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Two recent and related papers, published in the Journal of Clinical Epidemiology and Homeopathy (the journal of the Faculty of Homeopathy, the UK’s professional organisation of medically qualified homeopaths), have reconstructed the analysis carried out by the authors of The Lancet’s much vaunted 2005 meta-analysis, on the back of which the journal triumphantly editorialised “the end of homeopathy”, and have placed on record the fact that the study was hugely flawed and in some instances just plain incorrect.

These papers emphatically underline the position this blog has taken from the outset — that the underlying data does not support the assertion that homeopathy is no more than placebo. The jury is still out, and those that claim otherwise are misrepresenting their personal opinion as proven scientific fact when it’s nothing of the kind.

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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.

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This is the first paragraph from Ben Goldacre’s recent comment piece Benefits and risks of homeopathy in The Lancet‘s November 17 edition.

Five large meta-analyses of homoeopathy trials have been done. All have had the same result: after excluding methodologically inadequate trials and accounting for publication bias, homoeopathy produced no statistically significant benefit over placebo. 1–5

(1) Kleijnen J, Knipschild P, ter Riet G. Clinical trials of homoeopathy. BMJ 1991; 302: 316–23.
(2) Boissel JP, Cucherat M, Haugh M, Gauthier E. Critical literature review on the effectiveness of homoeopathy: overview of data from homoeopathic medicine trials. Brussels, Belgium: Homoeopathic Medicine Research Group. Report to the European Commission. 1996: 195–210.
(3) Linde K, Melchart D. Randomized controlled trials of individualized homeopathy: a state-of-the-art review. J Alter Complement Med 1998; 4: 371–88.
(4) Cucherat M, Haugh MC, Gooch M, Boissel JP. Evidence of clinical efficacy of homeopathy: a meta-analysis of clinical trials. Eur J Clin Pharmacol 2000; 56: 27–33
(5) Shang A, Huwiler-Müntener K, Nartey L, et al. Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy. Lancet 2005; 366: 726–32

Note that Goldacre omits the Linde et al meta-analysis published in The Lancet in 1997 (6) from his listed studies.

Below are comments and conclusions from each of these studies. Remember, Goldacre is saying that they each support his assertion that homeopathy has no statistically significant benefit over placebo.

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