Talk:Homeopathy/Archive 42
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New citations to lead
I have several problems with the new citations recently added to the lead in this diff [1].
- The first citation (Kleijnen 1991) says the evidence, while positive was "not sufficient to draw any definite conclusions", so I would be wary of using it to support the text 'supports the efficacy of homeopathy' which it does not appear to.
- The second citation (Boissel 1996), has not been, to my knowledge, actually published in a peer-reviewed refereed journal (or at least the citation does not represent that it was), so it is dubious to use it to support the text for "studies published in reputable journals".
- The third citation (Linde 1997) was qualified by the authors subsequently, and I would be very wary in using it, after it has been qualified.
- The fourth (Mathie 2003) was published in the journal Homeopathy, which I'm not sure would be described as "reputable" in the broader medical coumminity, though I could be mistaken.
Also, I'm not sure why the citations needed to be added to the already cluttered citation-ridden lead in the first place. The first part of the sentence, "Supporters claim that studies published in reputable journals support the efficacy of homeopathy" appeared to be adequately supported by the Time reference that was already there. I do not think anyone disputes that supporters of homeopathy believe that such evidence has been published by reputable journals, so I fail to see what the additional citations add except extra clutter to the lead.
As such, I have removed the references from the lead, pending further discussion. Yobol (talk) 02:02, 17 August 2009 (UTC)
- I think that (Boissel 1996) is published in a [decent journal http://www.ncbi.nlm.nih.gov/sites/entrez?db=journals&term=%22Eur%20J%20Clin%20Pharmacol%22[Title%20Abbreviation] Hope we are talking about the same thing.--JeanandJane (talk) 03:00, 17 August 2009 (UTC)
- Yes, I understand your first concern and it's a good point. Which is why it might be a good idea to qualify this to be inline with what was stated in the first sentence: "beyond the placebo effect." Then using these sources is no longer over-stating the case. I have made this change to the main article.
- About the other points:
- Kleijnen: Yes, which is why we need to qualify the statement as in the first sentence with "beyond the placebo effect."
- Boissel: This paper (in a later re-published form) can be found here in the European Journal of Clinical Pharamcology. Perhaps this is the version we should use instead?
- Linde97: If Linde et al. retracted their paper I think you would be correct in that we should not use it. However, as it stands they "qualified" the results to say they had "at least overstated the positive results..." which doesn't negate them. Perhaps we should add the "qualification" reference to the list as well?
- Mathie: I think you might have a point if all these references were coming out of one journal. But as it stands, they are quite well spread across a diverse selection of peer-reviewed journals. The problem is if we start filtering respected peer-reviewed journals even if they are considered lesser journals by those who have anti-homeopathic views then we open up the question of bias once again.
- Dbrisinda (talk) 04:19, 17 August 2009 (UTC)
- Agree with the addition of "beyond the placebo effect." Also fixed reference to Boissel. I have moved the first 3 refs to the end of the sentence as they support both parts of the sentence (positive effects in journal, but "not definitive" as all three references qualify the positive results). I also removed the Mathie reference; I agree it meets the requirements of WP:RS as to the views of homeopaths, however the in-text sentence adds the additional qualification of being a 'reputable journal' (in the context of the wider scientific community), which I do not believe Homeopathy has. I would prefer community consensus be reached on whether this journal is "reputable" before re-adding this reference in this context. Yobol (talk) 05:49, 17 August 2009 (UTC)
- The particular problem with Mathie is that it deliberately does not categorise trials by study quality (see p. 87), an issue that is known to have an effect on the outcome of studies (see, for example, Linde 1999), on the grounds that information about study quality is available elsewhere. Any reading of Mathie therefore needs to take the conclusions of other papers about the effect of study quality into account. So while Mathie finds some studies supporting efficacy for some conditions, we cannot come to any conclusions about the validity of this evidence without indulging in WP:SYN or WP:OR. Brunton (talk) 07:40, 17 August 2009 (UTC)
- I agree. Finally Brunton: We don't have and must not indulge in any WP:OR trying to make our conclusions about Homeopathy's efficacy or to proof or to disprove any review.Let the readers to do that. It is enough to read it, to comprehend what has been said and report it in a neutral way.--JeanandJane (talk) 18:10, 17 August 2009 (UTC)
- Yes, I also agree, as I can provide a similar but mirror argument for Shang (2005): it deliberately and rather arbitrarily excludes trials by not conforming to the QUORUM requirements of the Lancet/Cochrane Review, on the grounds that they do not meet their selection criteria. In addition, problems with pooling are not discussed: pooling of data from clinical trials makes sense only if all the trials measure the same effect, as stated by Linde et al. Any reading of Shang therefore needs to be taken with a grain (or two) of salt. So while Shang finds no studies supporting efficacy for any conditions, we cannot take this seriously given a large body of contradictory research that states precisely the converse, and their questionable methodology. However, I'm not prepared to exclude Shang even on these grounds, choosing instead to keep to WP:OR guidelines. Summary: no double-standards. Dbrisinda (talk) 23:55, 17 August 2009 (UTC)
- It seems a little odd to criticise Shang for excluding studies "on the grounds that they do not meet their selection criteria"; to include studies that did not meet the selection criteria would be post hoc selection of studies. Ironically, this is one of the things that homoeopaths have entirely unjustifiably accused Shang of (see Wilson, Homeopathy Volume 98, Issue 2, April 2009, Pages 127-128). Ludtke and Rutten (2008) amply demonstrates the problems associated with post hoc selection of trials for analysis. The criticism from Linde and Jonas with regard to the QUORUM requirements appear to be related to reporting rather than selection of trials, by the way, and were (as has already been noted above) addressed by the authors of the paper. Brunton (talk) 12:31, 18 August 2009 (UTC)
- This is not Dbrisinda 's point. The point is : not exclusion of reliable sources using double standards and not Original research comparing different reviews to figure out which is more correct instead of stating the findings of each one.--JeanandJane (talk) 19:34, 18 August 2009 (UTC)
- Pointing out glaring methodological errors or biases of authors and citing them as reason to downplay a given study’s findings isn’t original research, it’s proper source checking. WP:V clearly states that good sources are ones that have a good reputation for fact-checking and accuracy. — NRen2k5(TALK), 20:09, 18 August 2009 (UTC)
- Every source it has been suggested here over qualifies - look at the discussion above.--JeanandJane (talk) 20:46, 18 August 2009 (UTC)
- No, you. — NRen2k5(TALK), 21:28, 18 August 2009 (UTC)
- Every source it has been suggested here over qualifies - look at the discussion above.--JeanandJane (talk) 20:46, 18 August 2009 (UTC)
- Pointing out glaring methodological errors or biases of authors and citing them as reason to downplay a given study’s findings isn’t original research, it’s proper source checking. WP:V clearly states that good sources are ones that have a good reputation for fact-checking and accuracy. — NRen2k5(TALK), 20:09, 18 August 2009 (UTC)
- This is not Dbrisinda 's point. The point is : not exclusion of reliable sources using double standards and not Original research comparing different reviews to figure out which is more correct instead of stating the findings of each one.--JeanandJane (talk) 19:34, 18 August 2009 (UTC)
- It seems a little odd to criticise Shang for excluding studies "on the grounds that they do not meet their selection criteria"; to include studies that did not meet the selection criteria would be post hoc selection of studies. Ironically, this is one of the things that homoeopaths have entirely unjustifiably accused Shang of (see Wilson, Homeopathy Volume 98, Issue 2, April 2009, Pages 127-128). Ludtke and Rutten (2008) amply demonstrates the problems associated with post hoc selection of trials for analysis. The criticism from Linde and Jonas with regard to the QUORUM requirements appear to be related to reporting rather than selection of trials, by the way, and were (as has already been noted above) addressed by the authors of the paper. Brunton (talk) 12:31, 18 August 2009 (UTC)
Boissel
- I notice that Boissel says
- "CONCLUSIONS: There is some evidence that homeopathic treatments are more effective than placebo; however, the strength of this evidence is low because of the low methodological quality of the trials. Studies of high methodological quality were more likely to be negative than the lower quality studies. Further high quality studies are needed to confirm these results"
- Let's remember that this was for sourcing the sentence "Supporters claim that studies published in reputable journals support the efficacy of homeopathy", this is not exactly what I would call "supportive". This should go under #Research_on_medical_effectiveness. Something like "some reviews have pointed out that studies of higher methodological quality tend to have more negative results". I think that Ernst 2002 made the same point and maybe some other review. --Enric Naval (talk) 03:20, 17 August 2009 (UTC)
- Linde 1999 also came to the same conclusion. "We conclude that in the study set investigated, there was clear evidence that studies with better methodological quality tended to yield less positive results." Yobol (talk) 03:43, 17 August 2009 (UTC)
- I thought that we discussed this and said that less positive it is still positive but not definitive like the sentence states. Enric the first as well. They say some evidence which support a degree of efficacy beyond placebo but not definitively as again the sentence states. --JeanandJane (talk) 03:49, 17 August 2009 (UTC)
- Linde 1999 also came to the same conclusion. "We conclude that in the study set investigated, there was clear evidence that studies with better methodological quality tended to yield less positive results." Yobol (talk) 03:43, 17 August 2009 (UTC)
- This is a fair point which I addressed above. Which is why it might be a good idea to qualify this to be inline with what was stated in the first sentence: "beyond the placebo effect." Then using these sources is no longer over-stating the case. I have made this change to the main article. For Linde97, qualification is not the same as "retracted," "contradicted," or "nullified." The conclusions are still valid, though weaker than originally submitted. Dbrisinda (talk) 04:23, 17 August 2009 (UTC)
- But we don't know, from Linde 1999, how much weaker - it says that the earlier study "at least overestimated the effects of homeopathic treatments" That includes anything from, as you say "positive but weaker than originally stated" to "not positive". It certainly doesn't explicitly state that the positive finding is still valid. Brunton (talk) 09:49, 18 August 2009 (UTC)
- Exactly. Shoemaker's Holiday Over 193 FCs served 09:56, 18 August 2009 (UTC)
- If that were the case they would say negative. Positive is positive even less.--JeanandJane (talk) 16:35, 18 August 2009 (UTC)
- An excellent point. No effect at all (or even a poorer outcome) with homeopathic remedies would certainly qualify as "less positive". Looking briefly at Linde 1999, the highest quality studies according to one scale did not have a significantly positive homeopathic effects, but did according to another quality scale. The authors also explicitly state that their conclusions in the first paper were "weakened" by this evidence of bias in the Linde 1999 paper, and that new trials published since 1997 which showed negative results confirmed this. This would all indicate that using Linde 1997 as evidence for "positive" results is dubious at best, and I am leaning towards excluding it from the lead (though it should stay in the body of the text where these nuances are further explained). Yobol (talk) 17:00, 18 August 2009 (UTC)
- Exactly. Shoemaker's Holiday Over 193 FCs served 09:56, 18 August 2009 (UTC)
