OK. Enough is enough. Everyone’s entitled to their own opinions, but when they start claiming their opinions are ‘scientific’, write comments in learned journals quoting published papers in support of their arguments which don’t actually support their arguments at all, misrepresent statistics and generally twist things so far around their little fingers it defies belief, then if you’re a scientist, a homeopath, both or neither, it’s time to put the record straight.
Dr Ben Goldacre, junior doctor and journalist for the UK Guardian, has been adopting a high profile of late. His attacks on alternative therapies, and homeopathy in particular, have reached such a fever pitch it resembles more of a witch-hunt than a scientific debate. Of course all spindoctors know that if you repeat something often enough, sooner or later people start to believe it, whether it’s true or not. Goldacre’s writings, featuring a persuasive mix of jocular sarcasm, apparent scientific plausibility and fearmongering, would have you believe there’s now scientific consensus from unanimous evidence proving that homeopathy is no more than placebo. It’s one thing to publish that in the popular press, another entirely when it appears in The Lancet.
There is, in fact, no factual basis for these assertions. The evidence Goldacre cites doesn’t back up his claims and the ‘science’ he claims to champion is little more than opinion and spin. Of course I don’t expect you to believe me just because I said so, or even because I include citations (1) of papers published in peer reviewed journals in my footnotes. I’m not even asking you to believe me. I’m asking you to look at the actual scientific proof itself, and to do so with a thorough and critical eye.
For copyright reasons I can’t publish that in its entirety here, but I’ll quote what portions I can from these papers to give the gist of what they’re about in a way that’s hopefully as intelligible to a non-expert as it is to an expert. I’ll present evidence to show that in some instances the peer review process has failed, resulting in the publishing of studies of such low quality that they’ve seriously compromised the reputation of the journals which published them. I’ll also quote from papers published in other journals which present another side to this debate. And I’ll talk about the nature of proof in general.
Coming from a scientific background, I was as incredulous as anyone else when I first came across this paradoxical therapy. But being open minded and curious, I tried it for myself. That experience was dramatic enough to convince me that here was something worth exploring further. Similar experiences have been common to a vast number of people in homeopathy’s 200-year history. Very few are or were the sort of individuals to turn their backs on respectability and a satisfactory income to pursue a discipline out on the fringes of science (for next to no material gain and more than their fair share of ridicule) unless they felt there was something seriously worth pursuing.
There are many questions still to be answered about homeopathy, not least that it seems to frustrate all attempts to pin it down within the parameters of the biomedical perspective. There are as many still to be asked about what it implies for our understanding of healing in general and for scientific approaches to proof and assessing the validity of experience. What IS certain however, is that the null hypothesis (ie. homeopathy is no more than placebo) is invalid, and that much I can prove to you simply by citing the existing research.
(1) Socks, L M O. Do you ever check the citations themselves? Journal of Time Deficiency 2007;11;255-267
Laughing my socks off ... 
32 comments
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November 26, 2007 at 8:48 pm
Goodscience
Bravo!! I am waiting for more!!
November 27, 2007 at 12:41 pm
jdc
Have you considered posting links to the articles being discussed?
The Lancet piece is here: journals/lancet/article/PIIS0140673607617061/fulltext,
the G2 piece is available from Ben Goldacre’s Bad Science site or the Guardian’s own website and an edited version of the G2 article is available along with the Jeanette Winterson article here: http://www.dailymail.co.uk/pages/live/articles/health/healthmain.html?in_article_id=496612&in_page_id=1774
November 27, 2007 at 12:51 pm
laughingmysocksoff
Thanks jdc. I’ll put those in. Still getting the hang of this WordPress software …
November 28, 2007 at 10:47 am
jdc
Thanks for putting the links in LMSO, I think it’s good to be able to view the articles that are being critiqued.
PS – Dr LM Socks-Off’s paper in the Journal of Time Deficiency sounds great.
November 28, 2007 at 2:52 pm
laughingmysocksoff
Not just good — pretty essential if people are to verify your sources. I’m grateful you pointed out the omissions in this piece. When I did this first post I was battling with a browser (Safari) that doesn’t seem to integrate with the WordPress software very well and it kept knocking out all my formatting every time I uploaded. Those links were originally in the piece, but I was so busy trying to reinstate paragraph returns and get them to stick I didn’t notice they’d disappeared too.
I switched to Firefox thereafter, so I don’t think there’s any missing links in any other posts.
The Journal of Time Deficiency should be required reading for every medic. All new subscriptions come with a promotional trip in the Tardis to create the time for you to actually sit down and read it and check out all the citations as opposed to having to put blind faith in the peer review process to deliver you trustworthy content.
November 28, 2007 at 7:01 pm
zythophile
And these have all been double-blind tests?
Anecdote is not a substitute for proper research.
Science demands a rigorously testable theory that can predict results.
Homeopathy can’t offer that.
November 28, 2007 at 9:12 pm
laughingmysocksoff
Don’t mistake ‘science’ for the underlying assumptions of a particular model within it. Much of science – particularly medical science – still behaves as if absolute objectivity, internal consistency, linear logic and deterministic predictability are cornerstones of the fundamental “reality” under consideration. Quantum mechanics proved 80 years ago that all of these concepts are approximate, relative and contingent, and that absolute objectivity is a complete myth. The experimenter influences the results of the experiment, and linear logic isn’t very appropriate for understanding the workings of non-linear systems (which all living things are).
