... and other stories.

Anyone who spends any time looking at references about homeopathy will very quickly become aware that a relatively small number of papers appear time and again in the great lists which are presented by homeopaths as supposed ‘proof’ of its efficacy. These papers (the "usual suspects") crop up with such regular monotony that they have been given a separate section here, although the critiques are found with the main body of citations on the web site.

Mostly these are meta-analyses (i.e. papers which ‘summarise’ lots of other papers to get a broader view than can be obtained from just a single paper) and they are presented and re-presented in so many lists so frequently that one has to suspect they are just being copied and pasted from place to place without anyone actually reading the papers themselves. Because whatever else they do the “usual suspects” do not support homeopathy and it beggars belief that anyone could believe they do. As Bandolier says, "If this is the best they can do, why bother?"

Which papers constitute the usual suspects varies slightly but the core ones which are claimed to be positive for homeopathy are:

Boissel et al (1996) and Cucherat et al (2000) - these are pretty much the same thing, depite what the homeopaths would have us believe!
Kleijnen et al (1991)
Linde et al (1997) and its evil twin which homeopaths don’t like to mention, Linde et al (1999)
also Mathie (2003) is mentioned occasionally

There is also one (or possibly two) frequently mentioned paper(s) which are so obviously evidence that homeopathy is ineffective that even homeopaths aren’t able to spin their results (although some do try) in their favour. These ‘bete noirs’ are primarily Shang et al (2005), with Ernst (2002) also being mentioned occasionally. As they don’t say what homeopaths want to hear these papers are roundly denigrated for being unfair, inadequate, unscientific, unhomeopathic - you name it. Again, the criticisms levelled at these have, themselves been refuted (occasionally and amusingly by homeopaths themselves when attempting to defend papers which find in their favour) but homeopaths prefer to ignore that too, as they ignore refutations of their claims about the ‘usual suspects’.

Articles dealing with these papers and others en bloc can also be found here:

British Veterinary Voodoo society
Prescrire
“What value references” - Letter to the Veterinary Times
David Ramey at ACHS (2000)
Stephen Barret at homeowatch
Edzard Ernst in UK House of Commons Science and Technology Committe evidence check 2 - Homeopathy (p18) - there is also a detailed analysis of other papers in Table 1 (p88) and Table 2 (p90).

Articles on hoeopaths' selective view of evidence can be found here:

Ben Goldacre on homeopaths' "ambivalent" attitude to evidence: "By pushing their product relentlessly with ... scientific flim-flam, homeopaths undermine the public understanding of what it means to have an evidence base for a treatment".
More from Ben Goldacre on homeopaths' two faced attitude to research "With alternative therapists, when you point out a problem with the evidence, people don't engage with you about it, or read and reference your work. They get into a huff. They refuse to answer calls or email queries. They wave their hands and mutter sciencey words such as "quantum" and "nano". They accuse you of being a paid plant from some big pharma conspiracy. They threaten to sue you..." - ring any bells?

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I seem to have spent years as a sceptic, optimistically posting and reposting the ideas and opinions you will read in this web site in a wide range of contexts - discussion groups, forum threads, veterinary literature and so forth. On one occasion, many moons ago, I replied to a letter from John Hoare, a leading veterinary homeopath carefully and politely refuting the claims he was making for some of these papers, only to find in a similar discussion six years later he was still posting the same tired old references, apparently not having read a word of what I had written.

It appears impossible for homeopaths to admit that these papers are not what they claim despite the fact that, even if taken at face value, their claims are incredibly weak for homeopathy and garnered around with so many qualifiers and get-out clauses that any positive findings are weaselled away to nothing. These few papers are held up time and again as irrefutable proof that homeopathy works, they are cited and quoted so often that I’m sure homeopaths have convinced themselves that they are right. Well, they’re not as you will find when you read further on this site.

What it is, I now realise, is a war of words. Homeopaths realise that most people are trusting and will take the word of a plausible sounding advocate, especially when they’re playing the ‘poor underdog everyone is against us’ card, and will not look up the references for themselves. By the same token most sceptics should realise that it will never be possible to get homeopaths to understand how science works and why they are so wrong in their beliefs. Never-the-less it is still vital to keep refuting their preposterous claims whenever they are made simply in order to make sure that people can have both sides of the argument. Not just the sunny, optimistic anything-is-possible type of homeopathic propaganda but the other, true side of the story.

The real picture is inevitably more mundane; in contrast to bogus homeopathic certainties (all cure, no side effects) you have the real world with all its doubts and uncertainties, the scientific process whose main claim to fame is that it is constantly re-inventing itself and questioning pretty much everything really. It is human nature to turn away from such ‘shifting sands’ to the shallow promises of the homeopaths. We all want to believe that what is true today will also be true tomorrow and the next day but unfortunately life isn’t like that; science isn't magic (although its proponents claim homeopathy is) but then again it is real, not fiction.

We don’t know everything, as homeopaths are so fond of reminding us, so obviously as new information and fresh facts come along things will change; that’s how things get better, science is self correcting. Proper medical science is only 100 years old at most - we are still learning; that may be unsettling, but we have to be grown up about it. Medical science has given us so many miracles that it is easy to forget what we owe it, even in its infant state. Vaccination, the control of mass epidimics of polio, small pox, cholera and more; increased life expectancy and cures for many disease which even a couple of decades ago would have been death sentences, to name but a few.

Now, with so much misery, deformity and death controlled by technology we take for granted, we are starting to look at the fine detail, the ‘small print’ if you like, we are looking the gift horse in the mouth and worrying about the inevitable adverse effects and the down sides of some of these developments. “What about Thalidomide” is the rallying cry of the modern technophobe. Well, no one is denying there are two sides to medical technology but the answer is to do more research, more work and more education and to get it right next time because we know the massive benefits it can bring. The answer is most emphatically not to turn to some misty eyed guru who promises everything and delivers nothing. Looking at the evidence might sound mundane, hard work even, it certainly can be tedious, but it is the only way we’ve got to really find out about the world around us and what makes it and us tick. Science allows us to think for ourselves - and that is a very good thing.

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References and comments:

The individual papers are listed with links to abstracts and full text copies where available, brief comments from RationalVetMed [marked

] and links to comments and responses elsewhere. There is often a confusing spiderweb of links between papers, refutations, responses and counter-refutations which include not just papers in peer reviewed journals but opinion pieces in the same journals and also blog entries by clever people versed in the arcane art of reading and interpreting scientific papers.

This is a work in progress and if you know of any other responses which you feel ought to be included please let me know. If you feel that other papers ought to be included have a look at the main index first to see if they are already listed and, if not then again, let me know.

The Usual Suspects

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