Papers, listed by lead author: R-S
Ramey, D.W., (2000) The Scientific Evidence on Homeopathy American Council on Science and Health [online]
Introduction: The scientific investigations of homeopathy that have been completed and published are sufficient for drawing reliable conclusions about this counterscientific approach to medicine. These studies have generated widely assorted positive, negative, and neutral conclusions. Therefore, it is not difficult, especially if one does not consider the quality of the evidence, to find published conclusions compatible with, or pervertible to, a particular bias. But parading pieces of evidence thus culled does the public little or no good.
Ramey, D. et al and Hektoen, L. (2005) Homeopathic veterinary medicine (letter+author’s response) Veterinary Record 157:390-391 [full text - vet rec]
Ramey, D., (2010) Acupuncture and history: The “ancient” therapy that’s been around for several decades (blog entry) Science Based Medicine, October 18 (also attributed to Kavoussi, B.)
“Acupuncture proponents may assert... that acupuncture is “4,000 years old.” While the assertion isn’t true, it’s also ridiculous, since the Chinese hadn’t invented writing 4,000 years ago. Even if the assertion were true, there would be no way to possibly know about it, since no one could have written anything down about the practice.
... it can be stated that Chinese veterinary medicine isn’t unique, and it isn’t even particularly Chinese. That is, what is presented to the eager public as the essence of Chinese thought and practice is, in fact, just an adaptation of contemporaneous practices in Greece and the Middle East. In fact, most Chinese practices, such as bleeding, and burning at points, appear in Greek, Egyptian, and Arabic sources long before they were ever mentioned in China. Such practices first appear in China during a period of maximal western influence on China, corresponding with regular traffic on the Silk Road (during Han times, approx. 200 BCE – 200 AD), as well as with the coming of Buddhism, which brought in influences from Indian traditions.
... there is no reference to what can even be remotely considered as modern acupuncture in any of the pre-modern Chinese veterinary works”
Rao, M.L., Roy, R., Bell, I.R., Hoover, R., (2007) The defining role of structure (including epitaxy) in the plausibility of homeopathy Homeopathy Vol. 96, no. 3, pp. 175-182
This paper attempts to prove that liquids have a memory based on structural differences between different type of homeopathically diluted solutions of (in this case) ethanol. The authors claim that this memory can be demonstrated by spectroscopic analysis of the different solutions. It was thoroughly debunked by a group of authors in a letter to the journal which is reproduced in full in the Bad Science Journal Club (link below).
In a nutshell the paper is riddled with problems which render the conclusion "Preliminary data... illustrate the ability to distinguish two different homeopathic medicines... from one another and to differentiate, within a given medicine, the 6c, 12c, and 30c potencies" completely unjustified. The journal Homeopathy is a subscription only publication with the abstract being the only section publicly available; rather disingenuously although the authors mention the word "water" twice in the abstract and one of the phrases in the key words is "structure of water" at no point do they mention that the paper itself concerns ethanol (i.e. alcohol), not water - a curious omission but one which would certainly lead a reader to conclude from reading the abstract that their experiments had been performed on water.
The authors claim in the abstract "The key stumbling block to serious consideration of homeopathy is the presumed “implausibility” of biological activity for homeopathic medicines in which the source material is diluted past Avogadro's number of molecules". This is what is known as a strawman argument; homeopathy has a massive number of "stumbling blocks" of which extreme dilution is only one. The claim that any one of them is more 'key' than another is just wrong. Even if it were proved tomorrow that water had a memory there would still be many reasons why the proposed mechanisms behind homeopathy were impossible, and then, regardless of the propose mechanisms, there is the not so minor problem of why it always fails so badly in well conducted clinical trials.
The letter of refutation (the reference to a copy in the Bad Science comments section is given below but it was actually accepted for publication in the journal itself) is well worth a read as a masterclass in how to interpret a scientific paper. Its authors point out a myriad of fatal flaws in the original paper including the fact that the samples of ethanol used for comparison seemed to be from different sources with different levels of contaminants, and none of them were of a grade pure enough to perform reliable spectroscopy on anyway. Also the paper's authors appear to have got two of their graphs mixed up by mistake. Their key claim that the various remedies were spectroscopically different is simply incorrect, any differences infact being due either to faulty presentation of the data or to the presence of contaminants. Furthermore the lack of data and statistical analyses presented preclude any independent verification of the figures.
