Homeopathy and the Selling of Nonspecific Effects

[HuckleB]

http://www.sciencebasedmedicine.org/?p=8269

"...

This “observer effect” – an artifact of the process of observation – is now part of standard study design (at least well-designed studies). In medical studies it is one of the many placebo effects that need to be controlled for, in order to properly isolate the variable of interest.

There are many non-specific effects – effects that result from the act of treating or evaluating patients rather than a physiological response to a specific treatment. In addition to observer effects, for example, there is also the “chearleader” effect from encouraging patients to perform better. There are training effects from retesting. And there are long-recognized non-specific therapeutic effects just from getting compassionate attention from a practitioner. It is a standard part of medical scientific reasoning that before we ascribe a specific effect to a particular intervention, that all non-specific effects are controlled for and eliminated.

Within the world of so-called “complementary and alternative medicine” (CAM), however, standard scientific reasoning it turned on its head. After failing to find specific physiological benefits for many treatments under the CAM umbrella, proponents are desperately trying to sell non-specific effects as if they are specific to their preferred modalities. In other contexts this might be considered fraud. It is certainly scientifically dubious to the point of dishonesty, in my opinion.

...

The authors, however, are presenting the study as evidence that the homeopathic consultation works, when this study was not designed to test that variable. The effects can easily be explained as the non-specific effects of therapeutic attention. The study provides no basis upon which to conclude that there is any value to a homeopathic consultation beyond the raw benefit of time and attention.

..."


----------------------------------------------------------


This is a thorough debunking of another line of grift from those pushing the homeopathy scam. It really needs to be read in whole, however. Of course, anyone may respond, but I'll appreciate those who respond after reading the article in whole much more!

:hi:

[derby378]

1. Homeopathic case-taking factors heavily in this equation

While regular physicians take readings of blood pressure, temperature, weight, and the patient's own feedback as part of a regular visit, homeopathic physicians engage in a much deeper interview session with the patient, at least on the first visit. The rationale is that homeopaths want a clearer picture of "the whole patient" in terms of physical, mental, and emotional factors, but some of the questions asked during the case-taking can reflect a certain observer bias, whether intended or not. The sincere homeopath wants to partner with the patient in terms of restoring balance to the Vital Force, but in doing so runs the risk of sacrificing objectivity in the evaluation itself.

[HuckleB]

2. In this study, none of that was of concern, as the article noted.

"First, the study was not blinded for consultation vs no-consultation. Any comparison of this variable, therefore, is highly unreliable. It is likely no coincidence that the blinded comparisons were all negative, while some of the unblinded comparisons were positive. Also, even there the results are weak. The primary outcome measure was negative. Only the secondary outcome measures, which are mostly subjective, were positive.

And, perhaps most significantly, the study was not even designed to test the efficacy of the homeopathic consultation itself because it was compared essentially to no intervention (and in an unblinded fashion). There is therefore every reason to conclude that any perceived benefit from the consultation process is due to the nonspecific effects of the clinical interaction – attention from a practitioner, expectation of benefit, chearleader effect, etc.

If the authors wished to test whether there is something special about the homeopathic consultation then they should have compared it to attention from a health care provider that was controlled for time and personal attention, but did not contain elements specific to the homeopathic consultation. This study did not do that."

[derby378]

3. Duly noted

I was just making a comment about case-taking in general, but your response is correct.

[HuckleB]

4. Got it.

:toast:

[HuckleB]

5. Greetings to the pro-homeopathy scam unreccers!

:beer: Sorry, no beer for you. It's undiluted.

[laconicsax]

6. Those homeopathic lagers are too strong for me...

http://www.youtube.com/watch?v=HMGIbOGu8q0

[HuckleB]

7. Heavy metal contaminants: "Evidence" that homeopathy works

http://scienceblogs.com/insolence/2010/11/measuring_contaminants_and_concluding_th.php