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Posts Tagged ‘Edzard Ernst’

Homeopathy: the scientific proofs of efficacy

Monday, November 12th, 2007

“The opposite of a fact is falsehood, but the opposite of one profound truth may very well be another profound truth.”
Niels Bohr

“The world of homeopathic research is moving in the direction of investigating its rational, explicable, demonstrable, reproducible aspects and neglecting the more controversial and doubtful aspects. The purpose of this publication is to review the extensive literature available, and draw the reader’s attention to studies that comply with the strictest scientific methodologies.”

This Italian literature review, published in 2002, is available in English translation from the Italian homeopathic pharmacy Guna, and presents a comprehensive review of the trials of the last decade, summarised by an Advisory Board which includes professors in Immunology, Pharmacology, General Surgery, Clinical Morphology and Anatomy, Human Physiology, Psychiatry and Neurology from universities and medical schools in Italy, the US, Germany and Poland. Some salient quotations from the study:

“A number of large-scale studies designed to evaluate the huge amount of homeopathic literature have been conducted, especially in the last 10 years. Organisations and institutes of great international prestige and importance have dealt with the issue of homeopathy. All of them have concluded that homeopathy possesses therapeutic efficacy.” (Overview of Human Clinical Trials, p29)

“… most of the members of the medical profession and the media have failed to perceive the existence of this body of studies, which demonstrate the therapeutic efficacy of homeopathic medicines. The aim of the present volume was to fill this lack of information by a compendium made of some of the latest and most significant literature in the field.
Very briefly, a large body of studies demonstrates that the efficacy of homeopathic medicines is not due to the “mythical” placebo effect, thus finally dispelling a series of superficial, prejudiced attitudes.

“Among these, a set of studies compare homeopathic vs allopathic medicines. These trials were conducted in accordance with Helsinki Declaration on the therapeutic efficacy.
Most of the best studies relate to the branch of homeopathy known as homotoxicology which, with its pragmatic attitude and rejection of therapeutic extremism, seems to meet current demand for integrated medicine most effectively.
These studies demonstrate that the effect of homeopathic medicines may be at least similar to that of the allopathic reference drug used for the same disorder. They also confirm that homeopathic medicines, unlike allopathic drugs, rarely produce side effects. Finally, they show that homeopathic remedies are usually cheaper,and in some cases much cheaper, than the corresponding conventional treatment.

“Everybody is entitled to his own opinion and can deny the evidence, even when faced with the clearest proof. But who hold public and institutional offices and responsibilities have the duty to analyse actively all the body of information that may improve the patient’s quality of life.

[...]

“It may seem paradoxical that tiny amounts of an active constituent (diluted by the very special process of homeopathic production) can produce effects on living beings, but this is evidently a scientific fact.
Science acts on the basis of objective, verifiable observations; if the event demonstrated cannot be interpreted by a theory, it is the theory that needs to be revised. This is the principle behind the progress of science.” (Conclusions, p87-88)

This study was published in 2002. In 2005, the World Health Organisation were in the process of compiling what was believed to be a largely positive report on homeopathy, and which was apparently leaked to The Lancet in advance of its publication of the Shang et al meta-analysis. According to Dr Peter Fisher, Director of Research at the Royal London Homeopathic Hospital and the Queen’s homeopath:

“The same issue of The Lancet featured a leak of the World Health Organisation’s (WHO) draft report on homeopathy. The WHO document was apparently leaked to The Lancet by Dutch and Belgian doctors hostile to homeopathy; their comments and the (hostile) comments of Prof. Edzard Ernst of the University of Exeter were published. Dr Xiaorui Zhang, Traditional Medicine Coordinator of WHO, who is responsible for the report, was also interviewed, but declined to comment on a leaked, confidential draft. This leak came only 2 days after The Times of London published, as its front page lead, a remarkably similar story: a leak of the Smallwood Enquiry on The Role of Complementary and Alternative Medicine in the NHS commissioned by The Prince of Wales’ Foundation for Integrated Health. It is ironic that the editor of The Lancet, Dr Richard Horton, wrote to The Times accusing Prof. Ernst of having ‘broken every code of scientific behaviour’ for leaking the draft report of the Smallwood Enquiry (and incidentally describing complementary medicine as ‘a largely pernicious influence… preying on the fears and uncertainties of the sick’), while simultaneously doing the same to the WHO report in his own journal!

“Dr Horton also wrote an open letter to the UK Secretary of State for Health, Patricia Hewitt and the Chairman of the National Institute for Clinical Excellence (NICE) Prof. Sir Michael Rawlings, calling for the use of homeopathy in the NHS to be reviewed in light of this publication.”

What we appear to be looking at here is a very deliberate attempt to discredit homeopathy, allowing prejudice to hold sway over the results of scientific studies and making a mockery of evidence-based medicine. Not only are these individuals attempting to mislead the medical profession and general public, but are trying to deprive them of the right to choose and use a healthcare modality which is rapidly being reliably demonstrated as at least as effective as conventional medicine, and in some instances, more so. Futher, one that is also proving itself to be considerably cheaper than the present model and highly unlikely to kill upwards of 106,000 people per annum (in the US alone – Journal of the American Medical Association 2000;284:483-485) just through the side effects of the medication.