All in all this is just more disingenuous homeopathic flannel, badly done and claiming to prove something that it doesn't.
Ratajczak, H.V., (2011) Theoretical aspects of autism: Causes - A review Journal of Immunotoxicology Vol. 8 no.1 pp. 68-79
Reilly, D.T., Taylor, M.A., (1985) Potent placebo or potency? A proposed study model with initial findings using homoeopathically prepared pollens in hay fever British Homoeopathic Journal Vol: 74 pp. 65-75
Reilly, D.T., Taylor, M.A., McSharry, C., Aitchison, T., (1986) Is homoeopathy a placebo response? Controlled trial of homoeopathic potency, with pollen in hayfever as model. Lancet 1986 Vol. 2 pp. 881-886
Reilly, D., Taylor, M.A., Beattie, N.G., Campbell, J.H., McSharry, C., Aitchison, T.C., Carter, R., Stevenson, R.D., (1994) Is evidence for homeopathy reproducible? Lancet Vol. 344 no. 1 pp. 601-606
A meta-analysis of 3 trial of homeopathic treatment of asthma which apparently found that "homeopathy does more than placebo". No mention of blinding, no mention of randomisation method, no mention of homeopathic individualisation, the method used is isopathy not homeopathy, vague end points, questionable diagnosis and at the end the authors still couldn't decide whether "the reproducibility of evidence in favour of homoeopathy was proof of its activity or proof of the clinical trial's capacity to produce false-positive results" (or were they made to say that? Heh!) Doesn't matter to homeopaths though who continually and blindly persist in trotting this old paper out as one of the "usual suspects". Funny how all these points are used to denigrate trials which have negative findings for homeopathy yet there is a loud silence when the results are what the homeopaths want to hear. Best of all for the homeopaths it appears impossible to obtain the full text on-line (let me know otherwise) - very useful for hiding the statistical squirmings so favoured by other homeopathic researchers.
Rosa, L., Rosa, E., Sarner, L., Barrett, S., (1998) A Close Look at Therapeutic Touch Journal of the American Medical Association Vol. 279 no. 13 pp. 1005-1010
Roy, R., Tiller, W.A., Bell, I., Hoover, M.R., (2005) The structure of liquid water; novel insights from materials research; potential relevance to homeopathy Materials research innovations online 9-4 pp. 577-608
“This paper does not deal in any way with, and has no bearing whatsoever on, the clinical efficacy of any homeopathic remedy.”
Fair enough, pray continue…
“However, it does definitively demolish the objection against homeopathy, when such is based on the wholly incorrect claim that since there is no difference in composition between a remedy and the pure water used, there can be no differences at all between them…”
Nope, sorry, this article, effectively self published, doesn’t demolish anything. And even if anyone did manage, contrary to all decent, current research to show that homeopathic remedies were any more than water or sugar, that still wouldn’t validate homeopathy - there are plenty of other reasons that homeopathy would still be nonsense.
Rutten, A.L.B., and CF Stolper, C.F., (2008) The 2005 meta-analysis of homeopathy: the importance of post-publication data Homeopathy Vol. 97, no. 4, pp. 169-177
"their entire paper is an exercise in post-hoc analysis, as they try to find ways of torturing the data to get the result they want, i.e. that homeopathy works". See Dr Paul Wilson's articles in the Hank/Handsaw blog below for an eloquent critique of this paper as it tries the old homeopath trick of an "after the event" rehash on a well conducted paper (Shang, 2005) which happens to give results which homeopaths don't like.
Sainte-Laudy, J., and Belon, P., (2006) Improvement of flow cytometric analysis of basophil activation inhibition by high histamine dilutions. A novel basophil specific marker: CD 203c Homeopathy Vol. 95, no 1 pp. 3-8
Sampson, W., and London, W., 1995 Analysis of Homeopathic Treatment of Childhood Diarrhea Pediatrics Vol. 96 no. 5 pp. 961-964 (a response to Jacobs 1994)
Schmidt, K., Pittler, M.H., Ernst, E., (2001a) A profile of journals of complementary and alternative medicine Swiss Med Weekly Vol. 131 pp. 588-591
“ The number of original articles [in CAM journals] increased from a total of 61 in 1995 to 97 in 2000... the number of papers reporting clinical trials decreased by 4% between 1995 and 2000, and the number of surveys increased more than six times... The majority of articles published in 1995 suggested positive treatment effects, a phenomenon that was still present in 2000 albeit less strong. CAM journals, and most likely CAM itself, are associated with a lack of clinical trials and a bias in favour of positive conclusions.”
