... and other stories.
Papers, listed by lead author: B
B
Baker, S., et al, (2005) Homeopathic veterinary medicine (letter)Veterinary Record 157:390-391 (2005)
Links: [full text with links to references - vet rec, html ]
Responses: (This is a reply to Hektoen 2005)
Responses: (This is a reply to Hektoen 2005)
Balzarini, A., Felisi, E., Martini, A., De Conno, F., (2000) Efficacy of homeopathic treatment of skin reactions during radiotherapy for breast cancer: a randomized, double-
Weak and vague findings -
There are always people trying to exploit worried and vulnerable patients, but when it comes to cancer sufferers it is particularly disgusting.
Barnes, J., Resch, K.L., Ernst, E., (1997) Homeopathy for postoperative ileus? A meta-analysis Journal of Clinical Gastroenterology Vol. 25 pp. 628-633
A paper which looked at the time to first fart during recovery in patients having undergone abdominal surgery. The authors mention that "several caveats preclude a definitive judgment".
Links: [abstract, pub med]:[nhs library]:[CRD database]
A brilliant summary of all that is wrong with homeopathy with Stephen Barrett at his quiet, rational, informative best, methodically debunking the nonsense put out by those who profit from the sale of bogus remedies to desparate, worried victims. If there was any doubt about the self interested motives of CAM proponents just read some of the comments at the end of the article -
Links: [original article html]
Bell, I.R., Lewis, D.A., Brooks, A.J., Schwartz, G.E., Lewis, S.E., Walsh, B.T., and Baldwin, C.M., (2004) Improved clinical status in fibromyalgia patients treated with individualized homeopathic remedies versus placebo Rheumatology Vol. 43 pp. 577-582
"This pilot or feasability study replicates and extends a previous 1-month placebo-controlled crossover study in fibromyalgia that pre-screened for only one homeopathic remedy. Using a broad selection of remedies and the flexible LM dose (1/50 000 dilution factor) series, the present study demonstrated that individualized homeopathy is significantly better than placebo in lessening tender point pain and improving the quality of life and global health of persons with fibromyalgia."
Although the placebo was claimed to be indistinguishable from the remedy no check was done of participants at the end of the trial to determine if they knew what group they were in. Somewhat unorthodox outcome variables were chosen -
Links: [abstract, pub med]:[abstract, Rheumatology]:[full text, pdf, Oxford journals]
Responses: [Scienced based medicine on homeopathy and fibromyalgia]:[Perry et al 2010]
Responses: [Scienced based medicine on homeopathy and fibromyalgia]:[Perry et al 2010]
Bell, I.R., (2005) All Evidence is Equal, but Some Evidence is More Equal than Others; Can Logic Prevail over Emotion in the Homeopathy Debate Journal of Alternative & Complementary Medicine Vol. 11 no. 5 pp. 763-769
A guest editorial, this opinion piece is a homeopathic howl of anguish about a well conducted study (Shang et al 2005) which has found that homeopathy is ineffective.
It starts off reasonably well as Shang’s study is rightly criticised for not disclosing which trials fulfilled the selection criteria for inclusion in their meta-analysis (this error was recognised by the authors and rectified within a short time of publication). After that though it very quickly degenerates into a litany of the usual lame excuses trotted out by homeopaths about papers whose conclusions they don’t agree with.
Some of the 110 homeopathic trials involved in the selection were “unhomeopathic” we are told; Bell complains that some are "isopathy" - although this of course is never a criticism when results go more in homeopathy’s favour (Reilly et al 1994). Doctor Bell also complains that the Shang paper isn't the "final word" in homeopathic trials. Well the authors never claimed it was, this is simply a straw man argument. An editorial in the same edition of the Lancet did proclaim “The End of Homeopathy” but then quite clearly stated this was because of “150 years of unfavourable findings”, not because of any one paper.
The howl intensifies as the author continues according to the familiar mantra: political bias, including a "heterogenous" set of cases treated with different types of homeopathy, the “forgetting” of the alleged "better overall well-being" , and "greater energy" experienced by homeopathic patients during treatments (nicely vague end points, those, and ones which were never intended to be included in the study), the claim that homeopathy is supposedly cheaper (not if it doesn’t work it isn’t) are all dragged in to cloud the issue and of course the tired old ‘usual suspects’ (Cucherat et al. 2000; Linde 1997; Reilly et al. 1994) are brought into play, with the claim that they are "largely favourable" to homeopathy when in fact they are not (not to anyone who has actually looked at them anyway).