- But we don't know, from Linde 1999, how much weaker - it says that the earlier study "at least overestimated the effects of homeopathic treatments" That includes anything from, as you say "positive but weaker than originally stated" to "not positive". It certainly doesn't explicitly state that the positive finding is still valid. Brunton (talk) 09:49, 18 August 2009 (UTC)
- This is a fair point which I addressed above. Which is why it might be a good idea to qualify this to be inline with what was stated in the first sentence: "beyond the placebo effect." Then using these sources is no longer over-stating the case. I have made this change to the main article. For Linde97, qualification is not the same as "retracted," "contradicted," or "nullified." The conclusions are still valid, though weaker than originally submitted. Dbrisinda (talk) 04:23, 17 August 2009 (UTC)
Furthermore, Boissel writes - in the abstract, no less, "However, sensitivity analysis showed that the P value tended towards a non-significant value (P = 0.08) as trials were excluded in a stepwise manner based on their level of quality."[2] - That's pretty damning evidence, and is in line with later findings of Shang, Linde, etc. Shoemaker's Holiday Over 193 FCs served 10:08, 18 August 2009 (UTC)
- I think we talked about it. That's an assumption based on the comparative study of the other studies you made and it is the definition of Original Research. You (and every editor ) supposed to comprehend what was stated in any single review and report it - not to comparatively study all the reviews in order to proof or to disproof Homeopathy's efficacy. Someone could find similar problems in the Shang review but that will not change that its results state that homeopathy = placebo at best. Boisel concludes that the strength of the positive evidence is low and that it is stated clearly in the sentence- some degree of efficacy beyond placebo. --JeanandJane (talk) 19:24, 18 August 2009 (UTC)
- I'm sorry, but you seem to be advocating for ignoring what the authors say, in favour of liosting them by "Had anything at all sort-of-positive to say about homeopathy, or didn't. Linde 99 said that Linde 97 was either overstated or straight-out wrong. Boissel said that high-quality studies showed no effect for homeopathy, but you're advocating for instead saying that Linde 97 and Boissel are proof homeopathy works. And yet, you're attacking people for actually listening to what the authors said instead of what you want to say based on them. That just isn't on. Shoemaker's Holiday Over 193 FCs served 20:23, 18 August 2009 (UTC)
- I think we talked about it. That's an assumption based on the comparative study of the other studies you made and it is the definition of Original Research. You (and every editor ) supposed to comprehend what was stated in any single review and report it - not to comparatively study all the reviews in order to proof or to disproof Homeopathy's efficacy. Someone could find similar problems in the Shang review but that will not change that its results state that homeopathy = placebo at best. Boisel concludes that the strength of the positive evidence is low and that it is stated clearly in the sentence- some degree of efficacy beyond placebo. --JeanandJane (talk) 19:24, 18 August 2009 (UTC)
- Firstly I m not attacking anyone. I pointed out that we should not make original research in order to proof or disprove a method by comparing different reviews to figure out what is the [[truth]; just to report what it was said.--JeanandJane (talk) 20:39, 18 August 2009 (UTC)
- I'm sorry, but you're the one arguing for ignopring Linde's retraction, reporting Boisssel's findings as positive, instead f ambiguous at best (and negative for the best-quality reviews), and generally improving everything one step above what its authors state it as. Shoemaker's Holiday Over 193 FCs served 20:42, 18 August 2009 (UTC)
- Regarding your disagreement on the interpretation of the above studies I concur with User Dbrisinda. I think we discussed that above.--JeanandJane (talk) 20:54, 18 August 2009 (UTC)
- When I read Boissel's conclusions the first thing that catches my eye is that he says "From the available evidence, it is likely that among the tested homeopathic treatments tested at least one shows an added effect relative to placebo." He goes on about how they can't say which drug, which dose and against which disease, and finally says not much more than that the review warrants more research, yet everyone who doesn't agree that this is a good source is fobbed off with something like "we discussed this". --Six words (talk) 21:57, 18 August 2009 (UTC)
- Regarding your disagreement on the interpretation of the above studies I concur with User Dbrisinda. I think we discussed that above.--JeanandJane (talk) 20:54, 18 August 2009 (UTC)
- I'm sorry, but you're the one arguing for ignopring Linde's retraction, reporting Boisssel's findings as positive, instead f ambiguous at best (and negative for the best-quality reviews), and generally improving everything one step above what its authors state it as. Shoemaker's Holiday Over 193 FCs served 20:42, 18 August 2009 (UTC)
- Firstly I m not attacking anyone. I pointed out that we should not make original research in order to proof or disprove a method by comparing different reviews to figure out what is the [[truth]; just to report what it was said.--JeanandJane (talk) 20:39, 18 August 2009 (UTC)
- In response to Enric Naval's original statement at the start of this subsection, yes, that's a good point. Which is why that sentence was changed to include the qualification "beyond the placebo effect" to more accurately reflect results in the field, and not over-state the case. Dbrisinda (talk) 23:18, 19 August 2009 (UTC)
Location of citations
The citations are intended to support the phrase "Supporters claim that studies published in reputable journals support the efficacy of homeopathy beyond the placebo effect;" and not after the "negative" qualifications that follow. Please stop moving these citations where they don't belong. Moving them to the end of the sentence clearly misleads the reader into believing that they support the second "negative" phrase in the sentence after the semi-colon, which they do not. Also rewording the second phrase, so that these citations appear after "however, they are not definitive," is also misleading since it makes the reader believe that these citations support this phrase, which is clearly not the intent. Dbrisinda (talk) 08:14, 20 August 2009 (UTC)
- They support both, hence they go after the text they support. Verbal chat 08:44, 20 August 2009 (UTC)
- Instead of moving the citations back and forth all the time, why don't we simply change the semicolon to a comma to indicate the citations cover both the positive outcomes of some studies and their qualifications?--Six words (talk) 10:06, 20 August 2009 (UTC)
- I think Dbrisinda is correct. But we can discuss other possibilities.--JeanandJane (talk) 12:27, 20 August 2009 (UTC)
- These qualifications are in the cited sources, so what reason - besides that they show the weaknesses of those positive results - do you have for putting them somewhere else? --Six words (talk) 12:57, 20 August 2009 (UTC)
- I think Dbrisinda is correct. But we can discuss other possibilities.--JeanandJane (talk) 12:27, 20 August 2009 (UTC)
- Instead of moving the citations back and forth all the time, why don't we simply change the semicolon to a comma to indicate the citations cover both the positive outcomes of some studies and their qualifications?--Six words (talk) 10:06, 20 August 2009 (UTC)
- Have moved the references behind both phrases the sources support (it makes no sense to put them behind only the first unless the point is to hide the fact that it also supports the second). I also reworded to remove the semi-colon and "however" to hopefully better illustrate it supports both phrases. I am beginning to think we should remove those 3 sources altogether as 1) the Lead already has too many citations and 2) the citations do not add that much information compared to the version before they were added (the text did not change at all, only citations added, and no one as far as I could tell disputed the first phrase to require additional citations to it).Yobol (talk) 13:13, 20 August 2009 (UTC)
- They clearly support the words "not definitive". One of them even explicitly says that the evidence is "not sufficient to draw definitive conclusions" in its abstract. Brunton (talk) 20:25, 20 August 2009 (UTC)
- Placing the citations after the statement "Supporters claim that studies published in reputable journals support the efficacy of homeopathy beyond the placebo effect;" is accurate because this is precisely what the citations are intended to support. However, placing them after this statement or something like it: "While supporters claim that studies published in reputable journals support the efficacy of homeopathy beyond the placebo effect, these studies are not definitive," substantially changes the emphasis of what these citations are intended to support. In this latter sentence, the emphasis is clearly placed on "these studies are not definitive," which is inaccurate and highly misleading. The first and main clause of the statement, "While supporters claim..." is relegated to the background, something of comparably lesser significance.
- In short, when using citations on complex sentence structure that has multiple clauses, one needs to incorporate the citations after the specific clause that it is primarily intended to support.
- Case in point: the first sentence of this paragraph says "Claims of homeopathy's efficacy beyond the placebo effect are unsupported by the collective weight of scientific and clinical evidence." The citations that are intended to support this sentence follow it. But what if we changed this sentence to read: "Claims of homeopathy's efficacy beyond the placebo effect are unsupported by the collective weight of scientific and clinical evidence, though some evidence does exist." Placing the citations after this multi-clause sentence now clearly changes the weight of the citations to support "though some evidence does exist." Which is clearly not the intent of the original citations and is highly misleading. Dbrisinda (talk) 20:47, 20 August 2009 (UTC)
- Obviously.--JeanandJane (talk) 23:09, 20 August 2009 (UTC)
- What would be "highly misleading" would be to refuse to cite a part of the article to "emphasize" another part of the article which does not conform to the intent of the sources cited. I find it problematic that you recognize that both parts of the sentence as currently cited are both properly supported by the sources, but you want to completely ignore citation of one part to place "emphasis" on another part, in contravention to WP:Undue. Yobol (talk) 22:02, 20 August 2009 (UTC)
- Case in point: the first sentence of this paragraph says "Claims of homeopathy's efficacy beyond the placebo effect are unsupported by the collective weight of scientific and clinical evidence." The citations that are intended to support this sentence follow it. But what if we changed this sentence to read: "Claims of homeopathy's efficacy beyond the placebo effect are unsupported by the collective weight of scientific and clinical evidence, though some evidence does exist." Placing the citations after this multi-clause sentence now clearly changes the weight of the citations to support "though some evidence does exist." Which is clearly not the intent of the original citations and is highly misleading. Dbrisinda (talk) 20:47, 20 August 2009 (UTC)
- Those studies we cite as supporting the efficacy conclude:
- [12] Kleijnen, 1991
- The evidence presented in this review would probably be sufficient for establishing homoeopathy as a regular treatment for certain indications. [...] In our opinion, additional evidence must consist of a few well performed controlled trials in humans with large numbers of participants under rigorous double blind conditions. The results of the trials published so far, and the large scale on which homoeopathy is brought into practice, makes such efforts legitimate.
- [13] Boissel, 2000
- From the available evidence, it is likely that among the tested homeopathic treatments tested at least one shows an added effect relative to placebo. [...] However, the strength of the evidence for this conclusion remains low because of the overall low quality of the trial designs and reporting and the limitations of the meta-analysis approach used.
- [14] Linde 1997
- Our study has no major implications for clinical practice because we found little evidence of effectiveness of any single homoeopathic approach on any single clinical condition. Our study does, however, have major implications for future research on homoeopathy. We believe that a serious effort to research homoeopathy is clearly warranted despite its implausibility.
