The Guardian, has an online column called “Comment is Free” where The Guardian, The Observer, and about 600 writers contribute with posts on religion, current affairs, politics, science, and health. Unavoidably, along with thought provoking “comments” you also get “bullshit” -as Penn and Teller would so vividly say.

Rachel Roberts is the latest one I am aware of^*, that produced such bullshit. In her “I don’t know how, but homeopathy really does work“ article, Rachel managed to reuse once more all the crappy logic apparently inherent to her fellow magic-medicine proponents.

Rachel claims that scientific research confirms the efficacy of homeopathy, and the controversy that really remains is how exactly it works. “There has been much propaganda and misinformation circulated [in regards to homeopathy]” she, ironically, claims. Of course that is true, but Rachel is unfortunately one of those “circulators”.

She cites 5 major systematic reviews that (in a ratio of 4 positive to 1 negative) confirm homeopathy. Of interest, she seems not to have read or evaluated any of the systematic reviews she cites. Instead, her statements imply that she merely parrots the misrepresentations of other homeopath believers. Here is Rachel’s erroneous and misleading statement:

Five major systematic reviews have also been carried out to analyse the balance of evidence from RCTs of homeopathy – four were positive (Kleijnen, J, et al; Linde, K, et al; Linde, K, et al; Cucherat, M, et al) and one was negative (Shang, A et al). It’s usual to get mixed results when you look at a wide range of research results on one subject, and if these results were from trials measuring the efficacy of “normal” conventional drugs, ratios of 63:11 and 4:1 in favour of a treatment working would be considered pretty persuasive.

Disregarding the fact that she has omitted some negative meta-analyses and systematic reviews, her statement is simply wrong. I have already discussed in great detail how Boiron, the single biggest manufacturer of homeopathic remedies, and a multi-million dollar company, has misrepresented the evidence before. So I will not go in detail here -read that article and figure out yourself. Briefly though^**:

• Kleijnen’s[1] is the oldest one, and concludes that while “at the moment the evidence of clinical trials is positive but not sufficient to draw definitive conclusions because most trials are of low methodological quality and because of the unknown role of publication bias“. So not “positive” as Rachel would like us to believe. Incoclusive as the authors clearly state.
  
  
• The two by Linde et al. are the best for showing how true scientists should work. Linde did his first meta-analysis in 1997[2], finding that homeopathy might work better than placebo, but with a qualificiation that his team “found insufficient evidence from these studies that homoeopathy is clearly efficacious for any single clinical condition.” Again, incoclusive at the authors’ word.
  
  What is interesting though, is that Linde went on to test any possible confouding or external factors affecting his strange results (strange in that no scientific basis exists for homeopathy to work). First he re-analysed 32 trials that met his criteria[3], concluding again that homeopathy might work better than placebo, but “the evidence, however, is not convincing because of methodological shortcomings and inconsistencies“.
  
  What’s more, Linde went on to measure the impact of the methodological quality on the studies, and found that high quality trials tend to yield negative results and vice-versa[4], further adding that:

  the evidence of bias weakens the findings of our original meta-analysis, … It seems, therefore, likely that our meta-analysis [the 1997 one] at least overestimated the effects of homeopathic treatments

  This is important on so many levels. First, it shows how scientists should be willing to revise their conclusions in the light of new evidence. Second, not only does this review render the first one (1997) obsolete, it also provides evidence that good trials are likely to show homeopathy to be what it is: bollocks.
  
  Note that this last quote and conclusion, is from the second Linde paper that Rachel cites as positivie in her article!! Does it seem like she has read any of these?
  
  And just to show the big picture, here is Linde’s comment in regards to the “only” positive review cited by Rachel, that of Shang et al [5](after congratulating Shang for their work and conclusions):

  Our 1997 meta-analysis has unfortunately been misused by homoeopaths as evidence that their therapy is proven

  I believe this says it all…
  
  
• Cucherat’s review[6] conclusion was that “There is some evidence that homeopathic treatments are more effective than placebo; however, the strength of this evidence is low because of the low methodological quality of the trials. Studies of high methodological quality were more likely to be negative than the lower quality studies“. Again, Rachel cites this as positive!
  
  
• Of course even Rachel acknowledges Shang’s [5] damning conclusion:

  Biases are present in placebo-controlled trials of both homoeopathy and conventional medicine. When account was taken for these biases in the analysis, there was weak evidence for a specific effect of homoeopathic remedies, but strong evidence for specific effects of conventional interventions. This finding is compatible with the notion that the clinical effects of homoeopathy are placebo effects.

Even disregarding other negative meta-analyses and systematic reviews (like Ernst’s[7] that concluded that “the best clinical evidence for homeopathy available to date does not warrant positive recommendations for its use in clinical practice“) the results are: 2 incoclusive (Kleijnen, Cucherat), 1 obsolete (Linde’s 1997), 1 slightly negative (Linde’s latest one), and 1 definitily negative (Shang’s). Further, Cucherat’s (among others) points strongly to high quality trials yielding negative results.

So, please, Rachel, please explain to us, please, how did you, please, reach these completely ridiculous conclusions, please??? Is *anything* of what you say in that article correct? Did you even read the reviews you cite as positive??

But no reason to care. After all, bullshit is free in the internets…

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Footnotes:

1. * Hat tip to Elina for this [↩]
2. ** Yes, I am partly repeating myself in this post. But I believe that re-citing the evidence base, and emphasizing again how the homeopaths misrepresent this evidence is an important step towards fighting scientific distortion. [↩]

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References:

1. J Kleijnen, P Knipschild and G ter Riet, Clinical trials of homoeopathy, BMJ 302 (1991), pp. 316–323 [↩]
2. K Linde, N Clausius and G Ramirez, Are the clinical effects of homoeopathy placebo effects? A meta-analysis of placebo-controlled trials, Lancet 350 (1997), pp. 834–843 [↩]
3. K Linde and D Melchart, Randomized controlled trials of individualized homeopathy: a state-of-the-art review, J Alter Complement Med 4 (1998), pp. 371–388 [↩]
4. K Linde, M Scholz, G Ramirez and N Clausius, Impact of study quality on outcome in placebo-controlled trials of homeopathy, J Clin Epidemiol 52 (1999), pp. 631–636 [↩]
5. A Shang, K Huwiler-Müntener and L Nartey et al., Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy, Lancet 366 (2005), pp. 726–732 [↩] [↩]
6. M Cucherat, MC Haugh, M Gooch and JP Boissel, Evidence of clinical efficacy of homeopathy: a meta-analysis of clinical trials, Eur J Clin Pharmacol 56 (2000), pp. 27–33 [↩]
7. E Ernst, A systematic review of systematic reviews of homeopathy, Br J Clin Pharmacol 54 (2002), pp. 577–582 [↩]