There is the usual complaint of the lack of funding for homeopathic trials (even though the profits of homeopathic pharmacies run into the billions every year) which is completely irrelevant as of course the Shang paper was actually an extremely good study of homeopathy. The problem here for the homeopaths is not lack of funding, it's lack of results.
Nice try, but no coconut I’m afraid.
Links: [abstract, Liebertonline]:[Full text, pdf, OA, JPHMA]
Bell, I.R., Lewis, D.A., Brooks, A.J., Lewis, S.E., Schwartz, G.E., (2003) Gas discharge visualisation evaluation of ultramolecular doses of homeopathic medicines under blinded, controlled conditions J Altern Complement Med Vol.9 pp.25-38
"The procedure generated measurable images at the two highest voltage levels. At 17 kV, the remedies exhibited overall lower image parameter values compared with solvents (significant for Pulsatilla and Lachesis), as well as differences from solvents in fluctuations over repeated images (exposures to the same voltage). At 24 kV, other patterns emerged, with individual remedies showing higher or lower image parameters compared with other remedies and the solvent controls... the present findings also highlight the need for additional research to evaluate factors that may affect reproducibility of results"
Links: [abstract pub med]:[abstract liebertonline]
More weak and unconvincing stuff, many weaselly words in the abstract, slithering around the issue of statistical significance.
Bellavite, P., Ortolani, R., Pontarollo, F., et al. (2006) Immunology and homeopathy. 4. Clinical studies – Part 2. Evidence-based Complementary and Alternative Medicine Vol.3 pp. 397-409
An uncritical, non-
Things start to get desperate when, at one point, the authors even include a trial that someone heard a mention of at a conference but where the complete paper appears to be unavailable to report on. Things get worse as they stop off at one point to briefly argue that hoary old chestnut that proper trials are unsuitable for testing homeopathy since homeopathy “depends on in-depth anamnesis and atmosphere of trust, which is disrupted by randomization” (this is of course complete nonsense - either homeopathy works or it doesn't, lowering the bar for success is just cheating!) then, still careering around for credibility they strike a glancing blow at quantum physics by inserting the word 'entanglement' suggestively a few times before grinding to a halt mired in the no hope saloon of the homeopathic researcher, observational studies.
In the final conclusion the authors claim there is an “efficacy/effectiveness paradox” where homeopathy is rubbish in proper trials but the people who use it and make money from it think it's great. Or, as we at RationalVetMed would prefer to say, “it doesn't work” (stop me if I’m getting too technical).
Belon, P., Cumps, J., Ennis, M., Mannaioni, P.F., Roberfroid, M., Sainte-Laudy, J. Wiegant, F.A.C., (2004) Histamine dilutions modulate basophil activation Inflammation Research Vol. 53 pp. 181-188
Links: [full text BVVS pdf]:[abstract - ingenta connect ]:[Citation only, pub med]
Responses: [JREF forum]:[the great DBH rant]
Responses: [JREF forum]:[the great DBH rant]
Benre, V.V., and Dharmadhikari, S.D., (1980) Arnica and Hypericum in dental practice Hahnemannian Gleanings Vol 47 no. 2 pp 70-72.
Nothing available on line (let me know otherwise)
Benveniste, J., et al (1988) Human basophil degranulation triggered by very dilute antiserum against IgE E. Nature Vol. 333 no. 30 pp. 816-818
This is the notorious ‘memory of water’ experiment by Jacques Benveniste’s team, a source of much agonising on both sides of the debate. Although it is normally referred to as Benveniste’s paper (because it was -
Berrebi, A., Parant, O., Ferval, F., et al. (2001) Treatment of pain due to unwanted lactation with a homeopathic preparation given in the immediate post-partum period. Journal de gynécologie, obstétrique et biologie de la reproduction Vol. 30 pp. 353–357
The main article is in French.
Links: [abstract, pubmed]:[full text, ElsevierMasson]
Berezin, A.A., (1990) Isotopical positional correlations as a possible model for Benveniste experiments Med Hypotheses Vol. 31 no. 1 pp. 43-45
Links: [abstract, pub med]
“At least ten kinds of errors and biases can convince intelligent, honest people that cures have been achieved when they have not.”