- so basically the structure of their conclusions is the same as that of the sentence in our article. I don't see how keeping the structure of the sources' results is misleading. --Six words (talk) 22:32, 20 August 2009 (UTC)
- Agree. There is also no point in adding the words "though some evidence does exist" to the end of the first sentence - it is already implicit in the comment about "the collective weight of ... evidence". If it were to be included we would need a structure along the lines of "Claims of homeopathy's efficacy beyond the placebo effect are unsupported by the collective weight of scientific and clinical evidence; though some positive evidence does exist it is outweighed by negative and inconclusive evidence", otherwise it unnecessarily confuses the sentence. This would be unnecessary duplication in what is already a long lead. Brunton (talk) 07:41, 21 August 2009 (UTC)
- That is exactly why I offered that phrase appended to the existing first sentence. Not because I believe it should be included, but because it confuses the sentence, and the subsequent citations can be misread as supporting that phrase instead of the main sentence. It was an example of why this shouldn't be done. Your (correct) argument is the same argument I'm making for why placing the phrase "though not definitive" *before* the citations is problematic: it confuses the sentence and misleads the reader. Dbrisinda (talk) 09:24, 23 August 2009 (UTC)
- No, it doesn't, because that's what the sources say. Moving the citations to imply that they don't would be misleading. Brunton (talk) 10:10, 23 August 2009 (UTC)
- That is exactly why I offered that phrase appended to the existing first sentence. Not because I believe it should be included, but because it confuses the sentence, and the subsequent citations can be misread as supporting that phrase instead of the main sentence. It was an example of why this shouldn't be done. Your (correct) argument is the same argument I'm making for why placing the phrase "though not definitive" *before* the citations is problematic: it confuses the sentence and misleads the reader. Dbrisinda (talk) 09:24, 23 August 2009 (UTC)
- Agree. There is also no point in adding the words "though some evidence does exist" to the end of the first sentence - it is already implicit in the comment about "the collective weight of ... evidence". If it were to be included we would need a structure along the lines of "Claims of homeopathy's efficacy beyond the placebo effect are unsupported by the collective weight of scientific and clinical evidence; though some positive evidence does exist it is outweighed by negative and inconclusive evidence", otherwise it unnecessarily confuses the sentence. This would be unnecessary duplication in what is already a long lead. Brunton (talk) 07:41, 21 August 2009 (UTC)
- Actually, yes, it does because of the order of the clauses and position of citations. The citations need to occur beside the clause they are most intended to support. How about something like this as a modification of this sentence that both captures your desire to say that they are not definitive, and also the main clause of the sentence: "Though they are not definitive and have not been independently replicated, studies exist that show the positive results of homeoapthy beyond the placebo effect."[1][2][3] Dbrisinda (talk) 22:41, 24 August 2009 (UTC)
- That revision would not be acceptable for several reasons. 1) Since the weight of evidence is against the efficacy of homeopathy, it would fail WP:Undue to place the emphasis on the "positive" studies over the problems with the "positive" studies. 2) As the references do not all support the phrase "not indpendently replicated", you have said we cannot place those citations at the end of the sentence. If you will recall, this was your first objection to placing them at the end of the sentence, which led to start of this discussion. It would be helpful if you did not commit the same errors you purport others have done. 3) You left out the phrase "few in numbers", which has consensus to be in that sentence. Yobol (talk) 23:32, 24 August 2009 (UTC)
- Actually, yes, it does because of the order of the clauses and position of citations. The citations need to occur beside the clause they are most intended to support. How about something like this as a modification of this sentence that both captures your desire to say that they are not definitive, and also the main clause of the sentence: "Though they are not definitive and have not been independently replicated, studies exist that show the positive results of homeoapthy beyond the placebo effect."[1][2][3] Dbrisinda (talk) 22:41, 24 August 2009 (UTC)
- In response to your statements: 1) I don't believe this argument is relevant since the statement that is being supported with the citations is the only one we are talking about, and the underlying intent of this statement is to provide some contrast to the preceding negative statement by saying that there does exist evidence favourable to homeopathy. At present the statement fails WP:YESPOV. 2) True, they do not support the statement "not independently replicated" but this was an invitation for you or someone else to reword accordingly. One attempt at better wording gives:
- "Though they are not definitive, studies exist that show the positive results of homeoapthy beyond the placebo effect;[1][2][3] however, they are few in number and have not been independently replicated."[4]
- 3) I just placed that "few in number" in there to satisfy you; but this phrase has it's own problems being discussed in the thread "few" positive studies and so I won't repeat it here. Dbrisinda (talk) 03:50, 25 August 2009 (UTC)
WHO warns against homeopathy use
According to the BBC. Probably deserves looking at. Here is the source: WHO warns against homeopathy use. Verbal chat 06:31, 21 August 2009 (UTC)
- If we're going to include this in the article we really need something actually published by the WHO. The BBC story seems to be reporting a letter written by "Voice of Young Science Network" drawing attention to communications it has received from the WHO ("The group Voice of Young Science Network has written to health ministers to set out the WHO view"), rather than anything directly from the WHO itself. All it has is brief quotations from the director of the WHO's "Stop TB" department and an unnamed "spokesman for the WHO department of child and adolescent health and development". Including this as the WHO's position on the basis of the BBC story would be like including reports of the leaked draft report on homoeopathy that the WHO has apparently declined to adopt. Brunton (talk) 07:18, 21 August 2009 (UTC)
- Indeed, it would be good to find a WHO source. Hopefully it will come to light soon. Verbal chat 11:14, 21 August 2009 (UTC)
- I fully agree with Brunton. The BBC story seems to have been written quite carelessly; Wikipedia has higher standards than that. Notice how the headline promises much more than the article actually says: (1) It's not about homeopathy in general but about homeopathic treatment of specific serious diseases (TB, infant diarrhoea, influenza, malaria and HIV – I believe apart possibly from influenza it would already be illegal in Germany to treat them with homeopathy; at least exclusively, what seems implied here). (2) It's not a statement of the WHO that is being reported, it's a letter to the WHO. Hans Adler 11:57, 21 August 2009 (UTC)
- It's reporting the responses to an earlier letter to the WHO, but this letter appears to have been sent to (UK?) government ministers, and to include comments from WHO employees (but not necessarily statements of the WHO as a distinct entity). The comment about childhood diarrhoea from the dept. of child health etc. is perhaps interesting in the context of the papers by Jacobs et al. which have been cited here as some of the strongest evidence for homoeopathy, but there certainly doesn't appear to be anything here that indicates that any of this is an adopted WHO position. Brunton (talk) 12:38, 21 August 2009 (UTC)
- The letter itself, which has apparently been sent to "the health ministers of all countries", can be seen here. It includes quotations from five named individuals from various departments of the WHO, and a statement that "the office of Dr Margaret Chan, Director-General of WHO, stated on 14th August 2009 that these responses “clearly express the WHO’s position”." I still think we need something directly from the WHO rather than second-hand, though (and I'd like to see all of the quotations in context), but I have yet to find anything about this on the WHO website. Brunton (talk) 20:39, 21 August 2009 (UTC)
- I fully agree with Brunton. The BBC story seems to have been written quite carelessly; Wikipedia has higher standards than that. Notice how the headline promises much more than the article actually says: (1) It's not about homeopathy in general but about homeopathic treatment of specific serious diseases (TB, infant diarrhoea, influenza, malaria and HIV – I believe apart possibly from influenza it would already be illegal in Germany to treat them with homeopathy; at least exclusively, what seems implied here). (2) It's not a statement of the WHO that is being reported, it's a letter to the WHO. Hans Adler 11:57, 21 August 2009 (UTC)
- Indeed, it would be good to find a WHO source. Hopefully it will come to light soon. Verbal chat 11:14, 21 August 2009 (UTC)
References
Research on medical effectiveness
I was wondering if the current version which basically has a long listing of meta-analyses and results is the best format for this. Since I'm new to the article, it may be that this is the "consensus" established due to the contentious nature of the article, but it would seem that making general statements, such as "multiple studies meta-analyses have found higher quality studies show less positive results," "analyses have found significant problems with publication bias", etc. with multiple citations for each general statement would be more encyclopedic. Thoughts? Yobol (talk) 02:12, 20 August 2009 (UTC)
- That is what I was going to do with Boisse. --Enric Naval (talk) 03:51, 20 August 2009 (UTC)
- It's worth commenting on a few studies that have hasd significant dispute - mainly the retraction of Linde 97 and the particular praise given to Shang by the Lancet (with weaker weight given to the fringe "rebuttals" of Shang). +But on the whole, I agree that this should summarise more, if we can do so with minimal synthesis. Shoemaker's Holiday Over 197 FCs served 22:14, 20 August 2009 (UTC)
- Every time you refer to the qualification of Linde 97 someone has to remind you that Linde himself criticized Shang 2005 review in the lancet: ."Given these limitations, Shang and colleagues' conclusion that their findings “provide support to the notion that the clinical effects of homoeopathy are placebo effects” is a significant overstatement." Just to keep ourselves constantly aware of the controversies regarding Homeopathy' efficacy which have nothing to do with fringe "rebuttals".--JeanandJane (talk) 22:49, 20 August 2009 (UTC)
- There have been no significant criticisms of Shang that haven't been addressed. Verbal chat 06:35, 21 August 2009 (UTC)
- Of course they haven't been any significant critisisms. They tend to disappear when we pretend they dont exist. That's really magic! Like Linde and w letter to the Lancet; It does not really exist :)--JeanandJane (talk) 17:19, 21 August 2009 (UTC)
- Strike one. — NRen2k5(TALK), 07:51, 25 August 2009 (UTC)
- Of course they haven't been any significant critisisms. They tend to disappear when we pretend they dont exist. That's really magic! Like Linde and w letter to the Lancet; It does not really exist :)--JeanandJane (talk) 17:19, 21 August 2009 (UTC)
- There have been no significant criticisms of Shang that haven't been addressed. Verbal chat 06:35, 21 August 2009 (UTC)
- Every time you refer to the qualification of Linde 97 someone has to remind you that Linde himself criticized Shang 2005 review in the lancet: ."Given these limitations, Shang and colleagues' conclusion that their findings “provide support to the notion that the clinical effects of homoeopathy are placebo effects” is a significant overstatement." Just to keep ourselves constantly aware of the controversies regarding Homeopathy' efficacy which have nothing to do with fringe "rebuttals".--JeanandJane (talk) 22:49, 20 August 2009 (UTC)
- It's worth commenting on a few studies that have hasd significant dispute - mainly the retraction of Linde 97 and the particular praise given to Shang by the Lancet (with weaker weight given to the fringe "rebuttals" of Shang). +But on the whole, I agree that this should summarise more, if we can do so with minimal synthesis. Shoemaker's Holiday Over 197 FCs served 22:14, 20 August 2009 (UTC)
Question regarding wording of Q/A7 in FAQ
Hi, I find the wording of Q7 and A7 a bit odd. The short answer seems to say that proof of homeopathy working is simply not allowed, which seems odd for any article. The long answer then goes on to state that only reliable sources should be cited and these should be referred in the talk section for approval. It also states in the long answer that "no such proof has come from reliable sources". One would assume that real proof presupposes that it comes from a reliable source. The answers starts off talking about "alleged proof" which is different to what the question uses, "proof". I'd like to suggest this alternative wording that I think is clearer:
Q7: Can any proof that homeopathy works be included in the article? (No.)
A7: No. Unsupported evidence from unreliable sources that homeopathy works should not be considered proof and should not be included in the article. If you have found a reliable source, such as an academic study, that you think should be included, you can propose it for inclusion on the article’s talk page. Note that we do not have room for all material, both positive and negative. We try to sample some of each and report them according to their prominence. Note also that it is not the job of Wikipedia to convince those people who do not believe homeopathy works, nor to dissuade those who believe that it does work, but to accurately describe the current beliefs and evidence.
