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Ben Goldacre’s March 1st Bad Science piece for the Guardian, Don’t laugh, sugar pills are the future, in which he comments on the latest research to show that SSRIs are not much more effective than placebo in treating depression is, as usual, a bit thin on the ground with the actual science itself, even if his title might turn out to be remarkably prescient. And, wonder of wonders, I even agree wholeheartedly with a substantial amount of his earlier piece on February 27th, based on the same study, A quick fix would stop drug firms bending the truth. But far more interesting is the piece by Clive Cookson in the FT, Is there an ethical way to fine-tune the placebo effect?
I’ve been taking a closer look at what Ben Goldacre regards as ‘good science’, given that he makes such grandiose and sweeping claims about the respective quality of research into both homeopathy and pharmaceutical interventions in both his recent Guardian article, What’s wrong with homeopathy? and the accompanying comment piece in The Lancet, Benefits and Risks of Homeopathy.
In the Guardian, he claims:
I look about 12, and I’m only a few years out of medical school. This is all good fun, but my adamant stance, that I absolutely lack any authority, is key: because this is not about one man’s opinion, and there is nothing even slightly technical or complicated about the evidence on homeopathy, or indeed anything, when it is clearly explained.
He then goes on at great length, much of it speculative, to give his reasons for why just about all homeopathic research is meaningless nonsense full of nothing but bias and conventional medical research is robust.
But thanks to a rapid response on the BMJ’s website, we learn the following from John Stone:
This is the second paragraph from Ben Goldacre’s recent comment piece Benefits and risks of homeopathy in The Lancet’s November 17 edition.
During the cholera epidemic in the 19th century, death rates at the London Homoeopathic Hospital were three times lower than those at the Middlesex Hospital. (6) The reason for homoeopathy’s success in this epidemic is even more interesting than the placebo effect. At the time, nobody could treat cholera, and while medical treatments such as blood-letting were actively harmful, the homoeopaths’ treatments were at least inert.
(6) Hempel S. The medical detective. London, UK: Granta Books, 2006
Notice how Goldacre doesn’t give us the actual figures. (And this is The Lancet, not the Guardian.) Neither does he clarify that his reasoning is speculation, not established fact. The actual mortality percentages would allow readers to make some kind of sensible judgement about his conjecture that medical treatments exacerbated mortality while homeopathic treatment equated to no treatment at all.