Another Positive Study for Ultra-dilute Solutions

[Zep]

Quote:

Originally posted by Olaf/QII
Radiats Biol Radioecol. 2005 Mar-Apr;45(2):212-3. Related Articles, Links


[Changes in physico-chemical parameters of homeopathic remedies ferrum metallicum CH6 and ferrum metallicum CH30 after exposure to high frequency electromagnetic radiation of low intensity]

[Article in Russian]

Mendez NM.

It is considered the microwaves electromagnetic radiation do not affect the materials, alive or not, when used in low power. In high power, the interaction effects would be the material warming (thermal effect). However, in the last years, the studies about electromagnetic radiation with low power (non thermal effect) in the human being have been increasing. It was found out the electromagnetic radiation, even with low power, can affect the living organisms and biosubstratum. In the present work the influence of electromagnetic radiation (2.45 GHz 500 W/cm2), on physical and chemical parameters of the homeopathic pharmaceutics products in shown.

PMID: 15906864 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/entrez/q...864&query_hl=1

Translation: THEY PUT A KITTEN IN THE MICROWAVE FOR 30 SECONDS ON HIGH, AND IT WAS NEVER THE SAME AFTER THAT.

[Olaf/QII]

http://www.ncbi.nlm.nih.gov/entrez/...4779&query_hl=1

Chest. 2005 Mar;127(3):936-41.


Influence of potassium dichromate on tracheal secretions in critically ill patients.

Frass M, Dielacher C, Linkesch M, Endler C, Muchitsch I, Schuster E, Kaye A.

Ludwig Boltzmann Institute for Homeopathy, Duerergasse 4, A 8010 Graz, Austria. michael.frass@kabsi.at

BACKGROUND: Stringy, tenacious tracheal secretions may prevent extubation in patients weaned from the respirator. This prospective, randomized, double-blind, placebo-controlled study with parallel assignment was performed to assess the influence of sublingually administered potassium dichromate C30 on the amount of tenacious, stringy tracheal secretions in critically ill patients with a history of tobacco use and COPD. METHODS: In this study, 50 patients breathing spontaneously with continuous positive airway pressure were receiving either potassium dichromate C30 globules (group 1) [Deutsche Homoopathie-Union, Pharmaceutical Company; Karlsruhe, Germany] or placebo (group 2). Five globules were administered twice daily at intervals of 12 h. The amount of tracheal secretions on day 2 after the start of the study as well as the time for successful extubation and length of stay in the ICU were recorded. RESULTS: The amount of tracheal secretions was reduced significantly in group 1 (p < 0.0001). Extubation could be performed significantly earlier in group 1 (p < 0.0001). Similarly, length of stay was significantly shorter in group 1 (4.20 +/- 1.61 days vs 7.68 +/- 3.60 days, p < 0.0001 [mean +/- SD]). CONCLUSION: These data suggest that potentized (diluted and vigorously shaken) potassium dichromate may help to decrease the amount of stringy tracheal secretions in COPD patients.

Publication Types:
Clinical Trial
Randomized Controlled Trial

PMID: 15764779 [PubMed - indexed for MEDLINE]

[Badly Shaved Monkey]

Quote:

Originally posted by Olaf/QII
http://www.ncbi.nlm.nih.gov/entrez/...4779&query_hl=1

Chest. 2005 Mar;127(3):936-41.


Influence of potassium dichromate on tracheal secretions in critically ill patients.

Frass M, Dielacher C, Linkesch M, Endler C, Muchitsch I, Schuster E, Kaye A.

Ludwig Boltzmann Institute for Homeopathy, Duerergasse 4, A 8010 Graz, Austria. michael.frass@kabsi.at

BACKGROUND: Stringy, tenacious tracheal secretions may prevent extubation in patients weaned from the respirator. This prospective, randomized, double-blind, placebo-controlled study with parallel assignment was performed to assess the influence of sublingually administered potassium dichromate C30 on the amount of tenacious, stringy tracheal secretions in critically ill patients with a history of tobacco use and COPD. METHODS: In this study, 50 patients breathing spontaneously with continuous positive airway pressure were receiving either potassium dichromate C30 globules (group 1) [Deutsche Homoopathie-Union, Pharmaceutical Company; Karlsruhe, Germany] or placebo (group 2). Five globules were administered twice daily at intervals of 12 h. The amount of tracheal secretions on day 2 after the start of the study as well as the time for successful extubation and length of stay in the ICU were recorded. RESULTS: The amount of tracheal secretions was reduced significantly in group 1 (p < 0.0001). Extubation could be performed significantly earlier in group 1 (p < 0.0001). Similarly, length of stay was significantly shorter in group 1 (4.20 +/- 1.61 days vs 7.68 +/- 3.60 days, p < 0.0001 [mean +/- SD]). CONCLUSION: These data suggest that potentized (diluted and vigorously shaken) potassium dichromate may help to decrease the amount of stringy tracheal secretions in COPD patients.

