You and Yours Radio 4 Friday

December 15th, 2005 by Ben Goldacre in alternative medicine, bad science, bbc, homeopathy, onanism, references, statistics | 94 Comments »

I just said this on Radio 4, Homeopath David Spence responds on the show afterwards.

You’ll be able to listen to it again over the internet from 3pm:

www.bbc.co.uk/radio4/youandyours/items/01/2005_50_fri.shtml

Homeopathy is certainly popular, and I have no problem with people wanting to use it, enjoying it, and feeling a benefit from it. What I do object to is people misrepresenting the evidence for how useful it is, or misleading the public about the science behind it. Recently, a customer satisfaction survey from Bristol Homeopathic Hospital was being touted in the media as scientific evidence that homeopathy works. We were told, by the BBC amongst others, that this customer satisfaction survey “contradicted” in quotes, the robust scientific evidence which shows that homeopathy is no better than placebo.

When I say “scientific evidence”, there’s nothing mysterious or complicated here: you simply take a group of people who’ve been to a homeopath, and for half of them, you switch their homeopathic pills for placebo pills. It turns out that the people who get the placebo pills do just as well as the people getting the real homeopathy pills.

Sometimes, a study crops up where homeopathy performs better than placebo. But if you collect the figures from all the little studies, add them all up, and do one big count, you find, overall, again, that homeopathy is no better than placebo. That’s called a “meta-analysis”, and there was a very large well–reported one recently in the Lancet which showed, again, that homeopathy was no better than placebo.

Homeopaths have reacted to this placebo finding in various amusing ways. Many have simply denied that this damning evidence even exists: The British Homeopathic Association provide a list of systematic studies called “meta-analyses” on their website. I say list, but in fact, they only mention a few small flawed ones that go in their favour, and simply ignore all the large robust studies showing homeopathy is no better than placebo. I think that’s very deceitful.

Some homeopaths say, well, homeopathy, its not about the pills, it’s about the consultation, the ceremony, the whole process, comparing it to placebo is missing the point. A view I heartily endorse: I believe placebos are very powerful, and homeopaths are good at maximising the placebo effect. But to do that, they have to maintain the illusion that the pills work, and so they must deny the placebo evidence.

So what is this new evidence from Bristol, that we’re invited to believe can contradict all these large careful trials?

They took a few thousand patients, in a homeopathy clinic, and asked them if they thought they’d got any better since having homeopathy. That’s a customer satisfaction survey. It’s an interesting finding. But it’s got some major flaws: and most of them were glossed over by the media, and by the homeopaths who did the survey.

Firstly, for all we know, the patients could have got better by themselves. As people often do. Lots of things, even chronic illnesses, wax and wane: the menopause, one of the illnesses they studied, clearly gets better with time. For all we know, people on placebo might have felt better after that much time. People on a waiting list, even, might have felt better. Their study assumes that homeopathy takes the credit for the perceived improvement.

And there’s so much information missing. Were the people in their clinic also receiving conventional treatments? Presumably many were. For all we know, that’s what got them better. And what did they measure? They didn’t bother to use any of the standard research questionnaires for how unwell people feel, nor did they compare how unwell they felt to start with, with how unwell they felt later. People had to remember, on the spot, how unwell they were in the past, and then tell the homeopath whether they felt better or not.

And who were the homeopaths asking? People who chose homeopathy. And even then, they only looked at the people who came back to their clinic. They tell us nothing about the people who never came back after the first appointment. Did they decide it was rubbish? Did they get worse? Did they die? They are conveniently ignored, wiped from history, just like the British Homeopathic Association ignores the trials it doesn’t like.

Simply ignoring inconvenient patients, and inconvenient data, isn’t science.


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94 Responses



  1. BSM said,

    December 20, 2005 at 9:45 pm

    Here’s a good example of an advocate of homeopathy just not ‘getting it’, very much like Spence.

    www.hpathy.com/homeopathyforums/forum_posts.asp?TID=3680&TPN=8

    “my new recommendation for a protocol of homeopathic treatment:  maybe something like this:  pick a diagnosis or chief complaint – chronic complaint preferred, to avoid the vagaries of acute prescribing.  enroll the next 200 patients with that complaint in the trial.  ignore your randomization and blinding thing.  pre-test all participants with lab tests that are specific to their compaint, and also a general series of lab tests to sample a broad range of physiological function.  repeat the series of lab tests at the conclusion of each treatment episode.  no time limit.  no mongrelizing of methodologies.  classical homeopaths only need apply.  use statistical analysis with a comparison of outcomes to established “normal” course of illness in untreated subjects.”

