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Accolades & Quackolades

"Best blog of the day IMHO."
Simon Singh


"This blogpost is simply brilliant."
Mark Burnley


"You are a rude argumentative bully. You are a typical "skeptic" - not sceptical at all."
Andrew, anti-vaxer


"Your piece about House of Commons Science and Technology sub-Committee’s ‘evidence check’ on homeopathy was one of the best I’ve seen. Strength to your elbow."
Tony


"...an individual calling themselves ‘scepticat’ or ‘sceptikat’- a highly volatile dictatorial site run by a wannabe megalomaniac. A truly disturbed person with a anger management issue venting via their little site to their own personal herd of sycophants."
Centella, one of Dr Andrew Jones personal herd of sycophants.


"Excellent report, which I can vouch for completely."
Jack of Kent


"The ludicrous nature of the complaint, and some of the responses by Dr Ranj and the BBC, has already been expertly documented on the Skepticat UK blog".
Dean Burnett


"Choke on your own vomit and die in agony..."
r wesley edwards, aka @CommonCormorant, author


"A very good rebuttal…"
Anna Watson, anti-vaxer Arnica UK


"A staggering amount of pathological disbelief allied with a staggering amount of arrogance."
AJP, homeopath


"I just love this blog, and this post is a fine example of it’s content – ‘Inside the spine wizard’s den’ – Skepticat. Why do some of us feel that we are above challenging argument and peer review? I just wish that I could write as well as some of these bloggers!"
Jonathan Hearsey, osteopath


"Skepticat is a particularly venomousness (sic) skeptic, a humanist who lives by the "golden rule", she refused to let me follow her on twitter because I am "bonkers" which may endear her to many in the chiropractic profession..."
Richard Lanigan, chiropractor


"Die Die die die!"
r wesley edwards, aka @CommonCormorant, author


"Loved that article. It really shows what chiropractors are really all about. What I call the "chiro show" Exposing people to totally unnecessary X-rays should be criminal. Thank you!"
mt


"I think skepticat is plain mad at not having children of her own. Hatred projected out to the world. It's sad to see someone with so much self hatred, destroying themself internally without even realising it."
Bebo, chiropractor


"Hooray for Reason! Just want to thank you for writing this. Even though the arguments presented are tired, and played out, they still must be refuted."
Elijah


"I understand that you have been traumatised by your experience and that this is your way of coming to terms with the emotional scars."
Stefaan Vossen, chiropractor


"All you really seem interested in is banging your repetitive drum and preaching to the converted."
Rick, osteopath


"All the entries I’ve read are excellent. I’ll be coming back to read more. Love the cat logo as well."
Derrik


"Research in Homeopathy Conference - Skepticat's hilarious account. She went to it."
David Colquhoun


"Her site is Skepticat UK... she wouldn’t know a punchline if it raped her. Or maybe she’d thank it."
Scott Cappurro, comedian


"I rather love the lunacy of the anti-Homeopathists, such as yourself."
James Pannozzi, homeopath


"Good blog from a skeptic which examines the "science" of Homeopathy in a very detailed way. Skeptics will love this. Proponents of homeopathy? Not so much."
SidDithers


"I really shouldn’t waste my valuable time with someone who obviously has at the very least a borderline personality disorder."
Erika Alisuag, homeopathist


"I’m finding it difficult to come up with some suitable words to say how good and interesting your stuff is. So, in the absence of suitable hyperbole can I say what a very well written and presented blog you have here. Really well thought out and researched. And passionate about it too! Complimenti!"
pv


"You’re whole life is worthless because you lack reason."
AJP, homeopath


"Great stuff Skepticat."
Lifelinking


"When you have learnt some big words and also studied your history books you’ll find that the world was once thought to be flat…by people just like you."
Sarah Hamilton, homeopath


"Thanks for keeping the banner of reason flying high."
John Willis Lloyd


"This is just a general comment. I love this well-written an unfussy little blog (I don’t mean little in a derogatory way, but in the sense it’s not bombastic, self-important and posturing). Excellent material and a worthwhile focus, keep up the good work."
xenophon19


"Her website is a temple to diatribe – I have no sympathy for the homeopaths, etc, with whom she battles, but she clearly gets off on confrontation."
JF Derry


"Skepticat is strictly logical and attacks in unparliamentary words what she deems to be “quackery” – or suggestions that she sounds a little strident."
Andy Reporter


"LOVE the badass attitude! Seriously...KEEP IT UP!"
HelpIzOnTWay


"You were a playful little diversion for a. moment, but I do have better things to do with my time than waste more than half an hour of it stooping down to play your ego supporting self delusional mind games……"
Susan Elizabeth, homeopathist


"An excellent read, thanks for taking thr time to compose it."
Alan C


"You need to do a course in anger management."
katenut, nutritionist


"FWIW I think you manage your anger rather well...mostly by focusing it into a thin, narrow beam of incisive rage which you then use to inscribe words on screen. ;)"
Despard


"Excellent description of the events."
Simon Perry


"You seem to be of probably well-meaning, but bigoted and fundamentalist disposition, just parroting slogans from others without any really knowledge or insight yourself."
Neil Menzies


"Superb, as usual"
phayes


"You seem only interested in ranting against an enemy which you are apparently still struggling to come to terms with “fifteen years” later."
Rick, osteopah


"Bravo, great post!"
RBO


"One day if you are not very careful you will be left behind in the dark ages. I’m sure this will not be printed..but hope it is read by you poor little scaredy cats."
Sarah Hamilton, homeopath