Thoughts? --Rentrustic (talk) 16:14, 21 August 2009 (UTC)
- Now that you're saying that I see it, too. I like the wording you suggest. --Six words (talk) 17:29, 21 August 2009 (UTC)
- Agree on the answer. Perhaps the word "proof" in the question should be changed to "evidence"? Possibly starting "must all evidence..."? Brunton (talk) 19:58, 21 August 2009 (UTC)
- Agree that answer is an improvement over previous. "Must all evidence" is also an improvement; while "proof" can carry a (justifiably) bad connotation amongst those in the scientific community which works well with this question, such a nuanced use would likely be lost on anyone who would actually need to read the FAQ. Yobol (talk) 20:07, 21 August 2009 (UTC)
- Agree on the answer. Perhaps the word "proof" in the question should be changed to "evidence"? Possibly starting "must all evidence..."? Brunton (talk) 19:58, 21 August 2009 (UTC)
“Evidence” is much more appropriate than “proof”. Outside of Mathematics, you’ll very seldom see the word “proof”. It’s just too absolute. — NRen2k5(TALK), 18:59, 23 August 2009 (UTC)
- I'm not sure. How about "Must all evidence in favour of homeopathy...." - I think that "Must all evidence that homeopathy works..." is likely to result in someone starting up a battle over how the faq admits evidence exists that homeopathy works, and yet we say we refuse to include this interesting proof, etc. Shoemaker's Holiday Over 201 FCs served 13:18, 29 August 2009 (UTC)
- How about "any and all evidence"? Brunton (talk) 19:09, 29 August 2009 (UTC)
- "Mustn't this evidence I found that proves homeopathy works be put in the article?" That's what most of the problematic debates seem to boil down to. Shoemaker's Holiday Over 202 FCs served 18:12, 30 August 2009 (UTC)
- How about "any and all evidence"? Brunton (talk) 19:09, 29 August 2009 (UTC)
"few" positive studies
Sorry to add to the noise here, but I would like to note that I support Verbal's edit [3] restoring the word "few". After that edit, I noticed that this reference (following the first sentence with "few") says "but there is only a handful of these reports, and they are far from definitive", which supports use of the word "few". ☺Coppertwig (talk) 16:05, 16 August 2009 (UTC)
- Is a journalist's opinion such a reliable source compared to the peer reviews in medical journals to support this statement? More than the Lancet News and Notes which is excluded (no consensus for this but it is still excluded)--JeanandJane (talk) 16:15, 16 August 2009 (UTC)
- Could you give a link to the information? Is it in the talk archives? ☺Coppertwig (talk) 16:30, 16 August 2009 (UTC)
- (Keep in mind that I don't say that this statement is inaccurate.) But this should be supported by a proper source. New and notes is about influenza treatment I think - not only about the sentence with the few positive studies - I will look it up. I think it was suggested by Ullman but it was argued that it was too old, not peer reviewed too.. compared to a medical review. I think Brunton found it. Look above just before Ullmans ban.--JeanandJane (talk) 16:39, 16 August 2009 (UTC)
- Sorry, I would a more precise specification as to where the information is; I'm not even sure which thread you mean, let alone which comment within the thread. If you quote a unique phrase in a comment on the page I can easily find it. Anyway, I think Brunton has replied adequately (see subsection below): "If we can find a peer-reviewed study with a specific statement relating to the matter that the Time article is used to support, that would probably be a better source, but I think Time counts as RS." ☺Coppertwig (talk) 22:52, 16 August 2009 (UTC)
- Is a journalist's opinion such a reliable source compared to the peer reviews in medical journals to support this statement? More than the Lancet News and Notes which is excluded (no consensus for this but it is still excluded)--JeanandJane (talk) 16:15, 16 August 2009 (UTC)
- This edit is problematic for the reason that few implies what? Four or five? Ten? And the facts are, there are well over 78 published studies (as of 2008) that show various degrees of positive effects for homeopathy over and above placebo. Actually, they are not few. But what they *are* is lacking definitiveness, and usually (though not always) lacking in replicability. Dbrisinda (talk) 04:42, 17 August 2009 (UTC)
- Lets edit out "they are few" then. I agree.--JeanandJane (talk) 20:13, 17 August 2009 (UTC)
- We have a reliable source for the inclusion of the statement "few" as in "handful". As to the list you provide, it is a list of "positive" results that number 78 from diseases that range from hay fever to brain injury to ankle sprain to dry mouth to HIV(!). In other words, if I am supposed to be impressed by 78 studies spanning the entire spectrum of medicine from orthopedics to neurosurgery to allergy and only 78 results in the entire history of the field is positive, then yes, that is what I would consider "few". If you find a independent WP:RS that does not consider the body of evidence "few", then we can revisit the issue, but let's follow what the available reliable source says for now and not use WP:OR to suggest that the 78 articles you list is not "few". Yobol (talk) 20:43, 17 August 2009 (UTC)
- Lets edit out "they are few" then. I agree.--JeanandJane (talk) 20:13, 17 August 2009 (UTC)
- Which is the reference that states "few"? The source I offered above wasn't an attempt to impress, but only to show what's available. But remember, we are not comparing the 78 results that are favorable to homeopathy to the enormous body of literature in the entire history of the field of medicine. If we were, you would be absolutely correct, as it is a question of ratios. Rather, we are comparing against only the entire literature base within the field of homeopathy and the research that has been performed that shows "positive" results, "negative" results, and "inconclusive" results. The total available literature base in this area seems to constitute perhaps a couple hundred peer-reviewed publications. In this context, 78 is quite substantial, and to call it few does not seem accurate. Dbrisinda (talk) 22:35, 17 August 2009 (UTC)
- The reference is in the first comment by Coppertwig. Last paragraph, page 2 of the article. "Handful" of reports, i.e. few. Whether you agree that 78 references are "few" or not is besides the point. A reliable source has said they are small in number, i.e. a "handful", i.e. few. Please provide an independent, reliable source that disputes this if you want. I find your arguments otherwise unconvincing, and certainly not enough to contradict a WP:RS. Yobol (talk) 22:52, 17 August 2009 (UTC)
- The reliable source is the Time magazine or a medical review? The journals which have published the above studies are not considered reliable sources? --JeanandJane (talk) 23:00, 17 August 2009 (UTC)
- The reliable source is Time. It is, as far as I can tell, the only one to relatively quantify the weight of the 'positive' reports on homeopathy. The other source above may or not be reliable, but it does NOT relatively quantify the weight of the 'positive' reports on homeopathy. Yobol (talk) 23:44, 17 August 2009 (UTC)
- Which is the reference that states "few"? The source I offered above wasn't an attempt to impress, but only to show what's available. But remember, we are not comparing the 78 results that are favorable to homeopathy to the enormous body of literature in the entire history of the field of medicine. If we were, you would be absolutely correct, as it is a question of ratios. Rather, we are comparing against only the entire literature base within the field of homeopathy and the research that has been performed that shows "positive" results, "negative" results, and "inconclusive" results. The total available literature base in this area seems to constitute perhaps a couple hundred peer-reviewed publications. In this context, 78 is quite substantial, and to call it few does not seem accurate. Dbrisinda (talk) 22:35, 17 August 2009 (UTC)
- That article was published in 1995 (14 years old). A lot of work has been done in the years since. The statement "only a handful" was applied to the current state of the literature pre-1995 (as of 1994). When we are dealing with time-sensitive statements, we need to take this into consideration. For example, examining the list of studies published in the source I provided above, 14 out of the 78 were published prior to 1994. Therefore, at the time, "only a handful" may have been accurate, but it is no longer accurate today. Dbrisinda (talk) 23:25, 17 August 2009 (UTC)
- There is no evidence that it is inaccurate today. Things may have changed, though I see no evidence that this is the case. Again, I find your arguments not very persuasive. Again, if you want, you may provide your own independent WP:RS if you disagree with the article as cited.Yobol (talk) 23:46, 17 August 2009 (UTC)
- That article was published in 1995 (14 years old). A lot of work has been done in the years since. The statement "only a handful" was applied to the current state of the literature pre-1995 (as of 1994). When we are dealing with time-sensitive statements, we need to take this into consideration. For example, examining the list of studies published in the source I provided above, 14 out of the 78 were published prior to 1994. Therefore, at the time, "only a handful" may have been accurate, but it is no longer accurate today. Dbrisinda (talk) 23:25, 17 August 2009 (UTC)
- What do you mean there is no evidence that it is inaccurate today? 64 additional clincial trials/studies were performed since then that showed results favourable to homeopathy beyond the placebo effect. And another 100 or so inconclusive or negative. The very existence of these additional clinical trials and studies *is* the evidence. If you like, I can enter the 78 additional citations for this sentence, but it's simpler to provide a single reference to a list of them instead. Can someone else please enter the discussion here? Dbrisinda (talk) 00:16, 18 August 2009 (UTC)
- Taken from a different vantagepoint, you point out that 64 of the 78 articles were published since 1994. Thus, in 16 years, 64 articles were published, or 1 every 3 months. If that's not the definition of "few", I don't know what is.Yobol (talk) 23:51, 17 August 2009 (UTC)
- I don't see how that's pertinent. We are not talking about publishing frequency as compared to another field of medicine. This is specific to the area of clinical trials and studies within the field of homeopathy. "Few" is used as a comparison against the number of clinical trials and studies within the field of homeopathy that show inconclusive or negative results. Dbrisinda (talk) 00:16, 18 August 2009 (UTC)
- And since you and I disagree with how we should define 'few', which I find remarkably amusing, that's besides the point. It doesn't matter that I think 1 study in 3 months is quite obviously "few". What matters is that the current version of the article has reliable source which characterizes it as small in number, and you are arguing without any such sources. This is the 4th time I offer you to come up with an independent source if you disagree with the current version. Until you actually come up with a WP:RS that supports your position, everything that is being argued is nothing more than WP:OR and therefore not constructive to discuss further. I'll be waiting for said sources. Cheers. Yobol (talk) 00:31, 18 August 2009 (UTC)
- I don't see how that's pertinent. We are not talking about publishing frequency as compared to another field of medicine. This is specific to the area of clinical trials and studies within the field of homeopathy. "Few" is used as a comparison against the number of clinical trials and studies within the field of homeopathy that show inconclusive or negative results. Dbrisinda (talk) 00:16, 18 August 2009 (UTC)
- See below. Dbrisinda (talk) 02:27, 18 August 2009 (UTC)
- Ok since we disagree on the definition of few. You say that the number 64 means a few; we can add to the sentence the actual number in parenthesis.
