Posted by apgaylard on June 15, 2009
George Lewith, Michael Dixon and Peter Fisher had a puzzling letter in The Guardian yesterday, defending homeopathy. One of the odd things in the letter was the contention that, “out of six reviews of the scientific evidence carried out by the independent and respected Cochrane Collaboration, two are cautiously positive and four inconclusive.”
This description bears little resemblance to what they actually say. As you read these excerpts from their plain language summaries just remember that these gents are not appealing for more research, but for ongoing funding to treat patients at the UK taxpayer’s expense.
Here is what the six reviews actually say. Try and see if you can spot the two that are, “cautiously positive” (emphasis mine).
“Overall the results of this review found no evidence of effectiveness for homeopathy for the global symptoms, core symptoms or related outcomes of attention deficit/hyperactivity disorder.” (Heirs and Dean, 2007)
“The review of trials found […] that no strong evidence existed that usual forms of homeopathy for asthma are effective […] Until stronger evidence exists for the use of homeopathy in the treatment of asthma, we are unable to make recommendations about homeopathic treatment.” (McCarney et al, 2004)
“The researchers did not find any good quality trials and so cannot say whether it is or is not effective for treating this condition. As no information is available on how much homeopathy is used for dementia, it is difficult to say whether it is important to conduct more trials.” (McCarney et al, 2003)*
“[…] there were no trials including homeopathy […]” (Glazener et al, 2005)
“[…] trials demonstrated no differences in any primary or secondary outcome between the treatment and control group […] there was not enough evidence to show the effect of homoeopathy as a method of induction […]” (Smith, 2003)
“[…] Trials do not show that homoeopathic Oscillococcinum can prevent influenza. However, taking homoeopathic Oscillococcinum once you have influenza might shorten the illness, but more research is needed […]” (Vickers and Smith, 2006)
The only one that I think could be called “cautiously positive” is Vickers and Smith (2006)**. All this says is that a specific over-the-counter homeopathic remedy might shorten a bout of the ‘flu by a few hours. That’s it.
I cannot see how Heirs and Dean (2007) can be viewed as anything other than negative; but there again my livelihood and professional reputation are not bound up with the fate of homeopathy.
McCarney et al (2004) says that they cannot justify treating asthma with homeopathy. Smith (2003) shows that there is insufficient evidence to support the use of homeopathy for the induction of labour.
If you are trying to assess whether to actually treat patients with homeopathy – all these reviews say that this would not be supported by the available evidence.
So I’d score that: 3 negative (Heirs and Dean 2007; McCarney et al, 2004; Smith, 2003), one irrelevant (Glazener et al, 2005), one inconclusive (McCarney et al, 2003) and, being very generous, one apparantly positive (Vickers and Smith, 2006).
These members of the pro-CAM brigade*** appear to be justifying spending £4M p.a. from the public purse with nothing stronger than: taking a non-individualised homeopathy pill bought from a high-street chemist might shorten a dose of the ‘flu by a few hours. And other things might work if only we could find the evidence! ****
***With apologies to George Lewith.
****For a more complete dissection of this letter see “Let’s be aware. Very aware.” on Zeno’s Blog. This post is an elaboration of a comment I made there.
Glazener CMA, Evans JHC, Cheuk DKL. Complementary and miscellaneous interventions for nocturnal enuresis in children. Cochrane Database of Systematic Reviews 2005, Issue 2. Art. No.: CD005230. DOI: 10.1002/14651858.CD005230
Heirs M, Dean ME. Homeopathy for attention deficit/hyperactivity disorder or hyperkinetic disorder. Cochrane Database of Systematic Reviews 2007, Issue 4. Art. No.: CD005648. DOI: 10.1002/14651858.CD005648.pub2.
McCarney RW, Linde K, Lasserson TJ. Homeopathy for chronic asthma. Cochrane Database of Systematic Reviews 2004, Issue 1. Art. No.: CD000353. DOI: 10.1002/14651858.CD000353.pub2
McCarney RW, Warner J, Fisher P, van Haselen R. Homeopathy for dementia. Cochrane Database of Systematic Reviews 2003, Issue 1. Art. No.: CD003803. DOI: 10.1002/14651858.CD003803
Smith CA. Homoeopathy for induction of labour. Cochrane Database of Systematic Reviews 2003, Issue 4. Art. No.: CD003399. DOI: 10.1002/14651858.CD003399.
Vickers A, Smith C. Homoeopathic Oscillococcinum for preventing and treating influenza and influenza-like syndromes. Cochrane Database of Systematic Reviews 2006, Issue 3. Art. No.: CD001957. DOI: 10.1002/14651858.CD001957.pub3
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