"Brilliant piece!"
crabsallover


"While you babble on like a total airhead about Myhill, you ignore the real doctors who are a danger in the UK".
struck-off doctor, Rita Pal, 'NHS whistle-blower'


"I sincerely hope I never get to your stage of wilful ignorance. You know absolutely diddly squat about the subject but you think your opinion is the only opinion."
AJP, homeopath


"Keep up the spin, you manky old chicken's foot."
JB, chiropractor


"I am forced to conclude you are blogging on behalf of a specific entity that does wish to remain anonymous."
AJP, homeopath


"The person writing all this negative press on homeopathy must be getting a big fat check from one of the pharmaceutical companies who would dearly love to push homeopathy off the map."
Erika Alisuag


"Such reporting lands you clearly in the realm of fundamentalist extremism–much noise, no substance, and money from those who have something to sell. It is so unfortunate that your listening skills are in need of repair."
Tanya Marquette, homeopath


"She seems to revel in presenting the many insults that she has attracted as a column of “Quackolades” on her site, as if war wounds on display,"
JF Derry, self-publicist


"Oh shut up SK. You write hot air and spew rubbish as usual."
Rita Pal again.

Epic fail: Scientific Research in Homeopathy Conference 2010

Yes, I really did go to this and, no, it wasn’t the shortest conference in history — it lasted a whole dreary day. They didn’t know it was me because I had cunningly disguised myself as a middle-aged, middle-class woman so I wouldn’t stand out.

You may be wondering what possessed me to spend a day listening to a bunch of quacks talking piffle. Having done it, I’m wondering the same. The best I can say is that I went for the same reason I once consented to an examination by a chiropractor, wore a niqab and gave birth at home (not all at the same time) and why I might yet have a reiki massage and do the alpha course: I wanted to see what it was like. I saw it as part of the rich tapestry of out-of-the-ordinary experiences that life has to offer. What could be more bizarre than to sit listening to “top PhD research scientists” talk about one of the loopiest of all quack therapies as if there was a serious chance it could revolutionise health care systems in the developed world?


The conference, organised by the very scary Jayney Goddard of the Complementary Medical Association, was promoted thus:

‘Homeopathy is nothing more than placebo! It doesn’t work and homeopaths are cynically ripping off vulnerable people!’

We’ve all seen these ridiculous headlines. So, if you are as fed up as we are of hearing this constant nonsense, do come along to the 2010 “Scientific Research in Homeopathy” Conference. This is a not-for-profit event that will give you the proof you need to effectively counter these arguments.

Jayney opened the conference with the declaration that, “Homeopathy is weird. We know it works but we don’t know how,” and promised us speakers “at the zenith of their profession.”

Are you ready?

Lionel Milgrom

Call me naive, but when I go to conferences I expect to hear professional presentations in keeping with the theme of the event.

I’d never seen or heard Dr Milgrom perform live before and I initially mistook him for some cocky little barrow boy from Billingsgate market who’d wandered in by mistake. But, according to the conference website, he’d had a “a long career as an academic research scientist”. Blimey, as Milgrom would probably say, he certainly kept his scientific credentials well-hidden during the hissy-fit he gave in lieu of a presentation.

The list of targets was predictable enough: Edzard Ernst, Richard Dawkins, David Colquhoun, Michael Baum, Simon Singh and Ben Goldacre all came in for a tongue-lashing as did the Sense about Science charity, with a special mention for the charity’s founder, Lord Taverne: “Dick by name, dick by nature,” spat Milgrom, to approving sniggers from the audience. But the main target for his venom was Evan Harris. “I’ve always voted Lib Dem before,” he snivelled, “but I never will again.” He announced that he’d written to Nick Clegg requesting that Evan be censured — “and I really hope he is!” See gimpyblog for a look at the letter.

It seemed a curious decision to kick off a purportedly serious conference about homeopathy and scientific research with a session that was little more than a rant about “the new fundamentalism”, as Milgrom describes the growing opposition to the unethical promotion and public funding of scientifically unsupported therapies. It also seemed curious that he should give a presentation that, as far as I can see,  was virtually identical to the one he gave at the first such conference two years ago (available here or, for anyone who’d prefer to read the same old guff in article form, try here). As an update on his last rant, we’d been promised a “critique” of the article by Michael Baum and Edzard Ernst on the truth about homeopathy, but nothing that could reasonably described as a critique took place.

It will come as no surprise that Milgrom gave the usual quackish misrepresentation of what was happening in the BCA v Simon Singh libel case (in spite of Jack of Kent’s hilarious post about him last year), sneered at the 10:23 event and at skeptic bloggers in general. And, of course, he called the meta-analysis by Shang et al (the one that reveals homeopathy to be the biggest cock and bull story since the virgin birth) the “best example of bad science worthy of Ben Goldacre”, which is what he said last time (see apgaylard), and which is, of course, nonsense. There were a few criticisms of the Shang paper but these have been more than adequately answered and, anyway, they had no effect on the truth of Shang’s conclusions. Milgrom is not the type of quack who would let the truth get in the way of good story, however.

If anyone’s interested in any of the…ahem…‘scientific’ content of Milgrom’s slot, I suggest you go and read Andy Lewis’s superb article about what he said at the previous conference and if that isn’t enough for you, I can recommend Shpalman’s collection of articles on Milgrom. As far as I’m concerned, he’s a waste of space and I’m not going to waste any more of my time on him.

