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Old 4th May 2006, 06:35 AM   #1
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Another trial of homoeopathy

The Bristol Homeopathic Hospital is carrying out another trial of homoeopathy. This time they're looking at children with severe asthma. I wonder what sort of blinding they'll be using.

http://www.dailymail.co.uk/pages/liv...n_page_id=1774

By the way, does anyone want to vote on the poll on that page? At the moment "yes" has 57%.
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Old 4th May 2006, 06:50 AM   #2
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There wasn't anything on the Homeopathic Hospital's page, but there is a press release on the United Bristol Healthcare NHS Trust main site.
Quote:
Children will be allocated to receive standard asthma care or standard asthma care plus homeopathy. All children will then be assessed once a month for four months.

If allocated to receive homeopathy, the children will be seen at the Bristol Homeopathic Hospital by an experienced General Practitioner, who will spend time matching a tailor-made homeopathic medicine to each child.

Families will be asked to keep daily diaries and fill in questionnaires to monitor each child’s progress.
So no blinding, and no placebo for the control group, I guess.
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Old 4th May 2006, 07:02 AM   #3
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Notice the completely uncritical mention of this:

Quote:
Research published last year in the Journal of Alternative and Complementary Medicine showed that 70 per cent of people with chronic illness reported improvements after homeopathic treatment. There are five NHS homeopathic hospitals in the UK.
Which is totally debunked here:

http://www.ucl.ac.uk/Pharmacology/dc...ck.html#spence
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Old 4th May 2006, 07:33 AM   #4
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Originally Posted by Blue Wode View Post
Notice the completely uncritical mention of this:

Quote:
Research published last year in the Journal of Alternative and Complementary Medicine showed that 70 per cent of people with chronic illness reported improvements after homeopathic treatment. There are five NHS homeopathic hospitals in the UK.
Which is totally debunked here:

http://www.ucl.ac.uk/Pharmacology/dc...ck.html#spence
Well, it's essentially the same people doing the same sort of research. From the press release:
Quote:
The results of a six-year study at the Hospital showed that more than two thirds (70%) of patients with chronic disease reported positive health changes after homeopathic treatment.

...

The most marked improvements were seen in children with asthma
Elizabeth thompson, who is involved in the new study, was the second named auther of the study published last year.
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Old 4th May 2006, 07:46 AM   #5
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Originally Posted by Mojo View Post
The Bristol Homeopathic Hospital is carrying out another trial of homoeopathy. This time they're looking at children with severe asthma. I wonder what sort of blinding they'll be using.

http://www.dailymail.co.uk/pages/liv...n_page_id=1774

By the way, does anyone want to vote on the poll on that page? At the moment "yes" has 57%.
It seems to let you vote as many times as you want ...

Now it's 50/50
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Old 4th May 2006, 07:50 AM   #6
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Originally Posted by Blue Bubble View Post
It seems to let you vote as many times as you want ...

Now it's 50/50
Only if you have cookies switched off.
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Old 4th May 2006, 07:55 AM   #7
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Originally Posted by geni View Post
Only if you have cookies switched off.
Damned right I have cookies switched off !
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Old 4th May 2006, 08:02 AM   #8
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voted and commented.
It's the Daily Mail after all, hardly the most skeptical newspaper...
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Old 4th May 2006, 09:15 AM   #9
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Originally Posted by vbloke View Post
voted and commented.
John has a comment up, but no sign of yours yet.

I see "no" is up to 70%!
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Old 4th May 2006, 09:26 AM   #10
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Voted and commented.
70% "no" - much better.
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Old 4th May 2006, 08:03 PM   #11
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It's back down to 64%
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Old 4th May 2006, 08:44 PM   #12
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F'kin pisses me off. I have asthma, and it's nothing to fool around with.

I wonder what'll happen if a patient dies....
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Old 5th May 2006, 02:16 AM   #13
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Originally Posted by clarsct View Post
F'kin pisses me off. I have asthma, and it's nothing to fool around with.

I wonder what'll happen if a patient dies....
The homeopathy seems to be in addition to best pharmaceutical treatment.

So we treat the patients as best we can using steroids, B receptor antagonists, antihistamines and then refer them to a nice homeopath who will spend hours with them and their relatives giving them the additional reasurance.

In order to do a Placebo control at this level, we would need to refer the control group to a specialist Asthma nurse who will spend the same amount of time in gving reasurance and expalining how each medication will help them.

