Another nail in the coffin of Medicine's own Zombie reveals
Professor Paul Glasziou, a leading academic in evidence based medicine at Bond University, was the chair of a working party by the National Health and Medical Research Council which was tasked with reviewing the evidence of 176 trials of homeopathy to establish if the treatment is valid.
A total of 57 systematic reviews, containing the 176 individual studies, focused on 68 different health conditions - and found there to be no evidence homeopathy was more effective than placebo on any.
Still it persists, not only in the UK but also in the US. And a simple google search about health insurance payments for homeopathy will reveal that the homeopathy industry is very busy writing long winded explanations of how to con your insurance company into covering homeopathy.(Key trick: have your homeopath recommend a Nurse Practitioner which have prescription authority in many states, and who will write you a prescription for homeopathy along with a statement of medical necessity).
Professor Glasziou writes in his BMJ Blog:
One surprise to me was the range of conditions that homeopathy had been evaluated in, including rheumatoid arthritis, radiodermatitis, stomatitis (inflammation of the mouth) due to chemotherapy, and human immunodeficiency virus (HIV) infection. What subsequently shocked me more was that organizations promote homeopathy for infectious conditions, such as AIDS in Africa or malaria.
One wag posted to the Blog comments:
Prof Glaziou, I've been washing a homeopathy bottle every day for the last month, but the residue just keeps on getting stronger. Any advice?
Homeopathy is effective because the Pareto principle [wikipedia.org] also applies to illness. Approximately 80% of all illnesses are self limited and you will feel better all by yourself with absolutely no treatment. So if you visit a homeopath, a witch doctor, a bad allopathic physician ("regular" doctor), an acupuncturist, a clairvoyant or whatever, 80% of the time you will get better. And you will attribute this recovery to the method you used. It is very, very hard to be a bad physician (although some do actually manage it). Likewise, it is very hard to be a bad homeopath.
Speaking for myself I'm not against homeopathy because whatever makes a person FEEL better (whether it actually makes them better or not) is an important part of healing, medicine, and being human. However I wish homeopaths and other "alternative" medicine practitioners were trained to the point where they can recognize where they will NOT be able to help a patient, and send them to someone who can if that's possible.
... However I wish homeopaths and other "alternative" medicine practitioners were trained to the point where they can recognize where they will NOT be able to help a patient, and send them to someone who can if that's possible.
I'd extend this to "regular" doctors too, but don't have any stats to back it up.
I do have this recent anecdote: My mother had tremors and other neurological problems that started some months after heart valve repair surgery. Note that, before the surgery, she was easily tired out (due to valve leakage) but otherwise in great shape, no other complaints and no history of major illness.
When her recovery from surgery apparently stalled after several months, her long time GP diagnosed "age related" tremors and blamed all symptoms on age (mid-80s). When she asked about Parkinson's (because that is one well known source of tremors), this GP had a nurse practitioner give her a "test" (hand writing analysis) and blew her off, said there was no point in looking further than age-related problems.
She continued to feel that "something is wrong with me" as her energy level, balance, and coordination continued to go down hill over 2+ years. She was getting close to not being able to live independently, needed a lot of help from family to keep going. Dumped the long time GP 5 months ago and switched to a new one. He started from scratch and eventually offered a list of symptoms for Parkinson's which Mom said all lined up with her experience. Bottom line, she is night-into-day better after a 6 weeks of the Parkinson's meds (the dose is slowly ramped up). And the best part (for me) is that after ~3 years, she is smiling again.
So far, a happy ending...and we all have a desire (suppressed, so far) to send a nasty letter to the original GP.
I'm glad your mother is now receiving the appropriate treatment and that it's working for her. I can offer another personal anecdote of my own. I am a physician. Before I entered med school I had an incident which involved severe chest and later shoulder pain. I went to the ER and was seen by the duty physician. He performed a cardiac enzyme test and noted some alteration consistent with a heart attack however my pain had been going on for a few days and the alteration in the test was slight. But considering my age (I was 26), my normal electrocardiogram, and what in those days was not a very specific or elevated cardiac enzyme test (they hadn't invented Troponin T/I yet, just CK-MB and DHL) he said it probably wasn't a heart attack but he sent me to a cardiologist just to be sure. The cardiologist saw me a few weeks later, performed a stress test, sort of chuckled and said I was just "out of shape" and my pain was probably stress.