Publication Types:
Clinical Trial
Randomized Controlled Trial

PMID: 15764779 [PubMed - indexed for MEDLINE]

Can someone remind me? Is this the one where treatment and placebo groups were not properly matched?

[Olaf/QII]

http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

Growth stimulation of dwarf peas (Pisum sativum L.) through homeopathic potencies of plant growth substances.

Baumgartner S, Thurneysen A, Heusser P.

Kollegiale Instanz fur Komplementarmedizin, Universitat Bern, Insel-Spital, Imhoof-Pavillon, Bern, Switzerland. s.baumgartner@hiscia.ch

=========================

http://www.siib.org/Downloads/glutamateandkcl.pdf

http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

Int J Neurosci. 2003 Apr;113(4):491-502
Nonlinear effects of glutamate and KCl on glutamate toxicity in cultured rat cerebellar neurons.

Marotta D, Marini A, Banaudha K, Maharaj SV, Jonas WB.

Samueli Institute for Information Biology, Program on Neuroprotection, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.

Nonlinear responses to toxin exposure have been observed in multiple cell types and organisms across a wide array of phyla. High dose toxin exposures inhibit or kill biological systems, while low dose exposures can stimulate survival mechanisms. We examined the effects of low (10(-3), 10(-5), 10(-7), and 10(-9) M) and ultra-low (10(-25) and 10(-61) M) KCl and glutamate pretreatment (72 h) against glutamate toxicity in rat cerebellar neurons. Ultra-low dilutions (10(-31), 10(-61), and 10(-401)) of an Arnica montana mother tincture were also investigated for their neuroprotective potentials. Viability was significantly enhanced in neurons pretreated with either 10(-3) M glutamate (10.6%) or 10(-9) M KCl (6.3%). None of the toxins evaluated displayed significant toxicity at the concentrations indicated. The protective effect of glutamate is likely mediated through activation of N-methyl-D-aspartate receptors, whereas low dose KCl might confer neuroprotection through enhanced alteration of Na+/K+ receptor dynamics. This is the first time high dose glutamate tolerance has been shown along with low dose KCl, and is consistent with previous reports demonstrating tolerance induced by low dose toxin exposure.

PMID: 12856478 [PubMed - indexed for MEDLINE]

[Olaf/QII]

http://www.siib.org/Downloads/Non-Li...eurons.PDF.pdf

http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

Neurotoxicology. 2002 Sep;23(3):307-12.

Non-linear effects of cycloheximide in glutamate-treated cultured rat cerebellar neurons.

Marotta D, Marini A, Banaudha K, Maharaj S, Ives J, Morrissette CR, Jonas WB.

Samueli Institute for Informational Biology, Program on Neuroprotection and Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.

Multiple cell types and organisms across a wide array of phyla and a variety of toxins demonstrate non-linear dose responses to low-level chemical exposures with high doses inhibiting cellular function and low doses stimulating function. We tested whether such non-linear responses to low and ultra-low dose N-methyl-D-aspartate (NMDA), 1-methyl-4-phenylpyridinium (MPP+) or cycloheximide moderated toxic glutamate exposure in cultured cerebellar granule cells. Neurons were incubated over 72 h with successive NMDA, MPP+ iodide or cycloheximide additions producing specified low (10(-5), 10(-7), 10(-9), 10(-11), and 10(-13) M) and ultra-low (10(-27),10(-29), 10(-63), and 10(-65) M) concentrations. Subsequently these neuronal cells were exposed to a 50% excitotoxic concentration of glutamate for 24 h. Neuronal viability was significantly reduced in neurons treated with micromolar (10(-5) M) cycloheximide whereas viability was enhanced in neurons treated with an ultra-low dose exposure of 10(-27) M cycloheximide. Neither NMDA nor MPP+ elicited harmful or protective responses. This is the first report demonstrating non-linear dose-response effects of cycloheximide in low and ultra-low concentration ranges.

PMID: 12387359 [PubMed - indexed for MEDLINE]

[Olaf/QII]

http://www.siib.org/Downloads/jonas_dillnerJSE2000.pdf

Jonas, W.B., Dillner, D.K. Protection of mice from tularemia infection with ultra-low, serial agitated dilutions prepared from F. tularensis-infected tissue. Journal of Scientific Exploration. 2000; 14: 35-52.
PDF Link

http://64.233.161.104/search?q=cache...loration&hl=en

[Olaf/QII]

http://www.neuroreport.com/pt/re/neu...vycz7bL2c7xFqM!1362100327!-949856032!9001!-1

Neuroprotection from glutamate toxicity with ultra-low dose glutamate.
Neuroreport. 12(2):335-339, February 12, 2001.
Jonas, Wayne CA; Lin, Yu 1; Tortella, Frank 1
Abstract:
The protective effects of ultra-low doses (ULD) of glutamate against glutamate toxicity was studied in primary rat spinal, cortical and cerebellar neurons. Neurons were exposed to four subtoxic, ultra-low concentrations of glutamate (10-18 M, 10-20 M, 10-22 M and 10-30 M) for 72 h and then subsequently challenged with toxic concentrations (25 [mu]M) of glutamate. Neuron viability was consistently 10% higher in spinal and cortical neurons pre-exposed to glutamate concentrations of 10-18 M and 10-22 M, and in cerebellar neurons pre-exposed to 10-20 M and 10-30 M. Using laser scanning confocal micro- scopy and the fluorescent calcium probe fluo-3, we found no alterations in intracellular calcium dynamics in the protected cells. This protective effect is consistent with a growing body of evidence for tolerance induced by low-dose toxin exposure but is the first time that such tolerance has been demonstrated with ultra-low glutamate exposure. Our data show that pre-exposure of neuronal cells to ULD glutamate can protect against subsequent exposure to toxic levels of glutamate.

