Homeopathic Review: Putting the Boot In

Repeat with banging

Over the past week there has been an ongoing  ‘evidence check’ by the ‘House of Commons Science and Technology Sub-Committee’ to see whether the governments current policies on issues relating to homeopathy were supported by scientific evidence. The manner in which the evidence is being checked largely revolves around a series of expert panels being questioned by a committee of MPs.

In the first of these panels which took place on the 25th November 2009 the panels of experts stacked up as follows:

Panel 1

Dr. Ben Goldacre– Medical doctor, writer and Guardian columnist. Merciless mocker of bad science and tireless advocate of good science.
Tracey Brown- Managing director of science advocacy charity Sense About Science. Another tireless promoter of science who is a familiar face to all those following the Simon Singh libel case.
Prof. Jayne Lawrence- Chief Scientific Advisor for the Royal Pharmaceutical Society of Great Britain. Title says it all really.
Paul Bennet- Professional Standards Director of well known pharmaceutical retailer, Boots. Present because Boots is one of the largest retailers of Homeopathic remedies in the UK.
Robert Wilson- Chairman of the British Association of Homeopathic Manufacturers. Shockingly an advocate for homeopathy.

Panel 2

Prof. Edzard– Director of Complementary Medicine Group at Peninsula Medical School. Long term researcher into the validity of alternative treatments and co-author of Trick or Treatment: Alternative medicine on trial with Simon Singh.
Dr. James Thallon- Medical Director of NHS West Kent. Not familiar with the chap but he seemed to be an advocate of evidence based medicine and hence less than impressed with homeopathy.
Dr. Peter Fisher- Director of Research at Royal London Homeopathic Hospital. Hard to direct research at a homeopathic hospital without being a staunch advocate for homeopathy. A practising homeopath and a medical doctor.
Dr. Robert Mathie- Research Development Advisor of the British Homeopathic Association. Another staunch advocate for homeopathy.

Both sessions lasted around an hour and they can be viewed online here. For anyone thinking of watching them I would give advance notice that they are at entertaining and informative while simultaneously quite depressing. They are informative because there is a lot of discussion around what constitutes good evidence, when regulation is appropriate and what effects current government policies have on legitimising homeopathic treatments. They are entertaining because of the amusing comments offered at several points by the chair of the debate, Phil Willis, and due to the various uncomfortable evasions elicited after persistent questioning from the skeptical MP extraordinaire Dr. Evan Harris. And they are depressing because you have to listen to science and evidence be repeatedly mangled by the supposed ‘creme da la creme’ of the UK homeopathic world. All the same tired cliches including versions of ‘lots of people use it’ and ‘it is really old’ are trotted with complete seriousness as evidence for why continued support for homeopathy is necessary.

Since it has been a week now and we now live in the blogging era there has already been a lot of commentary and analysis of the panel discussion so here is a quick round up of some useful coverage:

• Skepticat provides a good overview of the main highlights and also points out that Boots may have got off lightly given the statements it makes about homeopathy on its Learning Zone website.
• Majikthyse gives another interesting recap from the perspective of a clinical scientist.
• Ben Goldacre recalls some of his favourite bits from the discussions and uses some of the more lamentable claims made during the panels to illustrate some interesting information about placebos and nocebos and why they are important.
• Various newspapers including The Telegraph, The Times & The Daily Mail picked up on Paul Bennet’s admission that Boots sells homeopathic remedies because they are popular not because there is evidence that they are effective. On top of those, the ever vigilant Prof. David Colquhoun discussed the admission in a follow up to a post discussing Boots shoddy standards of evidence.

I’m sure there is a lot more out there if you have a hunt but there are a few universal points that crop up in the discussions, namely:

1. Defenders of homeopathy have a really poor grasp of how science and medicine work! They cherry-pick their trials so hard and fast that I fear for the job security of any fruit picker alive. Obscure single studies are trotted out with aplomb as if they make looking at the rest of the research literature unnecessary and meta-analysis and reviews are discarded with nary a word  if they happen to have arrived at conclusions that the homeopaths don’t like.
2. Defenders of homeopathy do not appear convincing when presented alongside scientists. Seriously… a telling example is when Dr. Evan Harris asked Prof. Ernst for clarification about whether the meta-analysis of homeopathy really showed, as the homeopaths claimed, that 4 out of a total of 5 meta-analyses had been positive. Ernst’s response? He casually mentioned that he was aware of around 24 meta-analyses all of which were negative and he speculated that the only positive meta-analyses he was aware of contained case studies, non controlled studies and non randomised studies.
3. Phil Willis MP, the chair of the committee, is an amusing man and is good at highlighting the absurdity of arguments. As demonstrated when he responded to a comment from Robert Wilson suggesting that homeopathy deserved respect as a centuries old tradition by pointing out that the same could be said for prostitution.
4. Evan Harris MP, is an excellent illustration of how important it is to have the sceptical perspective represented in politics. His questions were probing and incisive and he managed to draw out the logical conclusions from a wide variety of impressively slippery and tangled obfuscations.
5. Boots sells remedies because they are popular and make them money and not because there is evidence that they work. This seems to have been treated as some kind of revelation but I thought it had been self-evident for a number of years. Regardless, it is nice to see such things being raised to the public’s attention.
6. All of the pro-science participants presented themselves well but Tracey Brown and Ben Goldacre, in particular, deserve several pats on the back for a job well done. Ben is already a well known figure in skeptic circles but Tracy despite being at the centre of a number of high profile Sense About Science campaigns including Simon Singh’s libel case remains less familiar. That is a shame and is something that will hopefully be rectified because she is an eloquent and well informed speaker.

And there you have it. If you have time and enjoy train wrecks or just want to check if the homeopathy advocates did as bad as I am claiming then go and have a look and judge for yourself…

Oh and one further point, the second committee meeting took place yesterday, this time with a bunch of figures from the current government. I was expecting this to be a more sober affair, displaying a bit more sense and a keener grasp of the (lack of) scientific evidence since there were no homeopaths around and the Chief Scientist was there but boy was I wrong. Have a look at this post from the Lay Scientist for further details of the silliness.