If The Lancet remains true to previous form in its next issue on homeopathy, then it doesn’t look like it has much future as a respected scientific journal under its present stewardship. That’s a shame, as it’s one of the oldest peer-reviewed medical journals in the world (founded in 1823). Homeopathy will survive, as it has done for longer than The Lancet despite all previous attempts to suppress it, because the truth has a way of finding its way out regardless.

If you support freedom of choice in healthcare and have had good experience of homeopathic treatment, you can register your support by signing the “homeopathy worked for me” declaration.

“In a time of universal deceit, telling the truth becomes a revolutionary act.”
George Orwell



Evidence? What evidence?

Tuesday, May 23rd, 2006

“I know that most men, including those at ease with problems of greatest complexity, can seldom accept even the simplest and most obvious truth if it would be such as oblige them to admit the falsity of conclusions which they have delighted in explaining to colleagues, which they have proudly taught to others, and which they have woven, thread by thread, into the fabric of their lives.”
Leo Tolstoy

And so it goes on …

It really is extraordinary to what lengths people will go to try to keep the world within their comfort zones. Whatever happened to the concepts of open mindedness and free choice?

Today we have Michael Baum, emeritus professor of surgery at University College London, along with 12 other doctors, writing to 476 primary care trusts urging them to discontinue the funding of complementary therapies. Never mind that an estimated 50% of GPs recommend their patients for complementary treatment, these 13 people clearly believe they have the right to dictate national policy on the matter. Signatories to the letter include Nobel Prize-winner Sir James Black, Sir Keith Peters, president of the Academy of Medical Science, and Edzard Ernst, the UK’s first “professor” of complementary medicine. The letter describes homeopathy as an “implausible treatment for which over a dozen systematic reviews have failed to produce convincing evidence of effectiveness”.

Seems these august gentlemen have got their facts just a little bit wrong here, which ought to royally backfire on them, but probably won’t because so few people bother to read beyond the sensationalist headlines and examine the data on which the conclusions are based. For example, linked from this article on the BBC’s website, is one from November last yearpublicising the Bristol Homeopathic Hospital study in which 70% of 6,500 patients reported positive health changes with homeopathic treatment. The article mentions last year’s Lancet meta-analysis, saying:

“The Swiss-UK review of 110 trials found no convincing evidence the treatment worked any better than a placebo.”

Again, factually incorrect. The review gathered a total of 220 trials for examination, but its conclusions were based solely on a comparison of just 8 homeopathic trials (selected from a total of 110) with 6 conventional medical trials (out of a total of 110). 8 undisclosed trials at that, making it impossible to determine whether what was being measured even falls within an acceptable definition of “homeopathy”. Further, the authors of the study declared their bias from the outset. They believed homeopathy to be placebo and there appeared to be no attempt to do any more than support that opinion. The quality of this study has been so widely condemned by serious academic scientists that it prompted the following comments from Mikel Aickin PhD, Research Professor at the University of Arizona:

“The Lancet article appears to be part of a recent trend, in which medical journals are publishing articles of exceedingly low quality to justify attacks on controversial therapies.”
[...]
“There is unsettling evidence that we are now in the midst of a methodological degeneration in biomedical science. This appears to be occurring in, of all places, our fundamental approach to inference – using observation and evidence to decide how to act or believe. That it might be happening in medical research makes it of more than just academic interest.”
(Aickin, Mikel. The End of Biomedical Journals: There Is Madness in Their Methods. Journal of Alternative and Complementary Medicine Oct 2005, Vol. 11, No. 5: 755-757)

(For a more detailed exposé of the Lancet study and the wider context in which it was produced see my post from March 18 and Myths and Misconceptions about homeopathy, both on this site.)

Edzard Ernst is quoted in the BBC article as saying, “I believe we need one single standard in medicine and that is the standard of evidence based medicine.” Indeed. Couldn’t agree more. Perhaps these 13 devotees of evidence-based medicine should take a closer look at their “evidence” before pontificating so loudly and publicly? If we’re to take their conclusions as representative of the quality and rigour of scientific investigation found in the upper echelons of the medical elite then biomedical science is, as Mikel Aickin suggests, in very deep doodoo.

Several news websites are conducting polls based on this letter. If you would like to take part, try:
BBC
Sky News
Daily Mail



DISCLAIMER
Thanks to the current insanity revolving around homeopathy in this country, in both media and blogosphere, it's become necessary to insult your intelligence by explicitly drawing your attention to the obvious fact that any views or advice in this weblog/website are, unless stated otherwise, the opinions of the author alone and should not be taken as a substitute for medical advice or treatment. If you choose to take anything from here that might be construed as advice, you do so entirely under your own recognisance and responsibility.

smeddum.net - Blog: Confessions of a Serial Prover. Weblog on homeopathy, health and related subjects by homeopathic practitioner Wendy Howard