In Cardiology trials compliance and responder rates improve significantly with weekly contact from a trial nurse, this even works when done over the telephone.
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Old 5th May 2006, 02:33 AM   #14
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I wonder how much time and money is wasted on researching homeopathy, and providing it on the NHS…

For a moment there I thought the Daily Mail had removed another poll with a result it didn’t approve of, but no, it was just me being blind! The result seems to be back to 70 % no. Thanks for the heads up. I don’t like clicking on their site, but sometimes it’s worth it.
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Old 5th May 2006, 02:36 AM   #15
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Originally Posted by Aardvark View Post
In order to do a Placebo control at this level, we would need to refer the control group to a specialist Asthma nurse who will spend the same amount of time in gving reasurance and expalining how each medication will help them.
Actually, all you need to do is to send both groups to the homoeopath, allow the homoeopath to do their thing and prescribe a remedy, and then have a third party give members of the verum group whatever remedy has been prescribed for them and the control group a placebo. This way everything is the same apart from the remedy.
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Old 5th May 2006, 02:41 AM   #16
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The Rolfe Protocol.
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Old 5th May 2006, 02:48 AM   #17
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the guardian's bad science writer is pretty good for debunking such stuff....here's his article on homeopathy.....

http://www.guardian.co.uk/comment/st...558417,00.html

if there were more guardian readers and less daily mail readers....the world would be a better place lol
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Old 5th May 2006, 02:49 AM   #18
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Originally Posted by Zep View Post
The Rolfe Protocol.
That's the one (although I'd rather not get lawyers invoved if we can help it...).

Edited to add link.
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Last edited by Mojo; 5th May 2006 at 03:04 AM.
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Old 5th May 2006, 02:58 AM   #19
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Originally Posted by Zep View Post
The Rolfe Protocol.
Book title?
Anyway the vote is 71/29 now. I've sent a comment - not yet posted.
The Daily Mail forum apparently has some sceptics - as in this thread.
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Old 5th May 2006, 02:59 AM   #20
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Originally Posted by andyandy View Post
the guardian's bad science writer is pretty good for debunking such stuff....here's his article on homeopathy.....

http://www.guardian.co.uk/comment/st...558417,00.html
His columns about homoeopathy are archived here.
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Old 5th May 2006, 03:23 AM   #21
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Originally Posted by Dragon View Post
Book title?
Anyway the vote is 71/29 now. I've sent a comment - not yet posted.
The Daily Mail forum apparently has some sceptics - as in this thread.
One of the many things that have annoyed me about homeopathy over the years is a rather poor grandmother posting me boxes of Oscillococcinum, depsite my objections, because she thought it was helpful.

Have homeopathy pills ever actually been analysed? My knowledge of chemistry is rusty (to say the least!), but pointing at proof there's nothing there could be useful? Anyone want a box of Oscillococcinum?!
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Old 5th May 2006, 03:39 AM   #22
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Originally Posted by rats View Post
Have homeopathy pills ever actually been analysed?
Not to my knowlage. Remeber a full analasis would cost tens of thousands.
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Old 5th May 2006, 03:52 AM   #23
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No need for analysis, really, They are all the same as sugar pillules that come out of the hundreds-and-thousands factory.

[thinks...]








You know, if we talk to the confectioners, we can make a fortune here! Bottle the different coloured H&T's so that all in one bottle are one colour, and call them "identified homeopathic remedies"! Easier to tell them apart!
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Old 5th May 2006, 04:07 AM   #24
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What I find most worrying is the high number of GPs who refer patients to homeopaths. Across the UK as a whole it’s 42%, with 86% of Scottish GPs said to be “in favour” of it. More here:

http://www.ucl.ac.uk/Pharmacology/dc...-sept-2005.pdf

If studies such as those done by the Bristol Homeopathic Hospital are taken at face value by busy GPs, then these numbers are bound to rise. It’s all so irresponsible.
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Old 5th May 2006, 04:09 AM   #25
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Originally Posted by rats View Post
Have homeopathy pills ever actually been analysed? My knowledge of chemistry is rusty (to say the least!), but pointing at proof there's nothing there could be useful?
Most homoeopaths these days wouldn't claim that there was any chemical difference between homoeopathic remedies and the base tablet or medicine, Avogadro's law is too well known.

