The Lower Quote, As If You Didn't Know, Is By Richard Dawkins, Son.

Monday, June 25, 2012

You Have a Degree in Balogna

Good friend Tony sent me a link to a site all about homeopathy. It's called Extraordinary Medicine and I thought I'd take a peek at what's happening in the world of the physically impossible. Care to join? Great.

I thought I'd look first at the section regarding the "evidence" for homeopathy and how it is actually - shock - very good. Right off the bat, however, the author lays the groundwork for ye olde special pleading:
In order to carry out scientific research, and keep up with the standards of evidence-based medicine, homeopathy has had to use a scientific model designed for conventional medicine, despite the fundamental differences between these systems.
Ok, I'll bite. What are the differences and why do they matter so much?
Evidence-based medicine uses current evidence, from scientific research, to assist in the process of making decisions in medical care. This concept leads us to consider an important question we want to leave you with: what were decisions in medical care based on, prior to the late 20th century?
Quick point: if we're also talking about Science Based Medicine, then we're also talking about prior plausibility which, when it comes to homeopathy, pretty much seals the case on the "it doesn't work" side.

Additionally, the last "important question" concerns me. Is the author suggesting somehow that prior to the late 20th century, practitioners of medicine had better insight into decision making? Hmmm...let's see.

The author then briefly discusses randomized, placebo-controlled trials and heads straight into a paragraph entitled, "The problem with RCTs for homeopathy". Here we go.
The methodology of RCTs, developed according to models that apply to conventional medicine, has several aspects that conflict with the principles of homeopathy.
Of course they do - they test what works and homeopathy doesn't. Obviously homeopaths are going to have a problem with them.

The author goes through several reasons that RCTs are not good for homeopathy (oddly, they're different from mine) beginning with "individualization".
Homeopathic methodology regards each person as a unique individual with unique characteristics. Homeopathic medicine selection that takes this individuality into consideration gives excellent results. However, in order to conform to the conditions of group treatment, for a specific ailment used in an RCT, this individualization cannot exist – despite the reality that this is one of homeopathy’s strengths.
Quick question regarding this: if everyone is a special unique snowflake that needs special unique attention to their unique specialness, why the fuck are homeopathic "medicines" sold in stores? There's no one at Wal-Mart fitting the homeopathic "remedy" in aisle 14 to customers' unique and special ailments. So which is it?

Next on the list of problems is "totality":
Conventional medicine treats symptoms—“the parts”—while homeopathy treats the whole individual—“the totality”
Oh, it's that old canard again. I don't know about you, but I can't count the number of times I've felt under the weather, gone to the doctor, and she just treated my esophagus.
The “totality” includes not only physical, mental and emotional symptoms, but also the interactions of the individual with their environment. RCTs measure quantitative parameters, making the model subject to errors when used in homeopathy.
Riiight. Doctors don't think about environmental causes for injuries, syndromes, or infections! What could possibly harm you in your environments?

The stupidity of this non-argument makes my head hurt, much like homeopathy itself. Do these people really think that MDs just blindly look at an elbow and not think about systemic infections or the possible flawed biomechanics that led to the injury? So so so dumb.

Moving on, the author gets to Efficacy trials and treatment trials. An explanation of how homeopathic substances are checked out, or proven, is given:
For a homeopathic drug proving trial, a medicinal substance with unknown, or few known, medical applications is tested in a randomized group of healthy subjects. Changes in the condition of the healthy subjects are evaluated individually, and in the group. The resulting number of common and significant symptoms is referred to as the symptom picture of the medicinal substance. This substance can be used to treat those experiencing the same symptoms. If significant improvement is obtained, the substance is included in the repertory, or materia medica, for the symptoms. Clinical results will differentiate between presence and absence of resolution of symptoms.
This might be decent if there was ANY evidence of efficacy once you find out that a certain substance that causes a certain reaction and that that substance, once diluted to a nonsensical degree would then reliably treat said reaction. I'm sure that the evidence is forthcoming....
The criticism of this system is subjectivity, because it relies on observations and reporting from the subject and the homeopaths involved in the experimentation.
No, the criticism of this system is that there is zero evidence that it is in any way effective in treating any disease whatsoever beside, possibly, dehydration.

Onwards to Blinding. This paragraph amounts to special pleading about how blinding homeopaths to each person's unique special specialness does not really allow for the caring homeopathic practitioners to make exactly the correct "medicine" or to make corrections that might help once the trial is underway. Hogwash. There is always a way to blind the practitioner and the patient.

Covering the Placebo Effect, we get this sentence:
It has been demonstrated that placebo effect resulting from homeopathic trials is not higher than that obtained from conventional drug trials.10
You might be wondering where that reference leads you. It is to the January 2010 issue of the respected journal, Homeopathy where there is an article about reviewing placebo responses to both conventional and homeopathic drugs. They're about the same, if you were wondering.