(C) 2001 Lippincott Williams & Wilkins, Inc.

[Zep]

Clearly you didn't read this last one at all, did you, Xanta. Allow me to quote from the Results:

Quote:

Ultra-low dilutions of Arnica montana (Figure 1c) displayed no significant protective or toxic effects against glutamate toxicity.

Whoops-a-daisy.

[Olaf/QII]

http://www.vhan.nl/documents/Rey.thermoluminescence.pdf

http://www.mercola.com/2003/jun/28/homeopathy.htm (Dr Mercola gives a lay explanation for the importance of Dr Louis Rey’s experiments.)


http://64.233.161.104/search?q=cache...hloride+&hl=en


Abstract Ultra-high dilutions of lithium chloride and sodium chloride (10 −30 g cm −3 ) have been irradiated by X-rays and gamma-rays at 77 K, then progressively rewarmed to room temperature. During that phase, their thermoluminescence has been studied and it was found that, despite their dilution beyond the Avogadro number, the emitted light was specific of the original salts dissolved initially.

[Olaf/QII]

http://www.ncbi.nlm.nih.gov/entrez/q..._uids=11737881


CONCLUSIONS: Both Cad Sulph-30 and 200 were able to combat cadmium induced genotoxic effects in mice and that combined pre- and post-feeding mode of administration was found to be most effective in reducing the genotoxic effect of CdCl2 followed by the post-feeding mode.

===========================================


http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract


Time related neutralization of two doses acetyl salicylic acid.

Aguejouf O, Malfatti E, Belon P, Doutremepuich C.

Laboratoire d'Hematologie, Faculte de Pharmacie, 146, Rue Leo-Saignat 33 076 Bordeaux Cedex, France.

[Olaf/QII]

http://www.newscientist.com/news/news.jsp?id=ns99991532


Bizarre chemical discovery gives homeopathic hint
19:00 07 November 01


It is a chance discovery so unexpected it defies belief and threatens to reignite debate about whether there is a scientific basis for thinking homeopathic medicines really work.

A team in South Korea has discovered a whole new dimension to just about the simplest chemical reaction in the book - what happens when you dissolve a substance in water and then add more water.

Chemist Jan Enberts of the University of Groningen in the Netherlands is more cautious. "It's still a totally open question," he says. "To say the phenomenon has biological significance is pure speculation." But he has no doubt Samal and Geckeler have discovered something new. "It's surprising and worrying," he says.

[Badly Shaved Monkey]

Spamta seems to have completely reverted to her old patterns.

Whatever homeopathy has done for her bowels, it's not helped her obssessive compulsive disorder.

I'd still like to be reminded whether I'm right in recalling that the tracheal secretion study was invalidated by prior differences in the patient groups.

[Olaf/QII]

http://www.abc.net.au/dimensions/hea...ts/s370216.htm


AMA calls for an "open mind" on homoeopathy

AMA calls for an "open mind" on homeopathy
Some medical groups have found it difficult to accept evidence of homoeopathy's effectiveness because it appears to counter the current understanding of how drugs work. Many homoeopathic medicines are so dilute that no single molecule is left in the solution.

" My view is that the evidence should speak for itself ," says Dr Roberta Chow, a member of the Federal AMA's Advisory Committee on Complementary Medicine. "There have been other studies like this and if the BMJ is prepared to look at it perhaps we should be more open minded about it."

Dr Chow also points to evidence involving the imprinting of water molecules that suggests a possible mechanism for how homoeopathy might work in the absence of molecules left in solution.

Dr Chow says she is disappointed that there is a lack of official support for doctor training in complementary medicine at a time when it is so widely used in the community.

"For doctors to be ignorant of such things, we are not giving our patients the best management available, the best advice we can."

[Olaf/QII]

http://www.entretiens-internationaux.mc/cambar.htm

Conclusion
The presentation of the results obtained in our laboratory for more than 12 years has been divided into two chronological and methodological parts, considering previous in vivo and recent in vitro experiments.
We have shown, in vivo in rodents, that high dilutions of mercury can significantly reduce the death rate induced by toxic doses of the same metal. Thus, the death rate of mice intoxicated with high doses of mercury was markedly reduced by a 7 day pretreatment with 10-30 M concentrations of that metal. For example, the death rate following a single injection of 5 mg/kg HgCl2 was 73.4% in control, 50% for those pretreated with 10-18 M and only 26.7% for those pretreated with 10-30 M.
We found the same profile of response with our in vitro model in which 10-30 and 10-40 M dilutions provided a fair protection against cadmium induced cytotoxicity in renal tubular cell cultures. Similar results have recently been described for high dilutions of thymulin (Bastide et al., 1987), bursin (Youbicier-Simo et al.., 1993) and silica (Oberbaum et al.., 1992).

