So now we have another prominent ‘scientist’ joining the chorus. Sir David King, the government’s chief scientific advisor, speaking to MPs on the innovation, universities and skills select committee about his role, laid into sections of the media (for their “campaigns” against GM foods and the MMR vaccine) and the Department of Health over its decision to allow homeopathic remedies to be licensed by the Medicines and Healthcare Products Regulatory Agency, the public body that licenses drugs.
“How can you have homeopathic medicines labelled by a department which is driven by science?” said King. “There is not one jot of evidence supporting the notion that homeopathic medicines are of any assistance whatsoever.”
(Reports in the Guardian, the Daily Telegraph, the Daily Mail)
Make no mistake, this “not one jot of evidence” is nothing more than a mantra which those continually repeating it seem to hope will eventually become accepted as some sort of “truth” merely through repetition. In no sense does it bear any relation to the actual state of the evidence base for homeopathy. It is, quite simply, a lie.
Evidence-based medicine is a laudable objective, but not when the whole process is being corrupted by theoretical bias as it is here to determine what is and is not “valid” evidence.
“When I asked 210 GPs to rate different forms of evidence that in practice they would want before using or recommending an unorthodox therapy their answers suggested that evidence forms a multidimensional mosaic – an ‘Evidence Profile’ 2. As Figure 1 shows, theoretical factors are seen as least important, while a systematic examination of outcome (“Experience”) is placed highest, with clinical trials next. Professional experience and patients’ views are still rated very highly, well ahead of theoretical or laboratory evidence. The nature of ‘evidence’ and ‘Evidence Based Medicine’ is evolving, seeking a balance between literature appraisal, clinical evaluation, and human caring (e.g. see http://www.cche.net/usersgui des/ebm.asp#31 ).
It is not a method to use the first of these factors to dominate the others.“Professor Sackett opens his seminal book on Evidence Based Medicine 3 with “Evidence based medicine is the integration of best research evidence with clinical expertise and patient values.””
The Evidence For Homoeopathy, D. Reilly. V8.3 Sept06
As far as homeopathy is concerned, the “best research evidence” is equivocal, but clinical evidence and patient values are most definitely not. Several clinical studies now (*), both in single conditions and in large cohort long-term evaluations of the therapy, show a high level of patient satisfaction as well as results that are comparable, and in many cases superior to, the results obtained by conventional pharmaceutical interventions.
Since Sir David King’s principal gripe about the British public’s opposition to GM foods was that Britain’s failure to adopt GM crops had cost the economy between £2bn and £4bn, it’s tempting to wonder whether his snipe at homeopathy comes from similar financial considerations on behalf of the pharmaceutical industry. This seems woefully out of touch with public opinion, which evidences more concern for the health of the biosphere and the humans inhabiting it than for the health of industry’s bank balances.
It also seems hugely disingenuous amidst recent revelations about contaminated cell lines in cancer research, almost daily reports of drugs being withdrawn for serious side effects, long-term studies showing one of the principal avenues of conventional treatment for cancer, cytotoxic chemotherapy, to have only minimal impact on survival, the ineffectiveness of antibiotic and steroid treatment for sinus infections, the fact that honey is a more effective cough medicine than the widely prescribed dextromethorphan, and so it goes on …
See also goodscience’s blog with a link to a video interview with Dr Maurice Hilleman, former chief of Merck’s vaccine division, talking about the catalogue of errors that accompanied the early development of vaccines for polio. “It was good science at the time because that was what you did …” Is there any reason to suppose, in the light of these daily revelations about the shortcomings of pharmaceutical interventions, that things are any different now?
(*) Outcome and costs of homoeopathic and conventional treatment strategies: A comparative cohort study in patients with chronic disorders. Witt, C, Keil, T, Selim, D et al. Complementary Therapies in Medicine (2005) 13, 79-86. German study concluding from an analysis of outcomes for 493 patients that patients seeking homeopathic treatment had a better outcome overall compared with patients on conventional treatment.
Homeopathic medical practice: Long-term results of a cohort study with 3981 patients. Witt, Claudia M, Lüdtke, Rainer, Baur, Roland, and Willich, Stefan N. BMC Public Health 2005, 5:115. A total of 3,981 patients were studied including 2,851 adults and 1,130 children. Ninety-seven percent of all diagnoses were chronic with an average duration of 8.8 years. Almost all patients had received conventional treatment (95%) prior to the start of this study. Disease severity decreased significantly (p<0.001) between baseline and 24 months. Disease severity and quality of life demonstrated marked and sustained improvements following homeopathic treatment period.