Journals written by practitioners of alternative medicine about alternative medicine seem reluctant to publish negative results - most strange, what could they possibly be trying to hide?
Schmidt, K., Pittler, M.H., Ernst, E., (2001b) Bias in alternative medicine is still rife but is diminishing British Medical Journal Vol. 323 no. 7320 p. 1071
“In 1995, journals of alternative medicine published virtually no studies with negative results, which suggests that the literature was far from objective”
This is a letter to the BMJ from the authors of Schmidt et al 2001 following the publication of their paper in Swiss Medical Weekly (above).
Schmidt, K., and Ernst, E., (2003) MMR vaccination advice over the internet Vaccine Vol. 21 pp. 1044-1047
A letter from a fictitious patient asking for advice about the MMR vaccine was emailed to homeopaths, chiropracters and GPs. After the reply was received the recipients were told of the purpose of the project at which point over a quarter of the CAM practitioners withdrew. Final response rates were: homeopaths - just over half responded, chiropracters - nearly a third responded, while GPs unanimously refused to give MMR advice over the internet. None of the homeopaths and only one of the chiropracters advised in favour of the MMR vaccine.
Schoen, A.M., (2000) Results of a survey on educational and research programs in complementary and alternative veterinary medicine at veterinary medical schools in the United States J Am Vet Med Assoc Vol. 216 pp. 502–509
“Currently, few veterinary schools offer educational or research programs in CAVM. Veterinary schools are aware of the interest in CAVM and acknowledge a lack of educational and research programs in these areas. More veterinary schools are in the process of developing educational and research programs in various aspects of CAVM."
Schott, H.C., (2002) Pituitary pars intermedia dysfunction: equine Cushing’s disease Veterinary Clinincs Equine Practice Vol. 18 pp. 237–270
A study of equine Cushing’s syndrome which is of great interest and mentions several possible ways of testing to both confirm a clinical diagnosis and to objectively monitor response to treatment. Strangely “looking at it and thinking it liiks a wee bit better” doesn’t figure as a reliable diagnostic test. Which is a shame for Mark Elliott because that’s pretty much all he relies on when it comes to assessing his patients’ so-called response to homeopathy. Needless to say, Dr Schott doesn’t think any more highly of Mr Elliott’s paper than we do here at RationalVetMed.
“Assessment of the efficacy of nutritional supplements and alternative therapies... is hampered by the same limitations as reports describing clinical response to medications. Specifically, most previous reports fail to include a comparison group or a nontreated control group to evaluate the effect of the intervention more objectively. Although this is an inherent ethical dilemma when studies are performed on client-owned animals, serial endocrinologic testing should be the minimum criteria to accompany clinical assessment of improvement... It cannot be overemphasized that efficacy claims for any treatment that are based on improvement in clinical signs alone remain poorly substantiated, because clinical improvement is likely to occur with management changes alone. For example, a recent report [see Elliott 2001] claimed a success rate of 80% when horses with Cushing’s disease were treated with homeopathic remedies; however, improvement was based on clinical response alone.”
Scott, D.W., Miller, W.H., Senter, D.A., et al. (2002) Treatment of canine atopic dermatitis with a commercial homeopathic remedy: a single-blinded, placebo-controlled study Canadian Veterinary Journal Vol. 43 no. 8 pp 601-3.
Danny Scott is an engaging and charismatic speaker who sports a long silver-grey pony tail and has a penchant for jeans and loud shirts. He looks as if he has just stepped off the cover of a 1970's Crosby, Stills, Nash and Young album cover and has a tendency to whoop, cowboy style during lectures. He is also one of the World's leading veterinary dermatologists and is, at the time of writing, professor of medicine and co-chief of dermatology at Cornell University. What he doesn't know about the skin of the dog isn't worth knowing. He has an open minded and pro-active approach to his specialism and has researched not only conventional pharmaceuticals but also homeopathy and Chinese herbs in relation to dermatology. Therefore the findings of this study, in which he is the lead author, should be taken seriously:
“A commercial homeopathic remedy and a placebo were administered orally as individual agents to 18 dogs with atopic dermatitis. The pruritus was reduced by less than 50% in only 2/18 dogs; 1 of these dogs was receiving the homeopathic remedy, the other was receiving the placebo. One dog vomited after administration of the homeopathic remedy.”