[Mojo]

Quote:

Originally posted by Olaf/QII
http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

Growth stimulation of dwarf peas (Pisum sativum L.) through homeopathic potencies of plant growth substances.

Baumgartner S, Thurneysen A, Heusser P.

Kollegiale Instanz fur Komplementarmedizin, Universitat Bern, Insel-Spital, Imhoof-Pavillon, Bern, Switzerland. s.baumgartner@hiscia.ch

And this one was the one where, although they screened homeopathic potencies from 12x-30x, revealing "revealed biological activity of certain potency levels of gibberellin and kinetin," they only assessed growth stimulation for gibberellin 17x, which is, of course, a dilution at which molecules of the hormone are still present. Last time I pointed this out Olaf accused me of nitpicking, so I assume he/she has no reasoned response to this point.

[Badly Shaved Monkey]

Quote:

Originally posted by Mojo
Last time I pointed this out Olaf accused me of nitpicking, so I assume he/she has no reasoned response to this point.

I think any lurkers can work out for themselves that Xanta's evidence is never quite as solid as she thinks it is, so I'm just going to leave her to it.

[Olaf/QII]

Quote:

Originally posted by Badly Shaved Monkey
I think any lurkers can work out for themselves that Xanta's evidence is never quite as solid as she thinks it is, so I'm just going to leave her to it.

BSM, did you know that...

...successive dilutions and succussions can permanently alter the physico-chemical properties of the water solvent.

Journal of Thermal Analysis and Calorimetry
Department of Chemistry, University 'Federico II' of Naples, Complesso Universitario di Monte S. Angelo, via Cintia, 80126 Naples

[Badly Shaved Monkey]

Quote:

Originally posted by Olaf/QII
BSM, did you know that...

...successive dilutions and succussions can permanently alter the physico-chemical properties of the water solvent.

Yeah, whatever you say Xanta. It has no bearing on homeopathy which is a fraud for numerous reasons, though you have declined to address any of those.

[Donks]

Quote:

Originally posted by Olaf/QII
BSM, did you know that...

...successive dilutions and succussions can permanently alter the physico-chemical properties of the water solvent.

You just keep telling yourself that. And keep telling yourself that solutions never get shaken and diluted in nature. I'm sure if you close your eyes, you try real hard and you really believe, it will suddenly become true. But watch out when it does, cause you might not like the consequences.

[Mojo]

Quote:

Originally posted by Olaf/QII
BSM, did you know that...

...successive dilutions and succussions can permanently alter the physico-chemical properties of the water solvent.

Journal of Thermal Analysis and Calorimetry
Department of Chemistry, University 'Federico II' of Naples, Complesso Universitario di Monte S. Angelo, via Cintia, 80126 Naples

Why do you never give the authors' names when you post this assertion? Citing by name of journal and place of employment seems rather odd.

Do you think there's something wrong with them?

[Badly Shaved Monkey]

Quote:

Originally posted by Mojo
Why do you never give the authors' names when you post this assertion? Citing by name of journal and place of employment seems rather odd.

Do you think there's something wrong with them?

No, it's just that Xanta is a dilettante playing at being a scientific reader.

[Rolfe]

Quote:

Originally posted by Badly Shaved Monkey
I'd still like to be reminded whether I'm right in recalling that the tracheal secretion study was invalidated by prior differences in the patient groups.

By my recollection, yes.

Rolfe.

[RationalVetMed]

Originally Posted by Badly Shaved Monkey

Can someone remind me? Is this the one where treatment and placebo groups were not properly matched?

Apologies but I would like to resurrect this thread as it has some useful stuff about an interesting paper - Frass, M., Dielacher, C., Linkesch, M., et al. (2005) Influence of potassium dichromate on tracheal secretions in critically ill patients Chest Vol. 127 pp. 936-941.

Abstract here - http://www.ncbi.nlm.nih.gov/pubmed/15764779
Full text here - http://chestjournal.chestpubs.org/co...127/3/936.long

The thread got completely derailed by silliness and data dumps from Olaf but the paper does seem fairly robust and I am interested to see if anyone has anything else to add to the critique.

I have tried to summarise some of the arguments here - [http://www.rationalvetmed.org/page28.html#Frass2005] but there may be more to be said, I'd be interested to know if anyone has another take on it.

To save people the trouble of trawling back through the dross I have selected significant posts below:

In post no 6 Geni said, in response to this section of the paper:

Quote:

Extubation could be performed significantly earlier in group 1 (p < 0.0001). Similarly, length of stay was significantly shorter in group 1 (4.20 +/- 1.61 days vs 7.68 +/- 3.60 days, p < 0.0001 [mean +/- SD]).

