“Its purpose was to set out to show that the evidence for homeopathy is mixed, which it is, not that no evidence exists or that it’s all negative, which is what commentators like Goldacre, King, Colquhoun and others had been trying to assert, and in doing so persuade PCTs and the like to decommission homeopathic services. There is quite a substantial gap between mixed evidence and no evidence at all. One means the jury’s still out. The other means it’s delivered its verdict.”

“A recent post on a homeopathic site made the claim that only intentional, living organisms are capable of healing.” If you refer to my post at the hpathy.com forums, then you must have misunderstood, and I had no chance to write you because the thread was closed.

What I meant is that it may be understandable that one could feel the need for intervention if something we consider inanimate went wrong (again, it is only our point of view), but with clearly living things – this is not an appropariate approach because they clearly possess the self-healing, self-correcting mechanisms, and external intervention disregarding the totality of the situation is bound to fail. You have indeed written that seemingly inanimate things, such as crystals, can restore their original form with time – I have thought about it, and indeed, you are right, but that means that OUR – human – definition of what life is maybe too restrictive, and actually everything around us may well be alive in the sense of ability to procreate, change and repair themselves – and indeed the fact that the technique of preparation of homeopathic remedies permits to “extract” some specific properties from “inanimate” things like sand or metals underscores this possibility – it’s just that the “life-cycle” of these entities is too slow for us to notice, and unless several generations of humans can concentrate on careful observation of a certain object – which they can if they stop being autistic as a whole and continue to ignore and destroy nature and everything around them, – then it will be possible to notice what’s really going on around us…

However, I don’t remember mention anything about intentionality? So maybe this was not my comment that you are referring to?

You also write: “People drive recklessly, take drugs and drink too much. Can homeopathy help here?” The answer is absolutely “yes”, and it is indeed very restrictive (again) to think that this sort of thing DOES NOT have any relation to people’s health and disease. I urge you to take a broader view at life, you’ll notice many interesting things, I assure you!

You’re welcome. The cellular collective known as Humber thinks that you have demonstrated its point. Because I suggested that medical trials are engineering, I therefore think of people as machines and am in some way connected to slavery?
Medical trials are closer to engineering, than say, pure research. I did not suggest trial subjects should be held in cattle pens and force-fed drugs, but only that the logic of both processes is similar.

Ah no. The slavery comment was attached to the notion that appears prevalent in some sections of the pharmaceutical industry that health is a commodity to be bought and sold (that’s not conspiracy theory, that’s fact, and commented on extensively in several medical journals), and has nothing whatsoever to do with my comments about your assertion that medical trials are closer to engineering, so let’s not get everything all conflated here.

A recent post on a homeopathic site made the claim that only intentional, living organisms are capable of healing. This is what I call wrong. There are many inanimate objects, both natural and man-made, that exhibit self-repair; crystals, amalgamating plastics and even complex machines. That refutes one claim. The immune system is an example of a healing and repair mechanism that does not have intentionality. There goes the other.

Well since I didn’t make that assertion, I can’t really comment on it, but I think it depends to some extent on how you define ’self-repair’ and ‘intentionality’. I’d agree with you that all sorts of interesting things can exhibit self-repair. I’m not sure how you’d prove that the immune system does or doesn’t possess intentionality though. You can’t separate it and its function from the intentionality that exists in the system. Where does the immune system begin and end? Can you take a scalpel and remove it from the body of a person to study it in isolation to see what intentionality it might possess? Of course not. Its existence and function is entirely contingent on the living being of which it’s part. And in any case, ‘immune system’ is an arbitrary distinction. It’s a cognitive construct, a product of a particular way of conceptualising the workings of the organism. So you can ascribe whatever properties you like to it really because it’s not so much a thing as an idea.

So much of what you write (and equally what I write too) is a matter of perspective, fundamental assumptions, circular logic and semantics. If you think this doesn’t apply to something as ’scientific’ as medicine, think again. It’s as well to bear in mind the perspective of epidemiologists such as Robert Hudson:

““Perhaps no one sentence captures the history of changing notions about disease better than a paraphrase of Humpty Dumpty’s haughty admonition: “When I use the word disease, it means just what I choose it to mean – neither more nor less.” Disease has always been what society chooses it to mean – neither more nor less. A number of important considerations lead to this generalisation. Among these are the following: (1) the definition of disease has varied with time and place in history; (2) the names assigned to diseases are ultimately abstractions, although it is useful at times to act as though they are real; (3) what we mean by diagnostic terms, as with words in general, can be discerned more accurately by what we do with them than what we say about them.”

or Jon Arrizabalaga

“Put plainly, every disease entity is an intellectual construction that is peculiar to some form of medicine; and every form of medicine is nothing but a historical variable in any human community.”

and realise that the biomedical model is no exception. Likely in 200 years time (if we haven’t completely destroyed the Earth’s ability to support life and died out by that time) we’ll be as amused by present theories and practices as we are now by blood-letting and leeches.