Instead they cite 'quantum' effects or even 'local' effects, the claims for which are indistinguishable from magic. This local effect has been used to excuse results of homoeopathy trials in the past which have failed to distinguish between remedies and placebo where the explanation is that the 'intention' of the practitioner to treat is enough to effect a result, regardless of whether the verum remedy was given or not.

When you're up against this sort of post-hoc rationalisation you really can't win.

Yuri
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Old 5th May 2006, 04:09 AM   #26
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Originally Posted by geni View Post
Not to my knowlage. Remeber a full analasis would cost tens of thousands.
and more waste of resources...
Good point.

Originally Posted by Zep View Post
You know, if we talk to the confectioners, we can make a fortune here! Bottle the different coloured H&T's so that all in one bottle are one colour, and call them "identified homeopathic remedies"! Easier to tell them apart!
I guess the colour white has more of an association with medicine. Grr.
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Old 5th May 2006, 04:15 AM   #27
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Originally Posted by Yuri Nalyssus View Post
Most homoeopaths these days wouldn't claim that there was any chemical difference between homoeopathic remedies and the base tablet or medicine, Avogadro's law is too well known.
I didn’t realise that. It’s all utterly crazy!

Originally Posted by Yuri Nalyssus View Post
When you're up against this sort of post-hoc rationalisation you really can't win.
Hence homeopathy = woo
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Old 5th May 2006, 04:26 AM   #28
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Originally Posted by rats View Post
I guess the colour white has more of an association with medicine. Grr.
Not necessarily, at least for certain types of medication: http://bmj.bmjjournals.com/cgi/conte.../313/7072/1624

I'm sure I've also seen claims that placebos of certain colours have more of an effect than other colours, but I can't find anything at the moment.
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Old 5th May 2006, 04:48 AM   #29
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Originally Posted by Mojo View Post
Not necessarily, at least for certain types of medication: http://bmj.bmjjournals.com/cgi/conte.../313/7072/1624
That’s one of the great things about this forum. You post a hypothesis, then someone replies with an interesting link providing evidence against it Thanks.
Though I wonder whether culture has a significant effect.

Originally Posted by Mojo View Post
I'm sure I've also seen claims that placebos of certain colours have more of an effect than other colours, but I can't find anything at the moment.
Perhaps this is what Renee Rynn was on about?
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Old 5th May 2006, 04:55 AM   #30
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I give in! Where the heck is that poll on that page???
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Old 5th May 2006, 05:10 AM   #31
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Originally Posted by Zep View Post
I give in! Where the heck is that poll on that page???
They've replaced it with one about body mass index, and moved it to their "polls" page. Click on "More Polls >>" (under "Have your say"), and it's the 4th one down in their 10 most recent polls.
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Old 5th May 2006, 05:53 AM   #32
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Ta! No vote registered.
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Old 5th May 2006, 07:32 AM   #33
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Originally Posted by andyandy View Post
the guardian's bad science writer is pretty good for debunking such stuff....here's his article on homeopathy.....

http://www.guardian.co.uk/comment/st...558417,00.html

if there were more guardian readers and less daily mail readers....the world would be a better place lol
This is an interesting article. It basically says that homeopathy only works because of the placebo effect. So what is the placebo effect? According to Wiki, it is
Quote:
the phenomenon that a patient's symptoms can be alleviated by an otherwise ineffective treatment, since the individual expects or believes that it will work.
So if you believe the placebo treatment will or may work, it may help you. If you don’t believe, it probably won’t. Further, if you believe it will hurt you, it may do so (this is called the nocebo effect).

From an FDA article, we have the following:
Quote:
Researchers have been studying the placebo effect for decades. In 1955, researcher H.K. Beecher published his groundbreaking paper "The Powerful Placebo," in which he concluded that, across the 26 studies he analyzed, an average of 32 percent of patients responded to placebo. In the 1960s, breakthrough studies showed the potential physiological effects of dummy pills--they tended to speed up pulse rate, increase blood pressure, and improve reaction speeds, for example, when participants were told they had taken a stimulant, and had the opposite physiological effects when participants were told they had taken a sleep-producing drug.
Quote:
"Expectation is a powerful thing," says Robert DeLap, M.D., head of one of the Food and Drug Administration's Offices of Drug Evaluation. "The more you believe you're going to benefit from a treatment, the more likely it is that you will experience a benefit."
I think that it would be beneficial to patients to be able to take advantage of the placebo effect, where possible. In addition to standard therapy, of course. In that situation is it ethical for a doctor to also prescribe a placebo while letting the patient think that he is prescribing an effective drug? Many doctors don’t think so, and don’t do it, but some will, if they think there is a good chance it will help the patient.