"that's one heck of a error compared to the result size" [http://www.internationalskeptics.com...78#post1070078]

In post 12 [http://www.internationalskeptics.com...23#post1070123] Capsid said "I agree. The SDs overlap, it seems unlikely that the significance level is <0.0001"

In post 14 [http://www.internationalskeptics.com...70#post1070170] Jeckyll said "... people in the control group were significantly more likely to be thinner, to have more severe COPD, with a lower FEV1 and twice as likely to need long-term oxygen therapy before the treatement started... and directly before treatment the measurement of arterial carbon dioxide tension(PaCO2) was significantly lower". Capsid questioned whether this difference would be statstically significant in posts 15 and 37 [http://www.internationalskeptics.com/forums/showthread.php?postid=1075463#post1075463]

Dana Ullman has also hinted that this imbalance between the two groups wouldn't have affected the significance of the results in his post at 05 Jul 2010 at 1:09 pm here - [http://www.sciencebasedmedicine.org/index.php/homeopathy-in-the-icu/] and on the same page 'qetzalon', at 05 Jul 2010 at 3:34 pm, although sceptical, believes Ullman has a point.

All input gratefully received

Yuri

[Andrew Wiggin]

Originally Posted by Olaf/QII

Potassium dichromate (kalium bichromicum, K2Cr2O7) is a drug widely used in natural and homeopathic medicine.

IIRC hexavalent chromium compounds in water in high concentrations have the effect of making Erin Brockovich appear and flash cleavage. By that token, the diluted solution should result in lawyers leaving and breast shrinkage...

[Deetee]

Originally Posted by Yuri Nalyssus

Apologies but I would like to resurrect this thread as it has some useful stuff about an interesting paper - Frass, M., Dielacher, C., Linkesch, M., et al. (2005) All input gratefully received

Yuri

I recall discussions on this paper. I see you said:

Quote:

"the two patient groups are unbalanced; the placebo arm having more patients at an advanced stage of COPD than the verum (although it is debatable whether this would have affected the statistical significance of the results)."

My view is also that the groups are unbalanced, but you are right and they don't quite reach statistically significance in their differences, but the trend is clear.

There were more patients with advanced disease in the placebo group. In their analysis, Frass et al categorise patients according to COPD group (1 = mild, 2 = moderate, 3 = severe). These are categorical variables, and so differences in the groups cannot be viewed statistically as though they are continuous variables. (They might just as well have been called Stage A, B and C for example).

There were 25 patients in each group, and Frass (incomprehensibly and astoundingly) calculated the statistical "mean" COPD stage for each group as 1.03 (range 1-3) for verum group, and 1.2 (1-3) for the placebo group, p=0.178.

I calculate there would therefore be 24 patients with stage 1 COPD and one patient with Stage 3 COPD in the verum group, and something like 20 or 21 patients with Stage 1 COPD in the placebo group. Not quite significant by chi square (but had it been 19 stage 1 in the placebo group then it would have been)

(Chi square for 20x Stage 1 vs 5 non stage 1 patients in placebo group = 0.08, for 19x Stage 1 patients vs 6 non stage 1 patients = 0.04)

I think this weakens the applicability of their results and conclusions. To have more patients with more severe COPD in the placebo group would undoubtedly have led to delays in extubation. I think this fact is sufficiently clinically significant enough to call Frass's conclusions into question.

[RationalVetMed]

Originally Posted by Deetee

I recall discussions on this paper.

It seems to attract all sorts of extreme reactions from both sides of the arguments - much ranting on JREF and both blogs which mention it for some reason.

Originally Posted by Deetee

There were more patients with advanced disease in the placebo group...
I think this weakens the applicability of their results and conclusions. To have more patients with more severe COPD in the placebo group would undoubtedly have led to delays in extubation. I think this fact is sufficiently clinically significant enough to call Frass's conclusions into question.

OK, thanks, I'll make that sentence a bit more robust.

Any thoughts on what Capsid said about overlapping standard deviations - I understand that would have degraded the p value, but from a starting point of 0.0001 even then might it still have been a statistically significant result? (Trying to hide the fact that I once got 4% for a statistics class exam at this point ).

Cheers,

Yuri

[Capsid]

Originally Posted by Yuri Nalyssus

Any thoughts on what Capsid said about overlapping standard deviations - I understand that would have degraded the p value, but from a starting point of 0.0001 even then might it still have been a statistically significant result? (Trying to hide the fact that I once got 4% for a statistics class exam at this point ).

Cheers,

Yuri

We need to see the raw data to run the stats using other tests maybe. But the raw data is not provided.

[edd]

p-values and the idea of statistical significance are fundamentally flawed in trying to assess if homeopathy works here. A p-value measures the probability given the null hypothesis that you get a result at least that extreme - here the null hypothesis would be that the dilute solution does nothing.

