Homeopathy and prostate cancer - new study

Looks sound enough. At least I couldn't spot any errors, in the first reading.

Only problem I see is that while they make the placebo by potentizing destilled water, there appears to be no check of how the honmeopathic remedies were prepared. But no matter how they were prepared, the result seems interesting.

Hans
 
Don't know. I want to see the full text. How many rats in each group, testing for multiple effects, that sort of thing. 100 rats assigned randomly to treated and control groups, but how many different treatments? The results look good but I can't see how they were calculated from the abstract.
 
You can download the full report in pdf from that site.

Hans
 
"This item requires a subscription to Integrative Cancer Therapies Online."

:(
 
The full text is only available through subscription or individual purchase. One thing that must be considered when evaluating reports concerning homeopathy (and herbs) is that proponents have been caught cheating. Thus, any serious evaluation needs assurance that an independent observer has confirmed the authenticity of the claimed treatment.
 
Oh, I am accessing it from work, and my company has a licence. Well it's a valid reporting channel, and of course you cannot really rule out fraud, but in these circles, fraud is professional suicide, and in many countries punishable by law.

Hans
 
This would make seven well designed, controlled studies that showed a positive effect for homeopathy.

I know this because there was a poster who was calling Randi a liar because he said that there were no well designed studies showing an effect.
 
I don't know about the six others, but this one seems to merit the label well-designed. Whether it holds up to closer scrutiny is another matter.

It was not a large study, 100 rats, but enough to provide statistical significance. Blinding appears to be OK, assessment methods clear and objective. They made a number of initial studies on smaller groups and where blinding was questionable, but the final study seems OK.

Hans
 
I was actually surprised that there were so few, but there could always be more out there that the cite simply didn't know about. At least one of the studies were the diarrhea studies. I know some people have argued that the blinding procedures were too loose, but you probably know more about that than I do.
 
Asolepius said:
I just saw this new study. Can anyone comment on whether it's sound?
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There is no description of the control group. There is no description of how the rats were assigned to treatment or control. There is no description of what is meant by "homeopathic treatment". There is no mention of blinding. There is no description of how the various parameters were assessed. There is no description of how many comparisons in total were made and what adjustments were made to the level of significance to account for multiple comparisons.

Unless these issues are addressed, one cannot assume the study is sound. If you or anyone has access to the full text, then an assessment can be made.

Linda
 
MRC_Hans said:
I don't know about the six others, but this one seems to merit the label well-designed. Whether it holds up to closer scrutiny is another matter.

It was not a large study, 100 rats, but enough to provide statistical significance. Blinding appears to be OK, assessment methods clear and objective. They made a number of initial studies on smaller groups and where blinding was questionable, but the final study seems OK.

Hans
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Thank you. Since you have access, can you answer some other questions?

How were the controls treated and how were they assigned (i.e. the randomization method)? What was the homeopathic treatment (including the degree of dilution)? How many comparison were made (they list seven in vivo outcomes)? And who was blinded (e.g. was a placebo used)?

ETA: I forgot to ask. Were the percentages given relative or absolute reductions?

Linda
 
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fls said:
There is no description of the control group. There is no description of how the rats were assigned to treatment or control. There is no description of what is meant by "homeopathic treatment". There is no mention of blinding. There is no description of how the various parameters were assessed. There is no description of how many comparisons in total were made and what adjustments were made to the level of significance to account for multiple comparisons.

Unless these issues are addressed, one cannot assume the study is sound. If you or anyone has access to the full text, then an assessment can be made.

Linda
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Yes, Linda, that is among least informative abstracts I have ever seen. I also wonder about the choice of journal. If any homeopathy shows a quantitative effect, it should be in Nature (or another top publication) because it would overthrow known physical principles.
 
ChristineR said:
I was actually surprised that there were so few, but there could always be more out there that the cite simply didn't know about. At least one of the studies were the diarrhea studies. I know some people have argued that the blinding procedures were too loose, but you probably know more about that than I do.
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I think there are only a few because there aren't very many well-done homeopathy studies. We'd expect about 1 in 5 to be positive due to chance (taking a typical level of bias into consideration).