Anecdote has its place alongside more rigorous research. It may be considered a weaker form of evidence, but it’s still evidence and far from being irrelevant.
And science doesn’t demand anything. Science at its best is an open-minded exploration of the nature of our existence based in empiricism. It’s a continual process of mapping and remapping, testing and retesting what we see around us and experience within us. And if the theories formulated as a result of all our observations don’t hold up to scrutiny in the face of new evidence and new ways of seeing things, then you ditch the theories and formulate new ones.
There are plenty of double-blind placebo-controlled RCTs showing a positive effect for homeopathy. When it comes to assessing these as a body of evidence however, certain assumptions are made about which trials should be included or excluded from the final analysis. Those assumptions are, by and large, predicated on the assumptions which underly the biomedical model. These are open to question. See the comments following the post Put a sock in it … for more on this.
Homeopathy has not been very successful in showing consistent results in tests of the therapy in individual conditions, but since individual conditions aren’t the focus of treatment in homeopathy, and people suffering from individual conditions can all get completely different treatment, it’s arguable whether the biomedical insistence on focusing on individual conditions should be imposed here. The two systems are different and you can’t test one system using the principles of another. You’ll just end up with null results. If biomedicine was tested using the principles of homeopathy, the same thing would happen.
There are many good studies now showing the effects of the therapy in use. These have been predominantly positive, and several have even demonstrated superior efficacy to biomedicine.
Also you should perhaps question your faith in double-blind placebo-controlled RCTs when they show a 20% failure rate in practice (ie. up to one fifth of all prescription drugs have to be withdrawn through safety fears and side-effects. Journal of the American Medical Association 2002;287:2215-2220, 2273-2275). It’s also the case that the higher the quality of the trial (ie. the higher its internal validity) the lower its external validity (ie. the less it reflects the day to day reality of the situation in which the intervention is/will be used). If you’re not replicating the environment at the coal face, then you’re not testing the therapy in application.
November 29, 2007 at 2:50 am
Bad
You talk about evidence, but then you cite anecdotes, which are probably the worst and most misleading of things when it comes to medical interventions especially.
I disagree with your characterization of the science of course, and the claims about how double-blinded testing miss out on the individualized tailored nature of homeopathy are a dodge. First of all, the claimed principles of homeopathy explicitly suggest that there should be a measurable effect even if the doses aren’t personalized. Second of all, the idea that conventional medicine isn’t personalized is silly: of course it is. And it’s personalized by things like actually examining the specific condition of the body and mind along with an understanding of how various interventions affect these things. Exactly on what basis are homeopathic treatments tailored to a patient?
Finally, even you must admit that if it really were impossible to test whether homeopathic treatments actually work, then we are left not with certainty that they are effective: we are left with no idea if they do anything at all.
“Quantum mechanics proved 80 years ago that all of these concepts are approximate, relative and contingent, and that absolute objectivity is a complete myth.”
Sigh. No it didn’t.
November 29, 2007 at 4:55 pm
laughingmysocksoff
When you’re elevating this notion of what you accept as ‘scientific evidence’ to something that denies the actual daily experience of life itself applied continually and consistently over many years, then you’ve completely lost the plot. Life is what we live every day. That’s what science is attempting to explain.
So tell me, if anecdotal evidence is misleading when it comes to medical interventions, why do so many people come to me in complete despair of conventional medicine? Their concerns have been regarded as insignificant, the symptoms they feel most concerned about are treated as irrelevant, they’ve been talked down to and made to feel like lesser forms of life, told what’s ‘wrong’ with them (which, when they explore the diagnosis for themselves, feels wrong and often is), they’ve had pills pushed on them when they’ve said they don’t want to take any drugs, taken the drugs and felt worse, not better, been told it’s “all in their heads” when they know it’s not (and are subsequently proved right), and so it goes on …
This is why homeopathy has become so popular in recent years. Biomedicine is failing these people in droves (when it’s not actually killing them in their tens of thousands through the side effects of medication alone). Science is empirical, is it not? This evidence says there’s something very wrong within the biomedical model and you’re not going to put it right by saying “ach … that’s just anecdotal evidence. It doesn’t count”.
You can test whether homeopathic treatments work very easily. Go and try it for yourself. That’s what everybody else does, and the evidence is perfectly good enough for them. None of them care about pontifications from the ivory towers of academe, they just care about one thing. Does it help them? If it does, then it does.
November 29, 2007 at 9:02 pm
M Simpson
Explain please – how can this be true: “There are plenty of double-blind placebo-controlled RCTs showing a positive effect for homeopathy.”
…if this is true: “The two systems are different and you can’t test one system using the principles of another.”?
November 29, 2007 at 11:38 pm
laughingmysocksoff
Again no inconsistency when you examine the body of work. Homeopathic researchers have gone to great lengths to try to design robust trials where some effect might be demonstrable within the assumptions of the biomedical model. Many of these have shown a positive effect. But to do so they’ve often had to resort to isopathy purely to be able to put a tick in each box that determines a high quality trial.
These show effect. But they’re not a particularly effective test of homeopathy as a medical system because they don’t conform to its base assumptions.
November 30, 2007 at 1:34 pm
Familyperson
The fatal flaw of thinking by Bad, Simpson, et al is this:
SURGERY
I have yet to see a successful double blind, placebo controlled study on surgery!