What you want to know is the probability you should assign, given the evidence, to the idea that homeopathy works. I would expect this remains approximately 0, if only because if you have eliminated the null hypothesis then there's probably a more likely explanation than homeopathy - to paraphrase Sherlock, you really do need to eliminate all the impossible before you think anything quite so ludicrously improbable must be the truth.

[fls]

Originally Posted by Yuri Nalyssus

Apologies but I would like to resurrect this thread as it has some useful stuff about an interesting paper - Frass, M., Dielacher, C., Linkesch, M., et al. (2005) Influence of potassium dichromate on tracheal secretions in critically ill patients Chest Vol. 127 pp. 936-941.

Abstract here - http://www.ncbi.nlm.nih.gov/pubmed/15764779
Full text here - http://chestjournal.chestpubs.org/co...127/3/936.long

The thread got completely derailed by silliness and data dumps from Olaf but the paper does seem fairly robust and I am interested to see if anyone has anything else to add to the critique.

I have tried to summarise some of the arguments here - [http://www.rationalvetmed.org/page28.html#Frass2005] but there may be more to be said, I'd be interested to know if anyone has another take on it.

I'm having a bit of trouble understanding why you make a point of characterizing criticisms of this study as clutching at straws. Is it your opinion that the results of this study should be considered valid, and we should be using this in intubated COPD patients?

Quote:

To save people the trouble of trawling back through the dross I have selected significant posts below:

In post no 6 Geni said, in response to this section of the paper:

"that's one heck of a error compared to the result size" [http://www.internationalskeptics.com...78#post1070078]

In post 12 [http://www.internationalskeptics.com...23#post1070123] Capsid said "I agree. The SDs overlap, it seems unlikely that the significance level is <0.0001"

Standard deviation and its overlap does not tell you anything about the p-value. It is the standard error which gives you the p-value. This particular criticism isn't relevant.

Quote:

In post 14 [http://www.internationalskeptics.com...70#post1070170] Jeckyll said "... people in the control group were significantly more likely to be thinner, to have more severe COPD, with a lower FEV1 and twice as likely to need long-term oxygen therapy before the treatement started... and directly before treatment the measurement of arterial carbon dioxide tension(PaCO2) was significantly lower". Capsid questioned whether this difference would be statstically significant in posts 15 and 37 [http://www.internationalskeptics.com/forums/showthread.php?postid=1075463#post1075463]

Dana Ullman has also hinted that this imbalance between the two groups wouldn't have affected the significance of the results in his post at 05 Jul 2010 at 1:09 pm here - [http://www.sciencebasedmedicine.org/index.php/homeopathy-in-the-icu/] and on the same page 'qetzalon', at 05 Jul 2010 at 3:34 pm, although sceptical, believes Ullman has a point.

All input gratefully received

Yuri

This particular criticism is valid. There are differences between the groups at baseline on at least one measure which may be relevant - the use of home O2. This indicates a degree of impairment which may may extubation harder. If only a few cases accounted for the bulk of the length of stay (for example, if most of the people were extubated after two days and a few had prolonged intubations), then the sickest patients would have a disproportionate effect. The ability to detect baseline differences is not measured by the p-value, but by the power of the study. With an N of 50, the power to detect small to medium differences in baseline characteristics is generally less than 50%. That is, you can easily fail to detect relevant differences.

Linda

[RationalVetMed]

Originally Posted by fls

I'm having a bit of trouble understanding why you make a point of characterizing criticisms of this study as clutching at straws.

Not the genuine criticisms, it was the flurry of ad hominem attacks and general ridicule from some sceptics that irked me, specifically because, for me, it made the job of spotting the valid criticisms more difficult. These last few posts have clarified things for me and I think the homeopaths behaved as badly or worse. I'll remove that bit.

Originally Posted by fls

Is it your opinion that the results of this study should be considered valid, and we should be using this in intubated COPD patients?

Nope, not least because they had to take these (unconscious) patients off real medicine in order to test their sugar tablets - I do wonder how informed the 'consent' that they obtained was. Also it would have been good if they had had a third group of conventionally treated patients to compare - maybe that would have been too uncomfortable for them (the authors that is) - I'll expand on the ethics bit.

I do think that this is one of the better pro-homeopathy studies, though obviously that's not saying much from all the flaws. The section of the site which lists papers given by homeopaths in support of homeopathy is called "The best they can do" from a quote by Bandolier ("If this is the best they can do, why bother") and as I work slowly through the list I see nothing which contradicts that sentiment.

Originally Posted by fls

Standard deviation and its overlap does not tell you anything about the p-value. It is the standard error which gives you the p-value. This particular criticism isn't relevant.

So is there any implication for the conclusions of the authors in these wide, overlapping standard deviations?

Originally Posted by fls

This particular criticism is valid. There are differences between the groups at baseline on at least one measure which may be relevant - the use of home O2. This indicates a degree of impairment which may may extubation harder. If only a few cases accounted for the bulk of the length of stay (for example, if most of the people were extubated after two days and a few had prolonged intubations), then the sickest patients would have a disproportionate effect. The ability to detect baseline differences is not measured by the p-value, but by the power of the study. With an N of 50, the power to detect small to medium differences in baseline characteristics is generally less than 50%. That is, you can easily fail to detect relevant differences.

