Stop the teaching of pseudoscience - Comments by John Harvey

[Soroush Ebrahimi]

Dear Colleagues - Please see this superb discourse by John
From: UBM Medica Liferay Administrator [mailto:do-not-reply@ubmmedica.com]
Sent: 01 September 2011 17:25
To: Soroush Ebrahimi
Subject: -----SPAM----- New Blogs Comments by John Harvey
Dear finrod@finrod.co.uk,

John Harvey commented on your Blog.

----------
Les/Simon's seven points summed up his reasoning -- and, as it happens, the reasoning of many others -- in contending
(a) that homoeopathy cannot possibly achieve clinical results;
(b) that it does not achieve them;
(c) that seriously researching the question of its clinical effectiveness is not worth doing; and
(d) that such serious research has never been done.
Leaving aside that not all four of these contentions are mutually compatible, let's examine the evidence for each of them.
(a) That homoeopathy cannot possibly achieve clinical results. This contention is based on three commonly propagated misconceptions.
(1) The first misconception is a negative rather than a positive one. It is the systematic overlooking of what homoeopathy is. It is not treatment by ultramolecular doses (which I'll come to next). It is in fact treatment by the best available mimic of the patient's condition. In critical discussion of homoeopathy's success or otherwise, it is intellectually negligent to overlook what it is that we're discussing. The necessity of relevance is too obvious a point to labour. There is something else, though, significant to distinguishing homoeopathy from random prescription of ultramolecular medication, and it is this: that in no criticisms of homoeopathy has it been seriously suggested that this observation -- that a patient is peculiarly susceptible to a substance capable of inflicting the symptoms he or she already suffers -- is illusory. In other words, in attacking its credibility as capable of achieving clinical results, homoeopathy's critics consistently fail to attack the credibility of homoeopathy itself, instead choosing to attack the credibility of ultramolecular doses' capability of deranging health. There is in fact a long tradition of medical oddities and experimental results to suggest very strongly that a medicinal mimic of a patient's condition is a substance to which a patient is peculiarly susceptible. And it is this peculiar susceptibility to the substances most homoeopathic to a person's natural (i.e. not medicinal) state of health that offers the most readily available predictors of individual hypersensitivities. But that is another story.
(2) It is that susceptibility to a substance with the potential to aggravates one's entire extant collection of symptoms that points to the significance of the second misconception, which is that homoeopathy (necessarily) uses ultramolecular doses. It does not. The fact that traditional allopathic medicine cannot be successfully practised using such doses is testament to the medicinal "force" necessary to alter a state of health by use of a medicine whose pathogenesis (i.e. the medicinal illness it is capable of causing in the healthy) is fundamentally dissimilar from that state. Homoeopathy's common use of such doses -- and generally few of them -- is not a necessity as those ignorant of its definition (see above) commonly assume, but merely a handy possibility. That possibility is due to the similarity -- in a homoeopathically competent prescription -- between the illness the medicine is capable of causing and the condition of the patient. Homoeopathy may be practised entirely without use of ultramolecular doses, as it was in its first decade or so, and with no less success for it. The use of such doses is merely a refinement commonly adhered to because it makes very uncommon the patient reactions that otherwise commonly arise to a medicine whose primary effect is to cause the very symptoms from which the patient is already suffering.
(3) The third misconception common in offhand dismissal of homoeopathy is that all ultramolecular medicines are biologically equivalent to the solvent from which they have been eluted. So extremely obvious is this tenet that it has become an article of faith by those with an immovable belief that homoeopathy cannot have effects and with utter contempt for any profession of evidence for such effects. Yet the presumption, so obviously correct, has been demonstrated to be catastrophically wrong. A large body of materials science by O'Reilly, Rey, and the late Rustum Roy, amongst others, demonstrates that the properties of such a simple substance as water are not confined to its chemistry alone but reside also in its structure -- structure that a host of calibrated tests show to be susceptible to such events as recent dilution, elution, and succussion. (b) The contention that homoeopathy has been shown never to achieve clinical results. This contention, which I notice is never made by the more cautious (i.e. scientifically tentative) commentators, arises from a misunderstanding that failure of a single meta-analysis, no matter how poorly executed, or even of a single experiment, to demonstrate results constitutes disproof of all capacity for valid positive results to appear in another experiment.
Many high-quality studies have shown positive results. Not all of these have been based on the random-controlled trial (RCT); but then the misconception that the RCT is the only form of scientifically valid evidence is itself a howler, whose common repetition among those with this particular axe to grind merely overlooks the other forms of experimental study accepted, with good reason, as valuable in assessing the results of medical practice. (The use of consecutive cases is just one common example.)
Even staying within the bounds of RCTs, however, it is possible to discern that a number of studies strongly suggest that something is going on. It's not possible to prove absolutely, ever, that any medicine of any kind results in the effects it obviously does. But if reasonable rigour and statistical power combine to suggest that any medicine is effective, then they're sufficient basis too for assessing homoeopathy. There is one caveat that must be made with respect to analysis of any multicause–multieffect relationship to be examined through an RCT: that the RCT's design must, if it is to be at all suitable, take into account the particulars of the complexity of the relationship it is seeking to test. The application of such caution in research design to homoeopathy as well as to any other similarly complex relationship is a necessity, not a luxury, in doing good science. Those who beg off the work of appropriate design do themselves and their field no service even if they obfuscate their negligence by simplistically asserting that a design appropriate to assess single cause – single effect relationships must suffice for assessment of a multicause–multieffect one.
(c) The contention that clinical research on homoeopathy is not worth doing.
This contention always seems to be based in the first one: that homoeopathy cannot possibly achieve results. When one removes that premise, one is left with a contention that appears to be completely baseless.
(d) The contention that no serious research on clinical results of homoeopathic treatment has been done (except, possibly, a single meta-analysis or a single clinical trial claiming negative results).
For a bookful of such studies, see Bellavite and Signorini's Homeopathy: A Frontier in Medical Science. A more accessible summary of meta-analyses and reviews appears at the Faculty of Homeopathy's site, at , which concludes that 10 of 24 systematic reviews focusing on RCTs of homoeopathy "in specific clinical areas" yielded conclusions of positive effect, nine were inconclusive, and six found no evidence of effectiveness. For those interested, I'm happy to cite individual peer-reviewed papers.
One meta-analysis I will particularly mention is the 2005 Shang et al. meta-analysis (The Lancet), based on just eight clinical trials of homoeopathy that were selected from 21 high-quality trials. The meta-analysis purported to show that those trials demonstrated no effect. Subsequent analyses (e.g. Lüdtke & Rutten, "The conclusions on the effectiveness of homeopathy highly depend on the set of analysed trials", J. Clin. Epidem. 2008) of the authors' data showed that the arbitrariness of their selections had played an undue role in the analysis, and others (e.g. Rutten & Stolper, "The 2005 meta-analysis of homeopathy: the importance of post-publication data", Homeopathy 2008, http://www.sciencedirect.com/science/ar ... 1608000891) showed that the quality of all the homoeopathy trials was higher than that of those of traditional medicine and that Shang et al. had mismatched the homoeopathy trials to the traditional ones.
Another critique (Fisher, "Homeopathy and The Lancet", Evid Based Complement Alternat Med. 2006 March; 3(1): 145–147, www.ncbi.nlm.nih.gov/pmc/articles/PMC1375230) showed that the authors had predefined some outcomes for certain failure. Even the programme that had commissioned the study criticised it heavily for its methodological failures (http://www.bag.admin.ch/kv/forschung/f/ ... ht_PEK.pdf), and its methodology has come under heavy fire by many respected researchers, some of whom have shown that corrected meta-analysis of Shang et al.'s eight trials showed that their results had in fact supported an effect significantly beyond placebo (e.g. Fisher, Berman, et al., "Are the clinical effects of homeopathy placebo effects?", The Lancet 366(9503): 2082–83, http://www.thelancet.com/journals/lance ... 8/fulltext; Rutten & Stolper, "'Proof' against homeopathy in fact supports homeopathy", Homeopathy Jan 2006; 95(1) 57–61, http://www.homeopathy.org/research/edit ... Rutten.pdf).
----------