You seem to be making an assumption throughout my posts here that I’m somehow trying to “prove” homeopathy or score points on its behalf. Granted you can read my posts that way, but that’s not why I started this blog. Its purpose was to set out to show that the evidence for homeopathy is mixed, which it is, not that no evidence exists or that it’s all negative, which is what commentators like Goldacre, King, Colquhoun and others had been trying to assert, and in doing so persuade PCTs and the like to decommission homeopathic services. There is quite a substantial gap between mixed evidence and no evidence at all. One means the jury’s still out. The other means it’s delivered its verdict.

I’ve made no bones about the fact that trial evidence for homeopathy is equivocal, but I’ve also said that there’s more than enough evidence from case history and clinical studies to at the very least justify ongoing study. The evidence does not justify discontinuing services. This is premature and based on prejudice and a distortion of the available evidence.

I also said I’d talk about the nature of proof in general, and in doing so I’ve tried to show how all thought systems are ultimately self-referential feedback systems that produce their own proof. But that they’re all based on assumptions which are open to question, and that this is no less true of ’science’ than it is of anything else, thus distinctions between different kinds of evidence based on their apparent verifiability according to a particular mind set aren’t necessarily supportable. You can dismiss that as post-modernist claptrap if you like, but it doesn’t make it any the less plausible.

You seem to draw greater distinctions and divisions between different medical systems than seems justified to me in practice. Those distinctions are in many cases more conceptual than real — useful to get a comparative point across perhaps, but not relevant in use. I don’t think there are many CAM therapists who see their therapies as some complete panacea for all the ills of humanity. A therapy may be capable of treating the whole person in any state of illness, but that doesn’t mean that it’s necessarily the right therapy for that individual in his particular circumstances. Nobody’s going to recommend going to see a homeopath if you’ve just broken your leg and it needs setting! CAM therapists work with every bit as much of a multi-disciplinary approach as biomedical specialists.

We could carry on ad nauseam arguing the toss, and get nowhere because to each of us our world views are utterly self-evident and consistently demonstrable, even scientifically so, within their own terms. You’ll never see the validity in other systems if you’ve never got as far as questioning the underlying assumptions which create the circular logic within your own system. Having once inhabited the scientific world view and then moved beyond it I guess that makes me a crank in your book, but I’ll take being a crank any day to the sheer hubris of imagining my way of seeing things is the only way there is and everyone else is a crank or an idiot.. As Giordano Bruno said, “Truth does not change because it is, or is not, believed by a majority of the people.”

This reminds me of nothing so much as the British Government’s present Early Years Foundation Stage initiative which makes it mandatory for all parents and carers to make sure each three-year-old ‘understands that s/he can expect others to treat her or his needs, views, cultures and beliefs with respect’. Hmmmmm … The socks would have flown out the window on that one, if it wasn’t too horribly serious to get cold feet over. The pigs are at the table and using knives and forks.

Individualized treatment is a nice idea, but the good people of the UK make 25 million visits to the GP annually. This means 10minute consultations, and within limits, statistical prescription.

But surely you need to look at this more holistically? The good people of the UK make 25 million visits to the GP annually, largely because they’ve come to expect magic bullets for every little problem and have been encouraged to take less and less responsibility for their own health. Several CAM therapies, because of their outlook, tend to encourage individuals to be far more responsible for their own health. There are some studies to show (will reference later — it’s too late right now, but I think it was the Berlin one) that homeopathic treatment leads to significant reductions in physician visits.

If you are going call the materialist view a failure, then I am afraid that I can’t allow you to restrict your comparison to pharmacology.

Where did I call the materialist view a failure? I think you’re making a different distinction there to the one I made. I said that applying the mindset of an engineer to living systems is pretty disastrous because living systems aren’t machines. You can see evidence of such thinking in all the short-sighted linear logic applied to ecosystems the world over and its terrible consequences. The mechanistic model is grossly inadequate in this context. Ditto in medicine where the human being is fragmented into all its various systems with a specialist for each and nobody looking at what’s happening to the whole person.