Thanks Linda and others - I think I'm beginning to see the light on this one!

Yuri

[Capsid]

Thanks Linda, for the clarification over the SD overlap. How rigorous is the analysis at discerning differences between groups when a simple 1,2 3 scoring system has been used? Wouldn't it better to analyse the sputum volumes rather than grading them into three groups?

[fls]

Originally Posted by Yuri Nalyssus

Nope, not least because they had to take these (unconscious) patients off real medicine in order to test their sugar tablets - I do wonder how informed the 'consent' that they obtained was. Also it would have been good if they had had a third group of conventionally treated patients to compare - maybe that would have been too uncomfortable for them (the authors that is) - I'll expand on the ethics bit.

The patients were conscious and breathing spontaneously. The intubation was so that positive airway pressure could be applied, not because they were undergoing mechanical ventilation. However, it was not ethical to stop effective medication for that which cannot be effective.

Quote:

I do think that this is one of the better pro-homeopathy studies, though obviously that's not saying much from all the flaws. The section of the site which lists papers given by homeopaths in support of homeopathy is called "The best they can do" from a quote by Bandolier ("If this is the best they can do, why bother") and as I work slowly through the list I see nothing which contradicts that sentiment.

I agree that this is one of the better homeopathy studies. As you pointed out, we should see a few of the better studies show up as positive due to chance.

Quote:

So is there any implication for the conclusions of the authors in these wide, overlapping standard deviations?

Not really, unless it indicates the data is unreasonably skewed, in which case the p-values aren't useful (the assumptions upon which they are based are violated).

Linda

[fls]

Originally Posted by Capsid

Thanks Linda, for the clarification over the SD overlap. How rigorous is the analysis at discerning differences between groups when a simple 1,2 3 scoring system has been used? Wouldn't it better to analyse the sputum volumes rather than grading them into three groups?

I don't think that a scoring system is unreasonable. These judgements tend to be subjective anyway - "none, small to moderate amounts, large amounts". What is odd is that the sputum volumes in all groups were quite small. None exceeded 15 ml/day, which is only a tablespoon. And this is much less than published reports which show that volumes smaller than 60 ml/day are associated with successful extubations. None of the patients in the study seemed to have the problem for which they were enrolled - excessive secretions prohibiting extubation. I think the sputum results have to be ignored, because they don't seem to be relevant.

This leaves us with significant differences in length of stay and extubation (which will be measuring the same thing). And there are clues that this result is not straightforward. If you look at table 2, there is substantial variability in these results, and the range is quite wide. In fact, the range is wider than the 95% interval, which tells us that these results violate the assumption that the results are distributed normally. And the longest length of stay in the placebo group is 17 days, which will have a disproportionately large effect.

It does look like there may have been a small number of people who were responsible for the differences in the results. And since that difference was not on the basis of sputum, it may have been on the basis of underlying hypoxia and need for home O2, which was unbalanced to begin with.

Linda

[Badly Shaved Monkey]

Also, we should not forget how this study gets cited by the likes of DUllman.

He is prone to say it proves homeopathy is effective for treating COPD, here for instance, which is a massive claim to make. Even if the study's results were actually to show that under the trial conditions, their intervention had a real effect you could not translate that into a claim for it being a useful treatment for the syndrome as a whole.

As ever with Dana, there is the merest hint of a little tiny dog being wagged by the great big shaggy tail that he has spotted.

The same would apply even if the intervention was something plausible like pre-warming the gas the patients were breathing.

[RationalVetMed]

Originally Posted by Badly Shaved Monkey

Also, we should not forget how this study gets cited by the likes of DUllman.

He is prone to say it proves homeopathy is effective for treating COPD, here for instance, which is a massive claim to make. Even if the study's results were actually to show that under the trial conditions, their intervention had a real effect you could not translate that into a claim for it being a useful treatment for the syndrome as a whole.

As ever with Dana, there is the merest hint of a little tiny dog being wagged by the great big shaggy tail that he has spotted.

The same would apply even if the intervention was something plausible like pre-warming the gas the patients were breathing.

An excellent discussion in Huffington Post there, thanks BSM - good to see Dr Jason MD giving it laldy!

I've revised the section of the web site in light of all the helpful comments (which I have stolen obviously!) - http://www.rationalvetmed.org/page28.html#Frass2005

Cheers,

Yuri

[Criticalist]

Originally Posted by Olaf/QII;1083631


======================


[url

http://www.headtraumarehab.com/pt/re/jhtr/abstract.00001199-199912000-00002.htm;jsessionid=C0ofDiNheLo2QXs8VP71BpUor2X5w sz8RWCgQnII6M2znqv32GVl[/url]!-796981593!-949856031!9001!-1
Homeopathic Treatment of Mild Traumatic Brain Injury: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial.
Journal of Head Trauma Rehabilitation. 14(6):521-542, December 1999.
Chapman, Edward H. MD, DHt; Weintraub, Richard J. MD; Milburn, Michael A. PhD; Pirozzi, Therese O'Neil ScD, CCC/SP; Woo, Elaine MD

Abstract:
Background: Mild traumatic brain injury (MTBI) affects 750,000 persons in the United States annually. Five to fifteen percent have persistent dysfunction and disability. No effective, standard pharmacological treatment exists specifically for this problem. We designed a pilot research project to study the clinical effectiveness of homeopathic medicine in the treatment of persistent MTBI.