Techniques have been developed through trial and error and even anecdotal. Is there a problem with that? Should we stop all surgery because it is not to your gold standard of purity, Simpson?
November 30, 2007 at 1:55 pm
Familyperson
And is surgery therefore “dangerous” because surgeons and patients of surgeons claim they have been relieved, even cured of pain and suffering?
December 3, 2007 at 11:54 pm
Geri Ann Cotone stroud
I HAVE BEEN UNDER THE CARE OF HOMEOPATHY FOR 14 YEARS, AND I AM HERE TO TELL YOU THAT WITH THE DISORDER THAT I HAVE, WHICH WESTERN MEDICINE CANNOT SPEAK TO, I WOULD NOT BE HERE WITH OUT HOMEOPATHY. FOR THAT I AM VERY GRATFUL, AND THE MEDICINE’S EFFECT HAS HARDLY BEEN PLACEBO!!!!
December 4, 2007 at 11:28 pm
laughingmysocksoff
Thanks for that testimonial Geri Ann. We know there’s you and many others like you out there. Homeopathy will survive this, as it has many other attempts throughout history to discredit and marginalise it, simply because it does actually work.
December 6, 2007 at 10:42 pm
caroline peckham
The important thing about homoeopathy – and any other form of energy medicine – is it does not DO it for the body – as a conventional chemical will – it gets the body to DO it for itself. Autonomy is retained. This is a model for a healthy, self-responsible individual who becomes part of a healthy, self-responsible society instead of a weakened individual who becomes more and more reliant on chemicals ‘doing it for them’ and leads to an unhealthy society. Just look at children in the west at the moment : never before has there been so much fresh food available all year round, warm, dry houses, clean water and access to washing facilities in all homes – and yet many of this generation are sick, medicated, chronically ill, cancerous and obese. One of the main causes of this is the abundance of chemical medications thrust into these children at every opportunity and the fact that they never get to resolve an illness or inflammation themselves – the god of biomedicine ‘does it for them’ and cashes in the while.
December 7, 2007 at 2:56 am
Bad
While true, that hardly supports your point. What people believe they experience in actual daily life is not always accurate. There are a million ways to fool yourself into making connections that are false or imaginary: the whole point of science is finding out whether or not we are making such mistakes or not.
Because treating serious medical conditions often has real side effects,a nd doctors don’t always tell people what they want to hear (and, hey, doctors make mistakes or are jerks sometimes: and if those are the people most likely to come see you then you are looking at an incredibly biased sample). And it sounds like most of the people who “come to you” have conditions that are self-limiting. In which case that right there has all sorts of a statistical problems which would lead anyone to falsely believe that this or that intervention was the cause of an improvement (like, for instance, regression to the mean), or to find excuses why the homeopathic treatment didn’t work this time.
No one ever said that people couldn’t feel positive about doing something. The question is whether it has any medical effect at all. And the answer is that there isn’t any convincing evidence for it doing anything medically, nor is there any plausible model for how it would.
And familyperson: you’re just wrong. Surgical techniques are put through rigorous and well controlled studies all the time. Of course, since surgeries often deal with truly serious conditions, it’s often a LOT easier to tell whether something improved outcomes or not vs. other treatments.
December 7, 2007 at 7:59 am
M Simpson
“The important thing about homoeopathy – and any other form of energy medicine – is it does not DO it for the body – as a conventional chemical will – it gets the body to DO it for itself.”
Which all sounds grand except that in many instances people’s bodies are capable of ‘doing it’ for themselves anyway. Provided we’re not weakened by some other serious condition, such as HIV or pneumonia, and provided we’re not almost dead anyway or only just been born, our bodies have an immune system which can fight off most diseases, or fight back against the worst bouts of a long-term condition.
Most of what homeopathy does is take credit for recoveries that would happen anyway. For example, a quick Google reveals 17,500 hits for homeopathy+”chicken pox” but everyone knows that childhood cases of chicken pox fade naturally anyway after a week or so. So what is there to ‘cure’? Homeopathy works on the same basic principle as praying to the gods in the middle of Winter to make the days longer again.
December 7, 2007 at 1:48 pm
laughingmysocksoff
Of course there are! But we’re not talking about isolated individuals taking a notion to themselves here. We’re talking about a large body of people over a period of 200 years all of whom have experimentally verified and consistently replicated this experience for themselves and their patients time after time after time. Many of these people have been trained scientists. This is not invalid data, whichever way you look at it. It may defy explanation, and it may defy attempts to replicate it under controlled conditions and certain assumptions, but the data is not deniable.
If an individual makes an erroneous series of connections in respect of their experience, and derives a rationale from it, then the only way that rationale is shown to be erroneous is to provide an alternative one that makes as much or more sense of the data, and can be verified and replicated. The “placebo” rationale that sceptics offer to explain homeopathy does not make sense of the data, even if it makes sense in terms of the existing model of therapeutic action. It only “works” on the most superficial of levels, and the devil is in the detail. This is also true for the notion that conditions treated with homeopathy are self-limiting conditions that just get better of their own accord. Both of these rationales leave far too many observations unexplained or in direct contradiction to the proffered rationale.
