Time whizzes by and I, I write of glimpses I steal

Wednesday, March 11, 2015

Homeopathy

There was a report published by NHMRC Australia that found, "Based on the assessment of the evidence of effectiveness of homeopathy, NHMRC concludes that there are no health conditions for which there is reliable evidence that homeopathy is effective. People who choose homeopathy may put their health at risk if they reject or delay treatments for which there is good evidence for safety and effectiveness."

It is surprising to believe that in this day and age that people flock to this pseudoscience but then people have always been enamored by snake oil salesmen with their panaceas. It is shocking though that some in the medical research community, *cough* my father *cough cough*, continue to defend practices such as homeopathy. Let me reassure you, dear reader, that I have no skin in this game. I am not paid by big pharma and if there is a global conspiracy to discredit homeopathy, I haven't been receiving their newsletters. 

There are two ways to approach the problem of effectiveness of a health system; the social sciences approach and the scientific way. The social sciences approach is simply to ask people who have used a medical treatment if they thought it was effective in curing them.  One of the pillars of the argument for homeopathy seems to be based on this "It worked for so and so". Clearly this is a tempting proposition. But fraught with danger. For one, it will almost entirely miss the "Didn't do a damn thing to me" demography. That is, if we are predisposed to believe in a treatment, we'll remember all the people who claimed that it worked and don't count the people who have had partial or no success with this approach. Call it confirmation bias. This works just as well for the opposite view. Say I am skeptical about a particular medicine, then I am bound to remember the negative reviews than the positive ones. 

Researchers can work to control this bias in their studies. If a questionnaire was sent to a hundred people asking what they thought of kittens, you can bet that the people who take the time to respond will be predominantly cat-lovers. This selection bias can be accounted for in a study but the layperson who says that they heard from their sister that her friend's mom had a colleague whose niece suffered from asthma which was miraculously cured when they went to a homeopath.... not so much.

The scientific method would be to look at the theory behind the medicine and try to understand the mechanisms by which they cure the disease. For instance, to say that chemical compound A has effect X on organ Y which releases a secretion of  Z which results in reduction of a particular symptom. The problem that scientists have with homeopathy is because this particular line of enquiry yields terrible results. Homeopaths make claims about "water memory" or "super-dilution" that have been tested and the results show that the active ingredient in the "medicine" is so minuscule that it cannot actually effect change in the human body. That is, there is no difference between a sugar pill with no trace of active ingredient and a real pill with a one-thousandth trace of the active ingredient. 

(Side note: western medicine has a similar problem sometimes, when scientists are not able to trace all the causal links and have to say that they don't know which reaction causes particular symptom to vanish but it does. Yes, we don't know everything but the body of knowledge is growing and we are understanding things that we didn't before)

So, why does homeopathy seem to work? It could just be the placebo effect or it could be more complex than that. Many complimentary medical treatments talk about holistic medicine and demand changes in the lifestyle choices of the patient. For instance, the homeopath may demand that you give up meat during the treatment. Or to go on early morning walks. Or breathing exercises. These may allow the natural immunity of the body to fight back and get better. Post hoc ergo propter hoc. After this, therefore because of this. 

It is important to note that the claim that a homeopathic medicine works (it does not and from what we know about chemistry, it cannot) is debunked but they may still have value as lifestyle gurus. Governments and medical institutions have an obligation to call them out for what they are, so that the unsuspecting public may make informed decisions. The NHMRC report is a step in the right direction.