How is it that a few linked blogs can sink, or at least torpedo so much of CAM’s academic output? I am not suggesting that all CAM scientists are frauds, but that there are some prominent examples, and that the remainder are letting belief get in the way of objectivity.

There are just as many blogs, if not more, taking various conventional studies apart, but with around 300,000 to aim at compared to a few hundred CAM trials it’s inevitable the anti-CAM blogs will have a disproportionate impact. And as for letting belief get in the way of objectivity, I suggest you go check the mirror. As I’ve repeatedly tried to show, your ‘objectivity’ isn’t objective. It’s a viewpoint based on a whole set of assumptions that are open to serious question (which I’ve detailed eslewhere, so won’t go into again here).

Well, agreed, but can you separate the turning of a profit from the production of drugs? From the rest of commerce or public demand? If so, then who is it that is ‘poisoning’ people? I don’t think that is the intention of the (materialist) researchers, do you?

I don’t think you can generalise. I don’t imagine it’s the intention of anyone within the system to poison anyone, though there may be more than a few in marketing departments and the like who are so caught up in their niche function that they lose sight of the bigger picture. Nobody likes to hear bad news either. The tendency is to dismiss it as an aberration or ignore it and hope it’ll go away. That can be largely unconscious or it can be deliberate. But you surely can’t ignore the amount of column-inches devoted to pharmaceutical companies’ highly dubious research and marketing strategies, the widespread disease mongering that goes on, and the suppression of studies that could have resulted in far fewer lives lost if dangerous drugs had been recalled when evidence of their harm was first available.

Lmso,
You’re welcome. The cellular collective known as Humber thinks that you have demonstrated its point. Because I suggested that medical trials are engineering, I therefore think of people as machines and am in some way connected to slavery?
Medical trials are closer to engineering, than say, pure research. I did not suggest trial subjects should be held in cattle pens and force-fed drugs, but only that the logic of both processes is similar.

A recent post on a homeopathic site made the claim that only intentional, living organisms are capable of healing. This is what I call wrong. There are many inanimate objects, both natural and man-made, that exhibit self-repair; crystals, amalgamating plastics and even complex machines. That refutes one claim. The immune system is an example of a healing and repair mechanism that does not have intentionality. There goes the other.
How much intentionality is required? Does a cell have enough? A rabbit?

Certainly before Hahnemann’s time, medicine took a largely intentional stance. The healer would administer some remedy or cure, with the intended outcome of healing the patient. Since that time, the very detailed study of the body’s processes and its pathogens has generally allowed science to move from the intentionalstance to the designstance. That’s engineering, and an enormous improvement. Nothing else changes. People are still people, but we now have an addedperspective that was not previously available.

…..“This, to my mind, is exactly why biomedicine is failing.”

Homeopathy is one of many current and discarded medical schemes that rely on one effector or locus to explain the operation of its panacea. Chiropractic has subluxations in the spine, reflexology maps the feet. A cynic might remark that ‘holistic’ is just a euphemism for ‘one-trick pony’

In your comparison of clinical efficacy, you have essentially restricted medicine to pharmacology after the fact so as to mirror homeopathy’s remedy after the fact. Medicine is not holistic, but divides the body and its treatments into groups and in doing so, brings many methods to bear upon them.
Advice is given to eat well and exercise, but where that fails, there is surgery or drugs, failing that, transplants or artificial devices. Vaccination, antibiotics and sanitation are ‘allopathic remedies’, in that they are a result of a materialist view.

It is only a matter of convenience that the goal posts have been shifted to the present, where science has already reduced the incidence of many diseases that homeopathy cannot cure. I thought of listing the scientific achievements of the past two centuries, and how homeopathy is riding on the back of them, but I don’t think I have to.

“Well of course! That’s the nature of human beings and the nature of medical science! Trial evidence for any intervention is rarely so incontrovertible that everyone agrees with the conclusions, and methodology rarely so robust that nobody can pick holes in it. It’s invariably a matter of perspective and opinion.”

See if homeopathy can prove that it can match even the worst case of this so-called poison. http://www.cdc.gov/std/treatment/Cefixime.htm

Historical records and gravestones attest that people now live longer and healthier lives because of science. If medicine is merely suppressing illness, then it looks to me that it makes no difference.

