BSc - in Homeopathy?

[WittyBird]

I was misled into thinking it was a dumbo university by the fact that it offers science degree courses in, as Barry would say, magic...

Can you get there from Platform 9¾? Or do you have to use the toll road like everyone else?

[Barry Shnikov]

astute, adj. : Having or showing shrewdness and discernment, especially with respect to one's own concerns.

learnt a new word today (well make it 2 in fact)

Eternal Gratefulness to Mr Shnikov

De nada por que

[Tessalicious]

This link was just sent round to my entire group (I think our senior publisher worships Ben Goldacre - quite rightly). I just had to share - just for Barry's entertainment even if none of the rest of you can be bothered to read it.

What's wrong with homeopathy, by Ben Goldacre | Science | The Guardian

[Barry Shnikov]

This link was just sent round to my entire group (I think our senior publisher worships Ben Goldacre - quite rightly). I just had to share - just for Barry's entertainment even if none of the rest of you can be bothered to read it.

What's wrong with homeopathy, by Ben Goldacre | Science | The Guardian

Thanks, Tess.

Hard to avoid the feeling that he's a bit of a voice in the wilderness, these days.

[batnurse]

This link was just sent round to my entire group (I think our senior publisher worships Ben Goldacre - quite rightly). I just had to share - just for Barry's entertainment even if none of the rest of you can be bothered to read it.

What's wrong with homeopathy, by Ben Goldacre | Science | The Guardian

Ben Goldacre is a God amongst men

[batnurse]

To: whoever repped me (+ve, by the way, so no whinging please)

I know the principles on which, for example, vaccination works.

Homeopathy, however, relies on the principle regardless of all other knowledge. Plus, the magic bit - Fever? that means...you're hot. So...what makes you hot? chili peppers. OK, take chili peppers, grind them to a paste and mix one gram of the paste with 10,000 swimming pool fulls of distilled water and then drink a thimblefull. Next!

...erm...but my fever is caused by a bacterial infection. Couldn't I take some antibiotics?

HA! You're willing to put the poisonous crap that multinational pharmaceuticals put on the market without any idea what disgusting horrible nasty unnatural chemicals it has in it?

Here, have some rotted duck liver - it's great for flu!!

As ever Barry, you have taken the words out of my mouth! Well said

[Andy McGregor]

Thanks, Tess.

Hard to avoid the feeling that he's a bit of a voice in the wilderness, these days.

You do not get published in The Lancet if you are a lone voice.

I remember reading about homeopathy when I was in my early teens. At that tender age I couldn't understand what was going on and thought it must have been my youth and inexperience that obscured my thinking. Older, wiser and richer people, including the Queen, said that homeopathy worked. My own logic said that it couldn't work

Now that I'm 51, have been a scientist and have worked in the pharmaceutical industry for many years I've seen much evidence of drug efficacy. I've also read, and been involved with, many studies that proved that a chemical has no effect in a particular condition.

There are two things about clinical studies that have always fascinated me. The first is the amazing efficacy of placebo. The second is the significant number of patients who get absolutely no benefit from a particular treatment. In many studies the treatment group will only be 20% more effective than the placebo group - and 20% of the treatment group will not no benefit at all (figures plucked from the air - please don't ask me for a bibliograhy or references).

In evidence based medicine one of the figures you will consider is NNT: Number Needed to Treat. This is the number of patients you need to treat to prevent one adverse outcome: heart attack, hip fracture, etc. In studies this figure sometimes single figures, however, I've seen studies where you need to treat 50 patients to prevent one hip fracture in one year. And these studies are done on particularly active drugs. For an example, go here. There is also a number called NNH, Number Needed to Harm, the number of patients you need to treat to cause one adverse outcome.

In properly construced studies the NNT is produced by comparing the treated group with the placebo group. However, homeopathy doesn't recognise the need for a placebo group. So their NNT will be produced with the assumption that no treatment will get no result. Also, consider NNH and homeopathy: a treatment that is water is unlikely to cause harm. I think it is this factor in homeopathy that is it's major selling point.

Let's compare homeopathy to cancer chemotherapy. Use chemotherapy and there is a good chance that your hair will fall out. This will not happen with homeopathy.

[Tiggerbabe]

This link was just sent round to my entire group (I think our senior publisher worships Ben Goldacre - quite rightly). I just had to share

Thanks Tess

[Tessalicious]

some good points about NNT

Absolutely - I will never say that people who perceive some additional benefit from homoeopathic treatmen should not use it along with their normal medication.

In properly construced studies the NNT is produced by comparing the treated group with the placebo group. However, homeopathy doesn't recognise the need for a placebo group. So their NNT will be produced with the assumption that no treatment will get no result. Also, consider NNH and homeopathy: a treatment that is water is unlikely to cause harm. I think it is this factor in homeopathy that is it's major selling point.

Let's compare homeopathy to cancer chemotherapy. Use chemotherapy and there is a good chance that your hair will fall out. This will not happen with homeopathy.