Links: [full text - CSI ]
Bignamini, M., Saruggia, M., Sansonetti, G., (1991) Homoeopathic treatment of anal fissures using Nitricum acidum Berlin Journal on Research in Homeopathy Vol 1 pp. 286-287
As examples of just how lame your average homeopath is about evidence have a look at the description of this paper (for which there is no offical, serious reference on line, just a load of pro-
The Homeopathic Research Institute describes what it calls the abstract, "The authors used randomized clinical experimentation that was controlled by a double-blind versus placebo challenge to evaluate the therapeutic activity of Nitricum acidum 9 CH on anal fissures. In general, the active treatment appeared to be satisfactory, but was statistically significant only in two of the 6 parameters considered: burning sensation and the subjective opinion of the patient regarding the efficacy of the treatment. ". The H'pathy web site states "Patients using Nitricum acidum 9C once daily in a double blind placebo controlled trial found subjective relief with the medicine over the placebo"
It is difficult to believe that the first quote is an abstract from an actual scientific paper, even one published in a pro-homeopathic journal. It looks as if it has been written by a five year old and it appears whoever wrote it doesn't understand any of they technical terms they are using. " The authors used randomised clinical experimentation... controlled by a double blind versus placebo challenge" is vague and imprecise and sounds more like something from a star trek script. Maybe it’s a translation issue but it is not the usual form of words found in scientific papers and one has to wonder why that particular phrasing was used and whether something is being hidden as a result. "Satisfactory" is a weasel word which (particularly when preceeded by its partner in crime "appeared") strongly suggests that the authors are desparately trying to squeeze more from the data than is justified from their actual findings, so although there was no statistical significance to the figures they never the less felt justified describing the treatment using a subjective and completely meaningless term which tells us more about the prejudices of whoever wrote this than about the effects of homeopathy.
We aren't told in the selected quotes available what the other parameters considered were but of the two where "statistical significance" is claimed (and we aren't given the figures behind the claim) both are extremely vague and subjective even according to the author of this "abstract". Remember, this is homeopathy versus a sugar tablet, a blank, in other words versus nothing at all, and the absolute best they can claim is an unspecified change in "burning sensation" and the patient's own, subjective opinion of the treatment, something which, however meaningful to the individual patient, has no place in a scientific study. We have no idea what other parameters were looked at, how significant those parameters might have been or how far short of the mark homeopathy fell. This is an excercise in cherry picking data.
I think the verdict here has to be "could do better"!
Links: [noting available online (let me know otherwise)]
Boissel, J.P., Cucherat, M., Haugh, M., Gauthier, E.. (1996) Critical literature review on the effectiveness of homoeopathy: overview of data from homoeopathic medicine trials. In: Homoeopathy Medicine Research Group: report to the European Commission Directorate General XII: science, research and development. Brussels 1996: pp. 195-210
This report is apparently unavailable online (though if anyone knows of a copy please let me know) but, from the similarity of the authors and title, it seems to have given rise to the paper by Cucherat et al, (2000), published in the European Journal of Clinical Pharmacology. Since they are effectively the same a critique of both works can be found following the Cucherat citation on this site. It doesn’t stop homeopaths reporting both pieces as if they were two different works of course to increase their “evidence base” - something which speaks volumes for the attitude of homeopaths to research!
Bordes, L.R., Dorfman, P., (1986) Evaluation of the antitussive effect of Drosetux syrup: double-blind study versus placebo. Cahiers d’ORL Vol. 21 pp. 731-734
an antique paper, in French, apparently not available in English or on line -
Bornhöft, G., Wolf, U., Ammon, K., Righetti, M., Maxion-Bergemann, S., Baumgartner, S., Thurneysen, A.E., Matthiessen, P.F., (2006) Effectiveness, safety and cost-effectiveness of homeopathy in general practice - summarized health technology assessment Forsch Komplementärmed Vol. 13 no. 2 pp.19-29
“Taking internal and external validity criteria into account, effectiveness of homeopathy can be supported by clinical evidence and professional and adequate application be regarded as safe”
Oh, wait, no it can’t... Just another uncritical and wildly optimistic trawl through what passes for research in the smoke and mirror world of homeopathy. Dozens of papers looked at, no mention of exclusion criteria, methods, numbers, power, significance or anything else. Only the abstract is available on line though - (let me know otherwise).
Oh, wait, no it can’t... Just another uncritical and wildly optimistic trawl through what passes for research in the smoke and mirror world of homeopathy. Dozens of papers looked at, no mention of exclusion criteria, methods, numbers, power, significance or anything else. Only the abstract is available on line though -
Also, ”Forsch Komplementärmed” translates as “Research in Complementary Medicine” - publication bias did anyone say?