Method: A randomized, double-blind, placebo-controlled trial of 60 patients, with a four-month follow-up (N = 50), was conducted at Spaulding Rehabilitation Hospital (SRH). Patients with persistent MTBI (mean 2.93 years since injury, SD 3.1) were randomly assigned to receive a homeopathic medicine or placebo. The primary outcome measure was the subject-rated SRH-MBTI Functional Assessment, composed of three subtests: a Difficulty with Situations Scale (DSS), a Symptom Rating Scale (SRS), and a Participation in Daily Activities Scale (PDAS). The SRH Cognitive-Linguistic Test Battery was used as the secondary measure.

Results: Analysis of covariance demonstrated that the homeopathic treatment was the only significant or near-significant predictor of improvement on DSS subtests (P = .009; 95% CI - .895 to - .15), SRS (P = .058; 95% CI - .548 to .01) and the Ten Most Common Symptoms of MTBI (P = .027; 95% CI -.766 to -.048). These results indicate a significant improvement from the homeopathic treatment versus the control and translate into clinically significant outcomes.

Conclusions: This study suggests that homeopathy may have a role in treating persistent MTBI. Our findings require large-scale, independent replication.

I feel the need to comment on this one as I have read this paper. I believe there is a problem with their statistics. Their outcome measure is the results of a questionnaire, which they administered to both groups, before and after the treatment. The authors admit that this tool had not been validated in previous trials, which in itself is a major problem - they simply have no idea if the primary outcome measure of the trial measures what they think it does.

The questionnaire comprises 3 sections with a total of 65 questions about various activities, to which the the subjects reply by scoring a 1 -5; (1= never, 2= rarely, 3= sometimes etc). These are rank ordered ordinal variables which means that while they progress in order, they don't provide quantitative information. So for example, someone who has a weight of 60kg is always exactly twice as heavy as someone whose weight is 30kg. However someone who replies "most of the time' (a score of 4) to the question "How often do you feel frustrated" is not always frustrated exactly twice as much as someone who had responded "rarely" (a score of 2). Ordinal variables like these have to be analysed statistically in a different manner to ratio scales like weight, but the authors do not do this.

Instead they add up all the numbers they get in each part of their questionnaire before and after the treatment and present it an arithmetic mean. They then perform a t test for each of seven sections of the questionnaire. Doing this they found no real differences in the majority of the data (quote " Our data revealed the limitations of our standardized tests to detect changes from treatment") Out of the seven analyses they performed one is significant (p=0.009) the rest are not. They then perform a whole raft of multivariate analyses, with again one or two results they claim are significant.

Overall, I am reminded of a quote from one of my statistics lecturers;

"If you torture the data long enough, eventually it will confess"

[RationalVetMed]

Originally Posted by Criticalist

I feel the need to comment on this one as I have read this paper... They then perform a whole raft of multivariate analyses, with again one or two results they claim are significant.

Overall, I am reminded of a quote from one of my statistics lecturers;

"If you torture the data long enough, eventually it will confess"

That's brilliant Criticalist, many thanks. This is another of the papers which homs commonly quote as showing positive evidence and I have a selection of links (including full text) to this paper here - http://www.rationalvetmed.org/c.html#Chapman1999 but no critique as yet. Would you mind if I quoted you on the site?

All the best,

Yuri

[Criticalist]

Not at all - please quote whatever you think would be useful

Great site btw

[RationalVetMed]

Originally Posted by Criticalist

Not at all - please quote whatever you think would be useful

Great site btw

OK, thanks for that and for the kind words about the site. The reference is here - http://www.rationalvetmed.org/c.html#Chapman1999. If you would prefer to be known by another moniker than Criticalist send me a PM and I'll make the changes.

Cheers,

Yuri

[RationalVetMed]

I've given the site a bit of a facelift and as a result some of the previous links have changed.

Frass, M., Dielacher, C., Linkesch, M., et al. (2005) Influence of potassium dichromate on tracheal secretions in critically ill patients Chest Vol. 127 pp. 936-941

Is now at: http://www.rationalvetmed.org/papers_e-f.html#Frass2005

and

Chapman, E.H., Weintraub, R.J., Milburn, M.A., et al. (1999) Homeopathic treatment of mild traumatic brain injury: a randomized, double-blind, placebo-controlled clinical trial Journal of Head Trauma Rehabilitation Vol. 14 pp. 521-542

Is now at: http://www.rationalvetmed.org/papers_c.html#Chapman1999

Just in case anyone has bookmarked them!

Cheers,

Yuri