This is what homeopaths and people who’ve had successful homeopathic treatment are continually trying to get across to you on these forums. Your explanations are totally unsatisfactory. They don’t fit the data. If the explanations are not a good fit for the data, then we need to look elsewhere. If attempts to replicate the data under controlled conditions and certain assumptions fail, then the assumptions and the conditions you’re controlling for need to be re-examined. They do not invalidate the data because there’s simply too much of it showing consistency and replicability over a considerable period of time in use by a large and diverse group of people from all sorts of ethnic backgrounds on every continent and in an enormous variety of circumstances.
Here’s a simple example to show you exactly what I’m talking about.
Take a case of food poisoning. A self-limiting condition. If the spoiled food was eaten in the evening meal, the average person in otherwise good health would typically wake at some point in the night and start vomiting. This would continue throughout the following morning, likely starting to tail off after midday. They might be able to take small amounts of liquid during this time, but nothing more. After a good night’s sleep the following night, they should be able to start taking some easily digestible food the next day, but their digestive system may take a couple of days to return to normal. A short bout of diarrhoea may ensue.
Let’s say you give homeopathic remedy A in the early morning when the vomiting is well established and it’s pretty clear by its intensity that this episode will follow the course outlined above. This does absolutely nothing. The development of the condition continues to follow its expected course.
After a half hour or so by which time it’s apparent the remedy is the wrong one, you give remedy B. Within 15 minutes, the person falls into a deep sleep and doesn’t wake to vomit any more. They finally wake late morning feeling absolutely fine, take a drink and a light meal with no problems and go back to work. No sequelae in terms of digestive upset are experienced and no diarrhoea develops.
This is a common response to remedy B prescribed in these circumstances. In other words, it’s replicable, and has been for 200 years. Most homeopaths will have at least one similar case in their records and if you ask homeopaths to tell you what remedy B is from the above description, most will give you the same answer. If you give another remedy, you don’t get the same reaction. Nothing happens, exactly as would be expected if homeopathy were assumed to have no impact. But the reaction to remedy B in these circumstances is not what you would expect to see in the normal course of an untreated bout of food poisoning. Neither is it what you’d expect to see from placebo.
This is just a single simple example to demonstrate that your explanations don’t fit the observations. On its own it means little, but when there are thousands more just like it for all kinds of complaints, all of which demonstrate consistency and replicability in the specific remedies used successfully in each defined pattern of illness, it’s not meaningless. So when people like Sir David King stand up and say “There is not one jot of evidence supporting the notion that homeopathic medicines are of any assistance whatsoever” they are not only being disingenuous, they are telling outright lies.
When homeopaths say that the assumptions and conditions controlled for in DBPCRCTs are not replicating the circumstances in which homeopathy works, they’re not dodging, they’re reporting a fact. We don’t know how homeopathy works. But we do know it doesn’t work very convincingly in these trials therefore what is being controlled for in the trials, or the assumptions behind the whole notion of these trials, is up for re-examination.
The RCT data suggests the therapeutic relationship is a critical part of the process, but that doesn’t mean it’s all there is to it. Again, this explanation doesn’t fit the data. The remedy prescribed has to be one that’s shown replicable and consistent results when prescribed for patterns of illness similar to the presenting complaint. If it’s not, it does nothing.
December 7, 2007 at 8:14 pm
M Simpson
“If attempts to replicate the data under controlled conditions and certain assumptions fail, then the assumptions and the conditions you’re controlling for need to be re-examined.”
This is pretty much the absolute antithesis of rational, impartial, objective, scientific enquiry.
A scientist says, “I’m sure A = B. Let me test this rigorously to see whether it is true. … Ah, look. If I remove all extraneous factors and test this assumption very, very carefully, I find that A /= B. So, despite what it looks like, despite what I was hoping for, despite what I expected, A is not B.”
A homeopath says, “I’m sure A = B. Let me test this rigorously to see whether it is true. … Ah, look. If I test this assumption, I find that A /= B. However I know, I absolutely know beyond a shadow of doubt, that A is B. Because I’ve seen it. So obviously I just haven’t tested it in the right way.”
Which of these seems a more sensible approach?
December 7, 2007 at 10:51 pm
laughingmysocksoff
That’s complete and utter nonsense M. But then, you did say that you’re not a scientist, didn’t you?
Scientific enquiry is first and foremost empirical in nature. It’s an absolutely fundamental requirement of scientific method that all hypotheses and theories must be tested against observations of the natural world, ie. any hypothesis must fit the observed data.
So we have a series of observations of the natural world (ie. people being treated for illnesses by homeopathy and responding to that treatment), made over a period of 200 years, by thousands of individuals across the world, that are consistent and replicable. This is your starting point. The observations have been made and recorded and continue to be replicated consistently. Now they need an explanation. We need to arrive at some kind of hypothesis as to the mechanisms involved.
The treatments, by the nature of their preparation, can have no biochemical effect. This presents something of a problem but only because the dominant medical model assumes that treatments can only have a “valid” effect on organic disease if they’re mechanism of action is biochemical. But this assumption has come about via a process of inductive (biochemical interventions are observed to affect organic disease therefore all successful interventions in organic disease must be biochemical) and deductive reasoning (from the principle that all successful interventions in organic disease are biochemical in nature, a non-biochemical intervention cannot be successful).