Links: [abstract pubmed]:[summary, Karger]
Bracho, G., Varela, E., Fernandez, R., Ordaz, B., Marzoa, N., Menendez, J., Garcia, L., Gilling, E., Leyva, R., Rufin, R., de la Torre, R., Solis, R.L., Batista, N., Borrero R., Campa, C., (2010) Large-scale application of highly-diluted bacteria for Leptospirosis epidemic control Homeopathy Vol. 99 pp. 156-166
A paper which was rejected by mainstream journals before finally being accepted by the homeopathy trade journal this non-
Links: [abstract, science direct]:[full text - sphq ]:[press report - medical news today ]
Responses: [apgaylard 2010 - here is the news ]:[apgaylard 2010 - much ado about nothing ]:[Lewis, A., 2009 - quackometer - Hasta el Absurdo Siempre! ]:[Lipson, P., 2010 - science based medicine ]
Keywords: leptospira, nosode, epidemic, Cuba
Responses: [apgaylard 2010 -
Keywords: leptospira, nosode, epidemic, Cuba
Brien, S., Lewith, G. and Bryant, T., (2003) Ultramolecular homeopathy has no observable clinical effects. A randomized, double-blind, placebo-controlled proving trial of Belladonna 30C. Br. J. Clin. Pharmacol Vol. 56 no. 5 pp 562-568
Conclusion: "Ultramolecular homeopathy had no observable clinical effects".The clue is in the title ;-)
The clue is in the title ;-
Links: [abstract - pub med ]:[full text - html ]
Brien, S., Lachance, L., Prescott, P., McDermott, C., Lewith, G., (2011) Homeopathy has clinical benefits in rheumatoid arthritis patients that are attributable to the consultation process but not the homeopathic remedy, a randomized controlled clinical trial Rheumatology Vol. 50 no. 6 pp. 1070-1082
“Homeopathic consultations but not homeopathic remedies are associated with clinically relevant benefits for patients with active but relatively stable rheumatoid arthritis”.
In other words, dear reader it’s the long chat which makes the difference, not the homeopathic pills. There is nothing unique or special about homeopathy, it’s all in the bedside manner; the only difference between a homeopathic practitioner with a good bedside manner and a real doctor with a good bedside manner is that the real doctor doesn’t do that little fibby-
Links: [abstract, rheumatology]:[full text, html, rheumatology]:[full text, pdf, rheumatology]
Responses: [Ernst, 2011]
Responses: [Ernst, 2011]
Brigo, B., Serpelloni, G., (1991) Homoeopathic treatment of migraines: a randomized double-blind study of sixty cases (homoeopathic remedy versus placebo). Berlin Journal on Research in Homeopathy Vol. 1 pp.98-106
A non-
Brinkhaus, B., Wilkens, J.M., Lüdtke, R., et al. (2006) Homeopathic arnica therapy in patients receiving knee surgery: results of three randomised double-blind trials Complementary Therapies in Medicine Vol. 14 pp. 237-246
“CONCLUSIONS: In all three trials, patients receiving homeopathic arnica showed a trend towards less postoperative swelling compared to patients receiving placebo”
Well, that sounds fantastic, surely this is proof that homeopathy works (well, at least a “trend towards” it, that’s got to mean something hasn’t it?). Absolutely it is, oh, apart from the next bit “However, a significant difference in favour of homeopathic arnica was only found in the Cruciate Ligament Repair (CLR) group”, well, but surely... err, hang on the CLR trial only has 57 of the 319 patients looked at in total. Yeah, but significance is significance isn’t it? Well, is it? In this paper the authors admit that the difference in absolute terms between knee circumferences (designated merely as a secondary outcome) was nowhere near statistically significant in any of the trials, being only a few millimetres between the two groups (placebo and verum) out of a total of around 390 mm - not that striking at all really when you think about it. It’s only when the percentages are looked at, using an unusual “triangle” test, that statistical significance appears, like a rabbit out of a hat.
Well, that sounds fantastic, surely this is proof that homeopathy works (well, at least a “trend towards” it, that’s got to mean something hasn’t it?). Absolutely it is, oh, apart from the next bit “However, a significant difference in favour of homeopathic arnica was only found in the Cruciate Ligament Repair (CLR) group”, well, but surely... err, hang on the CLR trial only has 57 of the 319 patients looked at in total. Yeah, but significance is significance isn’t it? Well, is it? In this paper the authors admit that the difference in absolute terms between knee circumferences (designated merely as a secondary outcome) was nowhere near statistically significant in any of the trials, being only a few millimetres between the two groups (placebo and verum) out of a total of around 390 mm -
This paper also is a classic example of looking at indirect outcomes of an intervention. The authors have chosen to look at post-
So this is yet another homeopathic lemon I’m afraid. In all the ways that are meaningful to the patient homeopathy is useless and, even in the parameters which present homeopathy in its best light, the minute differences in knee circumference are only different when looked at as a percentage, not absolute measurements and then in only 57 out of 319 patients. And remember, the RationalVetMed elephant-in-the-room as always with these so called favourable trials is that homeopathy is being compared WITH A SUGAR TABLET (sorry for shouting). Compared with real drugs even the authors admit homeopathy falls completely flat (they just don’t use those words, and they bury that bit in the last paragraph of the discussion) so, at the end of the day one has to ask “why bother”.