- Supporters claim that studies published in reputable journals support the efficacy of homeopathy beyond the placebo effect; however, they are few ( only 64 were published in the last 16 years), not definitive, and have not been independently replicated
- I think this is good solution. Dbrisinda ?--JeanandJane (talk) 00:22, 18 August 2009 (UTC)
- Very clearly a violation of WP:Synth. Yobol (talk) 00:31, 18 August 2009 (UTC)
- Yobol;this is not a serious argument. User Dbrisinda said that that the existence of these additional clinical trials and studies *is* the actual evidence. This is obvious. Furthermore you have the option to agree to my version : to report the actual number of the studies. If you don't agree even to that - I don't think anyone even among the skeptics will take this seriously. --JeanandJane (talk) 00:38, 18 August 2009 (UTC)
- I disagree with him, and your interpretation of Wikipedia guidelines. Your suggestion is a very clear violation of WP:Synth. Please review the guidelines. Yobol (talk) 00:46, 18 August 2009 (UTC)
- Wait a minute. I'm confused. Who just said what right above? Is there a missing signature? Dbrisinda (talk) 00:51, 18 August 2009 (UTC)
- Hi Dbrisinda. I think that if there is no other objection ( a serious one I mean ) we could go ahead and make the change.--JeanandJane (talk) 01:32, 18 August 2009 (UTC)
- Wait a minute. I'm confused. Who just said what right above? Is there a missing signature? Dbrisinda (talk) 00:51, 18 August 2009 (UTC)
- I disagree with him, and your interpretation of Wikipedia guidelines. Your suggestion is a very clear violation of WP:Synth. Please review the guidelines. Yobol (talk) 00:46, 18 August 2009 (UTC)
- Yobol;this is not a serious argument. User Dbrisinda said that that the existence of these additional clinical trials and studies *is* the actual evidence. This is obvious. Furthermore you have the option to agree to my version : to report the actual number of the studies. If you don't agree even to that - I don't think anyone even among the skeptics will take this seriously. --JeanandJane (talk) 00:38, 18 August 2009 (UTC)
- Very clearly a violation of WP:Synth. Yobol (talk) 00:31, 18 August 2009 (UTC)
- I think this is good solution. Dbrisinda ?--JeanandJane (talk) 00:22, 18 August 2009 (UTC)
- I don't think stating the number by itself is useful, unless the total number is also stated. Otherwise there is no context. I.e., 78 is few in relation to what? 10,000? Yes. 200? No. Also, stating any qualifications that requires so many more words in an attempt to try to justify the presence of one word "few" suggests, in my view, that something is wrong with the original word. In any case, the resulting text becomes extremely cumbersome. It's simper to just remove the word few since it is no longer supported by the evidence today. This word has it's roots in a 1995 article in Time, which accurately described the research of the day. This is a time-sensitive issue that was accurate as of 1994/5 as per WP:DATED. The reputable secondary reference I would supply is that of the British Homeopathic Association, a well-established organization, which collected the studies performed over the years and shows all the studies favourable to homeopathy as of 2008. Dbrisinda (talk) 02:27, 18 August 2009 (UTC)
- You are right. There is not a real problem with the removal of the word few given the above information. What you are saying is self evident - my suggestion had a rhetorical character to show the amusing aspect of the "issue". --JeanandJane (talk) 02:57, 18 August 2009 (UTC)
- My apologies, I didn't realize you were being rhetorical. Anyway, there are also additional sources for this by Mathie & Fisher (2007) in the British Journal of Clinical Pharmacology,[1] and of course Mathie (2003) in Homeopathy.[2] Dbrisinda (talk) 04:52, 18 August 2009 (UTC)
- Referring to a cherry-picked list of "positive" studies, which as far as can be determined pays no attention to study quality (and was produced by an organisation that, according to its own website, "exists to promote homeopathy") risks giving a highly misleading impression. Some of their list (the studies relating to hay fever) is discussed here, under the heading "What does the BHA have to say?" - NB: just to avoid any further confusion, I'm not suggesting that we use this as a reference in the article, I'm merely using it on the talk page to point out shortcomings in the BHA's approach. Brunton (talk) 09:39, 18 August 2009 (UTC)
- You've taken that quote out of context. What it said was "... exists to promote homeopathy practised by doctors and other healthcare professionals." And the anti-homeopathic perspective is not misleading? Really. One serves to balance the other. Anyway, that's not the point. Of course that site will tend to focus on the positive aspects of the evidence. Just as Ernst, Shang, Quackwatch, and whoever else will tend to focus on the negative aspects of the evidence. That list is not a systematic review, it's simply a list of peer-reviewed publications in the field, that have reported results that are favorable to homeopathy. To exclude it is equivalent to excluding the original works. As I said, we could just have 78 citations but that would be unwieldy.
- I don't think I'm being biased here. If a similar compilation exists showing all studies that are unfavorable and/or inconclusive, that can be sourced from a reasonable secondary source, for example, Shang and Ernst's professional and well-respected anti-homeopathy foundation, then by all means use it. We need to show that the statement "they are few" is not accurate. The *real* issue here (if we could all just manage to keep our eyes on the ball for a moment) is that the Time article posits a time-sensitive statement that is no longer valid as per WP:DATED. This lists clearly shows that. And so does the letter published in the British Journal of Clinical Pharmacology (above) by Fisher & Mathie, and also Mathie (2003). I know you don't like it, there are also many many things that I don't like, but we need to move past our personal feelings for a lot of these things if we want an article that is going to be taken seriously by both sides. Dbrisinda (talk) 07:45, 19 August 2009 (UTC)
- The letter from Fisher and Mathie says "the volume of peer-reviewed clinical trial research in homeopathy is minuscule compared with that in orthodox medicine". The position the letter attempts to refute is that there is no convincing positive clinical trial evidence, not that there are few positive trials, which it appears to concede. It's hard to see how this supports your position. Mathie 2003 actually concedes that it fails to take into account a known issue with potential to affect the results of trials (and if the volume of research was "miniscule" in 2007 when he wrote the letter with Fisher, presumably it can have been no greater four years earlier). As for the BHA and how out of context my quotation was, it's hard to see how they could promote homoeopathy practised by healthcare professionals without promoting homoeopathy itself (unless, of course, they were to campaign against the practice of homoeopathy by the many lay homoeopaths in the UK, or perhaps against the sale of OTC homoeopathic nostrums, which they don't appear to do). And regardless of this, it's still cherry-picked. Brunton (talk) 09:33, 19 August 2009 (UTC)
- Au contraire! And I might add, you are at serious risk of misrepresenting this statement by taking what was said very much out of context. Here is the quotation of the paragraph from which you drew that phrase:
- The letter from Fisher and Mathie says "the volume of peer-reviewed clinical trial research in homeopathy is minuscule compared with that in orthodox medicine". The position the letter attempts to refute is that there is no convincing positive clinical trial evidence, not that there are few positive trials, which it appears to concede. It's hard to see how this supports your position. Mathie 2003 actually concedes that it fails to take into account a known issue with potential to affect the results of trials (and if the volume of research was "miniscule" in 2007 when he wrote the letter with Fisher, presumably it can have been no greater four years earlier). As for the BHA and how out of context my quotation was, it's hard to see how they could promote homoeopathy practised by healthcare professionals without promoting homoeopathy itself (unless, of course, they were to campaign against the practice of homoeopathy by the many lay homoeopaths in the UK, or perhaps against the sale of OTC homoeopathic nostrums, which they don't appear to do). And regardless of this, it's still cherry-picked. Brunton (talk) 09:33, 19 August 2009 (UTC)
- With barely 100 full-length articles, the volume of peer-reviewed clinical trial research in homeopathy is minuscule compared with that in orthodox medicine. Since homeopathic medicines cannot be patented, homeopathy attracts very little research funding, and so this imbalance may never be redressed. However, statistically significant and positive data have been reported in about half of those published trials.[2] Much of the other half has been inconclusive. Few studies have been frankly negative (homeopathy less effective than control).
- It is understandable that homeopathy can seem 'unscientific' in its mode of action – and much more scientific investigation needs to be done in this field – but good research does exist to support its clinical effectiveness.
- The quote which is the main point of this paragraph "... and positive data have been reported in about half of those published trials ..." clearly is in support of my position. While the word "few" may have been accurate in 1994, it is no longer accurate today and really needs to be removed as per WP:DATED. Regarding the BHA, "homeopathy practiced by healthcare professionals" implies some kind of regulated process where the general public can have a degree of confidence amidst many purported homeopaths, some of which are qualified with training, education and certification, in contrast to many others who are not. Also, the list is not "cherry-picked" as what I'm saying is that use of the word "few" is not accurate, and evidence does exist to support the efficacy of homeopathy beyond placebo. It's no more "cherry-picked" than selection of Shang, or Ernst, or whomever else to support contentions that homeopathy is no better than placebo. By that criteria, *everything* is "cherry-picked." Dbrisinda (talk) 22:47, 19 August 2009 (UTC)
- Agree with Brunton, this source, if anything, confirms the correct usage of the word "few".Yobol (talk) 04:35, 20 August 2009 (UTC)
- ??? You can't be serious? Please say you're not serious. Dbrisinda (talk) 07:26, 20 August 2009 (UTC)
- Agree with Brunton, this source, if anything, confirms the correct usage of the word "few".Yobol (talk) 04:35, 20 August 2009 (UTC)
- The quote which is the main point of this paragraph "... and positive data have been reported in about half of those published trials ..." clearly is in support of my position. While the word "few" may have been accurate in 1994, it is no longer accurate today and really needs to be removed as per WP:DATED. Regarding the BHA, "homeopathy practiced by healthcare professionals" implies some kind of regulated process where the general public can have a degree of confidence amidst many purported homeopaths, some of which are qualified with training, education and certification, in contrast to many others who are not. Also, the list is not "cherry-picked" as what I'm saying is that use of the word "few" is not accurate, and evidence does exist to support the efficacy of homeopathy beyond placebo. It's no more "cherry-picked" than selection of Shang, or Ernst, or whomever else to support contentions that homeopathy is no better than placebo. By that criteria, *everything* is "cherry-picked." Dbrisinda (talk) 22:47, 19 August 2009 (UTC)
[<-undent] Dbrisinda, I'm not saying that choosing the BHA list is cherry-picking, I'm saying that the list itself is cherry-picked, because it excludes trials that don't show positive results (and that is an entirely different position to studies that include all the evidence, or include/exclude trials on the basis of prestated study quality criteria regardless of their results). The BHA/FoH doesn't really seem to concern itself with regulation - as members of regulated healthcare professions, the practitioners it is concerned with are already regulated by statutory bodies. I see no evidence whatsoever that they are opposed to non medically qualified homoeopaths - indeed, I notice that they promoted "homeopathy awareness week" alongside the non-medically qualified homoeopaths of the Society of Homoeopaths.
As for "few in number", you quote the letter saying that half of the trials are positive, but that does not increase the amount of research - halving a minuscule number is in fact going to make it even smaller (the "Law of Infinitesimals" doesn't apply to arithmetic). You seem to be confusing the small number of trials with the proportion of them that is allegedly positive. Would you prefer to use the word "minuscule" instead of "few" to reflect the wording of your source? Personally I prefer "few" as it is plainer English. Brunton (talk) 07:31, 20 August 2009 (UTC)
Incidentally, do you have any evidence that the information is "dated"? You have cited a source from 2007 saying that the volume of research is "minuscule", and there doesn't appear to have been a major increase in the number of trials since then (the BHA found only 4 new RCTs published in 2008, for example). Brunton (talk) 07:43, 20 August 2009 (UTC)
- Regarding your main arguments, I understand your concern. The whole point of my insisting on this list is simply to bring attention to the fact that much more than a "few" studies show evidence in favour of homeopathy as compared to the total body of clinical studies in the field of homeopathy: a little less than half. Any other comparison is just not meaningful: comparison to the total amount of medical research, comparison to the total amount of scientific research, or comparison to the total number of molecules in the universe. These are all irrelevant comparisons given the context of this statement. "Few" must be in relation to the total number of trials relating to homeopathy. I don't understand why this is so difficult to accept.
- I'm prepared to concede insisting on the use of this BHA list as a citation, if you would concede removal of the word or phrase "few" in the qualifying phrase as well as returning Mathias (2003) to this citation list, as per WP:RS. The main reason for removing this phrase is because it is no longer supported today as so much more work has been done after the Time (1995) article. The BHA list shows that 78 clinical studies have been performed which show results favourable to homeopathy as of 2008. A search on the Cochrane Central Register of Controlled Trials, turns up 231 total trials related to homeopathy (title, keywords, and abstract). An identical search up to 1994 turns up 61 trials in the field of homeopathy. Therefore, as of the date of writing of the Time article, 61 trials were available; today, 231 clinical trials are available—a 279% increase. And 78 trials is in no ways few in comparison to 231. (Incidentally, there is also a very strong likelihood that some of the more obscure trials that are also favourable to homeopathy have been missed by this BHA list, since Fisher and Mathias state in their letter published in the European Journal of Clinical Pharmacology (2007) that "about half" are favourable to homeopathy. In either case, it is still well well well beyond "few").