This premise can only be valid if the original inductive logic was predicated on a system about which everything is known, and I think even you M would concede that we’re a long long way from knowing everything there is to know about the human organism in sickness and health. In fact, it’s become very obvious that not all healing results from biochemical intervention and the “placebo effect” has become the dumping ground for all these other effects, though the main effort continues to be directed into biochemical interventions and “placebo effect” is assumed to be entirely due to the patient believing they are taking something that will help them (despite a fair amount of evidence, for those that care to look, that there’s more to it than that).
But back to our scientific method … notwithstanding the lack of possible biochemical effect, the treatments are tested under the same conditions and assumptions as those with biochemical activity, ie. they are isolated from the therapeutic process and tested on the assumption that the entire therapeutic effect resides in the material being tested. The results show that the more you isolate the remedies from the context in which they’re prescribed, the less clear and positive effect they have. From this, it’s concluded that since no consistent and replicable therapeutic effect has been demonstrated as residing solely in the remedy, that there is nothing in them and the whole therapy is therefore a load of rubbish.
It’s this reasoning that’s a load of rubbish, and completely unscientific. Remember, to be scientific, the hypothesis must fit the data, the observations from the natural world. Those observations are still intact. You can’t make them vanish in a puff of smoke just because you’ve arrived at the very unscientific conclusion that the therapy is nonsense on stilts. Don’t mistake the map for the territory. If the remedies alone show no consistent and replicable effect (though they do show effect), then the assumption must be that consistency and replicability in their action is dependent on some aspect of the therapeutic relationship, since this is what you’ve been filtering out in your trials.
This doesn’t mean either that it’s the therapeutic relationship that’s the sole cause of improvement, because remove the remedies from the equation and consistency and replicability start to suffer, not to mention that it fails to account for the number of occasions remedies don’t work, followed by a change of remedy that does have an impact.
To arrive at a satisfactory explanation for homeopathy, it will be necessary to bring together consistent and replicable observations from all situations in which homeopathic remedies are used, the nature of responses to them, and the impact of the other principal variables in the process. As I said in my previous post above, the sceptic theories don’t fit the data, not even anywhere close, therefore the scientific method requires that we question the basic assumptions on which testing has been predicated and do a bit of thinking outside the box. That’s not the antithesis of the scientific method, it IS the scientific method.
December 8, 2007 at 4:28 am
Bad
“We’re talking about a large body of people over a period of 200 years all of whom have experimentally verified and consistently replicated this experience for themselves and their patients time after time after time.”
But the ways in which they’ve done so look very very suspiciously like the very sorts of mistakes and self-deception that I was talking about. Self-selecting and observer bias look rampant. Regression to the mean and “curing” self-limiting conditions seem the rule, not the exception.
“Many of these people have been trained scientists.”
Some have, but that doesn’t mean that their methods have held up under scrutiny. Take Benveniste for instance, who I wrote about here (in the second half). Few skeptics have any doubt that he passionately believed, but the fact is that his research, which even today is treated as the gold standard of scientific proof for homeopathic principles, was fatally flawed and compromised: to the point where it very clearly made a difference who ran the experiment and whether or not they could influence the outcomes.
“It may defy explanation, and it may defy attempts to replicate it under controlled conditions and certain assumptions, but the data is not deniable.”
If it defies attempts at replication under controlled conditions, then you simply cannot claim that the data show much of anything at all. Controlled replication is pretty much the only way to be absolutely sure that one of those major bias errors (many of which are perfectly honest mistakes) aren’t to blame for a perceived or interpreted result.
“Your explanations are totally unsatisfactory. They don’t fit the data. If the explanations are not a good fit for the data, then we need to look elsewhere.”
Well, obviously, I think they fit the data just fine. What I think people like yourself fool yourself with is anomaly hunting: you focus in on this or that thing that looks inexplicable, without making any sort of systematic case or even acknowledging that what looks inexplicable may just be a matter of not understanding the situation well enough (as is very often what proves to be the case in these claimed examples).
“This is a common response to remedy B prescribed in these circumstances. In other words, it’s replicable, and has been for 200 years.”
So you say… but when people control for observer bias (things like remembering hits, forgetting misses, and so on), the effect vanishes. That’s a HUGE red flag.
“But we do know it doesn’t work very convincingly in these trials therefore what is being controlled for in the trials, or the assumptions behind the whole notion of these trials, is up for re-examination.”
This is a pretty amazing statement. You just know that it works, so therefore if evidence says it doesn’t, then the evidence or testing MUST be wrong.
But you can’t seem to explain why it is wrong, convincingly. Again, this is another big red flag. You should at least admit that with the sorts of arguments you are making, just about anyone could defend a belief in the efficacy of just about anything.
December 8, 2007 at 12:05 pm
laughingmysocksoff
It may look and seem like that to you, Bad, but I’d be willing to wager at least 30 pairs of socks that you’ve never gone further than your superficial assumptions to examine whether your theory actually does hold water. It appears that you’re also not perceiving the extent to which observer bias is colouring your own assessment of the situation, and to which self-selection is operating in what you’re accepting as “evidence”.
It’s also supremely arrogant of you to presume that no homeopathic practitioner or researcher is capable of approaching homeopathy from a rigorous scientific perspective. Any theory that relies on assuming all proponents of a conflicting system of thought are deluded idiots is ridiculously unscientific, and in Jungian psychoanalytical terms equates to you looking at your own reflection.