Homeopathic Treatment for Chronic Disease: A 6-Year, University-Hospital Outpatient Observational Study. Spence, David S and Thompson, Elizabeth A. Journal of Alternative and Complementary Medicine Volume 11, Number 5, 2005, pp. 793-798. Observational study of 6544 consecutive follow-up patients during a 6-year period in a hospital outpatient unit within an acute National Health Service (NHS) Teaching Trust in the United Kingdom. 70.7% of patients receiving homeopathic treatment reported positive health changes.
Laughing my socks off ... 
15 comments
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December 11, 2007 at 3:51 pm
yeshomeopathy!
The studies you quote are absolutely remarkable and positive for the success of homeopathy. It is strange that all the bad science people keep claiming there are no studies. These outcome studies moderate the problems with double blind in terms of the difficulty in applying it to homeopathic practitioner methodology. But then it compare homeopathy much more favorably to conventional medicine.
It seems to me that this should be the basis of any evaluation of homeopathy and not the double blind.
December 11, 2007 at 6:35 pm
goodscience
Brilliant!! And isn’t it interesting that there is not ONE comment from “badscience” bloggers. Seems you have done it! They have finally put a sock in it!!
December 11, 2007 at 7:35 pm
laughingmysocksoff
It is strange, isn’t it? I’ve had my nose in the journals today when I’ve had a moment and am finding progressively more and more positive evidence. Watch this space. It’s about time this information got out there.
Either the so-called “sceptics” are just plain ignorant of it all (in which case the ones that claim to be ‘scientists’ should know better than to shoot their mouths off until they’ve done their homework) or they can’t see past their own bias.
December 11, 2007 at 7:59 pm
GaleG
Hi-
I cut and pasted the studies above and included your link onto Gimpy’s blog – no one has commented.
We need your obvious brilliance in doing this research. Thanks-
-GG
December 11, 2007 at 9:34 pm
laughingmysocksoff
I’ve cited them on Gimpy’s blog before Gale. They’re dismissed like everything else. No controls you see.
But nobody has addressed the fact that homeopathy performs as well as or better than pharmaceutical interventions in all the trials comparing the two. To my way of thinking, these are the really critical comparisons, because at the bottom line it doesn’t matter one jot how homeopathy works. If it works as well as or better than the drugs that are killing tens of thousands annually through side effects alone, and that are crippling our health services through their cost, while the pharmaceutical companies individually amass more wealth than most nations can lay claim to, then there is something very very wrong here in all these attempts to dismiss, deny and destroy the therapy.
December 11, 2007 at 10:54 pm
yeshomeopathy!
Yes, whenever anything gets close to breaking apart their hardened opinions it is ignored. But I’m sure someone will come to this post and try to make these excellent studies sound woo woo. I’m beginning to think that maybe woo woo is on their mind a little too much to clearly see the proof.
But laughingmysocksoff- you are sounding the most clear and intelligent of any blogger about the topic of homeopathy and obviously know what you are saying and have the research to back it up. Unfortunately, I get the sense that there is a lot of parlor (magic?) tricks out there to prevent truth about homeopathy and how well it works getting out.
December 12, 2007 at 12:42 am
alwaysquestion
Visiting again after a shortish break, I am amazed how quiet it is from the sceptics’ front. Are they too busy backslapping each other over at Gimpy’s or Ben’s by any chance? Is it too painful to them being faced with so much erudite and informed argument deflating their stance?
As for ‘it doesn’t matter how it works’: quite right. And before any stray sceptic wears out the letters R, C & T on his or her keyboard any further, it might be worth highlighting again how very little is known about the actual mechanisms active in a large proportion of mainstream medicine. How often do we come across the words ‘not well understood’ or ‘not understood’ in research and in expositions about this or that medical intervention, as well as any number of biomedical processes? How many every-day medical interventions are actually chosen on the basis of the ‘gold standard’ RCT – and of those RCTs, how many actually demonstrate how and why a particular drug has a medical effect? If medicine restricted itself to processes that are fully ‘understood’ and to evidence base according to research ‘gold standards’ only, GPs and consultants up and down the country would have a serious problem finding enough validated treatment options.
