From: wsadjw@rw6.urc.tue.nl (Jan Willem Nienhuys)
Newsgroups: sci.skeptic
Subject: Re: homeopaty... NBC's da
Date: 28 Dec 92 12:15:52 GMT
Reply-To: wsadjw@urc.tue.nl
Organization: Eindhoven University of Technology, The Netherlands

In article <1hmc1gINNob6@agate.berkeley.edu> kuritzky@wheatena.berkeley.edu (Eric Kuritzky) writes:
>
[partly quoting a certain Bernie and an answer to Bernie from  sdb 
 on the subject of Kleijnen's paper]
#|
#|   However, a number of controlled, double blind studies have
#|   been performed which show the effectiveness of homeopathic medicine in
#|   treating a number of diseases. The following is a brief list of some
#|   of these studies.
#|
#|   D.T. Reilly, M.A. Taylor, C.McSharry et al., "Is Homeopathy a
#|   Placebo Response? Controlled Trial of Homeopathic Potency with Pollen
#|   in Hayfever as Model," Lancet (1986):881-886.

This paper score 90/100 in Kleijnen's meta-analysis.
#|
#|   J.P. Ferley, D.Zimirou, D. D'Adhemar, et al., "A Controlled
#|   Evaluation of a Homeopathic Preparation in the Treatment of
#|   Influenza-like Syndromes," British Journal of Clinical Pharmacology,
#|   27(1989):329-35. 
This paper scored 88/100.
#|
#|   P.Fischer, A.Greenwood, E.C.Huskisson, et al., "Effect of
#|   Homeopathic Treatment on Fibrositis (Primary Fibromyalgia)," British
#|   Medical Journal 299(1989):365-366.

Fisher, not Fischer.  This paper scored 45/100, in other words severely
lacking in quality.
#|
#|   E.Ernst, T.Saradeth, and K.L.Resch, "Complementary Treatment of
#|   Varicose Veins: A Randomized, Placebo-Controlled, Double-Blind Trial,"
#|   Phlebology (1990): 157-163.

Too recent for Kleijnen.

#|
#|   Kleijnen, Jos, Knipschild, Paul, ter Riet, Gerben, "Clinical trials of
#|   Homoeopathy.", British Medical Journal, Feb 9, 1991 v302 n6772
#|   p516(8).
#|
#|Have you actually read any of these, Bernie? I found the last one
#|particularly interesting.  It's a meta analysis (a study of studies)
#|of the quality of homeopathy trials. It was very critical of most
#|trials, calling their methodology *poor*. They were also concerned
#|with the possible role of publication bias (which they stated could
#|not be determined at present.) The strongest statement in favor of
#|homeopathy came when they said it could make a  case for further
#|evaluation.  Hardly a hue and cry for its effectiveness. In fact, the
#|positive trend statistics in the paper (on which they base their
#|opinion that homeopathy should be considered for further trials) came
#|from lumping together *ALL* trials, both questionable and
#|unquestionable.
#|
#|While it's nice of you to put this somewhat critical of homeopathy
#|trials paper in your list of references, it's rather misleading of you to
#|describe it as a demonstrating "the effectiveness of homeopathic
#|medicine in treating a number of diseases".
#|
#|sdb
#                              Eric Kuritzky

To which I might add
(1) that the famous Reilly paper may score 90/100 in "methodology"
but that the magnitude of the effect reported is ludicrous:
The statistics reported are about "hayfever patients"; 30% of the
participants dropped out of the study (always a worrisome aspect
in controlled studies; the two times 79 patients at the beginning of
the study were comparable groups, but nothing is said about the composition
after the fall out)
and the results (after five (5!) weeks of treatment):

               felt better      same      felt worse
homeopathic           34          9         13
placebo               27          5         21

And there are a couple of oddities in the report that didn't bother
Kleijnen et al., but that are cause for suspicion: the number of patients
mentioned in the computations seems to differ from one computation to the
next ( 52 placebos in the table and 53 in the diagram, and why are there
in the statistical analysis of 109 or 108 patients first 100 and then 92
degrees of freedom?).

A second remark:  Kleijnen et al. have been quoted by homeopaths as
supportive of homeopathy, even when they are on record as saying more
or less the opposite.  This has lead people like Petr Skrabanek to
lament that scientific investigation of these irrational systems
leads nowhere.  The proponents will not accept negative evidence,
and they will use accidental favorable results to gain scientific
respectability.

JWN
Newsgroups: sci.skeptic