Where is the hypocrisy regarding clinical performance?
The pie-chart results are not explicit enough. It cannot be assumed that because only 38% of remedies are effective, that only 38% of patients are effectively treated (or any other number.) The same applies to the sound-bite of ‘90% of drugs are only 30% effective’.
There is nothing untoward about remarking on these results, but I wonder how it is that homeopathy thinks this represents a gain for them.
(The BMJ informs me that the data for the pie-chart comes from the Dec 2007 issue of
http://clinicalevidence.bmj.com/ceweb/products/concise.jsp, behind a very high paywall)

Do you have evidence that there are false claims in this area? How exactly is homeopathy being suppressed in a manner that is not due to its own inadequacy? I mentioned the ‘proof of concept’ as means by which a pragmatic scientist, one who really wants to get knowledge out to the world, may approach the problem, as opposed to criticizing science and telling more stories of black swans.

Shang et al has been discussed to dust. If there is anything remaining for homeopathy to wring out of it, then it will not be substantial enough to make a difference. The poor quality of the trials is not the only reason to doubt CAM science. There is the previously mentioned lack of drive, but the generally, the approach does not inspire confidence.

“As for failures, every practitioner has their failures and I don’t know anyone shy of admitting that! You won’t find them published in journals, because there’s nothing constructive to be learned from them.”

Big time wrong, Lmso! Failures are very important. Surely you understand what is wrong with publication bias? I am sure you do.
Because homeopathy has no theoretical framework, it is even more important to include negative results than in science because of the difficulty of separating chance from a real effect.

“Because there are just as many valid reasons for believing the Maddox-Randi circus to be no less biased or potentially fraudulent.”

You may say that Randi deceived Beneviste, but that does not explain the latter’s reaction. A reputable scientist has been caught with his hand in the cookie jar, and his work is voided. He publicly protests injustice, and that his work stands. What would you do if you were innocent, Lmso? Wouldn’t you strike while the iron was hot, repeat the same tests (those which you were accused of rigging) then call Randi, telling him to bring his $million with him? Sure you would!

Beneviste does not. He forgoes his previously attested method, and with it, the most rewarding path, to take up a different and even more contentious method.
Is advancing science, regaining a lost reputation, the prospect of a Nobel Prize and a million bucks not enough incentive?
There has been no independent validation of any of Beneviste’s work, except where one or more of his team has been present. It never happened, but its ghost lives on, and is even commercially exploited.
You can hear Randi’s version; http://www.youtube.com/watch?v=tSoNGSsnZ5c

Dana Ullman acts much the same. He makes strident claims, gets caught out making contradictions, and errors of fact, then retreats only to return with another claim.
If Roy follows the scientifically rigid, logical path, he won’t get a result. So he obfuscates, providing just enough information to set the cat amongst the pigeons, but not enough to prove or completely deny his claims. I don’t have to look through the data to recognize flim-flam’scalling cards.

There are a number of scientists who have moved to the dark side. Now recall your words ‘Living systems are non-linear and have qualities of uniqueness, unpredictability, interdependence’. Indeed! Some scientists, someunique beings, become cranks.

With Roy, it’s quite clear that he has never had much time for orthodoxy, and has moved to the cooler kitchen of alternative science where he can romp without supervision.

These men are not the suppressed Einsteins they take themselves to be, but are vaingloriously unable to distinguish between idiosyncraticthinking and genius. They waste everybody’s time.

How is it that a few linked blogs can sink, or at least torpedo so much of CAM’s academic output? I am not suggesting that all CAM scientists are frauds, but that there are some prominent examples, and that the remainder are letting belief get in the way of objectivity.

Lmso, if I thought that homeopathy had a toxin-free panacea, and that medicine was suppressing it for no other reason than to maintain its monopoly, I would be on yourside. However, I can see no evidence to support either claim.

You have earlier described the materialist view as ‘lifeless’, and indicated a leaning towards Buddhist ideas of consciousness, whereas I regard Buddhism as inane. In its quest to understand consciousness, Buddhism gave up at the first hurdle to become subservient to it. Anodyne and of no utility. That’s what I call lifeless!

“Then you’ve clearly been highly selective in your reading. There is no blanket rejection of scientific principles in homeopathy. Just scientific dogma. Some practitioners may not be scientists by training or inclination, but that’s hardly a prerequisite for practicing healing modalities.”

“And since when was professing to material atheism a prerequisite for considering yourself part of the body of “science”? That sounds more like scientism than science to me.”