    The last 150 years of routine scientific experimentation has just passed these guys by.

  2. Morag said,

    December 20, 2005 at 10:18 pm

    Have you asked him yet where he’s going to get his comparator data, what analytes he’s proposing to measure and why, and what he would classify as an improvement?

  3. Morag said,

    December 20, 2005 at 10:20 pm

    “I think (I hope) the first point is clear in the paper – it was a point that was raised in the peer review process and the wording clarified thereafter, as a result, to the satisfaction of the peer reviewers…” You mean it was even worse in the original version as submitted?

    Come on, the paucity of actual recorded and reported results in this “study” is a joke.

  4. Rachel Findlay said,

    December 20, 2005 at 10:20 pm

    Marvellous commentary all you scientists (I pressume?) Ben now has a copy of a letter Dr Spence wrote me. My initial letter to Dr Spence was strongly worded (not impolite or abusive). I feel very strongly my father was denied treatment for rheumatoid arthritis for years while homeopathic clinics are funded by the NHS. Without my having mentioned my father in my critique of his Today programme effort Dr Spence suggested I had a “deep seated emotional issue” in his response to me. Too right I do. Does not make his pseudo science right though and the shameful thing is the bad choices made for scarce resouces in our health system based on bad science. But you all know this already. Am so grateful there are proper scientists out there who can challenge this medieval nonsense. Quote away Ben.

  5. Morag said,

    December 20, 2005 at 10:35 pm

    It’s very common for homoeopaths to attribute “emotion” – and “spite” and so on – to their critics even when faced with simple factual arguments.

  6. Morag said,

    December 20, 2005 at 10:36 pm

    Er, meant to mention this link in that context.
    vetpath.co.uk/voodoo/vettimes.html#gregory1

  7. Tessa K said,

    December 20, 2005 at 11:47 pm

    Morag: well, of course, anyone disagreeing with homeopathy must have an ulterior motive or be over-emotional. No sane person could possibly doubt its efficacy.

  8. Ben Goldacre said,

    December 21, 2005 at 12:12 am

    btw i made a quick call to elizabeth grice from the daily telegraph (v charming on phone). as you might remember, she mentioned prof matthias egger in her piece, the internationally respected epidemiologist who did the big lancet meta-analysis recently that showed homeopathy was no better than placebo.

    the relevance to this thread is that in her article, she said prof egger was known as “eggy”, and i wondered, who on earth could have given her this extraordinary piece of information? and it was, of course, dr spence. apparently he kept calling him “eggy” throughout the interview.

    so pause for a moment:

    he actually called a professor of epidemiology who disagrees with him… “eggy”.

    i am half david spence’s age, with a pretty solid reputation for childish jibes, and i feel totally outclassed. i can only hope that when i’m sixty i, too, will be calling respected academics who disagree with me “eggy”.

    except i’ll dance around the room when i do it, shouting eeegggggyyyy eeeeeeeeggggggyyyyyy.

    and if they get all eggy about it, i’ll do it even more.

    i mean really…

  9. Michael P. said,

    December 21, 2005 at 9:01 am

    “…the referral having been the suggestion of their consultant or GP. The interviewer intervened to say that they still chose it because they attended! Well that’s an interesting point but then it actually applies to us all in NHS secondary care.”

    Well, yes, but you have to include them in the follow-up of the study!!!!! The drop-outs are also your data, you dolt!

    I really really want to know, who are these people accountable to? GMC? Can they be struck off like normal doctors?? Can they be suspended whilst being investigated for making it up as they go along?!?!?!

  10. Paul said,

    December 21, 2005 at 9:04 am

    I think that BSM has hit the nail on the head – they just “don’t get it”. The fact that Specky Spence (I don’t know if he wears glasses, but if he does, that’s what I’m going to call him) wrote a reasonably detailed explanatory note is probably testimony to the fact that he doesn’t want to be simply a fly-by-night huckster. But the content of his explanation quite simply shows that he doesn’t understand the issues. (My suspicion is that this paper probably went somewhere like the BMJ (which actually lets some pretty ropey stuff through), got the mauling it deserved and thence plummeted down the impact factor ladder to where it currently resides).

