Tuesday, January 26, 2010

Puppy Dogs & Cancer Kids - The poor state of "evidence" for Homeopathy

I have to admit that sometimes we skeptics do leave ourselves open to reproach by being sceptical about subjects just because it seems pretty obvious to us how crazy the notion is.  Now this in itself is hardly sceptical, and is at best lazy and at worst arrogant.  Today I feel little better about this after reading through reams of blogs on the subject of the 1023 Campaign reminding me that it’s just not realistic to expect individuals to sift through massive piles of peer-reviewed articles, written using medical, scientific, or statistical jargon, before they decide how best to treat their malaise.  That is indeed why we should be able to look to those with proven scientific or medical knowledge to guide us, such as doctors, scientists, and pharmacists.

Unfortunately, this means that I have put myself back on the hook.  I am a scientist.  I love science, and I love trawling through good papers with strong data, showing a really novel story.  I think (if I had been a scientist when it came out) I would have found Jacques Benveniste’s  Nature article proposing the molecular memory of water1 extremely exciting, even with the foreboding editorial advice from then-editor John Maddox2.  This is exactly the kind of article that you want to be proved right; imagine, water with molecular memory! It just doesn’t make sense, and that is why it would have been truly amazing.  Just think of all the scientists thought absurd in their time, only to be proved right. Yes, the world is round! No, the earth is not the center of the solar system! 

However, I was nine years old when that article came out, and unfortunately I never got to enjoy that particular spine-tingle of excitement as it could not be reproduced in blinded experiments, and scientific query sadly turned to special pleading (which is still ongoing to this day on his behalf).  It has since been shown that one of the properties of water is that within its hydrogen bond network dynamics it can only hold a molecular “memory” for less than fifty millions of a nanosecond3 but then I’m sure there’s a perfectly good yet hitherto undemonstrated explanation for that…

Okay, so I’m getting to my point.   Although the practice of homeopathy is much older than Benveniste’s idea of molecular memory, this was by far the most well researched and seemingly well-presented data supporting the idea.  While it may have turned out to be a disappointing non-story, it does make me think.  If homeopathy holds any basis in truth, why are good, peer-reviewed articles about homeopathy absent from high impact-factor (IF) journals (or even from low IF journals without titles involving the words “Homeopathy”, “New Age”, or “Alternative” for that matter)?  Considering the wealth of anecdotal evidence and ‘professional’ opinion from alternative medicine advocates, you would expect there to be swathes of data on the issue.  Instead on the whole we are presented with; small cohort studies of pathetic statistical significance, non-, single- or ‘almost’-blinded research, and badly controlled experiments no more convincing than beyond the placebo effect.  Why don’t you go to http://www.ncbi.nlm.nih.gov/pmc/ and see for yourself, there are many papers publicly available on this site.

Now when it comes to alternative medicine, it’s only a matter of time before the sick kids are wheeled out to prove a heart-rending point.  Heart-rending is the important point here, far more important than well researched; i.e., not-quite single-blinded, based on forms that the patients fill out, and on kids with different disease progression states.  And for that reason, I’m going to bring on the animals. That’s right. Because, lets face it, there’s only one thing that can even start to compare with sick children, and that’s sad puppy eyes (figure 1).  

When dogs were used in a double-blind placebo-controlled study into the efficacy of a homeopathic remedy for fear of firework noises4 (scared dogs, did you say? Awwwww -  you just have cant help but imagine them whimpering in the corner), it inspired Karen Overall to write a no-BS take on what vets and veterinary researchers should consider when dealing with data on the subject of homeopathy5.  This study neatly addresses, amongst other things, the often-cited (and misunderstood) area of animals and the placebo effect, and is well worth a read.


         Figure 1: Puppy eyes

Finally, I find a little hope in this guide in none other than the journal ‘Homeopathy ’; 
Reporting experiments in homeopathic basic research (REHBaR) – A detailed guideline for
authors”6 - Now okay, it is basically just the CONSORT guidelines for correct reporting of randomised controlled trails7 with examples given with a homeopathic basic research-friendly slant, but hey, at least they realize that without changing the way they present research, they will never be taken seriously.

So come on, what are you waiting for? Enough with the ‘pilot studies’ that never come full-term, and enough with the ‘case studies’ that are basically reported anecdotes.  I’m here, waiting for that rush of excitement, the feeling of amazement I will surely get if someone can actually ‘turn science on it’s head” as has been promised by homeopaths for years. That’s exactly what I love about science.

I’d personally love to be turned on my head in the name of science. 

Did I mention I’m waiting?

- Janis Bennion
Janis graduated with a PhD in Genetics from the University of Basel, and is currently in Manchester researching the molecular basis of dementia. In her spare time, she takes part in national scientific public engagement activities, and watches way too much Sci-fi.  Her views are her own and not necessarily those of her employer.


References

1           Davenas, E. et al., Human basophil degranulation triggered by very dilute antiserum against IgE. Nature 333 (6176), 816 (1988).
2           When to believe the unbelievable. Nature 333 (6176), 787 (1988).
3           Cowan, M. L. et al., Ultrafast memory loss and energy redistribution in the hydrogen bond network of liquid H2O. Nature 434 (7030), 199 (2005).
4           Cracknell, N. R. and Mills, D. S., A double-blind placebo-controlled study into the efficacy of a homeopathic remedy for fear of firework noises in the dog (Canis familiaris). Vet J 177 (1), 80 (2008).
5           Overall, K. L. and Dunham, A. E., Homeopathy and the curse of the scientific method. Vet J 180 (2), 141 (2009).
6           Stock-Schroer, B. et al., Reporting experiments in homeopathic basic research (REHBaR) - a detailed guideline for authors. Homeopathy 98 (4), 287 (2009).
7           Begg, C. et al., Improving the quality of reporting of randomized controlled trials. The CONSORT statement. JAMA 276 (8), 637 (1996).




We're involved in the 10:23 campaign, and on Saturday 30th the Greater Manchester Skeptics will be taking part in a mass homeopathic 'overdose' in protest at Boots' continued endorsement and sale of homeopathic remedies, and to raise public awareness about the fact that homeopathic remedies have nothing in them. If you'd like to take part, please contact us at GreaterManchesterSkeptics {at}  GoogleMail.com.

The overdose is part of a nationwide campaign involving over 300 skeptics and several organisations, for more information please see www.1023.org.uk.

Gavin Schofield

1 comment:

  1. Nice to see someone else calling the homeopaths on their elastic approach to what constitutes scientific evidence.

    I wrote a bit about the Benveniste paper, and the subsequent famous debunking by the Nature team, in the last bit of a blogpost here. The punchline coems from James Randi, and is well worth a read if you don't know the story already.

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