- But perhaps I should be insisting that this reference (Time 1995) should be removed altogether and replaced with one that more accurately reflects the state of the art, since it is a (no longer accurate as shown above) time-sensitive statement that's being cited. Although I have done so, I don't understand why the burden of proof rests on me to show that this Time (1995) citation supporting the phrase "few" is no longer valid, when really, the burden of proof should be upon you to show that it is as per WP:RS and WP:DATED. Dbrisinda (talk) 23:28, 20 August 2009 (UTC)
- I find your arguments unconvincing, and your strained definition of "few" (i.e. not the straight-forward meaning everyone else uses -"small in number"- but as something else -"small in proportion when compared to another arbitrary set"-) particularly unhelpful. I do not think the Time article is dated (you have provided no convincing evidence that it is dated) and I have asked you to provide another WP:RS to back your position, and the only other source you have provided (which probably doesn't mean WP:RS anyways for this discussion), in my mind, bolsters the argument for the use of the word "few". Yobol (talk) 23:41, 20 August 2009 (UTC)
- It is published in 1995. Meanwhile more studies on Homeopathy have been published as Dbrisinda told you. What do you need more ? --JeanandJane (talk) 00:07, 21 August 2009 (UTC)
- A reliable source showing more than a "few" positive studies published on homeopathy. I've been waiting for a while. Yobol (talk) 00:12, 21 August 2009 (UTC)
- The source is cited now is dated. 1995. Since data has changed it should be removed. Fisher and Mathias's letter published in the European Journal of Clinical Pharmacology (2007) "about half" are favourable to homeopathy and the studies themselves in journals referred are not enough?--JeanandJane (talk) 00:50, 21 August 2009 (UTC)
- No, it's not enough. Half of a very small number is still a very small number. Yobol (talk) 01:05, 21 August 2009 (UTC)
- Arbitrary? Good grief. Noise. Dbrisinda (talk) 00:02, 21 August 2009 (UTC)
- It is published in 1995. Meanwhile more studies on Homeopathy have been published as Dbrisinda told you. What do you need more ? --JeanandJane (talk) 00:07, 21 August 2009 (UTC)
- I find your arguments unconvincing, and your strained definition of "few" (i.e. not the straight-forward meaning everyone else uses -"small in number"- but as something else -"small in proportion when compared to another arbitrary set"-) particularly unhelpful. I do not think the Time article is dated (you have provided no convincing evidence that it is dated) and I have asked you to provide another WP:RS to back your position, and the only other source you have provided (which probably doesn't mean WP:RS anyways for this discussion), in my mind, bolsters the argument for the use of the word "few". Yobol (talk) 23:41, 20 August 2009 (UTC)
Removed by 2over0 Dbrisinda (talk) 09:37, 21 August 2009 (UTC) In accordance with the Talk page guidelines, I have removed the above off-topic text and warned the user. - 2/0 (cont.) 16:58, 23 August 2009 (UTC)
- You have yourself provided a source, in the form of a 2007 letter saying that the volume of research is "minuscule", showing that the word "few" is still valid. By the way, this kind of "translation" of other editors' comments is not really helpful. Brunton (talk) 10:18, 21 August 2009 (UTC)
- I thought it was fun. You just did not hear ( again) that "Few" is used in the above source as comparative. In the article you just use "few" to make it look less significant which is supportet by a dated source from 1995 ? Hmmm.. --JeanandJane (talk) 17:33, 21 August 2009 (UTC)
- The wording that Dbrisinda claims supports the contention that the number of studies is not "few" is also comparative, as it is talking about the proportion of the already small number of trials that show positive results. Half of a small number is still a small number. Brunton (talk) 20:06, 21 August 2009 (UTC)
- I thought it was fun. You just did not hear ( again) that "Few" is used in the above source as comparative. In the article you just use "few" to make it look less significant which is supportet by a dated source from 1995 ? Hmmm.. --JeanandJane (talk) 17:33, 21 August 2009 (UTC)
- Yes, me, myself, and I have provided an WP:RS source which once again states:
- With barely 100 full-length articles, the volume of peer-reviewed clinical trial research in homeopathy is minuscule COMPARED WITH that in orthodox medicine. Since homeopathic medicines cannot be patented, homeopathy attracts very little research funding, and so this imbalance may never be redressed. However, statistically significant and positive data have been reported in about half of those published trials.[24] Much of the other half has been inconclusive. Few studies have been frankly negative (homeopathy less effective than control).
- My source uses the words "compared with" explicitly in the first sentence. And the underlying intent of this sentence and the following sentence is to show that there hasn't been a lot of research in the field of homeopathy when compared with other fields in medicine. And the reason this is stated is to show why little research funding exists in homeopathy. That is all.
- You have taken his use of the word "miniscule" to justify your use of the word "few" but he is *not* using it to say what you are trying to say. The way you are using the word, you are trying to say that "few total studies favourable to homeopathy exist." Yes, so? Why don't you also say "few total studies unfavourable or inconclusive to homeopathy exist"? Both of these statements are irrelevant. When people read the existing statement in the article, they will invariably naturally assume that you are using "few" to mean a relative amount when compared to the total number of homeopathic studies performed. And that's *not* how you are intending it, and so it is egregiously misleading.
- He then goes on to say that, even though the total number of publications is small (positive, negative, and inconclusive) half of them show data favourable to homeopathy. Brunton says: "Half of a small number is still a small number." Yes, so? Again, how is that relevant? If 10,000 trials are performed, half of those being in favour of homeopathy, represents, uhh, 50%. If 200 trials are performed, half of those being in favour of homeopathy represents, umm 50%. In either case, 50% of the total number of studies being measured against is statistically significant. Dbrisinda (talk) 04:09, 23 August 2009 (UTC)
- The article does not say that the positive studies are few compared to the non-positive ones. It just says that they are few. Your source says that the volume of research is minuscule. A proportion of a minuscule number is inevitably going to be a minuscule number. Brunton (talk) 08:31, 23 August 2009 (UTC)
- He then goes on to say that, even though the total number of publications is small (positive, negative, and inconclusive) half of them show data favourable to homeopathy. Brunton says: "Half of a small number is still a small number." Yes, so? Again, how is that relevant? If 10,000 trials are performed, half of those being in favour of homeopathy, represents, uhh, 50%. If 200 trials are performed, half of those being in favour of homeopathy represents, umm 50%. In either case, 50% of the total number of studies being measured against is statistically significant. Dbrisinda (talk) 04:09, 23 August 2009 (UTC)
- Correct, the article does not say that they are few compared to the non-positive ones, but the way it is being used in context, that is precisely what is implied. Especially considering that it's not mentioned anywhere in the same phrase or sentence that the non-positive ones are also few. This is exactly why it's misleading. Dbrisinda (talk) 09:11, 23 August 2009 (UTC)
- That's the way you're interpreting the article, perhaps, but that isn't what it says. Brunton (talk) 10:14, 23 August 2009 (UTC)
- This is not a question of interpretation. There is nothing to interpret. This is a question of correct use of language. Let me illustrate this with an example. Take a new drug (Cureallitol) that is tested in 10 independent clinical trials. Suppose the results of those trials show mixed results: 50% say it's effective beyond placebo, and 50% say it's ineffective beyond placebo. Some facts:
- That's the way you're interpreting the article, perhaps, but that isn't what it says. Brunton (talk) 10:14, 23 August 2009 (UTC)
- Correct, the article does not say that they are few compared to the non-positive ones, but the way it is being used in context, that is precisely what is implied. Especially considering that it's not mentioned anywhere in the same phrase or sentence that the non-positive ones are also few. This is exactly why it's misleading. Dbrisinda (talk) 09:11, 23 August 2009 (UTC)
- 1) the number of total studies performed are few in number (10)
- 2) the number of positive studies are few in number (5)
- 3) the number of negative studies are few in number (5)
- 4) 50% show positive results
- 5) 50% show negative results
- Now, suppose detractors of this new drug go on to say that "Pharma & Co. claim that clinical studies exist that support the efficacy of Cureallitol beyond the placebo effect, however they are few in number."
- What does this statement suggest? It *suggests* that the evidence that supports the efficacy of the drug is a small proportion of all the studies performed, and so the combined weight of evidence must indicate that the drug is not effective. But this is false! The statement "however they are few in number" is entirely misleading the reader, because it fails to indicate that the number of negative/inconclusive results are also few in number, and in this case actually equal!
- There are only 2 ways of getting around this: 1) Modify the statement "however they are few in number" so that it somehow says that the sum total of all the positive, negative, and inconclusive results are few in number; OR 2) Remove the phrase altogether. Dbrisinda (talk) 22:31, 24 August 2009 (UTC)
- Let's take your analogy a step further. If, hypothetically speaking, only two good trials on homeopathy were conducted, one showing positive results, and the other not. Is it your argument that since 50% of the (two total) trials show positive results, we are not allowed to use the word "few" to describe them, as is described in a reliable source? Yobol (talk) 23:35, 24 August 2009 (UTC)
- In your hypothetical example, I would advise extreme caution for drawing *any* conclusions from only 2 studies, as there is just not enough data available. And I would certainly not attach the word "few" to one side of such results (positive or negative). In truth, I would explicitly state, there have been only 2 studies, one positive and one negative. This way, I'm not misleading the reader, and they have all the facts.
- Let's take your analogy a step further. If, hypothetically speaking, only two good trials on homeopathy were conducted, one showing positive results, and the other not. Is it your argument that since 50% of the (two total) trials show positive results, we are not allowed to use the word "few" to describe them, as is described in a reliable source? Yobol (talk) 23:35, 24 August 2009 (UTC)
- When the total number of studies are too small (as in literally "a few" -- 4 or 5 or less), then from the vantage point of statistics, we don't have a sufficiently large population of studies to draw meaningful conclusions from -- especially if there is disagreement. Once we get into the realm of dozens of studies, as is the case in our no-longer hypothetical scenario, as opposed to 2 studies, or "a few" studies, then we probably have sufficient data to draw some meaningful conclusions, though more data is always helpful. Dbrisinda (talk) 03:19, 25 August 2009 (UTC)
- Wow. I will take others' advice at this point and move on from this discussion. It is apparent we are talking past each other and any further comments on my part seem futile.Yobol (talk) 03:34, 25 August 2009 (UTC)
- You are having to add words to the phrase that are not actually there in order to give it the meaning that you object to, and justify you request to remove it. If adding words that are not there to impose a particular meaning is not "a question of interpretation", how would you describe it? Brunton (talk) 09:56, 25 August 2009 (UTC)
- Come again? The phrase in the original was *exactly* "they are few in number". The whole point of this discussion was the problematic use of the phrase "few" as per the heading of this section, and how it misleads the reader. Dbrisinda (talk) 02:12, 29 August 2009 (UTC)
- If you had left my comment where I originally placed it, following the comment you made that I was replying to, in which you stated that interpreting the article's statement that "they are few in number" as meaning that the positive studies are few in number compared to the positive studies was not "not a question of interpretation", it would be apparent what I was getting at. I agree entirely that the wording was "they are few in number" - you were arguing that it actually meant "they are few in number compared to the positive studies" and was therefore misleading. If you had left my comment in its original context rather than moving it when you replied, this would be obvious. However, we might be able to close this discussion now, as we seem to be discussing an alternative wording below. Brunton (talk) 08:45, 29 August 2009 (UTC)
- Apologies, but I just moved your comment a couple down, because otherwise it starts to get crazy figuring out the location of recent comments vs. older comments. Your comment is indented once from my comment, so it should be clear to those reading that it is a response to that statement (which you've confirmed). Anyway, this is a trifling matter. What is important is use of the word "few" or phrase "few in number" in the article.
- Whenever there is ambiguity, it behooves us to clarify that ambiguity. In this case that would be achieved by not leaving the phrase "few in number" unqualified. Or alternatively removing the phrase altogether. By simply saying "they are few in number," in leaves too much to be misinterpreted by the reader, and is just plain misleading in my view. We might be able to close this discussion with the discussion below, which removes one problem and introduces a half-dozen more. Dbrisinda (talk) 02:25, 30 August 2009 (UTC)
Circumventing semantics
The above discussion seems to be going in circles to the benefit of nobody. Given that the phrasing of that sentence is nothing to write home with, I suggest that we rework it to avoid any ambiguity in comparison (heck, I called a trillion per cc "minuscule" doping just today). As a side benefit, this dumps onto the reliable sources the burden of determining whether twenty trials of fifty subjects is worth one with a thousand by sticking to collective weight. I also propose bringing up a few of the major points in #Research on medical effectiveness as better summary style.