    If I were an advocate of CAM who had a genuine desire to determine, scientifically, the efficacy of the treatments (pace Edzard Ernst) I would be horrified that Specky Spence was clouding the water with this drivel.

  11. rachel findlay said,

    December 21, 2005 at 11:03 am

    Hilarious Ben. And Morag thanks for your comments. I think you are right when you say there is a theme with these guys. Very reassuring when one doubts oneself in the face of Dr Spence’s honeyed words on posh Bristol NHS paper. I can admit to being a bit emotional (on account of growing up with knackered rhumatoid infested pa – who is a star by the way). I do know however I’m not an airy fairy twit and can see the emperor (or rather Dr Spence) is buffo when he’s left his tweeds at home. He has outclassed me also in evasive arguments and yes, “eggy”, does get the gold prize. I wouldn’t even try to compete.

  12. RS said,

    December 21, 2005 at 11:16 am

    “The interviewer intervened to say that they still chose it because they attended! Well that’s an interesting point but then it actually applies to us all in NHS secondary care”

    Except of course that most other branches of medicine are actually based on evidence rather than voodoo. Being referred to a homeopathic hospital is not like being referred to the dermatology department, or even to psychiatry, it’s more like being referred to your local New Age book shop, or Dr & Herbs. Most people would never even be referred because they wouldn’t go, and quite a few others wouldn’t go even when they are referred – because people are not quite as stupid as we think.

  13. RS said,

    December 21, 2005 at 11:19 am

    “I can admit to being a bit emotional (on account of growing up with knackered rhumatoid infested pa”

    Was it the Glasgow Homeopathic Hospital where, because of budget cust, they wanted to close it? In the end, after a campaign by society’s fans of pseudoscience, it was retained, meaning that the budgets of actually effective evidence based real medicine departments will have to be cut instead.

  14. rachel said,

    December 21, 2005 at 11:27 am

    Dad was treated ititially by specialists in Glasgow. They were excellent he was lucky enough to get on a trial when the “new” anti tnt drugs were trialed on NHS. Imagine his surprise when he found out most other european countries health systems had licensed these ages ago (and USA also) while the NHS was still dragging its feet. It took ages for NICE to ratify these drugs and we watched dad in hospital, surrounded by much younger sufferers whose joints were also being destroyed, being denied this. Of course the underlying reason for NHS not having these drugs as quickly as other countries is funding. They are there now but only after a fight with our local health board and I know, from an insider on the Board in Edinburgh, it was a funding problem to get these drugs. And yet, Dad could always have gone to Glasgow for some arnica do address his knackered joints pain of course. Darn wish we’d known that at the time!

  15. Delster said,

    December 21, 2005 at 12:30 pm

    RS,

    you shouldn’t dismiss herbs so easily (Dr & Herbs). many plants do have medicinal properties and many common drugs have been devoloped from them.

    The main difrence between herb / plant remedies and homeopathy is that the plants contain more than just water and so can actually do something (other than rehydrate!)

  16. lecanardnoir said,

    December 21, 2005 at 12:36 pm

    I’m feeling rather frustrated here. It is clear that our Health Service has been hijacked by self-serving irrationalists with the result that resources that could deliver real improvements in peoples lives are being diverted into mumbo-jumb.

    To me, finding out that the NHS funds homeopaths is like discovering that our courts still practice trial by fire if evidence of witch craft cannot be obtained in other ways, or that our schools are teaching that evolution is ‘not proven’ and that there must be an ‘Intelligent Designer’.

    It is not like more research into Homeopathy could show that it is effective. To find out that diluting a substance to the point where it is, to all effect, no longer there and then saying the water can cure you would overthrow pretty much all the physics and chemistry we know. Such a discovery would not be like finding the Loch Ness Monster – this is at least, theoretically possible – it is more like finding fairies at the bottom of my garden, or (more seasoanlly) finding Father Christmas squeezing down my chimney in a few days time.

    So what can we do? At the very least should we not be shuffling of a letter to our MPs? Thoughts?