Finally, the authors also claim that they found 40 trials of homeopathic arnica (presented conveniently in a non-English language journal) which, they say, found that, by and large, it was jolly t’riffic stuff. I wonder if all those trials were as rigorous as this one?
There are other trials of Arnica, not mentioned by the authors which come to the conclusion that arnica as a treatment for bruising and swelling is a complete waste of time, for example Stevinson (2003), Ernst and Pittler (1998) and Ernst (2003). One even appears in the Homeopathy journal - now that’s a refreshing change.
Brydak, L.B., Denys, A., (1999) The evaluation of humoral response and the clinical evaluation of a risk-group patients’ state of health after administration of the homeopathic preparation Gripp-Heel during the influenza epidemic season 1993/94 International Review of Allergology and Clinical Immunology Vol. 5 pp. 223-227
Despite this paper’s optimistic claim (“the clinical data we obtained indicate seroprotection against influenza after the administration of Gripp-
For a start there is selection bias as all participants were volunteers, so we have no way of telling whether or not patients were influenced by their own state of health, whether or not they believed in homeopathy or other factors when volunteering for the trial, in fact no selection criteria are given at all. The authors have conducted their trial in a population representative of the real world at-risk group which is good but it does mean that all participants were suffering chronic illnesses which inevitably will have an effect on their immune status and antibody levels (which is what the authors were investigating). We are told that the participants were “randomly divided into two groups” but are given no details of the randomisation process. This is important as it would be possible for those carrying out the randomisation to unconsciously influence which type of patient was entered into either the control or the verum group, introducing another form of bias. There may have been a tendency to put patients it was felt were less likely to contract flu or perhaps those who simply looked more ill or frail in one group rather than another.
The participants were living in nursing homes (how many isn’t specified but it is more than one) but we are not told whether patients were selected randomly across the whole group of them or whether all patients from one nursing home were put in one group. Obviously different conditions in one home compared with another would have a marked effect on the outcome so it is surprising that this isn’t even discussed. There is also no mention of whether or how the two populations were matched in order to make sure that the control group was comparable with the treatment group, an essential prerequisite to a study of this sort.
No blinding is mentioned and again this is crucial and throws real doubt on the paper’s methodology. Certainly there would have been no need to blind the participants, who would have presumably been unaware of their circulating antibody levels, but what about the people doing the analysis? It is not unheard of for a technician who gets an unexpected result to re-run the analysis “just to check”. It would be easy to unwittingly introduce bias at this point if someone tended to re-run tests which produced results that didn’t correlate with the outcome they were expecting yet didn’t re-run truly unexpected results which, however unlikely, did fit in with their expectations. The figures used in the paper include only mean antibody levels, we have no idea what individual patients’ levels were so the calculations can’t be checked and there is no way of telling whether there may have been bias at this stage or whether one or two extreme results had undue influence on the overall averages; results which might otherwise have been excluded from the calculations as ‘outliers’ or possibly spurious.
It cannot be said with any certainty whether any of these types of bias were present of course but from the way the paper is laid out and from the limited data we are given there is no way to be sure, and when you are testing a claim that remedies which contain no active ingredients are effective in protecting vulnerable individuals against a life threatening disease, the onus is on the authors to make sure that such loose ends are well and truly tidied up before making such bold claims. Making clinical recommendations from these results is irresponsible and this paper is by no means evidence that homeopathy has any discernible effect.
Links: [full text, pdf, biopathica]
Burger, J., Kirchner, M., Bramanti, B., Haak, W., Thomas, M.G., (2007) Absence of the lactase-persistence-associated allele in early Neolithic Europeans Proceedings of the National Academy of Sciences of the United States of America Vol. 104 no. 10
What has this paper, on the evolution of stone-
Links: [full text, PNAS, pdf]
Responses: [press release, UCL]
Key words: raw, food, meaty, bones, barf, rmb
Responses: [press release, UCL]
Key words: raw, food, meaty, bones, barf, rmb
| History of RVM |
| The Best They Can Do |
| The Usual Suspects |
| How to look at evidence |
| CAM journals and evidence |
| Scepticism about homeopathy |
| Arguments |
| Acupuncture references |