There is a strong leaning towards material atheism amongst scientists.
http://www.americanscientist.org/template/AssetDetail/assetid/55593
(All other studies show dominance of atheism, though the level depends on the discipline)

A recent vox pop at JREF.
http://forums.randi.org/showthread.php?t=106453
(Interestingly, the difference between groups 6 and 7, at least refutes the claim that skeptics are completely close-minded about the matter).

It has been noted that scientific training does not generally alter a student’s spiritual beliefs. Most have usually settled that matter earlier in life, and are perhaps attracted by the rationality of science. Now, I wonder what sort of mind is attracted to alternative science? That makes a big difference.

Personally, I am rather tired of being told that belief is enough, but I have to live with that. However, I object when such ideas are used against science by those who seem to ignore the real world. I have said to you that medicine is not perfect. You agree, saying we’re all human. That’s true, but it was not my point. Institutionalised medicine is a system Like all systems, there will be errors of control and implementation, meaning that it will never reach its theoretical performance, or even come very close, because to do so would require more energy and management than is practically possible.
The overall performance reaches a point where the incremental gain is insufficient to justify the additional cost. The ‘law of diminishing returns’ is a common simplification.

Individualized treatment is a nice idea, but the good people of the UK make 25 million visits to the GP annually. This means 10minute consultations, and within limits, statistical prescription. Perhaps you see this approach as similar to the ruthless triage of the battlefront, but the fact that medically-trained people are a small percentage of the population, and there are more customers than McDonald’s, perhaps the analogy is apt.
The limitations of the statistical approach are certainly recognized.
http://www.americanscientist.org/template/AssetDetail/assetid/54440

People drive recklessly, take drugs and drink too much. Can homeopathy help here?
Medicine and homeopathy are, as you tell me, two completely differentideas. If you are going call the materialist view a failure, then I am afraid that I can’t allow you to restrict your comparison to pharmacology. Medicine is branch of material science, and therefore takes a comprehensively materialist view. This view is denied by homeopathy, and is not part of Hanehman’s ideology. Homeopathy must have an independentsolution for all of the medical successes that currently lie outside its purview. To make a fair comparison, we would need to strip out all of medicine’s achievements since Hanhmenan’s time, and then see how homeopathy would fare without them. I predict ‘fullhouse’ at the cemetery.

“What an extraordinary statement! And exactly what has spirituality or lack of it to do with the price of fish? The primary and over-riding purpose of medicine IS TO CURE PEOPLE OF THEIR ILLNESS. Didn’t that even occur to you? And yes, I do take a very firm moral stance where that aim appears secondary to turning in a profit for the stockholders. People’s lives and their quality of life is not a commodity to be bought or sold. Slavery has supposedly been abolished.”

Well, agreed, but can you separate the turning of a profit from the production of drugs? From the rest of commerce or public demand? If so, then who is it that is ‘poisoning’ people? I don’t think that is the intention of the (materialist) researchers, do you?

“The USA is not the largest market for homeopathic preparations, either in value or volume. Most of the trials conducted to satisfy licensing requirements are for the German market.”

You are right, it seems that the US market is in decline, but I don’t think that German regulations include clinical efficacy for dilutions below 12C?

As you know, the pie chart data is not supported, but I assume you are comparing it to homeopathy’s claimed 70% success rate, but to do so is meaningless if the same treatments or patient numbers are not compared. Clinical data need not reflect pharmacological efficacy, but the performance of the medical system. The sheer difference in scale and breadth of treatment makes direct comparisons rather dubious.

Well we do know from the horse’s mouth that CAM treatments with trial data and unproven efficacy are placed in the ‘unlikely to be of benefit’ category, so even if that category is dominated by CAM treatments, that’s still only a maximum 6% of the total which in no way invalidates the points I was making in my post.

I’m not making direct comparisons, Humber, because direct comparisons — as you rightly say — can’t be made. However, studies that all fall into the same ballpark all fall into the same ballpark, and you can draw inferences from them that at least support calls for further study. GSK’s Allen Roses says 90% of pharmaceutical drugs are only effective in 30-50% of cases. BMJ Clinical Evidence says only somewhere between 26-34% of 2,500 commonly used treatments have some proven benefit. The Bristol study concluded 70%+ of patients reported some improvement with homeopathic treatment. The Berlin study came up with similar percentages and concluded that patients using homeopathy had better outcomes than patients using conventional medicine. Glasgow Homeopathic Hospital’s ongoing audits of patient response return similar percentages.