  17. Tessa K said,

    December 21, 2005 at 12:40 pm

    Delster: you’re right, plant medicine should not be lumped in with homeopathy. It certainly helped a lot of people when there was no alternative. However, these days, I’d rather take a measured dose with known side-effects and no impurities than gamble on getting the right active amount of leaf or root without any bird poo or mould in it. Plant-derived medicine is good, herbal medicine is a lottery.

  18. Michael P. said,

    December 21, 2005 at 12:46 pm

    I quite agree lecanardnoir, someone’s accountable for this. I would like to know who it is. If any other sector of the NHS used smoke and mirrors to create numbers justify themselves there would be a national outcry and a formal investigation!

  19. RS said,

    December 21, 2005 at 12:51 pm

    “you shouldn’t dismiss herbs so easily (Dr & Herbs). many plants do have medicinal properties and many common drugs have been devoloped from them.”

    Yes, thank you, I am well aware that some herbs can have medicinal properties, and that many drugs have been developed from them, and also many poisons. I am also aware that most people pushing herbal remedies haven’t got a clue what they’re doing, for instance Dr & Herbs promoted Ban Lan Gen tea to stop bird flu.

    www.bbc.co.uk/watchdog/reports/personal/personal_20051122.shtml

  20. RS said,

    December 21, 2005 at 12:53 pm

    “The main difrence between herb / plant remedies and homeopathy is that the plants contain more than just water and so can actually do something (other than rehydrate!)”

    But the main similarity is the almost complete lack of any evidence base. At least homeopathy works via placebo, I’m not sure I want some untested active ingredient fucking me up and counteracting my placebo effect.

  21. Morag said,

    December 21, 2005 at 1:04 pm

    Tessa K makes a very valid point. Of course many plants have active ingredients – but remember that they also have active poisons. The fact is that “big pharma” has practically mined out the known botanical sources of useful pharmaceuticals, identified the active principles, purified and (usually) managed to set up an artificial synthesis, just as well or the world’s plant resources would never stand the strain. Thus we have standardised, purified and licensed medicines.

    This leaves the herbalists with the ineffective plants, the poisonous ones, and the crude unpurified extracts which could contain practically anything. Which would you rather take?

    Yes, herbal preparations can be biologically active, but you don’t know what you’re taking, and always remember that biological activity might not be in the form you wanted. Think deadly nightshade, giant hemlock, yew, laburnum, foxglove and so on – several of these do give rise to useful pharmaceuticals but you’d be mad to take a crude extract. Frankly, if a herbal preparation really does have a useful therapeutic effect, that has probably already been exploited in the form of a nice safe and tested pill. If no such pill exists, one has to ask why not?

    Homoeopathy is one of a small group of alternative medicines which absolutely *can’t* do anything, and deserves to be laughed out of court until such times as its proponents have successfully persuaded the basic sciences to rewrite their textbooks to include magical effects. However, this shouldn’t lead us into being too readily accepting of the claims of other branches of alternative medicine, just because in these cases they *might* work.

  22. rachel said,

    December 21, 2005 at 1:39 pm

    lecanardnoir – you are quite correct. Enough mumping and time for a letter to one’s MP (or MSP here in Scotland as health is devolved issue). In fact I think I’ll write to the health minister. The Glasgow clinic noted above means we have a homeopathic NHS funded centre here in Scotland as well as in Bristol. Also, I wonder if the practitioners at these clinics (seemingly qualified doctors) have private clinics of their own ……….? If this is the case no wonder they are so keen to maintain the veneer of respectability.

  23. rachel said,

    December 21, 2005 at 1:46 pm

    Oh my lord….not the usual run of the mill NHS hospital. And I thought the NHS was short of funds.

    www.adhom.org.uk/welcome.htm

  24. Morag said,

    December 21, 2005 at 2:55 pm

    This is the big issue, of course. What homoeopaths like David Spence are desperately afraid of is being locked out of the NHS gravy train. Hence these dishonest studies, designed to show their methods in as good a light as possible, in the hope of being able to stave of the consequences of the negative results coming from properly designed trials.

    One common assertion (a favourite of the Southampton-based bunch) is that since patients want it (“demand” it), then homoeopathy must be made available. Since when? What about the breast cancer patients who want herceptin? What about Rachel’s father, who wanted proven treatments available in other countries? “Wanting” doesn’t get you anything until NICE have spoken. Except isn’t it strange the way NICE always seems to be sidestepped in favour of consumer satisfaction studies as soon as it’s homoeopathy we’re talking about?

