So now we have another prominent ‘scientist’ joining the chorus. Sir David King, the government’s chief scientific advisor, speaking to MPs on the innovation, universities and skills select committee about his role, laid into sections of the media (for their “campaigns” against GM foods and the MMR vaccine) and the Department of Health over its decision to allow homeopathic remedies to be licensed by the Medicines and Healthcare Products Regulatory Agency, the public body that licenses drugs.
“How can you have homeopathic medicines labelled by a department which is driven by science?” said King. “There is not one jot of evidence supporting the notion that homeopathic medicines are of any assistance whatsoever.”
Make no mistake, this “not one jot of evidence” is nothing more than a mantra which those continually repeating it seem to hope will eventually become accepted as some sort of “truth” merely through repetition. In no sense does it bear any relation to the actual state of the evidence base for homeopathy. It is, quite simply, a lie.
Evidence-based medicine is a laudable objective, but not when the whole process is being corrupted by theoretical bias as it is here to determine what is and is not “valid” evidence.
“When I asked 210 GPs to rate different forms of evidence that in practice they would want before using or recommending an unorthodox therapy their answers suggested that evidence forms a multidimensional mosaic – an ‘Evidence Profile’ 2. As Figure 1 shows, theoretical factors are seen as least important, while a systematic examination of outcome (“Experience”) is placed highest, with clinical trials next. Professional experience and patients’ views are still rated very highly, well ahead of theoretical or laboratory evidence. The nature of ‘evidence’ and ‘Evidence Based Medicine’ is evolving, seeking a balance between literature appraisal, clinical evaluation, and human caring (e.g. see http://www.cche.net/usersgui des/ebm.asp#31 ).
It is not a method to use the first of these factors to dominate the others.
“Professor Sackett opens his seminal book on Evidence Based Medicine 3 with “Evidence based medicine is the integration of best research evidence with clinical expertise and patient values.”"
The Evidence For Homoeopathy, D. Reilly. V8.3 Sept06
As far as homeopathy is concerned, the “best research evidence” is equivocal, but clinical evidence and patient values are most definitely not. Several clinical studies now (*), both in single conditions and in large cohort long-term evaluations of the therapy, show a high level of patient satisfaction as well as results that are comparable, and in many cases superior to, the results obtained by conventional pharmaceutical interventions.
Since Sir David King’s principal gripe about the British public’s opposition to GM foods was that Britain’s failure to adopt GM crops had cost the economy between £2bn and £4bn, it’s tempting to wonder whether his snipe at homeopathy comes from similar financial considerations on behalf of the pharmaceutical industry. This seems woefully out of touch with public opinion, which evidences more concern for the health of the biosphere and the humans inhabiting it than for the health of industry’s bank balances.
It also seems hugely disingenuous amidst recent revelations about contaminated cell lines in cancer research, almost daily reports of drugs being withdrawn for serious side effects, long-term studies showing one of the principal avenues of conventional treatment for cancer, cytotoxic chemotherapy, to have only minimal impact on survival, the ineffectiveness of antibiotic and steroid treatment for sinus infections, the fact that honey is a more effective cough medicine than the widely prescribed dextromethorphan, and so it goes on …
See also goodscience’s blog with a link to a video interview with Dr Maurice Hilleman, former chief of Merck’s vaccine division, talking about the catalogue of errors that accompanied the early development of vaccines for polio. “It was good science at the time because that was what you did …” Is there any reason to suppose, in the light of these daily revelations about the shortcomings of pharmaceutical interventions, that things are any different now?
(*) Outcome and costs of homoeopathic and conventional treatment strategies: A comparative cohort study in patients with chronic disorders. Witt, C, Keil, T, Selim, D et al. Complementary Therapies in Medicine (2005) 13, 79-86. German study concluding from an analysis of outcomes for 493 patients that patients seeking homeopathic treatment had a better outcome overall compared with patients on conventional treatment.
Homeopathic medical practice: Long-term results of a cohort study with 3981 patients. Witt, Claudia M, Lüdtke, Rainer, Baur, Roland, and Willich, Stefan N. BMC Public Health 2005, 5:115. A total of 3,981 patients were studied including 2,851 adults and 1,130 children. Ninety-seven percent of all diagnoses were chronic with an average duration of 8.8 years. Almost all patients had received conventional treatment (95%) prior to the start of this study. Disease severity decreased significantly (p<0.001) between baseline and 24 months. Disease severity and quality of life demonstrated marked and sustained improvements following homeopathic treatment period.
Homeopathic Treatment for Chronic Disease: A 6-Year, University-Hospital Outpatient Observational Study. Spence, David S and Thompson, Elizabeth A. Journal of Alternative and Complementary Medicine Volume 11, Number 5, 2005, pp. 793-798. Observational study of 6544 consecutive follow-up patients during a 6-year period in a hospital outpatient unit within an acute National Health Service (NHS) Teaching Trust in the United Kingdom. 70.7% of patients receiving homeopathic treatment reported positive health changes.