/<\/a><\/div>\n","protected":false},"excerpt":{"rendered":"

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