Linda
 
Sorry for late answer, I have been away.

fls said:
There is no description of the control group. There is no description of how the rats were assigned to treatment or control.
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100 rats were assigned to either verum or placebo treatment according to a random number table.


There is no description of what is meant by "homeopathic treatment".
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They gave:
200C + 1000C T Occidentalis on the first and fourth day of the week,
200C + 1000C C Saculatum on second and fifth day of the week,
200C + 1000C S Serratulata on the third and sixth day of the week,
1000C Carcosin on the seventh day of the week.

A nice piece of mixopathy, but they do acknowlege that this is not classical methodology, and from our POV, at least it was all proper high potency.

There is no mention of blinding.
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Preparations were coded and codes kept in sealed envelopes by an independent third party. Envelopes were only opened after all evaluations were done.

The people doing evaluations were blinded.


There is no description of how the various parameters were assessed.
There is no description of how many comparisons in total were made and what adjustments were made to the level of significance to account for multiple comparisons.
Click to expand...

"Tumor-free and overall survival days were compared using Kaplan-Meier plots, and a log rank test. Mean weekly body weight and geometric mean tumor volume (evey 4 days) were compared using repeated.measures analysis of variance followed by Bonferroni-adjusted post hoc comparisons where appropriate" ... The bit about post hoc comparisons when appropriate smells a little fishy.

"Average tumor weight at time of killing was compared using a 2-sided Student t test for independent samples, and the number of animals with visible lung nodules was compared using the Fisher exact test. P values less than .05 were considered statistically significant."

Hans
 
fls said:
Thank you. Since you have access, can you answer some other questions?

How were the controls treated and how were they assigned (i.e. the randomization method)? What was the homeopathic treatment (including the degree of dilution)? How many comparison were made (they list seven in vivo outcomes)? And who was blinded (e.g. was a placebo used)?

ETA: I forgot to ask. Were the percentages given relative or absolute reductions?

Linda
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Controls were treated with blank water potentized to the same level as the remedies. 100 rats were randomized into two groups (so I assume appr. 50 in each).

Relative, I think.

Hans
 
Could somebody sum up the significance of this study for the humanities graduates amongst us?
 
Big Les said:
Could somebody sum up the significance of this study for the humanities graduates amongst us?
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The study tried both exposing cancer cell cultures and rats inoculated with cancer cells to homeopathic remedies.

There was no effect noted on cell cultures.

There was a significant reduction of cancer growth in the rats.

From the report, it appears that proper scientific procedures were followed.

The experiment is of insuficient size to make any conclusions of efficacy of homeopathic remedies, but unless something turns up to discredit it, it must be considered valid evidence in favor of homeopathic efficacy.

The project leader, Wayne Jonas has doubtful scientific standing and is known to be an ardent proponent of homeopathy and other alternative methologies.

Hans
 
MRC_Hans said:
The study tried both exposing cancer cell cultures and rats inoculated with cancer cells to homeopathic remedies.

There was no effect noted on cell cultures.

There was a significant reduction of cancer growth in the rats.

From the report, it appears that proper scientific procedures were followed.

The experiment is of insuficient size to make any conclusions of efficacy of homeopathic remedies, but unless something turns up to discredit it, it must be considered valid evidence in favor of homeopathic efficacy.

The project leader, Wayne Jonas has doubtful scientific standing and is known to be an ardent proponent of homeopathy and other alternative methologies.

Hans
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What is known about the method of the innoculation of the cancer cells? Were they native cancers to the rat, or were they impregnated from another source? If they were impregnanted from another source then a reduction in size could be from any number of reasons.

If in vivo there was no effect, then how did they rule out a different source of destruction of those tumor cells in vitro?

Edit:

Also, without observation in vivo of the method by which these homeopathic remedies works, how do they account for the mechanism by which the cancer cells were destroyed?
 
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I have a problem with the idea that the design choses 4 putative remedies and tests them in series. A better design would surely be to test individual preparations. I would also have chosen as a control group rats who recieved homeopathic preparations thought useful for some other unrelated illness, such as menopause symptoms eg.