19.4.2010: Edited to add link so you can read Milgrom’s rant now published on some quack website. Don’t all rush.

Alex Tournier

The demeanour of this charming Frenchman couldn’t have been more of a contrast to that of the horrendous Milgrom. Not only did he not slag anyone off but his was one of only two presentations at the conference that contained some science and it is rather sad that someone so well qualified is wasting their time on homeopathy. Dr Tournier is a biophysicist and a research fellow for Cancer Research UK. He is also chair of the Homeopathy Research Institute.

I don’t propose to say much about the content of his presentation because, although I took copious notes, I don’t have a copy of the slides he used. (Copies of all the presentations were promised to attendees; none have so far materialised.) Even with the slides, I found his argument difficult to follow and it was even more difficult to take him seriously after he’d introduced his session with probably the daftest remark made by any of the speakers during the entire day, which is that the principle of like treating like — the ‘Law of Similars’ — is “pretty uncontroversial”.

Say what?

It isn’t the first time I’ve heard a quack from a scientific background mention vaccines in the same breath as homeopathy and, coming from people like that, I can’t see the comparison as anything other than dishonest. I know a lot of homeopaths say things like, ‘homeopathy works by stimulating the body’s own healing power’, but they’re just stupid. That’s not an explanation!

Surely the ‘treat like with like’ — sympathetic magic — idea is every bit as controversial as the ‘more dilute = more potent’ nonsense. (The latter is what Alex Tournier described as the ‘Achilles heel’ of any theory of homeopathy, when really it’s just the part that most easily lends itself to ridicule.) The ‘Law of Similars’ has always been a huge stumbling block to acceptance as far as I’m concerned and I still await answers to the questions about it I have posed several times already in previous posts.

Tournier soon made his second ludicrous and dishonest assertion of the day, which was that homeopathy’s detractors never pick up on the similarity of the high dilutions principle and hormesis. Oh, good grief! I may not have a PhD in biophysics but even I know the difference between something and nothing.

Another reason why I didn’t expect to be blown away by Tournier’s presentation is that I’d read Gimpy’s analysis of what he said last time. To quote Gimpy,

…he indulges in the familiar deceit, misinterpretations and hypocrisy of homeopaths when it comes to evaluating scientific approaches to homeopathy

Exactly.

Anyway, as I can’t bring Tournier’s presentation to you, I’ll just c & p what he said in the pre-conference information and move on. (I’d skip it if I were you.)

There is presently no accepted scientific theory of how the high-dilutions involved in homeopathy might carry any physical effect, let alone a therapeutic effect. Several lines of enquiry have been followed over the years with little success. There is currently a great need for a testable theory of high-dilutions, such a theory might be that of Quantum Coherence Domains (QCDs).
Giuliano Preparata (1942-2000), an Italian theoretical physicist at the university of Milan, hypothesised the presence of QCDs in room temperature condense matter. QCDs emerged out of Preparata’s extension of Quantum Electro-Dynamics to include interactions with external Electromagnetic (EM) fields. In the case of water these hypothesised QCDs would be small volumes of water each one acting as a single quantumly coherent entity.
These QCDs have interesting properties in terms of a potential explanation of the phenomena linked to high-dilutions. These QCDs are predicted to capture the EM fields present at the time of their creation. This process could, in principle, capture the specific EM signature of any given substance. The serial dilution/succussion process involved in homeopathy could then be seen as a way of propagating QCDs around a sample (through succussions or, equivalently, vortexing) and eventually removing all trace of the original substance (through dilutions).
QCDs are currently being investigated as a potential explanation of a number of anomalous behaviours reported in experiments investigating solvation effects. In the context of high-dilutions a number of experiments have already reported some effects, although not in a fully reproducible way.
I will present an overview of the theory of QCDs and how, when applied to homeopathy, it offers a framework through which many of the observed phenomena can be investigated and potentially explained.

Kate Chatfield

Chatfield’s name will be familiar to anyone who’s been following David Colquhoun’s campaign against quackademia (snigger). She still leads an MSc course at Uclan but it’s only in homeopathy by e-learning, which would explain why Chatfield, who described herself as a “philosopher not a scientist” is considered qualified to take it.

Obviously, as she’s not a scientist, her session wasn’t remotely connected to science. Instead she promised, in her session, to address the question of whether it is unethical to prescribe homeopathy. Chatfield, a homeopath, concluded that it isn’t. Fancy that.

Steven Cartwright

How lucky am I that Azneo has produced a very nice wee blog post on the same presentation — right down to the quote from Sir Arthur Conan Doyle — given by Cartwright at another venue! Before you click on the link, allow me to indulge in a bit of blatant well-poisoning.

I’m sorry but I just have to share with you some bits from an article by the same Dr Steven Cartwright that was published in The Homeopath magazine in 1996.

Cartwright had several years experience as a homeopath and four years involvement in shamanism, when he travelled to Peru to learn about the shamanic healing practices of a tribe of Amazon Indians. He “knew intuitively that there were important connections between shamanism and homeopathy”.

My favourite bit is his description of how a shaman deals with a sick person who comes to see him and how it may take several visits before the shaman ‘sees’ what is wrong with the person.

The shaman would say that the spirits have shown him. And in that moment of ‘seeing’ the cure takes place. The singing that follows, the plant infusions that are given, all help; but unless the shaman has ‘seen’, no cure can take place.