I don’t often look at sceptics’ blogs any more because by and large one hears the same old same old rehashed at infinitum. But in my various sojourns into that strange land of ‘we-all-agree-so-we-all-are-right-and-if-you-try-shatter-our-certainties-we’ll- have-your-guts-for-garters’, it stood out that where biographical information about members shines through, they do not tend to be doctors – with the notable exception of young Ben, who however can’t have had much time to gather an extensive body of experience in the realities of clinical practice and its evidence base, being far too busy with his journalistic career and feeding his faithful band of fans.
Studies of GP attitudes reveal again and again that a majority prefer being able to offer complementary therapies to their patients where indicated – surely they wouldn’t all be cynically opting for ‘offering placebo’? No, most people in the health care sector who actually care about people’s wellbeing are happy to go with what appears to work while minimising harm, whether we understand ‘how it works’ or not.
December 12, 2007 at 2:18 pm
laughingmysocksoff
Ah yes — I’d noticed this too and was saying exactly this on Goodscience‘s blog yesterday. Interesting, isn’t it? It appears also that quite a few of the most vocal critics are academic scientists working in highly controlled conditions which simply aren’t replicable or applicable in the consulting room or hospital ward. More and more GPs and front-line healthworkers I speak to volunteer quite freely that they have serious doubts about the theoretical assumptions underlying much of “scientific” medicine because “real life isn’t like that”.
A few years back I was at a series of seminars which were also attended by a good number of GP homeopaths. We all got to swapping stories at lunch-breaks about how we’d come to study homeopathy, and pretty much without exception this was the reason the GPs gave. This is good science in operation — 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. If many GPs feel the biomedical model is failing in that test and that the homeopathic model is a better fit, then this is of quite some significance.
December 12, 2007 at 5:37 pm
gimpy
Look you know as well as I do that two of those papers used no control group so are worthless and the one that compares homeopathy to conventional drugs uses tiny sample sizes, no negative control and the conventional drugs are presented with the same ‘ritual’ as the homeopathic remedies. Also, patient perceptions are used to monitor treatment outcomes rather than any biochemical marker of disease remission so you may simply be assessing patients mental state rather than actual remission. Now I do find it interesting that conventional drugs may not work as well as expected but this is a tiny study and the authors do admit as much and request that larger trials are carried out. They have not yet.
December 12, 2007 at 7:49 pm
laughingmysocksoff
Gimpy, see my reply here.
It’s pretty obvious how stupid you think the average homeopathic patient is, but give people credit for knowing when they’ve got better or not! And your blinkers must be size 10s, because it wasn’t the only outcome measure used, as I’ve already stated on your blog. Physician assessments were used as well and the two were in agreement.
Tiny study? 3,981 patients? I don’t think so.
December 13, 2007 at 11:09 am
gimpy
Did my reply get lost?
December 13, 2007 at 1:42 pm
gimpy
I’ll try again. The paper in your latest reply was not the one I was referring to as having a small sample size. The paper you are talking about has no control group so can yield no meaningful information. Basic error. I was talking about “Outcome and costs of homoeopathic and conventional treatment strategies: A comparative cohort study in patients with chronic disorders. “
December 13, 2007 at 3:51 pm
laughingmysocksoff
I’ve no idea but probably. You’re approved for participation on this blog so your responses come straight through unmoderated.
Here we go again. The paper I’m referring to can yield no comparative information (ie. homeopathy vs placebo or no treatment or conventional medicine), but that doesn’t mean it yields no meaningful information. It demonstrates what it demonstrates, which is
And since the findings are in broad agreement with other similar studies, then it’s reasonable to assume they’re robust.
You can carry on ad nauseam trying to dismiss whole studies out of hand because you can find something to criticise in each, but surely you must realise this approach is not exactly scientific. As I keep on saying, lower quality evidence does not equate to no evidence at all.
David Reilly again:
December 15, 2007 at 6:49 pm
gimpy
laughingmysocksoff, we’ve been through this before. Without a control group no conclusion can be reached regarding homeopathy. The only conclusion that can be reached is that the patients reported improved outcomes over time. As there was no control the cause of the improved outcomes remains unknown.
January 12, 2008 at 12:44 pm
Roger Thomas
Though not about homeopathy. Sir David also claims he was the original author of the risk assesment that climate change is a greater threat than terrorism. He wasn’t. This is the original. For a UN report commisioned by the UK Gov 13 months before he published. It’s now been taken off the DEFRA site, but we have placedthe original here.
http://www.mp2.worldfriend.com/sustainable_development_forum.htm