Yet again, no evidence that homeopathy works - makes me sick too.
Sehon, S., and Stanley, D., (2010) Evidence and simplicity: why we should reject homeopathy, Journal of Evaluation in Clinical Practice Vol. 16, no. 2 pp 276-281
Philosophical objections to homeopathy are not simply due to stubbornness or prejudice but because of a general epistemological principle known as the 'principle of simplicity'. This concept, which has profound relevance not just to science but to every day experience, is described most eloquently the above paper. Put briefly, the authors state that "given two theories, it is unreasonable to believe the one that leaves significantly more unexplained mysteries". If anyone is interested in a serious consideration of the reasons science is so far unable to take homeopathy seriously then a careful reading of this paper will serve as an excellent starting point.
Sehon, S., Stanley, D., (2010) Applying the simplicity principle to homeopathy: what remains? Focus on Alternative and Complementary Thearapies Vol. 15 no. 1, pp. 8-12
"Homeopathy is one of the more controversial types of alternative medicine. Millions of consumers swear by it and there are many practitioners who are quite convinced of its efficacy. The debate can be heated, with each regarding the other as biased or even irrational. We hope to illuminate this debate by making explicit an underlying philosophical principle that plays a key, but often tacit, role in the debate. By making the principle explicit, we can show why mainstream medicine views homeopathy so sceptically, and why such scepticism is justified."
A simplified version of Sehon and Stanley (2010) (above).
Shang, A., Huwiler-Muntener, K., Nartey, L., et al. (2005) Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy Lancet Vol. 366 pp. 726–32
This is the sort of paper that homeopaths absolutely hate; a well conducted metanalysis with good, pre-determined selection criteria and end points which finds that homeopathy is indistinguishable from placebo. There are so many responses, counter responses, refutations and counter refutations around, as homeopaths twist and squirm while attempting to get off this particular hook, that one could spend pretty much all one's waking hours collating them. I have given a few below and you will find that the internal links to responses cited in RationalVetMed have additional links to further discussions - wheels within wheels and all that. In a nutshell however the homeopathic arguments seem mainly to revolve around complaints that different selection criteria and different end points could have given different results - as one sceptic commented, “the homeopaths are complaining because the authors DIDN’T fiddle the results”! They conveniently choose to forget of course that the mark of a good metanalysis is that these things are chosen before you do the analysis and you accept whatever results you get afterwards. This is in contrast to the preferred homeopathic technique of choosing something to look at, then doing the analysis then re-jigging the analysis (changing end points, 'adjusting' results etc) to obtain the required results. Clever sciencey types call this "cherry picking" or "trawling for data". I'm not that clever, I call it lying.
One of the criticisms (Bell 2005) contains the memorable complaint that Shang (2005) was unfair because it lumped together a "heterogenous" group of conditions which were treated with different homeopathic remedies in the homeopathic group of papers - apparently that is a very bad thing to do and Dr Bell is outraged by it. But it seems that it is only a very bad thing to do when you don't like the results obtained because it has completely slipped her mind that the self styled "leading spokesperson for homeopathy and author of numerous books... etc" Dana Ullman, defended a weakly pro-homeopathy meta-analysis (Linde 1997), in his website by saying "There are two simple reasons why grouping studies together makes sense. First, the question that this analysis sought to answer is: are the effects from homeopathic medicines primarily placebo? And second, this analysis sought to evaluate: does homeopathy as a medical system seem to work?". Well, isn’t that what Shang et al set out to do? Strange how it's ok to criticise papers which find against homeopathy on that basis, but when a paper finds in favour of homeopathy using the same techniques then it's ok - the title of the Shang paper could almost have been taken directly from Ullman's quote of 7 years previously.
Shang, A., Jüni, P., Sterne, J.A.C., Huwiler-Müntener, K., Egger, M., (2005) Are the clinical effects of homoeopathy placebo effects? - Authors' reply Lancet Vol. 366, no. 9503, pp. 2083 - 2085
Shaw, D., (2011) Homeopathy and medical ethics Focus on Alternative and Complementary Therapies Vol. 16, no. 1, pp. 17-21
"This paper examines homeopathy from the perspective of medical ethics. It emerges that homeopathic practice is likely to breach basic tenets of medical ethics, even if homeopathic practitioners are well-intentioned."