This all sounds fair enough, doesn’t it? We are talking about a primitive people living in the Amazon rainforest, after all. I don’t suppose too many of them get the chance to go to university, unlike Steven Cartwright who, according to his conference profile, gained his PhD from Edinburgh University and spent many years as a research biochemist at Oxford University before discovering homeopathy. He continues:

The parallels with homeopathy were unmistakable. A patient can come several times to the homeopath, but only when we ‘see’ the nature of the patient’s sickness, only when we understand, can and does, cure take place…For the shaman it is the spirits who help him to ‘see’. The homeopath has only symptoms to help him or her to ‘see’. And intuition.

Now here’s the bit that made my jaw drop:

For those of us who do not follow the way of the shaman, there is a symbolic system above all others which is so versatile and which tells us so much about a patient and their state of being, including their heredity, even before they tell us their story, that it is invaluable as an aid to coming to the meaning of sickness; and that symbolic system is astrology. Astrology gives us access directly at the level of meaning, rather than manifestation, and that, to my mind, is its great value.

I’ve since learned that astrology — sorry, I mean medical astrology — is considered quite appropriate for incorporation into the homeoquack’s armoury. I am so tempted to book a consultation with Steven Cartwright just to hear him talk about ‘Mars in Scorpio rising’ or some such twaddle.

You may be wondering why somebody like this was speaking at a conference that has the word ‘science’ in the title. The answer is that he’s been involved in “experimental work at the Cherwell Innovation Centre in Oxford aimed at developing assay systems for homeopathic potencies as well as demonstrating changes in solution on succession, which it is hoped will eventually lead to an explanation of the mechanism of action of homeopathy”.

Steven Cartwright, bless him, comes over as a really sweet and personable man but he doesn’t half talk some hogwash. Here’s a sample taken down verbatim from his session:

Has anyone here given a remedy and it hasn’t worked, then given the same remedy further down the line and it has worked? (Murmers of assent.)

What’s happening?

The indications are that potencies oscillate in their effectiveness over time…What if James Maddox and James Randi had come to Benveniste’s lab on a day when the strength of the potency was at its lowest? And if they’d come when the strength of a remedy was at a peak, I wouldn’t be standing here now because Benveniste would have won the Nobel prize and it would all have been sorted.

OK, go away and read that other blog now, if you’re interested enough in what Dr Cartwright has to say. (As an alternative, I’d recommend yesterday’s interesting post by Prof Stephen Curry: Homeopathy and the Structure of Memory.)

By the way, if anyone doesn’t know the story of Benveniste, you could do worse than watch the 2002 Horizon documentary on homeopathy, which is now on youtube. The advantage of this is you get to see and hear Benveniste himself talk and he’s dead sexy. Well, just dead now, of course. Milgrom’s in it too.

Edited to add: Or see the Bienveniste story told in cartoon strip here — superb!

Oliver Dowding

We have huge “constituencies” of satisfied users consistently proving beneficial outcomes. These are satisfied users who generally have four legs, but in some cases, only two, and all come from the animal kingdom. Whilst not widely practised in this country, there are a great many more animal users of homoeopathy than sceptics are prepared to accept.

Yes, I know. This extract from Dowding’s conference profile is just begging for ridicule. You’re right, Oliver, I do not accept. Just put me in touch with some of these four-legged “users” and let them tell me themselves how satisfied they really are.

There is more of the same on this website, which he directed us to.

This article is written from the experiences I had in keeping 500 head of dairy livestock for 14 years, whilst managing the farm under organic principles.  I was meeting many health challenges that they faced, which we primarily resolved with homoeopathic remedies.  The overriding outcome and opinion formed was that cows are not inherent liars or fraudulent creatures!  They have no axe to grind, nor a commercial position to maintain or enhance.

There’s not more much I can say about this former dairy farmer, who was yet another speaker at this so-called science conference who began his session by declaring he wasn’t a scientist, had no degree of any sort in fact but he had “spent a lifetime doing things”. Well, that’s nice to know.

Dowding was as sour as Cartwright was sweet. Allopathic medicine is failing on a big scale, he told us, and we need alternatives. I’m sure he knew he was singing (or, rather, reading his speech word for word) to the choir but that didn’t stop him.

Like Lionel Milgrom, he felt the need to have a cathartic rant at the usual suspects — mainly Ben Goldacre — but also at the more humble everyday folk who like to challenge the promotion of dangerous nonsense on the web under “ridiculous pseudonyms”. I can’t think who he means. Strangely, the one he chose to focus on was my friend, Margaret Nelson, who makes no attempt to hide her identity in making her brief comment on libdemvoice.org, which Dowding read out because it ends with this throwaway line:

Oh, and if Oliver’s use of homeopathic “treatments” for his livestock causes them any suffering, he’s liable to be prosecuted on animal welfare grounds because it’s not treatment at all.

Dowding, to my astonishment, then read out his entire response, which is nearly a thousand words long! How surreal was it to be at a conference supposedly about scientific research listening to Worzel Gummidge read out some squabble he’d had on the internet? Honestly, it felt utterly bizarre. I will add that I go to quite a few meetings and conferences and if the humanists and skeptics I hear at them behaved like some of these people did, I’d have nothing to do with them.

Anyway, Worzel said nothing that was worth reproducing here so I’ll move swiftly on.

Clare Relton

During the conference, two conflicting views were expressed on the state of scientific evidence for homeopathy. One view is that there is loads of good quality scientific evidence that homeopathy works (Milgrom) and the other view was that there isn’t (Relton — though, in fairness, she implied this rather than said it in as many words).

