Intended for healthcare professionals

Rapid response to:

News

WHO warns against using homoeopathy to treat serious diseases

BMJ 2009; 339 doi: https://doi.org/10.1136/bmj.b3447 (Published 24 August 2009) Cite this as: BMJ 2009;339:b3447

Rapid Response:

RE: Voice of immature science

Laurence J Baskind accuses Voice of Young Science of being selective
with the evidence on the effectiveness, or otherwise, of homeopathy.
However, he is guilty of exactly the same thing when he writes the
following:

"...there are dozens of clinical trials that have been published in
the medical literature that indicate homeopathic medicines have an effect
greater than placebo. The meta-analysis cited (Shang The Lancet 2005) is
just one of several. Others (Linde The Lancet 1997) conclude that 'the
results of our meta-analysis are not compatible with the hypothesis that
the clinical effects of homeopathy are completely due to placebo.'"

What he says is true, as far as it goes, but it omits some important
points, and by doing so creates a false impression of the state of the
evidence base for homeopathy. While there are trials that show positive
results for homeopathy, these are almost invariably of small size, or poor
methodological quality, or both. When this is accounted for, the results
for homeopathy are consistent with it acting as a placebo.

Baskind discusses Linde et al. 1997[1], but omits to mention a re-
analysis of the same dataset by the authors published in 1999[2]. This
concluded that because trials of higher methodological quality had smaller
effect sizes, and that because a number of newly published high-quality
trials showed negative results for homeopathy, their 1997 paper had over-
estimated the effectiveness of homeopathy. It is notable that apologists
for homeopathy always mention the 1997 paper, but never mention the 1999
one. While the Shang et al. 2005[3] meta-analysis mentioned is indeed
"just one of several", it is also the most recent and most
methodologically advanced.

There is nothing "intolerant" or "totalitarian" about pointing out
that ineffective treatments are ineffective.

References:

[1]. Linde K, Clausius N, Ramirez G et al. Are the clinical effects
of homeopathy placebo effects? A meta-analysis of placebo-controlled
trials, Lancet (1997); 350: 834–843.

[2]. K. Linde K, Scholz M, Ramirez G, Clausius N, Melchart D, Jonas
WB. Impact of study quality on outcome in placebo-controlled trials of
homeopathy, J Clin Epidemiol 1999; 52: 631–36.

[3]. Shang A, Huwiler-Müntener K, Nartey L et al. Are the clinical
effects of homeopathy placebo effects? Comparative study of placebo-
controlled trials of homeopathy and allopathy, Lancet 2005; 366: 726–732.

Competing interests:
None declared

Competing interests: No competing interests

04 September 2009
Paul Wilson
Research Associate
University of Manchester, Manchester M13 9PL