And is it ethical for a doctor to refer a patient to a homeopothist, knowing that the homeopothist will very likely conduct placebo therapy, which may help the patient if the patient believes it will? I suspect that many doctors do just that, rather than prescribe a placebo themselves.

So perhaps homeopathy has a place in medicine, for those who aren’t skeptical about it. Provided, of course, that the placebo is not substituted for conventional therapy, but is used in addition to it.

There is a catch 22, here, in that the more intelligent and knowledgeable (and skeptical) you are, the less likely you are to benefit from placebo therapy. Unless, of course, you can learn to harness whatever causes the placebo effect, and invoke it without benefit of an actual placebo, sort of like the mind-over-body control that buddhist monks in Tibet are supposed to have after a lifetime of meditation.
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Old 5th May 2006, 09:08 AM   #34
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Originally Posted by Yuri Nalyssus View Post
Instead they cite 'quantum' effects or even 'local' effects, the claims for which are indistinguishable from magic.
Sorry, meant to say 'non-local' effects, ie/ according to some practitioners homoeopathy has an effect not limited to the 'locale' of the remedy; the presence of the practitioner or mere intent is sufficient.

See http://www.dr-walser.ch/magic_of_signs.pdf for a paper, written by a homoeopath, that seems to admit that controlled trials show little or no effect from homoeopathic remedies so it must work by magic instead. Well worth a read if you are interested in understanding the mind-set of these people.

Yuri.
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Old 5th May 2006, 09:26 AM   #35
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Originally Posted by joe87 View Post
I think that it would be beneficial to patients to be able to take advantage of the placebo effect, where possible. In addition to standard therapy, of course.
Placebo effects are induced by all treatments, not just bogus ones like homeopathy. So there's not a lot of point in prescribing it in addition to a conventional treatment as placebo effects will already be present.
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Old 5th May 2006, 11:07 AM   #36
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Originally Posted by joe87 View Post
There is a catch 22, here, in that the more intelligent and knowledgeable (and skeptical) you are, the less likely you are to benefit from placebo therapy.
This is an interesting statement. Do you have any cites or evidence for this? I'd be interested to learn that the placebo effect is inversely correlated with intelligence.
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Old 5th May 2006, 01:35 PM   #37
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Originally Posted by John Jackson View Post
Placebo effects are induced by all treatments, not just bogus ones like homeopathy. So there's not a lot of point in prescribing it in addition to a conventional treatment as placebo effects will already be present.
We just need to get proper doctors to pay their patients the same sort of attention that homoeopaths do.
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Old 5th May 2006, 04:36 PM   #38
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Originally Posted by Beth View Post
This is an interesting statement. Do you have any cites or evidence for this? I'd be interested to learn that the placebo effect is inversely correlated with intelligence.
I meant that it was positively correlated with belief in the efficacy of the placebo, which I infer would be inversely correlated with intelligence. I.e., if a person is smart enough to realize that, say, homeopathy is nonsense, then homeopathic therapy isn't going to work on that person.
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Old 5th May 2006, 04:51 PM   #39
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Originally Posted by John Jackson View Post
Placebo effects are induced by all treatments, not just bogus ones like homeopathy. So there's not a lot of point in prescribing it in addition to a conventional treatment as placebo effects will already be present.
That's true in some cases, but there are many situations where conventional treatment doesn't or can't really cure the problem. At the point where no additional conventional treatment is likely to be effective, additional placebo therapy may produce additional results. Placebo studies have shown that the placebo effect is stronger with therapies that the patient believes will work. There may be a lot of patients out there that are predisposed to believe in unconventional therapies (the woos and similar people, for example). These people may get more of a placebo effect out of unconventional therapies than they do out of standard therapy because they believe. Optimists live longer than pessimists, and credulous people may have the advantage in some situation over skeptics (I say this as a card-carrying skeptic, BTW).
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Old 6th May 2006, 07:31 AM   #40
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Originally Posted by joe87 View Post
These people may get more of a placebo effect out of unconventional therapies than they do out of standard therapy because they believe. Optimists live longer than pessimists, and credulous people may have the advantage in some situation over skeptics (I say this as a card-carrying skeptic, BTW).
But conversely, card-carrying skeptics might get more out of conventional therapies in the same way: because they believe in them?
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