Milgrom repeated the lie that “there are many good quality scientific trials and meta-analyses showing that homeopathy can demonstrate clinically observable effects over and above placebo”. Relton, on the other hand, while stating that since 1945 there have been some 200 RCTs published on homeopathy and that a new one lands on her desk every couple of weeks, repeated the argument so beloved of altmed devotees, which is that “lack of evidence of effectiveness is not the same as evidence of lack of effectiveness”.

Indeed it isn’t and it’s a perfectly reasonable thing to say in relation to a therapy that — unlike homeopathy — is scientifically plausible but hasn’t been trialled extensively. When a treatment that — unlike homeopathy —  doesn’t flout any fundamental laws of physics but — unlike homeopathy — hasn’t been subjected to rigorous scientific testing, then of course we can’t know for certain whether it works or not.

Take, for example, the extract from the foxglove plant, digitalis, which was originally part of an old folk remedy for heart disease and which is still used by homeopaths “for people who are prone to heart and circulatory disorders. The remedy is considered particularly appropriate if symptoms are accompanied by a fear of death, or a fear that moving — especially walking — may cause the heart to stop beating”.

For more than two centuries digitalis (digoxin) was considered a life-saver by physicians practising orthodox medicine as well.

…doctors based their ideas on their clinical experience and intuition, and knew that digoxin saved lives. They could see it working. The 1997 trial showed that doctors had been wrong on this point for two centuries. People who took digoxin lived no longer than those who swallowed a placebo. That was not because it was less ‘natural’ than chewing on a foxglove, simply because the effect of the active compound on the human body was not as miraculous as intuition suggested.”

Druin Burch,Taking the Medicine p. 237

When it comes to a therapy that has been tested in a couple of hundred RCTs and when the better quality trials demonstrate an effect no better than placebo….well, if that isn’t evidence of lack of effectiveness, I don’t know what is.

But for homeopaths — or any other breed of quack for that matter — if the science tells us something we don’t like, then there is something wrong with the science. Clare Relton used her slot to talk about clinical trials — the subject of her recently completed PhD. She was the most engaging speaker at the conference and her presentation was the only one I found vaguely interesting, though not as interesting as her story of how she flunked science at age 13, got a “motley collection of GCSEs” yet ended up being employed by the NHS to provide homeopathic treatment and is now a research fellow at Sheffield. She said she found the fact that she now earns her living from science “intriguing” and, having heard her presentation, so do I.

She mentioned her extensive experience of treating menopausal women with homeopathy. As someone who’s spent the best part of a year finding out just how bad the menopause sucks and how it can ruin one’s social life, I had no trouble imagining how nice it would be to spend an hour in the company of this charismatic woman. I could envisage her listening intently, maybe even holding my hand as she nodded sympathetically. Then she would prescribe an individualised remedy — a remedy just for me — devised after careful consideration of everything from my food preferences to my phobias (for a list of questions used in homeopathic consultations, see here). I have not the slightest doubt that if anyone can cure my menopause, Clare Relton can. A series of appointments with her and I’m sure the hot flushes would lessen in frequency and eventually disappear altogether. Yep, I’m convinced of it.

Anyway. Dr Relton talked about perceived shortcomings of RCTs and about her pioneering work on a new trial design: Relton et al BMJ. 2010 Mar 19;340:c1066. doi: 10.1136/bmj.c1066. Rethinking pragmatic randomised controlled trials: introducing the “cohort multiple randomised controlled trial” design.

Here’s an extract from the article:

We have obtained ethical approval for and have conducted a pilot study of the cmRCT design. (Relton C. A new design for pragmatic RCTs: a “patient cohort” RCT of treatment by a homeopath for menopausal hot flushes. [PhD thesis] ISRCTN 0287542. University of Sheffield, 2009.)

In this pilot, a large observational cohort of 856 women aged 45-64 was recruited and their outcomes measured. A total of 72 women reported frequent or severe menopausal hot flushes, or both. Of these 72 women, 48 were eligible for the trial treatment (NA) and 24 were randomly selected to be offered the treatment (nA). The outcomes of the randomly selected patients were then compared with the outcomes of those eligible patients not randomly selected (NA – nA) using both intention to treat analysis and CACE analysis.20 Patients were not told about the treatments that they were not randomly selected to be offered.

Now, here’s how she described to the conference audience, what she’d told the women selected to be offered the treatment:

There is a treatment that we think might benefit you but we are not sure. There doesn’t appear to be any risks because it is homeopathic, although there is not much evidence about it.

I don’t pretend to be any kind of expert in these matters but even I managed to spot a teensy-weensy problem with that scenario. We know by now (and, indeed, have known for more than 200 years) that the mere belief that a medical intervention is taking place can result in an improvement (or worsening) in some medical conditions. That’s why trials have control groups and why both groups are blinded. Isn’t comparing a group who know they are being treated to a group who know they aren’t, asking for bias? What am I missing here? I hope someone will be able to explain it to me — preferably someone who knows what they are talking about.

If you’re wondering why I didn’t pose this question to Dr Relton at the time, it’s because we were forbidden by Janey Goddard from asking questions in the sessions. The conference wasn’t an occasion at which conferring was encouraged until a brief all-speaker panel session at the end. Goddard said it was more “holistic” (yes, she really said that!) to save questions until the end of the day when, inevitably, there were too many — mostly daft — questions for the time allotted.