It’s worth emphasising that while controls might be absent in these studies, the patient cohorts tend to have a high percentage (80%+) of chronic complaints of which an equally high percentage (80%+) have failed to respond to conventional treatment. If they failed to respond to conventional treatment, in which the placebo effect is likely to be considerably stronger than in homeopathy, then it’s reasonable to suggest that these are patients who are not particularly susceptible to placebo response. If they failed to respond to conventional treatment, then it’s reasonable to suggest that for these patients, homeopathy proved to be the more effective option.

Shang’s work has been digested and dissected elsewhere, by everyone. Even within homeopathy results are interpreted in accordance with viewpoint. Earlier positive results by Linde et al, were denied by Walach (entangler) but supported by Oberbaum (localist).

Well of course! That’s the nature of human beings and the nature of medical science! Trial evidence for any intervention is rarely so incontrovertible that everyone agrees with the conclusions, and methodology rarely so robust that nobody can pick holes in it. It’s invariably a matter of perspective and opinion.

“It’s also the case that homeopathic trials are a rather heterogeneous collection of (homeopathic) methodologies and trial objectives, so meta-analyses of the entire data set are more than usually prone to the apples-and-oranges argument.”

Quite. That’s the problem. Why is the science so bad?

Whoops … there go the socks again …

So bad? Homeopathic trials tend to fare rather better than conventional ones these days. Shang et al could only find 9 (out of their 110 selected from … let’s see … a third of a million?) to meet their quality criteria to homeopathy’s 21 (out of 110 from maybe 200?) in their initial sifting.

The science isn’t uniformly “bad” Humber. There are poor trials, of course, but the reason so many homeopathic (and barely “homeopathic”) methodologies are represented in the trial data has to do with the difficulties in trying to shoehorn an individualised complex therapy into the homogeneity criteria of a DBRCT.

Too much effort has gone into finding some wriggle room to escape the inevitable result. That is to be expected. A discipline that rejects much of science is hardly likely to adhere to its tenets upon demand, or to satisfy skeptics.
Alternative science knows no failures. Ideas are never wrong, just not yet proven. Negative outcomes are common enough in science, but they seem to be a surprise to homeopathic researchers.

Then you’ve clearly been highly selective in your reading. There is no blanket rejection of scientific principles in homeopathy. Just scientific dogma. Some practitioners may not be scientists by training or inclination, but that’s hardly a prerequisite for practicing healing modalities. We know we’re dealing with something that doesn’t find a ready explanation in existing theory, but that doesn’t mean we’re going to abandon everything we’re doing until we can explain it, because explaining it is a very distant second place to the aim of helping people overcome their illnesses. For most patients of homeopathy, it’s enough to experience it working. They don’t much care how it happens. Even supposing it’s all happening through psychosomatic means, clinical studies are indicating it’s considerably more effective than either pharmaceutical drugs or psychotherapy in a wide range of conditions and therefore has enormous potential to be a useful and cost-effective addition to available therapies which is why … d’oh … it’s been proving so popular among GPs.

As for failures, every practitioner has their failures and I don’t know anyone shy of admitting that! You won’t find them published in journals, because there’s nothing constructive to be learned from them. 4 pages of “it didn’t work and I don’t know why or what will” is of no value to other practitioners next to “this worked for this patient in these circumstances”.

The lack of rigour is all but palpable. Claims of bias and poor methodology are not prejudice, but there for all to see. Where trials are rigorous, the results are negative.

Those are broad-brush statements which are not borne out by a thorough examination of the literature. There is as much rigour evident in homeopathic trials as in conventional ones. There’s also as much lack of rigour, and as much bias on occasion, but on balance (inasmuch as you can compare a data set of c200 trials to one of over 300,000) there doesn’t seem to be any evidence of any more absence of rigour or bias than is found in conventional trials. So claims of bias and poor methodology are rather hypocritical, particularly in view of the 21-9 subset identified by Shang et al. And rigorous trials have produced many positive results. The 8 mentioned in my previous reply plus the studies by Jacobs et al in childhood diarrhoea for starters. Check your facts before making such sweeping statements.

Biased results, and underpowered trials are not ‘nearly right’, but inadmissible. It as if they never took place. Beneviste’s work never took place. The positive results were due to bias by one or more of the researchers, if not outright fraud, yet it is still referred to as if it were valid.

Because there are just as many valid reasons for believing the Maddox-Randi circus to be no less biased or potentially fraudulent.