Old:
- Claims of homeopathy's efficacy beyond the placebo effect are unsupported by the collective weight of scientific and clinical evidence. While supporters claim that studies published in reputable journals support the efficacy of homeopathy beyond the placebo effect, these studies are not definitive, they are few in number, and they have not been independently replicated. Several high-quality studies show no evidence of any effect from homeopathy, and the few studies which do show positive results for homeopathy have generally had flaws that prevent them from being considered unambiguous evidence for efficacy.
New:
- Claims of homeopathy's efficacy beyond the placebo effect are unsupported by the collective weight of scientific and clinical evidence, and several high-quality studies show no evidence of any effect. Higher quality trials tend to report less positive results; trials indicating efficacy are preferentially published in alternative medicine journals. Positive studies have not been replicated, and are generally small, insufficiently blinded or randomized, or show other methodological flaws that prevent them from being considered unambiguous evidence.
References omitted, first sentence unchanged from the present version up to the comma. The inverse relation with study quality I pulled from Ernst (2002) (currently reference 8); the publication bias I pulled from Caufield (2005) (currently reference 108). This version removes the repetition of placebo and few, and collects the reasons why reports of positive findings are not considered definitive (in the EBM sense; plausibility is treated in the next paragraph). - 2/0 (cont.) 03:57, 25 August 2009 (UTC)
- Looks good to me. --Enric Naval (talk) 13:41, 25 August 2009 (UTC)
- Support change. I like the change away from "reputable journal" to the more explicit alt med journal (reputable to who?); I agree the medical effectiveness section needs to be re-worked to support this change in the lead.Yobol (talk) 14:45, 25 August 2009 (UTC)
- Done. Just bold, revert, discuss with suggestions back here if we need more discussion about this. - 2/0 (cont.) 22:25, 27 August 2009 (UTC)
- I'm a little concerned about the phrase "several high-quality studies show no evidence of any effect." We need to be considering the collective evidence here. I would prefer something along the lines of "peer-reviewed analyses of published trials have failed to conclusively demonstrate efficacy", quite apart from anything else to avoid the suggestion that the article is cherry-picking negative studies. Brunton (talk) 10:28, 28 August 2009 (UTC)
- Brunton, I appreciate your valid concern above, and your use of a non-double standard by being concerned with cherry-picking from either side of the debate. Dbrisinda (talk) 02:25, 30 August 2009 (UTC)
- There are several problems with the new paragraph:
- 0) The sentence "Higher quality trials...; trials indicating efficacy..." is confusing as to which references are intended to support which clauses. Remember, when you place references after a compound sentence, with semicolon, or comma, they tend to support the most recent phrase, particularly when we are dealing with conjunctions. If a paper supports multiple statements, then just duplicate the citation after each major phrase instead of trying to be spartan in the use of citations at the cost of clarity.
- 1) The phrase "trials indicating efficacy are preferentially published in alternative medicine journals" is not supported, and the citations make one believe it is. Linde's (1997) paper that is cited is published in the Lancet. The main point of this phrase in its original form was to say that positive results exist. In the current incarnation that point practically disappears, and is replaced with the statement that they are preferentially published.
- 1.5) You are trying to say too many things in a small space. If you want to talk about preferential publications, this falls into the area of bias. Conflating these ideas does not make things any clearer -- quite the opposite.
- 2) The citations that were originally used (to support the fact that some positive studies exist), are no longer there, and instead replaced with other citations, and I'm not clear as to how they are being used.
- 3) The final sentence is interesting because of the use of the disjunction, but still problematic. There are too many statements. Why do you insist on placing all the citations at the end? Place the relevant citations after the phrase they are intended to support. Not all of those citations support all of those phrases.
- Incidentally, I was told by more experienced editors that the way to get contentious changes through, is not to change large segments of text, such as an entire paragraph, but rather to change things incrementally, by sentences and phrases. I offer the same advice for what it's worth. Dbrisinda (talk) 02:36, 29 August 2009 (UTC)
Back to semantics: middle ground?
The current wording adds some useful additions, but doesn't seem to be an improvement overall. Specifically, the sentence about higher quality trials tend to report less positive results is a fair statement which wasn't in the text before. I would like to suggest the following, which also simplifies that last sentence which I think can be condensed to "methodological problems" as is the phrase that is usually used in the literature:
Old:
Claims of homeopathy's efficacy beyond the placebo effect are unsupported by the collective weight ofscientific and clinical evidence, and several high-quality studies show no evidence of any effect. Higher quality trials tend to report less positive results; trials indicating efficacy are preferentially published in alternative medicine journals. Positive studies have not been replicated, and are generally small, insufficiently blinded or randomized, or show other methodological flaws that prevent them from being considered unambiguous evidence.
New:
Claims of homeopathy's efficacy beyond the placebo effect are unsupported by the collective weight of scientific and clinical evidence. Advocates point out that studies exist that support the efficacy of homeopathy beyond the placebo effect. However, higher quality trials tend to report less positive results, and most positive studies have not been replicated, or show methodological problems that prevent them from being considered unambiguous evidence of homeopathy's efficacy.
Dbrisinda (talk) 08:00, 1 September 2009 (UTC)
- Again, I'm a little wary about the hint of cherry-picking in that second sentence - it needs to be qualified to indicate that there are also many trials not showing efficacy (indeed, the whole paragraph as proposed above entirely fails to mention that there are any non-positive trials - just "studies ... that support the efficacy" and "less positive" studies).
- I agree with the substitution of "methodological problems" - we need to keep the lead brief, and it would be more appropriate to discuss the nature of the problems in the relevant place in the body of the article. It would be nice if we could find a less "technical" (i.e. more "plain English") expression than "methodological problems" though. Brunton (talk) 09:31, 1 September 2009 (UTC)
- I've made a couple of edits to indicate that the evidence is not entirely positive, but I'd still prefer to change the second sentence so that it is discussing systematic reviews rather than the habit advocates have of cherry-picking positive results. Brunton (talk) 09:47, 1 September 2009 (UTC)
- What about adding a mirror sentence that says the same thing for the negative/inconclusive studies/trials? That way we can remove any perceived cherry-picking, since both sides are addressed. Rewording sentence 2 to something like: "Many studies and clinical trials do not support the efficacy of homeopathy beyond the placebo effect.[citation needed] Other studies and clinical trials do seem to support the efficacy of homeopathy beyond the placebo effect." The phrase "do seem" seems a good segueway into the following qualification sentence that address the quality of the positive trials. I'll make this addition so it can be seen in context, and we can see if it is an improvement or not. Dbrisinda (talk) 22:07, 1 September 2009 (UTC)
- Seeing it in context, I'm not so sure that mirror sentence works afterall. It seems to be repeating the first sentence of the paragraph, which says essentially the same thing. Thoughts? Dbrisinda (talk) 22:24, 1 September 2009 (UTC)
- What about adding a mirror sentence that says the same thing for the negative/inconclusive studies/trials? That way we can remove any perceived cherry-picking, since both sides are addressed. Rewording sentence 2 to something like: "Many studies and clinical trials do not support the efficacy of homeopathy beyond the placebo effect.[citation needed] Other studies and clinical trials do seem to support the efficacy of homeopathy beyond the placebo effect." The phrase "do seem" seems a good segueway into the following qualification sentence that address the quality of the positive trials. I'll make this addition so it can be seen in context, and we can see if it is an improvement or not. Dbrisinda (talk) 22:07, 1 September 2009 (UTC)
- I've made a couple of edits to indicate that the evidence is not entirely positive, but I'd still prefer to change the second sentence so that it is discussing systematic reviews rather than the habit advocates have of cherry-picking positive results. Brunton (talk) 09:47, 1 September 2009 (UTC)
- I reverted this addition because it suggests a false equivalence between the sources used to support the "efficacy of homeopathy beyond a placebo effect" assertion and the systematic, comprehensive reviews used to support the "no evidence of any effect" statement. I would also point out that the word "quackery" is quite well-sourced, attributed, and belongs in the lead. Skinwalker (talk) 23:01, 1 September 2009 (UTC)
- And has been discussed almost ad nauseam on this talk page, with a well-established consensus to keep it in the lead. Brunton (talk) 07:38, 2 September 2009 (UTC)
- Furthermore, it is apparent that the references that support the "beyond a placebo effect" sentence in this version are being misrepresented. Ref. 13 is in fact highly skeptical of effects beyond placebo, and discusses the role of publication bias - a perennial topic here. Refs 15 and 16 are from low-impact journals and should not be given equal consideration. Skinwalker (talk) 02:22, 2 September 2009 (UTC)
- Even though I don't agree with you that referencing Kleijnen et al. (Ref. 13) as supporting homeopathy's efficiency (They argue that "The evidence presented in this review would probably be sufficient for establishing homoeopathy as a regular treatment for certain conditions.") is misrepresenting them in the stricter sense, overall they're concluding that there's a need for additional evidence (the paper was published in 1991), a demand that Linde (Ref. 14, 1997) and Boissel (Ref. 15, 1999) repeat more vigorously. I have no subscription to "Homeopathy" so I can only access the Abstract of Mathie (Ref. 16, 2003), but he still seems to point out "the need for much more and better-directed research in homeopathy", so I'd definitely prefer to use them along the lines of "some systematic reviews suggest that beneficial effects of homeopathic remedies are possible and therefore research on homeopathy is still warranted".--Six words (talk) 11:40, 2 September 2009 (UTC)
- The reversion by Skinwalker back to August 31, goes too far back in time. Brunton made some modifications on Sept. 1 to this paragraph which this reversion also undoes. At least revert to Brunton Sept. 1 so we can discuss modifications up to then. Also, Skinwalker, the references are not really being misrepresented as you perceive, and as I think Six words is suggesting. The references show that there are positive results achieved beyond placebo that are convincing enough in some cases (Kleijnen et al.) to warrant establishing homeopathy as a regular treatment in certain conditions, to showing sufficient positive evidence that warrants further research in others references. Yes, they are not definitive. But that's not what we're trying to communicate, and we even qualify this with the phrases that follow. So this should be clear to the reader. These are "positive" results to different degrees, and broadly speaking, as they don't support negative or inconclusive results. However, if you are really concerned about this, then I would second Six words' suggestion of qualifying with an extended phrase for the positive results. Also, Skinwalker, we've talked about this before, and even though the 2 references you mentioned are not "high-impact" these references support the accurate statement in question. And it's not like we're "hinging" everything on these references, only to show some "positive" evidence exists. As such it is fair to include them, especially considering they are RS. BTW, what are the chances of refraining from having these sorts of RS discussions that seek only to prevent certain RS references from being used? Virtually all RS's can be criticized in some way, and in this topic have, quite fairly in my view. It just doesn't seem fruitful to argue inclusion of RS again. Dbrisinda (talk) 03:53, 3 September 2009 (UTC)
- How about this, to include Six words' suggestion by qualifying with what many authors conclude for positive results: that more research is necessary? I've also added the word "some" to pre-qualify the "positive" studies (originally added by Brunton a couple of reverts back, and to address concerns by Skinwalker for "false equivalance"):
- The reversion by Skinwalker back to August 31, goes too far back in time. Brunton made some modifications on Sept. 1 to this paragraph which this reversion also undoes. At least revert to Brunton Sept. 1 so we can discuss modifications up to then. Also, Skinwalker, the references are not really being misrepresented as you perceive, and as I think Six words is suggesting. The references show that there are positive results achieved beyond placebo that are convincing enough in some cases (Kleijnen et al.) to warrant establishing homeopathy as a regular treatment in certain conditions, to showing sufficient positive evidence that warrants further research in others references. Yes, they are not definitive. But that's not what we're trying to communicate, and we even qualify this with the phrases that follow. So this should be clear to the reader. These are "positive" results to different degrees, and broadly speaking, as they don't support negative or inconclusive results. However, if you are really concerned about this, then I would second Six words' suggestion of qualifying with an extended phrase for the positive results. Also, Skinwalker, we've talked about this before, and even though the 2 references you mentioned are not "high-impact" these references support the accurate statement in question. And it's not like we're "hinging" everything on these references, only to show some "positive" evidence exists. As such it is fair to include them, especially considering they are RS. BTW, what are the chances of refraining from having these sorts of RS discussions that seek only to prevent certain RS references from being used? Virtually all RS's can be criticized in some way, and in this topic have, quite fairly in my view. It just doesn't seem fruitful to argue inclusion of RS again. Dbrisinda (talk) 03:53, 3 September 2009 (UTC)
- Even though I don't agree with you that referencing Kleijnen et al. (Ref. 13) as supporting homeopathy's efficiency (They argue that "The evidence presented in this review would probably be sufficient for establishing homoeopathy as a regular treatment for certain conditions.") is misrepresenting them in the stricter sense, overall they're concluding that there's a need for additional evidence (the paper was published in 1991), a demand that Linde (Ref. 14, 1997) and Boissel (Ref. 15, 1999) repeat more vigorously. I have no subscription to "Homeopathy" so I can only access the Abstract of Mathie (Ref. 16, 2003), but he still seems to point out "the need for much more and better-directed research in homeopathy", so I'd definitely prefer to use them along the lines of "some systematic reviews suggest that beneficial effects of homeopathic remedies are possible and therefore research on homeopathy is still warranted".--Six words (talk) 11:40, 2 September 2009 (UTC)
- Old:
- Claims of homeopathy's efficacy beyond the placebo effect are unsupported by the collective weight of scientific and clinicalevidence, and several high-quality studies show no evidence of any effect. Higher quality trials tend to report less positive results, and the few positive studies have not been replicated, and are generally small, insufficiently blinded or randomized, or show other methodological flaws that prevent them from being considered unambiguous evidence.