During her slot Relton also highlighted, with the help of the BMJ pie chart, “how little we know about the effectiveness of NHS-funded healthcare”. To her credit, she didn’t do what I’ve mostly seen quacks do with that pie-chart and claim that it refers only to conventional medicine when it fact it refers to all commonly used treatments including the one Dr Relton has spent years practising. She focussed very much on the 51% of treatments of unknown effectiveness (treatments “for which there are currently insufficient data or data of inadequate quality”) without mentioning the criteria on which treatments were included or left out so I’m not sure what point she was making. Funnily enough, she made no mention at all of the 13% of treatments of proven effectiveness and of the fact that homeopathy was not included amongst them.

Dr Rob Verkerk

Verkerk is a “compelling speaker who is also extremely personable,” said the pre-conference publicity. In fact, Verkerk, who has a PhD in something to do with agriculture comes across a dreary, whingeing and obnoxious gobshite, very much in the Milgrom mould. He is the Executive Director of the Alliance for Natural Health — whatever that is — and, like many of the presentations at this ‘Scientific Research in Homeopathy’ conference, his had nothing much to do with scientific research but, like Clare Relton’s session, focussed much more on dissing the methodology employed by scientific researchers because it doesn’t suit quack remedies.

He quickly endeared himself to the audience with a hilarious joke that went something like this: “It’s important to declare one’s biases and my bias is that I don’t like pharmaceuticals a lot”. His second bias is that he doesn’t like “corporate imperialism”. I’m sure you can work out one of his favourite themes from those two biases and his argument was so tired, I’m not even going to go there.

My interest was piqued when he informed us that “energy-based medicine” is central to some ancient tradition or other and that the only people who don’t understand it are orthodox physicians. But my hope that he was going to give some sort of explanation of this energy-based medicine was not realised, alas. Instead he told us his third bias is Ben Goldacre, whom he doesn’t think is a very good doctor or scientist. But then Dr Verkerk evidently doesn’t think that any doctor or scientist who considers the totality of available evidence for quack remedies and concludes that they are basically crap, is a very good doctor or scientist.

Verkerk talked about the difference between efficacy in the “ideal experimental world” and effectiveness in the “real world”. As every quack knows, the methods of research favoured by scientists tend to demonstrate a lack of efficacy in quack therapies and this, he whined, is mainly because scientific researchers ignore clinical experience, which isn’t what David Sackett intended at all. No, indeed! Then again, I don’t think he intended that clinical trials should be cherry-picked and the larger, better quality ones ignored. In his 1996 article in the BMJ, (which Verkerk mendaciously referred to as a “complaint” that clinical experience is being disregarded), Sackett said,

Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research.

It follows that, as the best clinical evidence from systematic research of homeopathy shows it’s a crock, NHS funding for it should be withdrawn immediately.

Of course, Verkerk also had a go at Edzard Ernst. He went on about Edzard rather a lot, in fact. To give a flavour of what he said and the tone in which he said it, this is Verkerk reading from a systematic review of RCTs of individualised herbal medicine conducted by “Ernst and his chums”, in 2007.

“There is a sparsity of evidence regarding the effectiveness of individualised herbal medicine and no convincing evidence to support the use of individualised herbal medicine in any indication”…so says God! And it is utter rubbish! If only he was to look at what’s happening in a clinical environment…

If this conjures up a picture of a surly adolescent having a tantrum, I’ve succeeded in conveying my own impression of Verkerk’s session. If not, you might like to look at Verkerk’s written response to the same systematic review, in which he says pretty much the same thing and in the same way as he did at the conference.

Scientists like Prof Ernst have become so introspective over their worship of their reductionist methods that they fail to see how they do or don’t relate to the much, much bigger picture of how extremely complex and diverse natural substances interplay with even more complex and diverse genomes. This truly is an abuse of science.

Worship of reductionist methods? Enough already! I really can’t be bothered to transcribe the rest of what this guy said. Let’s just consider that the pre-conference publicity said the main purpose of Verkerk’s session was to “outline a potential way forward aimed at facilitating greater acceptance and uptake of homeopathy by mainstream medicine”.

This is what he said in conclusion:

It is time to park some of the thinking on efficacy. It ties up a huge amount of resources. If they want to do it, that’s fine, but the work is done so consistently badly and inappropriately that, most of the time, it’s not worth it…We need to be thinking about mechanisms but it’s not not the end of the line if we don’t have one. We need to focus on finding better tools to measure what is going in a clinical environment. We have to translate that patient experience and find better ways of translating what’s happening at a clinical level into a so-called scientific approach.

In other words, stop worrying about how it works; the way scientists do science sucks and we just need to find ways of making all our anecdotes look like convincing evidence. Clare Relton said pretty much the same thing — she just said it in a nicer way.

Conclusion

The conference has been described as a “huge success” but only, so far as I know, by the person who organised it. It’s not clear what criteria she is basing her judgment on but probably that people enjoyed it as a social occasion. One thing I can be sure of: not a single person left that conference equipped to “effectively counter” the arguments against homeopathy as a therapy or against its provision on the NHS.

Something I hoped to gain from the day was a better understanding of why people so passionately believed in such an implausible idea. Is there something more going on here (I mean psychologically, not with homeopathy) than the naive post hoc ergo propter hoc assumption?

I don’t think so.