That might seem wholly plausible from your standpoint, but in actuality, controlled replication can write as many biases into the trial as it’s attempting to remove. We saw that very clearly in Shang et al where the meta-analysis did no more than conform to the initial assumption that all positive effects of homeopathy were either due to bias or methodological flaws.
But let’s take a more tangential angle on this and see if you can follow my reasoning.
If you control for a dependent variable that’s essential to the mechanism of action, then of course you’re going to get equivocal results. Trials on homeopathic remedies have been undertaken on the assumption that the entire therapeutic effect resides in the physical properties of the remedy. That assumption is predicated on the biases of the biomedical model which assumes that therapeutic interventions are only of value or “valid” if they operate “objectively” in the material/biochemical realm. This despite the so-called “placebo effect” which has been the elephant sitting in the room for a long long time now, and operates in biomedicine every bit as much as it does in homeopathy.
So where is the scientific validity in this assumption that the only way a therapy can be considered to “work” is if the therapeutic effect is objective/material/biochemical? That’s just a bias of the biomedical model derived from an inductive/deductive feedback loop in reasoning (see my previous post). It’s NOT particularly scientific, not least because it’s ignoring the “placebo effect”.
You people put so much faith in these methods, don’t you? How on earth do you assess the number of remembered hits in relation to forgotten misses if the misses are forgotten?! And individual variation in this respect will be enormous. Study the methods — they’re little more than guessing games, approximations, imputed averages. In any case, those are not the things being controlled for in meta-analyses. Read them. Filtering for bias looks at things like the number of positive trials published in relation to the number of negative ones, and in the absence of what is felt to be a “realistic” figure, a certain level of bias is assumed. Ditto with the extent to which trials are published in “sympathetic” journals as opposed to more “mainstream” ones, etc. Quantifying bias in any way is fraught with difficulty and is a highly subjective judgement which can vary enormously according to the underlying assumptions of the individual researcher. Further, using imputed averages in this way can only ever ultimately result in regression to mean, which is exactly what we’re seeing. All this is only to be expected when inductive reasoning is the primary logic being employed here and a review of the literature would seem to support the idea that the more “bias” a researcher perceives in a conflicting system, the less he perceives his own. Bias is inherent, and can’t be adequately or even scientifically controlled for.
The thing is, both sides of this argument are pointing up valid observations about the way the therapy works, but the rationales each are deriving are inappropriate, i) because they’re not wholly consistent with the observed phenomena, ii) because they’re irreconcilable, and iii) because they’re not adequately taking account of conceptual bias.
What we appear to have in homeopathy is a therapeutic system which engages primarily with non-material aspects of the organism and brings about a reversal of pathology through those means (which is basically what Hahnemann outlines). It’s an interdependent system, so if you conceptually fragment it into its component variables and start to test them in isolation, results start to become unstable. But the point is that when all those variables come together, the results demonstrate consistency, replicability and predictability and in many cases are more powerful than the results obtained in biomedicine. There is plenty of evidence to this effect, and it can’t be ignored in any rational assessment of the therapy. Your notion that homeopaths are “anomaly hunting” is frankly absurd in the face of the volume of case history, much of which relates to non-self-limiting conditions (see citations in my previous post for starters).
The bottom line here is that it doesn’t matter one jot if a conscious correlation between patient and practitioner is an essential part of engaging the specific effect of the remedy. If this produces consistent, replicable, predictable and powerful results that are at least as effective as pharmaceutical interventions (again, see above citations), then why are the health services of western nations bankrupting themselves to the pharmaceutical industry? Why are tens of thousands of people dying, and the quality of life of many more being ruined by the side effects of drugs alone?
What the trials tell us is that “bias” is essential to the therapy working, and when it’s present, then it works very well. What on earth is “wrong” with that? It’s no less true of biomedicine which holds a different set of biases which it takes to be self-evidently “true”, and it’s not in the least “unscientific”. Don’t conflate “science” with “objectivity”. Quantum mechanics demonstrated the role of the observer in the outcome of any experiment getting on for a century ago now, and the cutting edge of new scientific explorations into the nature of consciousness is revealing more and more the extent to which consciousness equates to a “reality creation software” with quantum mechanical properties. In other words, what you take to be self-evidently “true” invokes a feedback loop whereby your personal experience of reality constantly reinforces those assumptions. Change the assumptions, and your experience of reality changes accordingly. Psychologists are well aware of this dynamic, as have been eastern religious philosophers for centuries, and it’s no less rampant within the sceptic camp as you perceive it to be amongst homeopaths.
December 8, 2007 at 1:18 pm
M Simpson
“If this produces consistent, replicable, predictable and powerful results that are at least as effective as pharmaceutical interventions (again, see above citations), then why are the health services of western nations bankrupting themselves to the pharmaceutical industry? Why are tens of thousands of people dying, and the quality of life of many more being ruined by the side effects of drugs alone?”
Why indeed? Consider the many medical charities out there, large and small, all around the world. Each concentrates on a disease or condition – HIV, cancer, MS, ME, diabetes, whatever – and their only aims are to relieve the suffering of those who currently have the condition and to help in finding something which will prevent and/or cure that condition. These are independent, philanthropic organisations, uncontrolled by governments or big pharma.