    The use of scarce NHS resources for quack therapies is a public scandal. Not just homoeopathy but acupuncture, reflexology, and several other nutball approaches. If people are really helped by a long consultation, an hour or two one-to-one attention, having their feet massaged with a nice smell in the air, then come clean and offer this as relaxationaids or even psychotherapy. And evaluate the cost-effectiveness in these terms. But spare us all from subsidising the telling of barefaced lies to patients.

  25. Michael P. said,

    December 21, 2005 at 3:42 pm

    Hmmm, I’m not sure about all this. When you look for information, you go round and round in circles.

    I tried to find info on the Glasgow centre. Thanks for that link you gave us Rachel. It shows that it’s a very nice building indeed. Nice garden too. Costs no more than a ‘normal’ hospital apparently.

    Anyway, it tells you sod all about what they do. Or who does it. A quick look on the Scottish Executive website gets you the National Panel of Specialists from May 2005 as a PDF. In there for homeopathy is listed Dr. Thomas Edward Whitmarsh at the Glasgow joint. But, alarm bells ringing – I don’t think he’s NHS. On their system, I mean. His email address is tom.whitmarsh@virgin.net Very professional. And here I was expecting scot.nhs.uk. How silly!

    So, funded by the NHS. Referred to by the NHS. Regulated by….

    Answers on the back of a postcard.

    (hint – ‘themselves’)

  26. Peter Evans said,

    December 21, 2005 at 7:27 pm

    Just been to the NICE site ( google it ). You can put in a request that they do some research into any aspect of current or planned treatment. I am not qualified. Perhaps someone who knows how to complete the technical sections would do a much better job ( I completed the form as a memeber of the public ). Worth a shot?

  27. Rachel said,

    December 21, 2005 at 10:44 pm

    One could always drop NICE a letter. That’s the next one for me. Today I wrote Andy Kerr our illustrious health minister in Scotland and the chair of “Health Scotland” the Rt Hon Lesley Hinds who is the Provost of Edinburgh in her other life (that’s mayoress to any non Scots). Not sure where this will get me but one must try. Starfish and all that.

  28. Delster said,

    December 22, 2005 at 9:58 am

    RS,

    was not aware that Dr & Herbs had been promoting that tea for bird flu. having said that, one of the ingredients for Tamiflu is, or is derived from, Star Anise. So rather than put down Ban Lan Gen tea out of hand, what i’d say is ask who’s done an analysis of the tea and what it contains, then test the active ingredients to see if there is any provable benefit…. who knows they may actually have something…. stranger things and all that.

    Also as for “But the main similarity is the almost complete lack of any evidence base” i’d have to say that there is evidence in plenty. After all if there was no evidence for medicinal properties then why were medicines developed from them?

    Yes there are problems in herbal medicine as both Tessa and Morag pointed out along with your self is that there is a quality control problem. Different batches of the plants will contain differing levels of the active ingredients and may also contain impurities depending on the soil it was grown in. So yes the pill form is much more practical and a good bit safer to boot.

    Morag also said “This leaves the herbalists with the ineffective plants, the poisonous ones, and the crude unpurified extracts which could contain practically anything. Which would you rather take?” Sorry but i’d have to disagree with this. Herbalists are not left with the ineffective plants, they are left with exactly the same plants as they have always used.

    Also “Big Pharma” are not even coming close to discovering all the medicinal properties of plants, fungi etc let alone being able to synth the active ingredients. There are still plant species being discovered and as long as thats the case then the posabilities, let alone the actual benefits, are nowhere near tapped out.

    I’ve just had a thought….. you all remember the water that could draw the sharpness out of lemon juice? well if it works the way it say’s then we could sort out the problem of nuclear waste by burying it surrounded by bottles of water…. and people said it would be a problem for centuries!!

  29. Morag said,

    December 22, 2005 at 12:55 pm

    Dr & Herbs were crucified on “Watchdog” about that flu promotion. One of their top brass was actually lured into the studio and put on the spot. All he could say was, “why can’t we advertise it for flu, the Chinese have been using it for flu for hundreds of years.” Nothing at all about any evidence they were *successfully* using it for flu, or that it might contain anything with an active ingredient.