And this is the problem. On it's own, homoeopathy is not harmful, and may or may not be beneficial. The problem comes, as Lord Goldacre points out, when homoeopaths - without formal medical training - recommend that their clients stop taking normal prescription medication in favour of their homoeopathic prescription. People have died, contracted malaria, etc in these circumstances, and it is completely irresponsible.

[ducasi]

The placebo effect is powerful. Powerful enough that sometimes it can cure – especially in the sorts of conditions which are influenced greatly by brain states. So while it can't cure a broken arm, it may make the difference between living or dying when the attitude of the person makes a difference.

The key to effective placebo treatment is that the patient doesn't know that the treatment is a placebo. As soon as the patient believes that they are not being actively treated they placebo effect falls away to next to nothing.

Unfortunately medical ethics says that we cannot deceive patients with placebo medicines.

What I see in Homeopathy is a good way to continue placebo medicine in an ethical manner. While people are prepared to accept there may be something to the homeopathic method, it is ethical to use homeopathic medicines.

The result is better patient care, more successful treatments for illnesses and disorders, and ethically happy medics.

So what's the problem? Would you rather people stayed ill and died? That's a big price to pay to be scientifically sound.

[ducasi]

And this is the problem. On it's own, homoeopathy is not harmful, and may or may not be beneficial. The problem comes, as Lord Goldacre points out, when homoeopaths - without formal medical training - recommend that their clients stop taking normal prescription medication in favour of their homoeopathic prescription. People have died, contracted malaria, etc in these circumstances, and it is completely irresponsible.

That's a good point. However, in cases where conventional medicines are making no difference, and the patient is expected to die, maybe switching to a homeopathic remedy will make the remainder of their lives better, even if it doesn't cure.

I'd suggest though that the doctors in NHS Homeopathic hospitals, and those trained with their degrees in Homeopathy, are much less likely to do things which endanger the lives of their patients.

[boardrider]

snip

The key to effective placebo treatment is that the patient doesn't know that the treatment is a placebo. As soon as the patient believes that they are not being actively treated they placebo effect falls away to next to nothing.

Unfortunately medical ethics says that we cannot deceive patients with placebo medicines.

What I see in Homeopathy is a good way to continue placebo medicine in an ethical manner. While people are prepared to accept there may be something to the homeopathic method, it is ethical to use homeopathic medicines.

I'm not so sure but am fully prepared to be enlightened.

Can a medic prescribe or recommend homeopathy as a treatment? Not if they are to stay within the guidelines of best practice and informing the patient.

If a medic recommends a treatment that is a placebo, they must inform the patient it is a sugar pill, nice massage, soothing hot stone, etc....
If a medic recommends a treatment they have not researched or read about, that would be a bad thing. So they must research any treatment they recommend.
If a medic recommends a treatment they have researched, and it is shown to be no more effective than a placebo, but doesn't inform the patient that it is a placebo, how would that be perceived?

So can a medic ethically recommend homeopathy?

[Andy McGregor]

The placebo effect is powerful. Powerful enough that sometimes it can cure – especially in the sorts of conditions which are influenced greatly by brain states. So while it can't cure a broken arm, it may make the difference between living or dying when the attitude of the person makes a difference.

The key to effective placebo treatment is that the patient doesn't know that the treatment is a placebo. As soon as the patient believes that they are not being actively treated they placebo effect falls away to next to nothing.

Unfortunately medical ethics says that we cannot deceive patients with placebo medicines.

What I see in Homeopathy is a good way to continue placebo medicine in an ethical manner. While people are prepared to accept there may be something to the homeopathic method, it is ethical to use homeopathic medicines.

The result is .

So what's the problem? Would you rather people stayed ill and died? That's a big price to pay to be scientifically sound.

Ducasi's reasoning is completely flawed. There is no evidence that homepathic treatments will result in "better patient care, more successful treatments for illnesses and disorders, and ethically happy medics". The only result I can foresee is poorer patients and richer homeopaths.

And it gets worse, Ducasi contradicts himself too. His stream of logic goes;

Placebos are effective.
Placebos do not work if the patient knows they're getting one.
Homeopathic medicines are placebos and will therefore have the same effect as a placebo.
Therefore the result will be "better patient care, more successful treatments for illnesses and disorders, and ethically happy medics".

There are 2 reason that his logic is flawed. The first is the word "better". Because in drug treatment it has to be better than something, usually placebo, but sometimes an alternative treatment. The second reason is the phrase "ethically happy medics", how can a medic be "ethically happy" to give a placebo? Ducasi says it himself in the line "Unfortunately medical ethics says that we cannot deceive patients with placebo medicines". So, we know that homeopathic medicines are a placebo, therefore we can not be "ethically happy" to knowingly administer a placebo.