Fast forward a few years, I'm now 30 years old and studying at med school in an entirely different country. One Friday, once again I have severe chest pain in the shower. I feel weak, short of breath and I have cold sweats. The pain is also in my throat and lower jaw. I call an ambulance and end up in a hospital, where they diagnose a heart attack. I stay in the hospital over the weekend. On Monday the attending cardiologist comes, looks over my chart, my normal electrocardiogram, and says I was too young to have a heart attack. It was probably stress. So they discharge me from hospital that day and schedule a stress test. That Thursday I'm feeling fine, I go do the stress test in the morning. Everything is pretty normal. "You're just out of shape, it's probably stress".
As I'm driving home, I feel chest pain. When I get home, the pain increases to the point where I'm vomiting. My dad is nearby and he offers to take me to the hospital. I tell him to take me to a different hospital and he does. I get to the ER with a copy of the stress test I did a mere few hours ago, begging them to find the cause of this pain that comes and goes, and to look for something that's not my heart because I've heard quite often now that my heart is fine. I'm in the middle of getting an electrocardiogram when I do a ventricular fibrillation...
So it was my heart after all. I just needed to die in front of a doctor to convince one. Anyway long story short I had bypass surgery in my 30's, I've had a few heart attacks since then, I have 9 stents, a pacemaker/defibrillator, etc. But like Elton John said: "I'm still standing". But the above was just to illustrate that first, medical students and doctors don't really get "preferential treatment" lol, and second, that mistakes can and DO happen. And it sucks for the patient when it does. I understand that no one is perfect, and I try not to fault not one but TWO cardiologists who didn't even suspect heart disease in my diagnosis just because I was so young and my heart attacks didn't result in typical "Q" waves on an EKG. It's sad, but bad doctors do exist, and even good doctors sometimes make mistakes. The trick is in my case to be better than them and try not to make mistakes. Even so looking back at my career I have made a few. I like to think that they have been minor and never resulted in serious problems for a patient. But sometimes it does happen. Errare humanum est. What HAS happened is I have a lot of empathy for sick people now, having been one myself. So it wasn't all bad. In fact, I recommend it to all doctors. Compassion, after all, is supposed to be the hallmark of our profession.
Homeopathy is effective because the Pareto principle also applies to illness. Approximately 80% of all illnesses are self limited and you will feel better all by yourself with absolutely no treatment.
I can see that homeopathy would work by making a person become more disciplined in taking care of themselves while ill. Many illnesses can be cured simply by getting proper rest, fluids and nutrients. If the homeopathic "cure" helps bring a person to proper behavior, something they would not have done otherwise, it can be considered useful.
I wonder to what degree "placebos work" is that if you're paying attention (which people who know they're doing a "medical trial" are liable to do) you can become hypersensitive to the effects of a VERY small amount of sugar -- about a tablet worth -- so if the placebo is a sugar tablet, this could skew results, especially for something like how it was found that "more-expensive placebos work better". Naturally people pay closer attention when there's more money involved!
[Then again, I notice very small effects that most people don't. My doctor has about decided I'm a freak, but has also started to pay attention when I point out some ridiculously minor effect. If you have thyroid patients, you'll find microscopic exam of their thumbnails fascinating, I shit you not.]
They shouldn't use sugar. Sugar isn't an inert substance.
The widespread use of sugar as a placebo may be a reason why placebos seem to be getting stronger in the USA:http://www.nature.com/news/strong-placebo-response-thwarts-painkiller-trials-1.18511 [nature.com]http://www.bbc.co.uk/news/magazine-34572482 [bbc.co.uk]
Perhaps more people in the USA are addicted or sensitive to sugar. Think of the relief many addicts have when they finally get their fix/drug.
That's exactly my point. To be a valid test, placebos must be chemically inert (including being unavailable to gut bacteria). Sugar is about as far from biochemically inert as you can get, and in my experience, even a tiny amount can have an effect.