http://www.pulsetoday.co.uk/comment-blo ... udoscience

Sincerely,
UBM Medica Liferay Administrator
do-not-reply@ubmmedica.com

[Tanya Marquette]

While there have been many good responses by homeopaths and supporters, the focus of the responses is way off.
Everytime 'we' respond in defense of homeopathy we play into the hands of these denialists. We still let them set the
agenda.
Our response should be an onslaught of evidence of pseudoscience of the allopathic community and the medical industry.
This week , alone, I recieve a call about adverse reactions to Dilantin and 2 posts on the adverse reactions to Avastin.
Today there was a NYTimes article on Avastin being used for totally non-tested, off label visual problems. The end result
was blindness. Where is the science here? This is what should be hammered at these denialists. The list of non-science
practices and teachings is as pseudoscience as it gets. The public is being used a) as a market to build drug corp and
doctor bottom lines, and b) as public guinea pigs without informed consent.
Again, this week received articles on the expose of government/industry collusion in STD research on syphyllis in Brazil.
The Tuskgeegee experiment has long since been exposed, but the Brazillian connection expose is recent. This occurred
because a graduate student was doing research and uncoved this surreptitious abuse of poor people, incarcerated people,
and peope of color. The Eugenics link was also exposed in this connection.
There is a growing list of the adverse effects of psychotropic drugs resulting in horrific violence. It is online. Where is the
science here.
Then there are the numerous articles in 'respected' medical journals that reveal anything from the collusion of drug corporations in
the research results to the lack of effectiveness of the drugs being sold. Also, the level of side effects not reported. This week, too,
an article in a medical journal focused on research articles that mislead doctors who read them. The results of the research are
not reported fully , ultimately misleading doctors as to the consequences of the drugs. This is pseudoscience.
The list goes onl
This is what homeopaths should be answering in a dialogue about pseudoscience. I did post a couple of times on this particular
PULSE blog early on. This is what homeopaths and naturopathic healers and supporters should be addressing when these denialist
and corporate shills go on the attack.
tanya
________________________________