So why do they plough millions of dollars every year into funding drug research? Why would they do that if there is already a very cheap, completely safe, easy to mass-produce alternative which provides “consistent, replicable, predictable and powerful results”? The amount of money that just one or two big cancer charities spends on pharmaceutical research every year would pay for enough homeopathic treatments for, well, pretty much everyone.
These organisations are devoting vast amounts of time, effort and money into the search for a cure for cancer, a cure for AIDS etc. If those cures already exist, if they have been proven to work and if the effects that they produce are “consistent, replicable, predictable and powerful” then what the heck are ALL those major medical charities doing with the money we give them?
Is there some sort of conspiracy among all the major medical charities to try and keep the cure – for which they constantly say they are still searching – a secret? And how could it possibly be kept a secret if the proof is already out there, published in journals and supported by overwhelming anecdotal evidence from around the world over more than two centuries?
This doesn’t make sense to me. What is your explanation?
December 8, 2007 at 3:38 pm
Bad
Socks, you keep insisting that there is a large body of reliable evidence for homeopathy working at the same time you are basically claiming that it’s untestable. It can’t be both.
I’m not sure you even understand what I meant by observer bias. The point is that your body of anecdotes is highly suspect precisely because there are so many potential problems with interpreting anecdotal experience. You’ve so far failed to rule out all of these effects coloring the interpretation and making it seem like there’s something there when there isn’t. You keep admitting that some of that could explain some of the data, but not all of it. But lots of different tiny mistakes can add up pretty easily to big mistakes in judgment. It happens ALL THE TIME in actual science, especially social science. Even some of the best examinations of phenomenon still turn out to be wrong because it turns out something unexpected wasn’t controlled for. And yet you want us to take seriously the idea that you just know it works with no controls at all.
This is simply a straw man. Very few of the well-designed studies which tried to find an effect, ANY effect from a homeopathic tincture did anything that mandated or restricted any particular mechanism for the effect. They simply tested the procedures, and found that when you control for bias, the effects go away. This is the case regardless of whatever sort of magic you are claiming takes place. The fact is, handing people vials of what is simply water (because of the number of dilutions) doesn’t itself seem to have any effect. If you think that there is some special power in the ritual of homeopathy that transfers through the doctor into the patient or something, that should show up as well, and isn’t any harder to study than anything else. But nothing shows up with that, either.
Because drugs are primarily used on people that are really and seriously sick, and because these drugs actually do something to the body, they have all sorts of effects and side-effects.
Just about any time someone tries to say that QM proves this or that, they are just making stuff up. It’s no different here. Observance is relevant in QM in the case of the way single particles behave, and especially given that the only means we have to measure things at this scale involves effects that are just as if not more powerful than the things they are measuring. It is not a glibly generalizable principle.
Again: that data can be thought to appear and vanish dependent on whatever assumptions one takes is another huge red flag.
December 9, 2007 at 1:33 pm
laughingmysocksoff
Your idealised notion is very plausible in theory, M, but try coming back down to earth.
Have you ever worked for a charity? Or talked to anyone who’s responsible for fundraising for one? These organisations are totally dependent on donations for their survival. The larger the organisation becomes, the more infrastructure it has to find regular cash flow to finance, the more fearful it becomes of doing anything in the least bit unconventional that might jeopardise its funding. Public whims change like the wind. One minute you’re this year’s favourite cause. The next you’re forgotten about. And if you want to undertake any sort of sizable project, you have to compete for block grants which are invariably ring-fenced by all kinds of restrictions on what you can do with the money. Charities are very very far from being “independent”.
December 9, 2007 at 2:16 pm
laughingmysocksoff
Read what I wrote again. Carefully. I’m not claiming it’s untestable, only that the interpretations that are being made as a result of the testing are not the only plausible or logical ones that can be made, and that a bit of lateral thinking may well provide the resolution. In this kind of situation it usually does.
The very reason there is so much to-ing and fro-ing about this is precisely because the proffered rationales don’t fit the evidence when it’s examined in depth. You’re obviously fond of the red flags: well this is a MAJOR one. The sceptical position is receiving so much opposition from homeopaths precisely because it’s not consistent with the evidence. Anecdotal evidence and personal experience are not 100% reliable. Agreed. But they’re very very far from being 0% reliable. You can’t dismiss them altogether and as a result claim there’s no evidence in support of homeopathy (and by the way all homeopaths and their patients are deluded fools) and still claim to be scientific. There’s plenty of evidence: it’s of varying quality, certainly, but that doesn’t make it “no” evidence. And there’s quite sufficient to justify investigating this phenomenon in more depth, which is why — d’oh — it’s being investigated in more depth.
The cardinal rule of scientific experiment when you’re investigating a phenomenon that has this sort of evidence going for it is that if your test fails, then you question your assumptions. Most of the people regularly involved in scientific testing of homeopathy are doing just that. I don’t see any evidence from any of them that they’re ready to write off homeopathy yet. It seems the vast majority of those who are trying to are onlookers who already hold preconceived notions about its implausibility because they can’t seem to think past Avogadro.
