“SCIENCE DEGREES WITHOUT THE SCIENCE”

The Society of Homeopaths, the UK’s largest register of professional homeopaths, supports the conferment of science degrees on graduates of homeopathy courses, strongly refuting the assertion by Professor David Colquhoun in ‘Nature’ (Vol 446/22 March 2007) that homeopathy is “anti-science.”

In fact there is considerable evidence demonstrating the clinical effectiveness of homeopathic treatment, including a large outcomes study published in 2005, of an analysis of over 23,000 outpatient consultations at the Bristol Homeopathic Hospital,in which more than 70% reported clinical improvement. (1)

Chief Executive, Paula Ross comments “Colquhoun’s attempt to pitch science against what he unhelpfully terms “anti-science” is typical of the sort of reductionist approach that would have science focus only on the known whilst ignoring the presently unknown.

What he conveniently chooses to overlook is the fact that homeopathy is a growth area, with thousands of people seeing a practitioner and in excess of £25 million pounds being spent on homeopathy each year. Surely what is needed is more funding and research into exactly how so many people are benefiting from it. And what better section of a university is suited to this task than the science faculty?”

Ends

Notes to Editors
(1) Homeopathic treatment for chronic disease: a six-year University-Hospital Outpatient Observational Study. Dr. D.S Spence, Dr. E A Thompson & S J Barron. J. Altern. Complement. Med. 2005; 11:5:793-798

The Society of Homeopaths
The Society of Homeopaths is the largest body of professional homeopaths in the UK. Established in 1978, it has over 1,300 registered members.

Registered members of The Society of Homeopaths have graduated from a Society recognised college, are fully insured and practise in accordance with a strict Code of Ethics & Practice. A copy of the Society’s Code of Ethics & Practice plus the register is available on www.homeopathy-soh.org.

For further details, please contact Paula Ross or Pamela Stevens, Communications Department on 0845 450 6611 or info@homeopathy-soh.org

The Society of Homeopaths, 11 Brookfield, Duncan Close, Moulton Park, Northampton NN3 6WL
Tel: 0845 450 6611 Fax: 0845 450 6622 Website: www.homeopathy-soh.org

In summary:

3 studies deal with the prevention of flu
2 with treatment of flu
1 with prevention of conjunctivitis
1 using arnica for muscle soreness in long distance runners

Needless to say none of them invloved individualised treatment

The article by Shang et al (1) concludes that their findings are compatible with the notion that the clinical effects of homeopathy are placebo effects but it raises more questions than answers.

In this report the authors thoroughly examine 110 trials of homeopathy and 110 matched trials of allopathic medicine, comparing effects and the looking for presence of bias resulting from inadequate methods and selective publication. When they examined the 220 trials they find no evidence of more bias in the homeopathy trials than in the allopathy trials.
They then go on to estimate the treatment effects in a very small subset of 14 trials that they deem to be least likely to be affected by bias and base their conclusions upon these estimates.

Of the total 220 trials the authors identify 21 homeopathy trials and 8 allopathic trials that are of higher standard according to their own set criteria. They then proceed to further select the small subset of purportedly larger and higher methodological quality trials (8 homeopathy trials and 6 conventional medicine trials) from which the paper’s conclusions are drawn. The authors do not provide an explanation as to how they chose the particular cut off point that they used to select the 14 trials nor do they reference the selected trials. Since this small subset of trials form the basis for their conclusions it merits more explanation in description of method and is of fundamental importance when assessing validity of the authors’ conclusions for many reasons including the following:
* The authors generalise from an extremely small pool of data to draw their apparently broad and damning conclusions.
* Identification of the particular trials that are used in the final analysis would enable a fair critique of the validity of the included trials. The conflict between internal and external validity which plagues research in CAM has resulted in some homeopathy trials being of high internal validity but bearing little or no resemblance to the practice of homeopathy leading to spurious results. Such results may then feed into wider meta-analyses when selection criteria are based purely upon internal validity as is the case in this study
Elucidation of the rationale for choosing this small number of studies as well as a list of which studies this seemingly comprehensive interpretation was drawn from is essential.

Other questions that this piece of research raises:

1. The authors_ conclusions are premised upon the supposition that the placebo controlled randomised trial represents the gold standard against which all research should be judged. It is becomingly increasingly understood that there are considerable problems in using this method to test complex interventions such as homeopathy
2. It is always going to be difficult to adopt reductionist research method of RCT to measure effects of complex intervention such as homeopathy. Two primary concerns for homeopaths are that the treatment is holistic and that it is individualised. Treatment cannot be standardised and patient response is unpredictable. Some patients may take months to show any improvement. RCTs are looking for specific effects whereas homeopathy is attempting to treat the whole person
3. Many different types of prescribing method for homeopathy trials are all considered equally. Of the 100 trials selected only 18 (16%) deemed _classical homeopathy_ i.e. the type of individualised prescribing that occurs in real life and there is no indication of how many of the selected 8 trials involved this type of prescribing
4. The authors define 4 different types of homeopathic intervention whilst the majority of the allopathic trials are pharmaceutical. Hence in their attempt to match pairs of trials the authors will have been forced to match some homeopathy trials of complex intervention with simple intervention of the allopathic trials.
5. Assessment of study quality focuses upon 3 key domains of internal validity with apparently no regard to external validity. Hence the selected trials may have been deemed highest quality without actually bearing any relation to the practice of homeopathy
6. Any meta-analysis of homeopathy will necessarily be considering only a small number of trials as there are relatively few for any one condition. This leads to the pooling of heterogeneous data.
7. The authors display their own bias in interpretation when they dismiss out of hand the substantially beneficial pooled effect from 8 trials of homeopathic remedies in upper respiratory tract infections. This in spite of the fact that the trials perform well in the authors_ own set test of funnel_plot asymmetry which demonstrated that there was no significant difference between effects in the higher quality trial and the lower quality trials. Here the authors speak of _biases prevalent in these publications_ to excuse the effect without specifying in any way how they relate to these trials and indicate that conclusions from these trials _cannot be trusted_
8. 21 homeopathy trials and 9 allopathic are identified as being of higher quality, why are so few allopathic trials of higher quality? We know that research in homeopathy is seriously under-funded and undermanned but this is not the case for pharmaceutical research
9. Since they have already established that a far higher percentage of homeopathy trials (21%) than allopathy trials (8%) were of highest quality it does beg the question as to how we are ever able to trust the conclusions of allopathic drug trials