I think we already know the factors that come into play: perhaps the most important one is that bad experiences with proper medicine make one more disposed to wanting any alternative to work, however batty it sounds. The apparently miraculous recovery of a loved one (or oneself) when nothing else had worked — as was the case with Relton’s son’s chronic ear infections, which hadn’t responded to antibiotics but got better after getting homeopathic treatment — can provoke an ephiphany and I use that word deliberately. The conversion to homeopathy is closer to a religious experience than it is to anything else, just as homeopathy is more like a religion or cult than it is like a proper health discipline. I don’t think faith in homeopathy can be explained by any new insight into the human condition that has thus far eluded us.

And, of course, once someone has invested days, months or years and a considerable amount of money to becoming a homeopath and especially once they’ve found they can make some sort of living out of it, their minds become resolutely closed to the possibility that they can be wrong about it. (By the way, in my usual spirit of open-minded enquiry, I wouldn’t mind doing this two-day beginners’ course at the Centre for Homeopathic Education, if only it didn’t cost £250. Any offers to fund me?)

Talking of money, I will say that if the conference had really lived up to the title and the promises, i.e. if it had really been about scientific research, if the speakers had really been top PhD scientists and at the zenith of their profession and if it had really equipped people to effectively counter what are really very simple arguments, then it would have been a fantastic bargain at £58.

As it is, the best thing I got out of it was a rather nice goody bag which, once I’d binned the contents, proved quite useful on my next trip to Sainsbury’s.

32 Responses to Epic fail: Scientific Research in Homeopathy Conference 2010

  • Great blog, really enjoyed the read.

    I find it astonishing the good press Homeopathy is getting and think the skeptic bloggers are doing a great job of holding them to account. Tip Top.

  • This is excellent stuff. Sort of thing I’d love to do myself, but I doubt I’d sneak in unnoticed.

    My presence in a room is not what one might describe as subtle.
    Anyway, how many 6 foot 2, overweight, beardy skinheads were in the audience?

  • I commend your endurance. I tend to snort loudly when I laugh. That would have given the game away.

  • Thanks for your comments, everyone.

    @XtalDave: Hahaha! Actually, you’d be surprised. I reckon there were about 60 there and about one third were men, who came in all shapes and sizes. :-) If there are any great advances in the ‘science’ of homeopathy in the next two years, then you could go to the next one, if they have one.

  • Darn it
    I just spent ages typing a long comment, but when I tried to submit it my FireFox did something really weird.
    Did it come though or should I retype it all again?

  • ‘Fraid there’s no sign of it, DM.

  • Such disappointing reporting from one who portends to scientific inquiry. It is obvious that you took copious notes, but clearly they were intent on creating emotional hyperbole. This, my dear, is not scientific inquiry. It is called bias and prejudice. Such reporting lands you clearly in the realm of fundamentalist extremism–much noise, no substance, and money from those who have something to sell. It is so unfortunate that your listening skills are in need of repair.

  • Yay – bring on the quackolades! :-)

  • Awesome report and I commend you for your patience and courage. Milgrom is a right nasty piece of work and Cartwright is away with the fairies. I’m amazed that the “very scarey Jayney Goddard” (LOL!) called this a conference about scientific research when most of the talks weren’t about science, nor the speakers, scientists.

    Keep up the good work.

  • I’m dismayed that scientist employed by Cancer Research is also a homeopath. That reflects badly on them.

    As for the ignorant and abusive comment from tanya marquette, (why do they always resort to abuse – do they think it hides the fact that they don’t have a rational argument)…you may be interested in another comment from the same person:

    ” Posted by: tanya marquette | May 23, 2008 7:24:51 AM

    based on this ‘report’ i next expect to hear that a major pharmaceutical corporation has purchased consumer reports!

    i have used homeopathy as my primary health protocol for over 20 yrs. i can assure you that it has dealt with anything from measles in my children to chronic ankle problems from childhood to releasing repressed memories with amenorrhea. my pets have benefitted enormously from homeopathy on issues including stomatitis, cancer and currently uri and bacterial infections in a 19 yr old cat.”

    http://blogs.consumerreports.org/health/2008/03/homeopathic-rem.html

    Shocking.

  • “if they have one.”

    Why not? Easy to prepare, lucrative and without substance. That’s their speciality!

  • So what were the tea and coffee like during the breaks? One tea-bag or one teaspoon of Birds Mellow per twenty cups?

    Excellent summary – you sure know how to enjoy a day off!

  • “The indications are that potencies oscillate in their effectiveness over time…”

    At least homeopaths are very creative when trying to explain why for 175 years now those remedies seem to lose their (otherwise incredibly strong) effects whenever they’re put to the test.
    Thanks for this write-up!

  • Somehow the link I added didn’t show up (I guess that’s due my limited html-skills). Second try:

    http://www.sciencebasedmedicine.org/?p=4750

  • That’s a terrific link, Vicky, thanks. The comments are interesting too. What an odious lying twat that Dana Ullman is. I caught him at it commenting on another site today

    http://news.discovery.com/human/uk-government-study-homeopathy-worthless.html

    Thanks for the kind comments, everyone. Especially yours, tanya marquette. Anytime you want to talk about the science of homeopathy, you’re welcome.

  • You sound like a very open minded person. Maybe you should focus your career on highlighting the positive beneficial effects of therapeutic interventions, as that would certainly be of more value to human kind.

  • Thank you, Carly – I am indeed a very open-minded person.

    This is not my “career”, however, and as I am not qualified to advise people on the benefits of therapeutic interventions – nor am I trying to sell any – it would be irresponsible of me to do so.

    This is simply something I do in my free time because I am concerned at the misinformation being spread about unproven therapies and the hurt and damage this misinformation is causing to vulnerable people. I’m sure, when you think about it, that you can appreciate the value to humankind of this more humble endeavour.