[John Harvey]

Hi, Tanya --
I think you're right: that it's important for those defending rationality in medicine to do more than defend their own but to take the offensive on irrational, partial, and frankly corrupt practices.
That said, the topic of the discussion I'd entered into upon Soroush's mention of it had been thoroughly highjacked into attacking homoeopathy as baseless nonsense, and simply letting such attacks stand unchallenged by evidence appears to tacitly confirm the assertions, so I challenged the corrupt and the partial with argument and evidence. (The concatenated version below of my challenge is not as it appears on the site, by the way, where it does contain spaces for breath!) And Ernst (the blog entry's author)'s entire credibility is based less on his smarmy support for traditional medicine than on his putatively critical criticisms of homoeopathy.
To put your excellent suggestion into practice, it would be useful perhaps to institute a site taking continuing stock of the latest news to emerge of failures of scientific rigour in medical research. Any offers to put up such a site would be most welcome, and I'll happily contribute.
Kind regards --
John
________________________________

[Tanya Marquette]

thanks John.
I think your response on Pulse was excellent, but as per usual, fell on deaf ears. These denialists are, what I have called in political arenas,
a case in 'studied stupidity.' There is nothing you can say to them that won't be met with blatant rejection; they have their mantra encased in stone.
So it, seems to me that we need to put them on the defensive. I agree that Ernst was put into place to attack homeopathy, later to be followed by
attacks on anything holistic and unpatentable. It isclearly part of the Codex plan that was written with a heavy pharmaceutical and chemical hand.
There is a site that tracks the adverse effects of pharmaceuticals as well as cases of fraudulent science in medicine. Additions can be sent into it.
But the format of a mainstream medical site stll feels all too delicious to not use to present our critiques. I think there is also a Facebook organizing
site to which one can post. I have to look that up. Unfortunately, my computer savvy is way too limited to set up a site such as you suggest.
May I forward your post to another homeopathy group?
tanya
________________________________
________________________________

[Hennie Duits]

Antipsychotic Drugs No More Effective than Placebo in PTSD Treatment

Of the enlisted who see heavy combat, 10-20 percent develop
persistent symptoms of post-traumatic stress disorder (PTSD), and about
20 percent of those who seek treatment end up getting a prescription for
an antipsychotic drug.

The reason why so many veterans are now prescribed antipsychotics
is because PTSD symptoms were found to be unresponsive to
antidepressants. Antipsychotics like Risperdal are more potent in terms
of affecting and altering mood. However, according to a recent study
published in the Journal of the American Medical Association (JAMA), the
drug Risperdal is no more effective than a placebo, and is associated
with a long list of potentially devastating side effects.

The study included 123 veterans with PTSD who received Risperdal,
and another 124 who received a placebo. After six months of treatment,
about five percent of the participants in both groups recovered, and
between 10-20 percent in each group reported minor improvement.

According to the lead author, Dr. John H. Krystal, who is also the
director of the clinical neurosciences division of the Department of
Veterans Affairs' National Center for PTSD:

"We didn't find any suggestion that the drug treatment was
having an overall benefit on their lives."

Although the study focused on just one drug, Risperdal, experts
have stated that these results most likely extend to the entire class of
similar drugs, which also include:

Seroquel
Geodon
Abilify
Risperdal

Risperdal is known as an "atypical antipsychotic," used to treat
schizophrenia and biopolar disorder in adults, and irritability
associated with autistic disorder in children. Side effects, some of
which may be permanent, include:

Somnolence and fatigue Increased appetite and weight gain Upper
respiratory tract infection
Restlessness Metabolic disorders Muscular tics, tremors, muscle stiffness
Vomiting, coughing, fever Indigestion Urinary incontinence

More serious side effects include:

Neuroleptic Malignant Syndrome, which can be fatal
Hormone disruption (including breasts producing milk and breast
development in males)
High blood sugar and diabetes

http://articles.mercola.com/sites/artic ... _DNL_art_2

Hennie

Op 3-9-2011 4:17, John Harvey schreef: