According to this article in Pulse, the number of prescriptions written for homeopathic 'remedies' in the UK fell significantly between 2005 and 2007. 83,000 prescriptions were written in 2005, 62,700 in 2006 and 49,300 in 2007.
Naturally, if you're a homeopath, this is the result of a 'hate campaign' conducted against homeopathy by Prof Edzard Ernst, the Laing Professor of Complementary Medicine at the Peninsula Medical School (Universities of Exeter and Plymouth). At least, this is what one Dr Tim Robinson says in the Pulse article. This is fairly typical of the homeopathic community, who inevitably confuse a desire to rigorously assess the evidence base with a 'hate campaign'. Dr Robinson writes "Patients are not asking for [homeopathy] because of what has been written in the press..." This ignores woefully uncritical articles like this one that appear in the press, and columns for homeopaths in local papers that amount to free advertising, like this in the Manchester Evening News. If it was left to the press, people could be forgiven for thinking that there was decent evidence that homeopathy works.
Perhaps the message is getting out: that in an NHS with scarce funding, there's no room for funding things that don't work.
Friday, 18 July 2008
Monday, 7 July 2008
The homeopathic memory hole: not much progress since 1861...
A recent conference on the current state of research in homeopathy once again exposes the field as an intellectual shambles.
The bloggers have already written a good deal about some of the presentations at the conference. AP Gaylard points out that homeopaths are still "saying the thing that is not" about a meta-analysis (Shang et al.) that was published in 2005. The Quackometer goes into great detail about why Lionel Milgrom is talking rubbish; something that is also ably demonstrated in several excellent posts by shpalman. And Gimpy explains why Dr Alex Tournier PhD's assessment of the evidence is fundamentally flawed.
What I find difficult to understand is how the homeopaths can justify their selective quoting of evidence. The repeated instances of saying the thing that is not about the Shang paper are only one example. A materials science paper by Rao et al. is constantly wheeled out as evidence that homeopathy could work, for all the world as if it hadn't been demolished by a critical letter to the editor in a subsequent issue of the journal (I should know, I was a co-author of the letter). This letter has gone down the homeopathic memory hole, never to be mentioned again, while the original (execrably bad) paper refuses to die. There is also an identifiable pattern to how homeopaths discuss meta-analyses. Apparently positive ones that take no account of trial quality are always mentioned, but crucial caveats are always omitted (for example, Linde et al. 1997 said they could find no evidence that homeopathy worked for any particular condition: this is never mentioned). A later paper by Linde et al. looked at trial quality, and concluded that the results weakened the positive conclusions of their earlier paper: this is never mentioned. The Shang et al. paper is only mentioned to make erroneous criticisms of its methodology, to incorrectly state that critical information was missing from the paper, or to accuse the authors of scientific misconduct based on a total misunderstanding of the paper.
A bit of googling the other day turned up this. Back in 1861, a former editor of the North American Journal of Homeopathy, one Dr Peters, publicly renounced homeopathy. I recommend having a quick read of it. The points made are just as valid today as they were in 1861. And yet since then, homeopathy has persisted in heading into an intellectual cul-de-sac. Perhaps this is because homeopaths only retain the bits of evidence that superficially seem to be in favour of homeopathy: everthing else goes down the memory hole, even when it is published in homeopathic journals.
For some time, I've been considering putting together a summary of the evidence on homeopathy, and sending it off to Homeopathy (the in-house comic of the Faculty of Homeopathy) for publication. It seems clear that there's no point, even if the journal would print it. Firstly, homeopaths will pretend it never existed. And secondly, there are plenty of decent books on the subject for those who are genuinely curious about the evidence. The homeopaths will continue to be deluded.
The bloggers have already written a good deal about some of the presentations at the conference. AP Gaylard points out that homeopaths are still "saying the thing that is not" about a meta-analysis (Shang et al.) that was published in 2005. The Quackometer goes into great detail about why Lionel Milgrom is talking rubbish; something that is also ably demonstrated in several excellent posts by shpalman. And Gimpy explains why Dr Alex Tournier PhD's assessment of the evidence is fundamentally flawed.
What I find difficult to understand is how the homeopaths can justify their selective quoting of evidence. The repeated instances of saying the thing that is not about the Shang paper are only one example. A materials science paper by Rao et al. is constantly wheeled out as evidence that homeopathy could work, for all the world as if it hadn't been demolished by a critical letter to the editor in a subsequent issue of the journal (I should know, I was a co-author of the letter). This letter has gone down the homeopathic memory hole, never to be mentioned again, while the original (execrably bad) paper refuses to die. There is also an identifiable pattern to how homeopaths discuss meta-analyses. Apparently positive ones that take no account of trial quality are always mentioned, but crucial caveats are always omitted (for example, Linde et al. 1997 said they could find no evidence that homeopathy worked for any particular condition: this is never mentioned). A later paper by Linde et al. looked at trial quality, and concluded that the results weakened the positive conclusions of their earlier paper: this is never mentioned. The Shang et al. paper is only mentioned to make erroneous criticisms of its methodology, to incorrectly state that critical information was missing from the paper, or to accuse the authors of scientific misconduct based on a total misunderstanding of the paper.
A bit of googling the other day turned up this. Back in 1861, a former editor of the North American Journal of Homeopathy, one Dr Peters, publicly renounced homeopathy. I recommend having a quick read of it. The points made are just as valid today as they were in 1861. And yet since then, homeopathy has persisted in heading into an intellectual cul-de-sac. Perhaps this is because homeopaths only retain the bits of evidence that superficially seem to be in favour of homeopathy: everthing else goes down the memory hole, even when it is published in homeopathic journals.
For some time, I've been considering putting together a summary of the evidence on homeopathy, and sending it off to Homeopathy (the in-house comic of the Faculty of Homeopathy) for publication. It seems clear that there's no point, even if the journal would print it. Firstly, homeopaths will pretend it never existed. And secondly, there are plenty of decent books on the subject for those who are genuinely curious about the evidence. The homeopaths will continue to be deluded.
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