    But thanks for taking the time to comment.

  • Thanks for producing such a detailed account of proceedings, Skepticat. I would have bet money they had little “scientific” to say, and it doesn’t sound like I would have lost any. I like your take on the underlying logic of Clare Relton’s presentation. I predict there will be some, er, “heated discussion” to come in the comments following her BMJ paper, so they will be worth keeping an eye on over the next couple of weeks.

    BTW, Orac gave DUllman a good thrashing today. Not that it will make any different to the Energizer Bunny of Homeopathic Self-Promotion.

  • Int J Oncol. 2010 Feb;36(2):395-403.

    Cytotoxic effects of ultra-diluted Homeopathic remedies on breast cancer cells.
    Frenkel M, Mishra BM, Sen S, Yang P, Pawlus A, Vence L, Leblanc A, Cohen L, Banerji P, Banerji P.

    Integrative Medicine Program-Unit 145, Department of Molecular Pathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030-4009, USA. frenkelm@netvision.net.il

    Abstract
    The use of ultra-diluted natural products in the management of disease and treatment of cancer has generated a lot of interest and controversy. We conducted an in vitro study to determine if products prescribed by a clinic in India have any effect on breast cancer cell lines. We studied four ultra-diluted HOMEOPATHIC remedies (Carcinosin, Phytolacca, Conium and Thuja) against two human breast adenocarcinoma cell lines (MCF-7 and MDA-MB-231) and a cell line derived from immortalized normal human mammary epithelial cells (HMLE). The remedies exerted preferential cytotoxic effects against the two breast cancer cell lines, causing cell cycle delay/arrest and apoptosis. These effects were accompanied by altered expression of the cell cycle regulatory proteins, including downregulation of phosphorylated Rb and upregulation of the CDK inhibitor p27, which were likely responsible for the cell cycle delay/arrest as well as induction of the apoptotic cascade that manifested in the activation of caspase 7 and cleavage of PARP in the treated cells. The findings demonstrate biological activity of these natural products when presented at ultra-diluted doses. Further in-depth studies with additional cell lines and animal models are warranted to explore the clinical applicability of these agents.

    PMID: 20043074 [PubMed - indexed for MEDLINE]

  • Kafail

    I’m not sure what you hoped to achieve by giving the abstract to that flawed paper.

    It has been utterly demolished:

    A giant leap in logic from a piece of bad science

    Dynamised Preparations in Cell Culture?

    A “homeopathic” bit of breast cancer “science,” or: Who knew alcohol was so toxic?

    I recommend you read all of these.

  • Thanks for the info on Alan Tournier. As he is — presumably — by CRUK, I will no longer support that charity.

  • I can’t think of any other discipline in the modern world that attempts to forge new knowledge by going back to what life was like before the invention of the wheel.

    Perhaps by doing so questers after ancient wisdom will come up with a square wheel for conquering stairs.

    M.

  • Good post over at Quackometer, http://www.quackometer.net/blog/2010/06/fossilised-medicine.html, covering the use of fossils in homeopathy.

    If this is true then the whole substance of homeopathy is possible made from ultra-diluted coprolite, http://www.enchantedlearning.com/subjects/dinosaur/glossary/Coprolite.shtml.

  • This is such a vitriolic essay it was painful to have to read through it. I can only suspect the author will die a premature death from such anger, animosity and hubris over the denial in the true ethics of science that is of discovery, asking questions, querying our results and conclusions and for open debate that will benefit all.

  • @R Gale

    OK, but do you actually disagree with anything I’ve written? If so, which bit and why?

  • Nice article. They seem to be re-hashing much of the content from last time. I did a couple of posts on the previous presentations:

    http://apgaylard.wordpress.com/2008/09/12/dangerous-delusions/
    http://apgaylard.wordpress.com/2008/07/13/blind-anger/

    I still can’t believe that Milgrom is still going on about Shang et al. Most of the criticisms were flawed, and those that weren’t were addressed by the authors (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2805%2967881-6/fulltext). I’m just stunned that he wrote: “Not only does it lack any literature citations”. This is just untrue. In its original form the paper did not identify which of the cited studies made it into the “arger trials of higher methodological quality” group. This was out right three months after publication, in December 2005!

    It’s also odd that Milgrom only ever sees philosophical problems with the science that doesn’t comform to his views. His philosophial posturing tries to distract by claiming critics of homeopathy are making universal claims for science, when all that is required for the critics to be right is that the methods of science are capable of falsifying the very testable claims made by homeopathy.

    It’s also significant that he only ever engages with the most basic, and largely discredited, philosophical accounts of science. Not that Milgrom getting his philosophy right (which he doesn’t) and all critics of homeopathy being “scientistic” (which they are not) would actually make homeopathy work!

  • And as for Kate Chatfield, on the evidence of some of her published work, she’s not much of a philosopher either:
    http://apgaylard.wordpress.com/2007/11/08/its-evidence-jim-but-not-as-we-know-it/

  • Here are some other posts on Milgrom’s typical arguments, as seen in a paper he wrote last year:

    http://apgaylard.wordpress.com/2009/09/06/a-homeopathic-refutation-part-one/
    http://apgaylard.wordpress.com/2009/09/13/a-homeopathic-refutation-%E2%80%93-part-two/

    I was going to pick the paper apart some more, but ran out of enthusiasm.

  • I finally got round to reading all those links, Adrian. Many thanks!

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