    I should point out that while they were looking for the antimalarial that eventually became artimisinin, they tested over 300 herbs the Chinese “had been using for” malaria “for hundreds of yeards”. All but one was found to have no efficacy at all. The remaining one was the jackpot. I think there’s a lesson there somewhere.

    I didn’t just say the herbalists were left only with the ineffective plants, please don’t use selective quoting. I said “This leaves the herbalists with the ineffective plants, the poisonous ones, and the crude unpurified extracts which could contain practically anything.” Which is pretty much what they had in the beginning, right enough. My point was that such has been the interest in purifying and exploiting useful compounds from herbs, pretty much everything in common use has already been looked at in that respect. So, if there really is useful activity in the herb, there is almost certainly a purified and standardised and tested and licensed version of the compound. If no such pill exists in relation to any herbal claim, you really have to ask yourself, why not?

  30. Delster said,

    December 22, 2005 at 3:06 pm

    I have to admit to not watching much TV these’s days (result of enforced exposure to daytime tv) so missed that watchdog… still begs the question has anybody analysed and tested the stuff?

    as for selective quoting it was just pointing out they have what they have always had. As for the poisonous etc it just means never cross an apothacary! 🙂

    As for all commonly used “medicinal” herbs having been researched etc….. does anybody know of a database or some central knowledge base that lists what has been researched along with results? After all i’ve not seen any Vetiver sleeping tablets and it’s a damn fine soporific (in my own experience that is, sample size one, no control group)

  31. Delster said,

    December 22, 2005 at 3:35 pm

    just as an aside, if medicinal drugs have to pass stringent tests to get a licence, then how exactly did homeopathic treatments, which are after all taken internally, get approved? If that is they are actually approved?

    And what basis were they approved on… that fact thay they are just unlikely to kill someone? (or do anything to them for that matter)

    And if they are not approved then what on earth are we doing paying for these things on the NHS for….. and thats apart from the whole matter that these things don’t bloody work anyway.

    If the effect is only as good as placebo then why don;t we have the normal GP do a consultation and (if warrented) then send them down the chemist with a prescription for a bunch of sugar coated sugar pills? It would be cheaper than the tapwater merchants

  32. rachel said,

    December 22, 2005 at 3:37 pm

    www.ucl.ac.uk/Pharmacology/dc-bits/quack.html

    Here’s another webpage that’s got a nice cartoon and articles on dodgey scients/medicine including references to Dr Spence’s dodgey homeopathy trials.

  33. Morag said,

    December 22, 2005 at 8:36 pm

    Delster, homoeopathic remedies have a special licensing system all to themselves which excludes any requirement to prove efficacy. Don’t ask me why, I don’t know, exvept that it’s politics.

  34. Morag said,

    December 22, 2005 at 8:41 pm

    Here’s the relevant page on the MHRA web site.
    www.mhra.gov.uk/home/idcplg?IdcService=SS_GET_PAGE&nodeId=98

    Background to the legislation on licensing of homoeopathic products
    Until the introduction of the Homoeopathic Registration Scheme in 1994 the only homoeopathic medicines available on the market were those granted product licences of right (PLRs) when the Medicines Act came into force in 1971. Attempts to acquire marketing authorisations for new homoeopathic medicines were unsuccessful owing to difficulties in proving efficacy in conventional clinical trials.

    Current legislation for homoeopathic medicines
    The Homoeopathic Registration Scheme, implemented under a European Directive 92/73 EEC, is a simplified regulatory procedure, whereby products are assessed for their quality and safety and can then be marketed without specific medical claims. The simplified registration scheme thus enables a rapid introduction of new homoeopathic medicines onto the UK market.

    Fantastic, isn’t it?

  35. Michael P. said,

    December 23, 2005 at 9:09 am

    Delster: “does anybody know of a database or some central knowledge base that lists what has been researched along with results?”

    I doubt it. These things are usually done on massive scale screening projects, sometimes by the academics but usually by pharma. The results of the millions of compounds that bring no leads in the pharma screens are more than likely trashed and they move on to the next set of compounds.