N.B. There are many physicians who would be happy to prescribe a placebo without stirring a hair - luckily for my argument that Ducasi's logic is flawed, he didn't mention that fact

That's a good point. However, in cases where conventional medicines are making no difference, and the patient is expected to die, maybe switching to a homeopathic remedy will make the remainder of their lives better, even if it doesn't cure.

This is a simplistic view. But is does, IMHO, have a small amount of merit. Once a doctor has decided that a patient is going to die from their condition the management objectives change. A great deal of that management is about patient comfort and peace of mind. Homeopathy might be the right option if it gives the patient more peace of mind. However, I believe a physician should make that choice in the full knowledge of ALL the available treatment options. A homeopath is, by their very nature, only going to consider homeopathic remedies.

I'd suggest though that the doctors in NHS Homeopathic hospitals, and those trained with their degrees in Homeopathy, are much less likely to do things which endanger the lives of their patients.

I think the best way for homeopaths to stop endangering their patients is to let real medics treat patients with proven therapies.

[Barry Shnikov]

That's a good point. However, in cases where conventional medicines are making no difference, and the patient is expected to die, maybe switching to a homeopathic remedy will make the remainder of their lives better, even if it doesn't cure.

I'd suggest though that the doctors in NHS Homeopathic hospitals, and those trained with their degrees in Homeopathy, are much less likely to do things which endanger the lives of their patients.

Well hold on, Hengist.

Before we start enrolling homeopathy as the route to salvation when orthodox medicine fails, we have to point out that homeopaths do not accept that their treatment works because of the placebo effect; they maintain that it works because their medicines are efficacious.

Add to that the fact the homeopaths will casually assert that their treatments are to be tried before and/or rather than orthodox medicine (AIDS, malaria, etc.) and it's clear that a whole bunch of issues have to be dealt with before we can say 'oh well at least homeopaths do no harm and may well invoke the placebo effect so let's not be hasty in condemning it, eh?'

[batnurse]

Hey Barry,

Do you dare me to start a thread called "MMR, is it good for your children?"

[Andy McGregor]

Add to that the fact the homeopaths will casually assert that their treatments are to be tried before and/or rather than orthodox medicine (AIDS, malaria, etc.) and it's clear that a whole bunch of issues have to be dealt with before we can say 'oh well at least homeopaths do no harm and may well invoke the placebo effect so let's not be hasty in condemning it, eh?'

This "casual" assertion is the bit that really bugs me.

In the world of pharmaceuticals we have to prove everything we say. And we have to publish all our results, good or bad. And we, quite rightly, get our pants sued off when we make a mistake.

Look at homeopathy. No studies, no evidence, wild claims. And now a degree in the subject. What, exactly, do they study? Is there any substance to the course at all? Or is it just remembering dilutions and names of different bottles of water?

There are many treatments that respond to non-pharmaceutical intervention. For example, there is significant evidence that physical conditions like severe burns respond well to hypnosis. You could extrapolate from this clear evidence that a consultation with a homeopath might have a similar effect on some conditions as the homeopath plants suggestions of healing in the mind of a patient. Once you have agreed that the consultation with a homeopath is an intrinsic part of any treatment you then have difficulty conducting a placebo controlled study as there is no placebo for a consultation. Again, this argument is spurious. You would simply conduct the same consultation and then give a randomised selection of patients either placebo or the homeopathic remedy. The study would have to be double-blind: that means neither the homeopath or the patient would know if the bottle they received contained the homeopathic remedy or a placebo.

I've been thinking a bit more about the theory of molecule memory that is asserted by homeopaths. This is obviously bunkum. Over the millions and millions of years of their existence, most molecules of water will, at some time, have been in contact with or even part of most other things*. If those water molecules were able to somehow "remember" a particular contact, how would they forget all previous contacts?

Furthermore, once you get to a certain dilution, the water molecules that were in contact with the original ingredient will cease to be present in your sample. Do those water molecules somehow pass on their "memory" to the others around them? Because, if they do, all you'd need to do to cure the whole world would be to pop down to the beach with your dropper and add a bit of arsenic or whatever you believed was a cure. It's all plainly rubbish.

N.B. The above two paragraphs are not intended to logically prove that homeopathy is ineffectual (studies have proved that fact). It is intended to prove that the theory behind the medicines is completely flawed.

*Strange thought, but possibly being in contact with God/Jesus/Allah/Muhummed/Budda/Hitler/Nero/etc.

[Andy McGregor]

Hey Barry,

Do you dare me to start a thread called "MMR, is it good for your children?"

Please don't. The guy who started that rumour caused real deaths. We might end up with even more mothers mistakenly denying their children protection. It's really not a laughing matter.

[DavidY]

The wonderful New Scientist has published a link to this homeopathy website.

[Barry Shnikov]

The wonderful New Scientist has published a link to this homeopathy website.

It might be interesting to go back in a year or so and see how successful they've been. It could be a new medical phenomenon!

[DavidY]

It could be a new medical phenomenon!

I particularly liked their slogan:
"Nothing acts as well as FairDeal Homeopathy"