Shekelle, P.G., Morton, S.C., Suttorp, M.J., Buscemi, N., Friesen, C., 2005 Challenges in Systematic Reviews of Complementary and Alternative Medicine Topics Annals of Internal Medicine Vol. 142 no. 12, Part 2 pp 1042-1047
“The many biases in the publication and indexing of CAM research pose a challenge for locating literature. Publication bias refers to the tendency of investigators, reviewers, and editors to submit or accept manuscripts on the basis of the strength or direction of the findings. While publication bias is a concern in conventional medical research, in CAM research the issue is particularly complicated. Most studies published in leading CAM journals have positive results. Some countries, such as China, Japan, Russia, and Taiwan, publish more studies with positive results than studies with negative results; this imbalance may reflect publication bias”
To quote Richard Dawkins, "Either it is true that a medicine works or it isn't. It cannot be false in the ordinary sense but true in some 'alternative' sense". CAM practitioners who promote watered down trials as described in this paper, for instance “pragmatic” trials, observational studies and postmarketing surveillance are fully aware that when subject to real science CAM is always found lacking so, instead of being honest with themselves and us, they prefer to change the way the trials are done until they get the results they want. How dishonest can you get?
Smith, K.R., Sampson, W., 2008 Word use and semantics in alternative medicine Medscape News today - Medscape Journal of Medicine Vol.10 no. 5 p.12
"Proponents of altmed have encountered major difficulties in achieving acceptance of their methods by the medical community. Such difficulties remain pervasive because many rationales, bases, and claims for alternative approaches conflict with the logicoscientific foundations of medicine. Faced with this fundamental problem, a tempting solution for proponents of altmed is one of semantics: alter the words but not the substance...
"Some altmed advocates have proposed using language change as a tool for swaying public opinion, with the intent of changing laws, presumably to legalize methods and practices now or previously considered illegal"
If proof were needed of the devious tactics employed by CAM profiteers then this is it. Unable to prove their case logically or by scientific means they employ linguistic tricks instead to gain acceptance. They don’t care whether what they do really works according to any real sense of the word, this is pure politics, a power play intended to make this dangerous nonsense acceptable by making it sound all touchy feely, empathic and (inevitably) natural. This is simply the cynical exploitation of vulnerable people who deserve better - a little honesty would be a good start.
Spence, D., Thompson, E., Barron, S., (2005) Homeopathic treatment for chronic disease: a 6-year university hospital based outpatient observational study Journal of Alternative and Complementary Medicine Vol 5 pp. 793-798
This paper is nothing more than a customer satisfaction survey where patients who had used homeopathy (so hardly an unbiased sample) said they thought it was really t’riffic. This was then passed off as evidence that “homeopathic treatment is a valuable intervention”. No controls, no blinding, nothing. A complete waste of time and public money.
David Colquhoun (link below) isn’t pulling any punches, “Papers like this do not add to human knowledge, they detract from it. By reverting to pre-enlightment forms of argument, they mislead rather than enlighten. To make matters worse, this work was done at public expense, by the Directorate of Homeopathic Medicine, United Bristol Healthcare, National Health Service Trust, Bristol, United Kingdom.
“What on earth is a respectable hospital and medical school, like those in Bristol, wasting money with this sort of mediaeval hindrance to medical knowledge? We are truly living in an age of delusions”
Nicely put Prof.!
Spencer, W., (1997) Homoeopathy Skeptical Intelligencer Vol. 2 no. 2
This article is reproduced here by kind permission of Mike Heap of the Skeptical Intelligencer magazine, the journal of the Association of Skeptical Enquiry (ASKE).
Stevinson, C., Devaraj, V.S., Fountain-Barber, A., Hawkins, S., Ernst, E., (2003) Homeopathic arnica for prevention of pain and bruising: randomized placebo-controlled trial in hand surgery Journal of the Royal Society of Medicine Vol. 96 pp. 60–65
“... The results of this trial do not suggest that homeopathic arnica has an advantage over placebo in reducing postoperative pain, bruising and swelling in patients undergoing elective hand surgery”
...Homeopathy = sugar tablets. 'Nuff said really.
Szeto, A.L., Rollwagen, F., and Jonas, W.B., (2004) Rapid induction of protective tolerance to potential terrorist agents: a systematic review of low- and ultra-low dose research Homeopathy Vol. 93 no. 4 pp. 173-178
“Weaponised anthrax!?” - quick, fetch my sugar tablets!