The size of the placebo effect should be the same because, surprise, it's the same effect. The difference here is that pharmaceutical drugs actually have an effect on the body. They have to in order to be able to be regulated. They also have to show that they're safe in the recommended doses. Homeopathic "drugs" are sold over-the-counter because they have no medicine in them. They are, almost by definition, nothing. It's one of the best scams ever.
Good evidence that the action of homeopathic medicines is real, and not a result of placebo effect, is the improvement of ailments suffered by babies and animals (who can’t verbally express what they feel and are not affected by psychosomatic influences) due to homeopathic treatment.
Here is a line of argument we skeptics encounter all the time. It has been answered, of course, but still, laypeople who can't be expected to know all the ins and outs of CAM argumentation give this line of reasoning, and CAMsters who know better (and some who don't) keep going back to the woo-well.

Babies and animals are just like us, because we are animals. Just because they can't speak doesn't make them magical. If they get sick, most of the time they will get better. When you give a baby or animal any treatment, you are giving it to them because you see symptoms. Chances are that if you did nothing, they would likely have gotten better anyway. When owners/parents see improvement, it is because of natural recovery and not homeopathy. A longer answer can be found at RationalWiki.

The author then gives a few citation-free examples of homeopathy being awesome, then gives a citation (from the same journal, Homeopathy) from a mastitis study in dairy cows. I found another one from a more reputable journal from the same year, conveniently discussed at the Skepvet's Blog. Go read that for why this study and its compatriot in the lesser journal are not the cat's meow, if I may.

A selection of study references follow on homeopathy's efficacy on in-vitro virus and bacteria cultures. I do not know enough to properly critique these except to say that if it were true that these were fantastic breakthroughs, we would have heard much more about it.

The last section is entitled, "Why is there so much controversy and criticism concerning homeopathy and homeopathic scientific research?" The author starts by saying:
Accepting that homeopathic medicines have a biological effect, even in potencies where dilution goes beyond Avogadro’s number—the point at which not a single molecule of the original substance is likely to remain in the solution—is not easy. It is hard for people steeped in long-established precepts of chemistry to accept that their knowledge might be wrong, or at least incomplete.
Yes, of course it is hard. It is especially hard when the laws of chemistry are essentially carved in stone now because of endless testing and re-testing. If no molecule of the active ingredient remains, then no effect from that ingredient will be seen. If you think differently, prove your case.

The author brings up both Jacque Benveniste and Luc Montagnier as martyrs for homeopathy and how the scientific establishment attacks non-conforming ideas and people. The relevant section of wiki for Benveniste is here and for Montagnier is here

The author brings up the Cuban study by Dr. Gustavo Bracho:
who did a 2.3-million-population clinical trial on homeopathic prevention of leptospirosis in Cuba, had spectacular results, yet his paper was rejected by several prominent medical journals
His paper was rejected because it was flawed, as discussed by Dr. Peter Lipson at Science Based Medicine points out.

Finally, a barrage of questions asking:
Who could be interested in attacking homeopathy now...Who, lacking real interest in seeing chronic diseases cured and cost-effective improvement of health for wealthy and poor alike, would feel menaced by homeopathy...Who would have the money and power to fund pseudo skeptics (individuals without any knowledge of homeopathy, who dare to criticize a science without an understanding of science, or the application of a ‘scientific method’ to prove/disprove their denigrating arguments against the science of homeopathy)...Who, for obvious reasons, would not be interested in reviewing any clinical evidence or “scientific” proof of homeopathy...Who could be using their power over the media to counteract the popularity of homeopathy?
I particularly like her use of "pseudo skeptics". I think most skeptics understand quite well the mechanics of homeopathy and why it is nonsense. Flailing around and repeatedly using flawed studies and arguments to back up claims that resemble fairy tales only brings mockery and ridicule your way.
The fact that studies have shown positive results for homeopathy, despite numerous obstacles and continual accommodations to fit the standard medical science model, is a testament to the validity of homeopathy—a system of medicine with a 200-year record of successful clinical results.
"Successful clinical results"? I don't think so.

More time will be spent sifting through this site and looking at its claims for homeopathy. Today, however, I am spent.

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2 Barbaric Yawps:

At 25/6/12 8:44 pm, Anonymous L.Long said...

Homeopathy use to work because the quackery that was called medicine back in the GOOD OLD DAYS (that's one silly statement) was so bad that doing noting was better then well bleeding (there was good medicine).
But like all science based medicine the quackery was replaced and change to what worked better. Unfortunately 'doing nothing' is now no longer all that good.

At 27/6/12 8:38 pm, Anonymous Woody said...

I HATE psuedo-medicines
I live far away, BigHeathenMike, but when you're hanging shit on the ridiculous words made in defence of psuedo-medicines, my voice is right there with yours.


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