Medical trials are science, but in practice and purpose, they are closer to engineering. Engineers often make working prototypes that are not full implementations of their final design, but demonstrations of the operating principles. These proof of concept models are made to gain investor confidence, and to show them what they could be missing. The engineer puts himself in the position of the skeptic, so that their objections are anticipated and met beforespending time and money. Things go a lot better if both sides are satisfied that the idea will yield the claimed result. CAM scientists seem to lack this common sense, and their trails demonstrate it.

Well there you have it. Beautifully stated. Medical trials are closer to engineering. Oh boy … a whole sock drawer full … thank you for that one!

This, to my mind, is exactly why biomedicine is failing. What did you see when you last looked in the mirror, Humber? A machine? Or a human being? These techniques are perfect for machines and non-living inanimate systems. Applying them to living systems doesn’t work and is little short of disastrous in the long term. That’s principally why the world has come to be in the parlous state it’s in. Living systems are non-linear and have qualities of uniqueness, unpredictability, interdependence. The mechanistic model is grossly inadequate in this context.

“Many trials are performed to satisfy licensing requirements for homeopathic products in other countries.”

I don’t know of any (but why not both?) In the USA, surely the largest market

The USA is not the largest market for homeopathic preparations, either in value or volume. Most of the trials conducted to satisfy licensing requirements are for the German market.

Yes, time to market can be 10 years. There are regulatory bodies to satisfy. Legal challenges and misuse to consider. A promising compound may be impractical to produce. Problems not shared by homeopathy.

Because there is no toxicity in homeopathic remedies and they don’t kill and maim people.

Pharmacology is business, like any other. If you are taking a moral stance on commercialisation, then I should remind you (and any conspiracy theorists) that mostof Big Pharma’s employees, from marketing to human resources, have spiritual or religious beliefs, rather than science’s minority view of material atheism.

What an extraordinary statement! And exactly what has spirituality or lack of it to do with the price of fish? The primary and over-riding purpose of medicine IS TO CURE PEOPLE OF THEIR ILLNESS. Didn’t that even occur to you? And yes, I do take a very firm moral stance where that aim appears secondary to turning in a profit for the stockholders. People’s lives and their quality of life is not a commodity to be bought or sold. Slavery has supposedly been abolished.

And since when was professing to material atheism a prerequisite for considering yourself part of the body of “science”? That sounds more like scientism than science to me.

Shang’s work has been digested and dissected elsewhere, by everyone. Even within homeopathy results are interpreted in accordance with viewpoint. Earlier positive results by Linde et al, were denied by Walach (entangler) but supported by Oberbaum (localist).

“Agreed. Which is precisely why so much effort has gone into designing and running trials of homeopathy”

“It’s also the case that homeopathic trials are a rather heterogeneous collection of (homeopathic) methodologies and trial objectives, so meta-analyses of the entire data set are more than usually prone to the apples-and-oranges argument.”

Quite. That’s the problem. Why is the science so bad?

Too much effort has gone into finding some wriggle room to escape the inevitable result. That is to be expected. A discipline that rejects much of science is hardly likely to adhere to its tenets upon demand, or to satisfy skeptics.
Alternative science knows no failures. Ideas are never wrong, just not yet proven. Negative outcomes are common enough in science, but they seem to be a surprise to homeopathic researchers.
The lack of rigour is all but palpable. Claims of bias and poor methodology are not prejudice, but there for all to see. Where trials are rigorous, the results are negative.

What of Rustrum Roy’s spectography? He has a contentious hypothesis, which he backs with an experimental trial that would embarrass a lab technician. He is an iconoclast, a renegade, and does not care if he proves his point to what he sees as the establishment. Perhaps he even avoids it.

Biased results, and underpowered trials are not ‘nearly right’, but inadmissible. It as if they never took place. Beneviste’s work never took place. The positive results were due to bias by one or more of the researchers, if not outright fraud, yet it is still referred to as if it were valid.

Medical trials are science, but in practice and purpose, they are closer to engineering. Engineers often make working prototypes that are not full implementations of their final design, but demonstrations of the operating principles. These proof of concept models are made to gain investor confidence, and to show them what they could be missing. The engineer puts himself in the position of the skeptic, so that their objections are anticipated and met beforespending time and money. Things go a lot better if both sides are satisfied that the idea will yield the claimed result. CAM scientists seem to lack this common sense, and their trails demonstrate it.

Even if true, the double standard of evidence raises another issue. Trying to gain acceptance against the tide is a common occurrence. If someone in marketing has an idea for a new product of any sort, they will accept that their idea must be presented in a way that may not suit them, but the target audience.