As Rustum Roy said, this assumption ” … relies on a quaint old idea from the nineteenth century that the ONLY way that the property of water can be affected or changed is by incorporating foreign molecules. This is the Avogadro-limit high-school level chemistry argument. To a materials scientist this notion is absurd, since the fundamental paradigm of materials-science is that the structure-property relationship is the basic determinant of everything. It is a fact that the structure of water and therefore the informational content of water can be altered in infinite ways”
Whether it turns out that there is a measurable, consistent and replicable physical property to homeopathic remedies or not, the FACT is that people are helped by homeopathy to a degree comparable to, or even better than, pharmaceutical interventions. I don’t see any of you addressing this data. (Check out Lies, Damn Lies and Socks if you want the citations.)
December 9, 2007 at 3:27 pm
M Simpson
Laughing, yes I have worked for several charities and I know how they operate. Rather than quibbling semantics, why not address the main thrust of my inquiry:
Why do you think that an organisation dedicated to finding a cure for [cancer, HIV, whatever] would spend its precious, hard-won funds on research into pharmaceutical treatments if there is already a cheap, safe treatment which has been proven to be effective? Why would an organisation devoted to relieving the suffering of people with [cancer, HIV, whatever] steadfastly ignore a cheap, safe, reliable treatment which could relieve so much of that suffering? Why would these charities do something so completely opposed to their stated aims?
December 9, 2007 at 8:28 pm
laughingmysocksoff
Call it “quibbling semantics” as much as you like M, it doesn’t make it any less valid. If the principles of good science and noble aims were always uppermost in peoples’ minds, then yes, this would be a good question. But the fact is, they’re not. Medical charities are no different to the population at large, or to “science” at large, and have no independence of thought when it comes to what’s regarded as “acceptable” research. (If anything, the larger the organisation, the more conservative and conventional the line of research appears to be.) They’re risk-averse and are not going to be rocking any boats when it comes to what they’re prepared to sponsor or investigate. CAM therapies by definition (and regardless of their merits) fall into the unconventional category, and whether or not homeopathy might prove a useful therapy in these conditions, they’re highly unlikely to consider it unless someone else has established a satisfactory degree of efficacy by conventional standards first, so they can justify the expenditure decision to the board of trustees and other stakeholders.
After all, given the very serious questions being posed about the validity of the causative link between HIV and AIDS and the way it’s diagnosed (Eleni Papadopulos-Eleopulos, Valendar F. Turner and John M. Papadimitriou. Is a Positive Western Blot Proof of HIV Infection? Biotechnology Vol 11, June 1993), you’d think, for instance, that an AIDS charity would put its efforts into establishing whether or not the link is scientifically verifiable before going chasing after “cures”. But that doesn’t seem to be happening any more than investigating CAM therapies as a possible means of treatment.
As P Balaram writes in the editorial in Current Science, Vol 85, No 2, 25 July 2003:
This is the territory in which medical charities operate, like it or not. If you think they ought to be taking a more independent line and investigating unconventional avenues to possible cure, then why don’t you ask them that question at their next public meeting?
December 9, 2007 at 8:54 pm
laughingmysocksoff
And M, since I’ve been good enough to address the issues you raise, how about you address these points, which I’ve made many times now.
It’s been established in 3 major studies and at least 21 trials of individual conditions that homeopathy produces outcomes as good as, or better than, pharmaceutical interventions. This applies in chronic conditions as well as acute. This being the case, why do you persistently deny it’s of any use?
And if you continue to pursue your line that it’s of no use, what do these study results say about the state of biomedicine? Particularly in view of the fact that tens of thousands of people die annually from the side effects of medication alone?
January 9, 2008 at 6:36 pm
Humber
Lmso,
I see that you have raised QM again. Please, QM is part of orthodox science. Einstein died more than 50 years ago, things have moved on.
Only in the eyes of Mysterions is QM still so enigmatic.
Einstein had a long running battle of thought experiments with Bohr, but never bested him. Bohr was right, but is rarely quoted by the alternative sciences, I wonder why.
In the QM case, The Big E was wrong. Moreover, even though Einstein’s ideas were radical, they were not entirely novel. His papers on relativity are logical constructs, and as with all his work, lucidly described.
QM may well be science’s Cheshire Cat, but it is a cat with a job. It finds regular work within the semiconductor industry, for example. Nor is it so esoteric. Hobbyists are currently building Scanning Tunneling Microscopes at home. Not yet up to the resolution of commercial devices, but they are made from little more than scrap, as a Google search will show.
Unless you can show that QM operates at the macroscopic scale, and could plausibly be responsible for the Homeopathic effect, then you are just blowing smoke. There are many more down to Earth matters to address!
January 10, 2008 at 12:01 am
laughingmysocksoff
I think this is probably better explained on this thread.
There’s observational data to suggest that effects which, at present, seem to be most amenable to explanation by a qualitative interpretation of QM, operate in therapeutic interactions (and possibly many others). These seem to be more obvious in therapies which don’t rely on a high degree of specific effect from a biochemical agent.
The ‘placebo effect’ is presently the trash can into which all non-specific effects of healing are dumped without much thorough investigation ever having been done to clarify exactly what’s going on there, or how many and what type of effects might be operating. With biomedicine’s philosophical and commercial focus on material interventions, the psychosomatic dimensions, although acknowledged, have scarcely begun to be explored. It would appear — to CAM practitioners and researchers at least — that these mechanisms can be harnessed far more effectively than is the case in biomedicine and, in combination with material agents which create far more subtle effects than pharmaceutical interventions (and with considerably less harmful side-effects), produce an effect that is every bit as powerful and efficacious.