I have a problem with the KM survival curves (Fig 1a and b). The text suggests that tumour free survival was measured for Fig 1a - fair enough. But what is measured in Fig 1b? The text says rats were sacrificed, so this is an artificial end point. What determined when the rats were sacrificed?
Median time to sacrifice was 26 days in the water-treated control
group and 31 days in the homeopathy-treated group (P = .0002; Figure 1b).
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It is unclear whether any rats actually died "naturally". The text also says 2 rats in the homeopathy group died unexpectedly the day after treatment. These deaths are not apparent from the KM chart, which has "deaths" (or sacrifices, whichever you wish to call them) occuring from around 3 weeks. Were these 2 deaths excluded from the analysis?​


Perhaps we can say homeopathy might help your prostate cancer, if you are fortunate enough to survive the first day of treatment!

I haven't looked at all the study in depth, but I noted that the conclusion section is virtually bereft of significant caveats. It is almost de rigeur in scientific studies to include these, since no study is perfect and the authors, who are best placed to know possible deficiencies of the study, are honest enough to acknowledge this most of the time.​

​
 
Thanks everyone for all these useful points. I have now got a colleague outside the forum working on it, and a key issue is the number of potential endpoints. There were multiple interventions, 3 cell lines, various outcome measures etc. Can someone skilled in the art draw up a table of all the possible endpoints? We think it's at least 100, but would like it checked and refined.
 
Hans,

Thank you for answering my initial questions. I see several areas where there could be potential problems, but this is an awkward way to address them. And it looks like the OP is now doing a more detailed analysis anyway.

Linda
 
MRC_Hans said:
The study tried both exposing cancer cell cultures and rats inoculated with cancer cells to homeopathic remedies.

There was no effect noted on cell cultures.

There was a significant reduction of cancer growth in the rats.

From the report, it appears that proper scientific procedures were followed.

The experiment is of insuficient size to make any conclusions of efficacy of homeopathic remedies, but unless something turns up to discredit it, it must be considered valid evidence in favor of homeopathic efficacy.

The project leader, Wayne Jonas has doubtful scientific standing and is known to be an ardent proponent of homeopathy and other alternative methologies.

Hans
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Many thanks Hans. Not sure how to respond to this. Although "bugger" does come to mind. Do they (or does anyone else) propose how the homeopathic remedies might have achieved this result?
 
Big Les said:
Many thanks Hans. Not sure how to respond to this. Although "bugger" does come to mind. Do they (or does anyone else) propose how the homeopathic remedies might have achieved this result?
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Don't get too upset. When it comes to homeopathy, any positive study is at least a thousand times more likely to be a false positive, than a true positive. It's equivalent to using your (I assume you are male) urine for a pregnancy test and declaring that you are pregnant based on a positive result.

Linda
 
fls said:
Don't get too upset. When it comes to homeopathy, any positive study is at least a thousand times more likely to be a false positive, than a true positive. It's equivalent to using your (I assume you are male) urine for a pregnancy test and declaring that you are pregnant based on a positive result.

Linda
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But you can fool some people all of the time... (or try, at least)

http://news.bbc.co.uk/1/hi/world/africa/6190772.stm
 
fls said:
Hans,

Thank you for answering my initial questions. I see several areas where there could be potential problems, but this is an awkward way to address them. And it looks like the OP is now doing a more detailed analysis anyway.

Linda
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Yeah. I don't know if emailing or PM'ing you a copy of the full report would be a violation of copyright, but I assume so.

Anyhow, with the reputation of the study leader, and all, I suppose we should not expect too much. However, it is difficult to find more without an actual audit of the trial, and of course we can't do that.

Hans
 
Big Les said:
Many thanks Hans. Not sure how to respond to this. Although "bugger" does come to mind. Do they (or does anyone else) propose how the homeopathic remedies might have achieved this result?
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Bugger? I don't know about that. After all, effective homeopathic remedies would be a wonderful discovery. Cheap, easy to produce, fairly simple to use, and presumably safe, they would answer our prayers, especially for the third world's need for medication.

Unfortunately, I don't think it's gonna happen. The things have been around for 200 years, and I would expect they would have made a more obvious impression on the world by now, had they worked as advertized.

And, of course, while we can never rule out new discoveries, the lack of support in physics is weighing more and more heavily on homeopathy, as we get ever deeper into an understanding of how substances are put to gether, with still no hint of how it might work.

Hans
 
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