I don’t know how, but homeopathy really does a number on some people…
Cross-posted from Divisible By Pi.
Poor Rachel Roberts has had rather a tough time of it. Passionate about science from a young age, she went to university and managed to land a position in a neuroscience PhD program — rather on track for a promising career in research, one might assume.
But then she threw it all away. She gave “[her] coveted PhD studentship over to [her] best friend” and set sail for a three year course in homeopathy. And now, of course, she has to put up with all those meanie scientists telling that homeopathy is a load of bollocks! Why can’t they just leave her alone???
Given that the linked article is all about how science is apparently proving the effectiveness of homeopathy, you may be wondering what exactly the turning point was in Rachel Roberts’ life that convinced her to chuck in a career in neuroscience for the medical equivalent of a tin foil hat. Perhaps it was a particularly clear and well performed study related to her chosen field of science? Maybe she saw a homeopathic balm regrow the arm of an amputee, or witnessed an ultra-dilute tincture cure cancer?
Nope. In her own words:
That turning point is etched in my mind. A woman I’d known my entire life told me that a homeopath had successfully treated her when many months of conventional treatment had failed. As a sceptic, I scoffed, but was nonetheless a little intrigued.
She confessed that despite thinking homeopathy was a load of rubbish, she’d finally agreed to an appointment, to stop her daughter nagging. But she was genuinely shocked to find that, after one little pill, within days she felt significantly better. A second tablet, she said, “saw it off completely”.
I admit I ruined that dinner party. I interrogated her about every detail of her diagnosis, previous treatment, time scales, the lot. I thought it through logically – she was intelligent, she wasn’t lying, she had no previous inclination towards alternative medicine, and her reluctance would have diminished any placebo effect.
HOLY BRIGHAM YOUNG, CALL OFF THE SCIENTISTS!!! We’ve got unassailable, incontrovertible proof that homeopathy works now — a single anecdote, related by an old friend at a dinner party, about how an unnamed person who could ne’er lie or be deceived was cured of an unspecified ailment with only two homeopathic tablets. Conventional medicine be damned: It couldn’t do diddly-squat to treat this vaguely malicious infection-slash-disorder.
After all, it’s well known in scientific circles that uncorroborated dinner gossip trumps peer reviewed research every time.
The rest of the article is, sadly, no more than the tired old argument that scientists and skeptics are ignoring all of the peer reviewed literature in favour of homeopathy because…well, she never really says why. She does, however dive even deeper into delusion when she starts discussing what she considers the evidence for homeopathy. She brings up some of the systematic reviews of homeopathy, labelling four of them as positive (Kleijnen, J, et al; Linde, K, et al; Linde, K, et al; Cucherat, M, et al) and one as negative (Shang, A et al). First, let’s take a look at what the negative one had to say:
Background Homoeopathy is widely used, but specific examples of homoeopathic remedies seem implausible. Bias in the conduct and reporting of trials is a possible explanation for positive findings of trials of both homoeopathy and conventional medicine. We analysed trials of homoeopathy and conventional medicine and estimated treatment effects in trials least likely to be affected by bias.
Interpretation Biases are present in placebo-controlled trials of both homoeopathy and conventional medicine. When account was taken for these biases in the analysis, there was weak evidence for a specific effect of homoeopathic remedies, but strong evidence for specific effects of conventional interventions. This finding is compatible with the notion that the clinical effects of homoeopathy are placebo effects.
Ooh, ouch. It doesn’t get much more painful than that. Maybe we should take a look at some of the positive studies, to lessen the sting for any supporters of homeopathy that may be reading this…
Kleijnen, J, et al:
At the moment the evidence of clinical trials is positive but not sufficient to draw definitive conclusions because most trials are of low methodological quality and because of the unknown role of publication bias. This indicates that there is a legitimate case for further evaluation of homoeopathy, but only by means of well performed trials.
Well, that doesn’t seem particularly positive. Sure, it doesn’t hurt as much as being told that homeopathy is implausible and likely placebo, but still — after however many trials, you’re still stuck with inconclusive results due to poorly performed studies? Let’s just say, I would be trumpeting that from the rooftops.
What about the other positive studies? Surely things can only look up, right?
Linde, K, et al:
The results of our meta-analysis are not compatible with the hypothesis that the clinical effects of homoeopathy are completely due to placebo. However, we found insufficient evidence from these studies that homoeopathy is clearly efficacious for any single clinical condition. Further research on homoeopathy is warranted provided it is rigourous and systematic.
Linde, K, et al:
Studies that were explicitly randomized and were double-blind as well as studies scoring above the cut-points yielded significantly less positive results than studies not meeting the criteria. In the cumulative meta-analyses, there was a trend for increasing effect sizes when more studies with lower-quality scores were added. However, there was no linear relationship between quality scores and study outcome. We conclude that in the study set investigated, there was clear evidence that studies with better methodological quality tended to yield less positive results.
Cucherat, M, et al:
There is some evidence that homeopathic treatments are more effective than placebo; however, the strength of this evidence is low because of the low methodological quality of the trials. Studies of high methodological quality were more likely to be negative than the lower quality studies. Further high quality studies are needed to confirm these results.
With friendly studies like this, who needs hostile ones? Hell, even the studies that you cite as positive point out that better quality studies lead to a worse result for homeopathy — for those of you playing along at home, that’s the opposite of what you’d expect in the case of a real effect. Even the most positive of these studies (the first Linde one) is only able to say that it seems like homeopathy can’t be explained by the placebo effect alone, not that there is clear evidence it works in any particular situation.
Imagine if conventional medicine was based on such poor footing: “Hmmm…looks like you’ve got some kind of a rash on your arm. Have some antibiotics — we’re not sure what they work for, or in what situations, but we’re pretty sure they work for something.” The homeopaths would be outraged — of course, the skeptics would be too, but then the skeptics wouldn’t try to sell you sugar pills and water afterwards.
Overall, the article is more of what we’ve come to expect from purveyors of woo — unsupported anecdotes, arguments to popularity, and a big ol’ whingefest about how the skeptics are ignoring evidence and suppressing the truth for some surely nefarious though unstated reason. Personally, I’ll be waiting right here with an open (yet critical) mind whenever homeopaths are able to bring something new to the table.
I won’t be holding my breath though.