    So it’s interesting what you say Morag: “pretty much everything in common use has already been looked at in that respect.” There’s a change in the way pharma are looking at this. Historically the chemists and the informaticists got together and thought up criteria for compound-types to screen for a particular application and the biologists screened it. Or, alternatively the chemists screened them themselves using modelling techniques and other clever stuff. But now they are turning more to screening theme and variations on ‘natural’ compounds as their starting points. i.e. start with a compound type from a plant etc. and make progressive changes to it’s structure then screen them all against your target. But it’s a monumental task – screen every imaginable substance with every known medical condition. It will never all be known.

  36. Michael P. said,

    December 23, 2005 at 9:15 am

    OMG Morag! The best bit is right at the bottom…

    Registration criteria –
    In order to qualify for registration the products must:
    1. Be for oral or external use – this includes all methods of administration with the exception of injections;
    2. Be sufficiently dilute to guarantee their safety;
    3. Make no therapeutic claims.

    So they stopped the introduction of new ‘treatments’ because they couldn’t prove it. But now they can sell what they like, as long as it’s quackery!

  37. rachel said,

    December 23, 2005 at 9:55 am

    Michael and Morag: Brilliant. Thank goodness there are people who know the detail of this and can analyse it. It’s also good the NHS sponsored homeopaths know you are out there too.

  38. Deetee said,

    December 28, 2005 at 2:47 pm

    Thanks for the links to the Glasgow Homeopathic Hospital. I was entranced by the views of its marvellous new facilities. The concept of a creative, healing environment with artistically designed areas of space, gardens, water features and lighting effects will do much to promote “wellness” in itself.

    [Quote from grateful patient: “Thank you so much for everything you have created at the hospital. I wonder if you realise how important it is for those of us who depend upon it’s environment to calm us, strengthen us, and then send us out into the world to cope for another while.”]

    One must ask, why bother with homeopathy at all when the environment does all the healing for you? And, how wonderful to find that they imagine this could all be provided within the usual constraints of the NHS budgeting process!

    I would suggest a little trial which could help resolve the issue as to whether homeopathy works……

    Get a homeopath to run outpatient consultations in a draughty portacabin in the middle of a car park next to a building site, at least 100 yards from the main hospital building with all its ancilliary services, and at least 500 yards away from the pharmacy and 800 yards from the laboratory (I was in this situation until very recently). Give the patients 10 minutes per visit.

    Give a conventional hospital consultant the opportunity to work from the facilities of the Glasgow Homeopathic Hospital site, and give him 45m – 1 hour per consultation.

    After 6 months, compare patient outcomes using a similar “customer satisfaction” survey as did Dr Spence at Bristol. Publish the results on the front page of the the Daily Mail.

  39. Rachel said,

    December 30, 2005 at 8:01 pm

    Yes indeed and thanks for the clever observation Deetee. Dr Reilly certainly gives himself a lot of coverage. As you point out, should I everI have an illness then I’ll go straight to the Glasgow homeopathy clinic with a view to the calming, strengthening environment healing me. Won’t bother with the “normal” doctors….they don’t work in calming, strengthening environments so surely can’t be as good.

  40. Kimpatsu said,

    January 10, 2006 at 8:28 am

    One observation about animals and the placebo effect: there are respectable studies by veterinarians that show white coat hypertension in animals. That being the case, animals should also certainly respond to placebos.

  41. Gilles said,

    January 26, 2006 at 9:57 pm

    Here’s a link to the audio of David Spence’s reply.
    www.bbc.co.uk/radio4/youandyours/items/01/2005_50_fri.shtml

  42. Ben Goldacre said,

    January 29, 2006 at 12:29 pm

    In October 2004, Peter Fisher, ubersenior homeopath, appeared on the BBC Radio 4 programme, “The Other Medicine”. He said ” . . . pool them [clinical trials] using a statistical technique called metanalysis. Everybody who’s done that concludes that the evidence says homeopathy really does work compared to placebo, it is not a placebo effect.”

    What is it with these guys denying the existence of all meta-analyses except the one early flawed one that benefits them?

  43. ‘Medical apartheid’ (at wongaBlog) said,

    May 23, 2006 at 10:37 pm

    […] See here, too. The Department of Health isn’t terribly helpful: A spokeswoman for the Department of Health (DoH) said it was up to clinicians and trusts to decide on the best treatment for a patient. […]

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