“Many trials are performed to satisfy licensing requirements for homeopathic products in other countries.”

I don’t know of any (but why not both?) In the USA, surely the largest market, the FDA applies only the food regulations. Homeopathic remedies are not required to meet any regulations applicable to drugs. There are some restrictions that apply to OTC remedies, but again, as there are generally no assayable active ingredients, compliance is almost automatic.

“After all, even conventional trails struggle to obtain funding unless they’re being financed by the pharmaceutical industry, and the pharmaceutical industry won’t fund a trial unless they can smell a profit at the end of it.”

Yes, time to market can be 10 years. There are regulatory bodies to satisfy. Legal challenges and misuse to consider. A promising compound may be impractical to produce. Problems not shared by homeopathy.

Pharmacology is business, like any other. If you are taking a moral stance on commercialisation, then I should remind you (and any conspiracy theorists) that mostof Big Pharma’s employees, from marketing to human resources, have spiritual or religious beliefs, rather than science’s minority view of material atheism.

Regarding censorship on the bad science web site- the commercial sponsors of must have been offended.

I have said before that I am not trying to deny patients their choice. I am diffident about the role of CAM, but I think that it should demonstrate that it can support it claims, or at least acknowledge its limitations.

Agreed. Which is precisely why so much effort has gone into designing and running trials of homeopathy.

The trail evidence thus far is contentious. For every document supporting Shang, there is another undermining it. There is considerable disagreement amongst homeopathic researchers on this matter.

Such equivocal evidence would tend to indicate that not all variables are being adequately accounted or controlled for. These are generally the sort of results you get when this is so (which I’ve argued elsewhere). Small sample sizes don’t help either. It’s also the case that homeopathic trials are a rather heterogeneous collection of (homeopathic) methodologies and trial objectives, so meta-analyses of the entire data set are more than usually prone to the apples-and-oranges argument. More work is plainly needed, but it’s wholly premature to argue, as The Lancet did in 2005, that the present state of the evidence base justifies the judgement of “the end of homeopathy”.

I am not sure that the claim of double standards is valid. There may be conventional therapies that do not produce very convincing results, but there are some drugs that are clearly very effective. Homeopathy has yet to produce this sort of result, so the double standard, if there is one, only applies at the margins.

I don’t think it’s as clear cut as your statement suggests.

Firstly, if the order of the figures produced in BMJ Clinical Evidence are any indication, only around 13% of conventional treatments can claim that level of efficacy.

Secondly, homeopathy does have data that support similar levels of efficacy. For example, per Shang et al

For example, for the eight trials of homoeopathic remedies in acute infections of the upper respiratory tract that were included in our sample, the pooled effect indicated a substantial beneficial effect (odds ratio 0·36 [95% CI 0·26–0·50]) and there was neither convincing evidence of funnel-plot asymmetry nor evidence that the effect differed between the trial classified as of higher reported quality and the remaining trials. Such sensitivity analyses might suggest that there is robust evidence that the treatment under investigation works.

Whereupon they of course concluded, according to their initial premise, that in the absence of methodological deficiency, such positive results must all be due to ‘bias’. Homeopathy can’t win in the face of such assumptions. The results of this meta-analysis were already determined from the moment it began as a twinkle in Mathias Egger’s eye.

In the current context, homeopathic trials are intended to demonstrate that the principle is sound, rather than the efficacy of a particular remedy. This begs the question as to why they are not more convincing. Put your best foot forward and all that. I know – a lot of satisfied patients.

Well that’s just it. Homeopathic trials don’t all set out with that uniform objective, so the data don’t have that homogeneity of purpose. Many trials are performed to satisfy licensing requirements for homeopathic products in other countries. Many are barely recognisable as “homeopathy”. I’ve already gone into the variety of possible reasons why such equivocal results are obtained at great length elsewhere.

In an ideal world we’d be able to run the large trials needed and repeat them at regular intervals to provide the sort of evidence being demanded, but with limited funding, limited resources, small data sets, etc, what else can homeopathy do? Rocks and hard places come to mind. After all, even conventional trails struggle to obtain funding unless they’re being financed by the pharmaceutical industry, and the pharmaceutical industry won’t fund a trial unless they can smell a profit at the end of it.

BTW, a post containing this link appeared briefly on http://www.badscience.net this a.m., before being pulled, in common with other inconvenient posts there. Since CAM practitioners are constantly excoriated for avoiding difficult questions, including censoring blog posts, it is only fair to point out that science fundamentalists are just as bad.