Conclusion

Far from being the ultimate test of homeopathy this meta-analysis leaves many questions unanswered. In summary, the conclusions that the authors draw are premised upon the supposition that the placebo-controlled RCT is the highest standard against which we should measure quality of research method, and takes no account of the complex nature of the homeopathic intervention. In addition, broad conclusions are drawn from a small pool of data from a total of 8 homeopathy trials and 6 allopathic trials. The trials selected for final analysis are not referenced and we are therefore unable to establish their external validity and verify the authors_ statements that these represent trials of homeopathy of highest quality available.

Kate Chatfield MSc RSHom
Clare Relton MSc RSHom

Wednesday August 31, 2005
[ http://www.guardian.co.uk/ ]The Guardian

Ben Goldacre’s thought-provoking piece (A tonic for sceptics, August 29) moves forward the debate about homeopathy and complementary and alternative medicine (CAM). The argument is no longer about whether homeopathy works, but how it works. He is absolutely right, therefore, to single out the placebo effect as “the most interesting phenomenon in medicine”, and that it goes into the cultural meaning of treatment. But it’s a pity he stopped there, for the whole of western science is also culturally defined. For homeopathy, this raises two issues - one theoretical, the other practical.

First, the observation problem. Physics teaches us that reality and our observation of it cannot be separated. The corollary - that any attempt at such separation can essentially destroy the “reality” under observation - is precisely what is perpetrated during blinded trials of homeopathy. Consequently, the double blind placebo-controlled trial, as applied to homeopathy and CAM, is the scientific equivalent of Nelson putting a telescope to his blind eye.
Second, if Goldacre believes “that in many cases, homeopathy does seem to help, as a complex intervention” albeit one that is “placebo, in all its rich glory” then there is no further need for debate. However homeopathy is deemed to “work”, it should be available alongside conventional medicine, where apart from its therapeutic benefits, its non-toxic and economic advantages would be appreciated.
Lionel Milgrom London

Why is it that only the negative research results about homeopathy get the headlines? Take, for instance, the research done at the Institute for Pharmacy at the University of Leipzig: using concentrations of belladonna which were literally less than a drop in the ocean, statistically significant changes in the contractions of the gut of rats were measured consistently and repeatedly. The study used double-blind techniques designed to detect the placebo effect. It compared results obtained by following precisely the special stirring techniques used in homeopathy, or by ignoring them, and found a positive correlation in favour homeopathy.
Kevin Mannerings
Pforzheim, Germany

Homeopathic treatment has excellent outcomes in NHS community menopause clinic

Dear

I am enclosing the latest findings from Sheffieldís NHS community menopause clinic which has run a homeopathy service since 1998. In an audit conducted between 2001 and 2003, patients reported significant benefit from the service. The audit was repeated in 2004 and the results form the basis of this report, published in the Journal of the British Menopause Society in June 2005.

The results are consistent with earlier findings and conclude that 88% of patients reported clinically significant improvement in their primary symptoms. Greatest clinical benefit was for headaches, tiredness, vasomotor symptoms, locomotor symptoms and sleeping difficulties.

I hope you will agree the homeopathic treatment of menopausal problems might offer a useful alternative to hormone replacement therapy, since this treatment is often contra-indicated and has come under considerable scrutiny in recent months.

Yours sincerely,

The views expressed by the author may not necessarily reflect the views or policies of the Society of Homeopaths.

BBC NEWS
Campaign to save homeopathy unit
Supporters of a Kent clinic which is one of just five in the UK to provide homeopathic treatment on the NHS have met to fight plans to close it.

The Homeopathic Hospital, in Tunbridge Wells, treats up to 1,000 patients a year but the primary care trust (PCT) which runs it needs to save £160,000.

A public meeting on Tuesday heard how patients had come to rely on the unit.

James Thallon, of the South West Kent PCT, said the trust was “critically reviewing every aspect of expenditure”.

“In order to save the large amounts you need to look at every little last bit on your balance sheet, and we have had to look at homeopathy in that light,” the medical director said.

I’ve relied on the hospital… it just mustn’t shut down
Mary Williams, patient

He explained that the hospital as a whole was not facing closure, just the homeopathy department.

The hospital also houses community paediatrics and a child and adolescent mental health service.

Mr Thallon said in future all patients referred for homeopathy would be considered by a special panel to ensure their treatment was appropriate.

“Homeopathy has been around since the 18th Century and has got a large body of very convinced adherents, but in the era of evidence-based medicine it’s beginning to struggle a little bit, so I’m afraid that we’re reflecting this in our decision.”

Mary Williams, 87, has been going to the hospital for 56 years, where both her mother and grandmother were patients too.

She is allergic to conventional medicine and said: “I’m devastated. I’ve relied on the hospital… it just mustn’t shut down.”