- New:
- Claims of homeopathy's efficacy beyond the placebo effect are unsupported by the collective weight of scientific and clinical evidence. However, some studies and clinical trials do seem to support the efficacy of homeopathy beyond the placebo effect, though most conclude further research is necessary. Furthermore, higher quality trials tend to report less positive results, and most positive studies have not been replicated or show methodological problems that prevent them from being considered unambiguous evidence of homeopathy's efficacy.
- I'll make the edit so it can be seen in context with references, and we can then do the WP:BRD dance. Dbrisinda (talk) 04:40, 3 September 2009 (UTC)
- How about "While some studies have positive results, systematic reviews of all the published trials fail to conclusively demonstrate efficacy", citing Linde 1999 as well as 1997? In particular, the "however" is not necessary as the existence of some positive results does not contradict the statement about the collective weight of evidence - the "however" implies that it somehow does. Brunton (talk) 06:58, 3 September 2009 (UTC)
- Actually, we could just use Ernst 2002 (a RS describing all the earlier systematic reviews) as a source for that. Brunton (talk) 08:48, 3 September 2009 (UTC)
- How about "While some studies have positive results, systematic reviews of all the published trials fail to conclusively demonstrate efficacy", citing Linde 1999 as well as 1997? In particular, the "however" is not necessary as the existence of some positive results does not contradict the statement about the collective weight of evidence - the "however" implies that it somehow does. Brunton (talk) 06:58, 3 September 2009 (UTC)
Hahnemann came to believe
He didn't content himself with belief, he experimented and cured peoples, and as a veterinary MD I can witness that placebo effect by animals don't exist and that even diluted products can cause aggravations--Ha-y Gavra (talk) 10:19, 2 September 2009 (UTC)
- You'll have to give us more than your own, personal experience, on Wikipedia we need reliable sources. --Six words (talk) 10:48, 2 September 2009 (UTC)
- Ha-y Gavra, please do not make general comments here, only concrete suggestions for improving the article. See WP:TALK. --Art Carlson (talk) 10:53, 2 September 2009 (UTC)
Quackery?
From one discussion above regarding changes to the lead reqarding use of the word quackery. It doesn't really matter if use of the word is well-sourced by those who are considered critics of homeopathy. The use of the word, especially in the lead is not very appropriate. The lead is intended to summarize the essential elements of the main article, not introduce new information, or to say things that are not represented in the main article to any substantial degree. This is really an unjustified, and I would say unfair use of precious "lead" space, and a misrepresentation of the contents of the article itself. Dbrisinda (talk) 04:06, 3 September 2009 (UTC)
- I don't understand your reasoning. If you look under Homeopathy#Medical_and_scientific_analysis, you'll see that it says: The lack of convincing scientific evidence supporting its efficacy[22] and its use of remedies without active ingredients have led to characterizations as pseudoscience and quackery,[23][25][26][89] or, in the words of a 1998 medical review, "placebo therapy at best and quackery at worst."[27] Use of homeopathy may delay or replace effective medical treatment, worsening outcomes or exposing the patients to increased risk.. So the use of quackery in the lead is a perfect summary of the article contents. Morever, it's clear from RS that many scientists/medical researchers think it and say it, so it's important that we represent their thoughts and give them prominence per WP:FRINGE. Phil153 (talk) 04:21, 3 September 2009 (UTC)
- Hmmm. It's one thing to mention this in the main article in a line or a sentence. But it's quite another to mention it in the lead. That whole section in the main article cannot be accurately summarized by using this word, even though it appears there. Not to mention that that word is far too powerful, and sets off sirens and flashing lights, and megaphonic warnings. But more importantly, quackery implies something utterly false. And yet, we have seen there is some evidence that seems to support the efficacy of homeopathy beyond the placebo effect. Even if we don't understand it, it's there (actually much more than "some"). If there were zero or near-zero evidence, then perhaps greater allowance for characterizations such as "quackery" in the main article might be appropriate, which would then justify inclusion in the lead. But this is not the case here. Dbrisinda (talk) 05:21, 3 September 2009 (UTC)
- This has been discussed at length many times. Please see the archives. Stet.LeadSongDog come howl 05:27, 3 September 2009 (UTC)
- Your efforts would be better directed elsewhere. It is extremely unlikely that you'll get consensus to remove the term, given the preponderance of reliable sources describing homeopathy as quackery. Skinwalker (talk) 22:41, 3 September 2009 (UTC)
- I found more than 20 reliable sources a few months back describing homeopathy as quackery. I'll dig the thread out of the archives. Fences&Windows 23:31, 3 September 2009 (UTC)
- Here we go, it was in March: Talk:Homeopathy/Archive_38#Quackery. Fences&Windows 23:33, 3 September 2009 (UTC)
- Your efforts would be better directed elsewhere. It is extremely unlikely that you'll get consensus to remove the term, given the preponderance of reliable sources describing homeopathy as quackery. Skinwalker (talk) 22:41, 3 September 2009 (UTC)
- This has been discussed at length many times. Please see the archives. Stet.LeadSongDog come howl 05:27, 3 September 2009 (UTC)
- Thanks for the link—I've read the discussion. Much of the debate of several months ago seems to seek to justify use of the word "quackery" by citing sources in the media, letters to the editor, opinion articles, websites, blogs, etc. I can cite at least as many sources that say the opposite. These sources and quotations do not an RS make. Further, if you limit your sources to scientists and physicians, the available RSs that use the word "quackery" become exceedingly sparse. Even more so if you limit to peer-reviewed sources. Why? Because such persons know they *can't* use the word—it would be a clear demarcator of their own partiality and bias. Especially when research is ongoing and a some amount of research exists that shows efficacy beyond the placebo effect. No thoughtful scientist or qualified medical practitioner would put all their eggs in one basket, so-to-speak, at the risk of compromising their perceived objectivity and credibility by calling homeopathy outright in any RS reference "quackery" as the science does not support this statement: the science instead supports "further research is necessary." That's not to say that there aren't individuals in the field of homeopathy for whom "quack" would be a very apropos characterization. They exist. But to describe the whole field as such is untenable, especially in an encyclopedic article, and further, especially in the lead of such an article.
- Some seek to redefine "quackery" to make it more suitable to their prerogatives, while carrying with it all the commonly accepted connotations. For example, Mr. Barrett of Quackwatch disingenuously re-defines the term "quackery" to "avoid problems with semantics," which suggest a severe disconnect with reality. The fact of the matter is, in colloquial and commonly accepted usage, the term "quack" or "quackery" does *not* have the meaning he suggests. Instead it is widely accepted across cultural boundaries as synonymous with shamster, sheister, charlatan, snake-oil salesman etc., and more loosely synonymous with deception, fraudulence, cheat, liar, etc. To use the term here is quite inappropriate, irrespective of who said it. To thoughtful individuals, all it shows is how the person being quoted views the field. Nothing more.
- Comments? Dbrisinda (talk) 22:57, 6 September 2009 (UTC)
- We do in fact justify our use of terms and concepts based on what reliable sources report. You have articulated no policy-based reason why we should remove "quackery", for which we have multiple sources. Demarcation is not Wikipedia's job, that we leave to reliable sources. If you are going to get into the "my sources are better than yours" tap-dance, that is a long-settled argument here. Let me repeat myself - you aren't going to get anywhere with this. You know, there's a whole encyclopedia out there for you to edit. Skinwalker (talk) 01:56, 7 September 2009 (UTC)
- It says it's been described as quackery. While we could argue about the overly-wordy presentation (clauses like "more plainly", the attribution to Oliver Wendall Holmes, and so on don't add much), it is a major viewpoint, and needs mentioned. Shoemaker's Holiday Over 204 FCs served 01:28, 7 September 2009 (UTC)
- Speaking as someone who thinks homeopathy is utter bollocks, harvested by bollock-maidens from the bollock fields of Lower Bollockshire, I'd reeeeeaaallly like to see the word "quackery" removed from the lead. It's not necessary. A mention in the body would be ok. Short Brigade Harvester Boris (talk) 01:44, 7 September 2009 (UTC)
- The issue I have with the way this sentence is worded is that there are much more "diplomatic" ways of saying that something is complete nonsense. Just as you wouldn't say "it's been described as bollocks", or "it's been described as utter nonsense," so too one ought not say "it's been described ... (more plainly) as quakery." All these phrases, though to different degrees, carry with them similar derogatory connotations, which will annoy a *lot* of people, homeopaths, and non-homeopaths alike. Part of the mandate of an encyclopedia is to write so as to not to upset individuals by using antagonistic language. Why not simply remove the phrase "(more plainly) as quackery", and possibly also "by Oliver Wendell Holmes, Sr." to give:
- Speaking as someone who thinks homeopathy is utter bollocks, harvested by bollock-maidens from the bollock fields of Lower Bollockshire, I'd reeeeeaaallly like to see the word "quackery" removed from the lead. It's not necessary. A mention in the body would be ok. Short Brigade Harvester Boris (talk) 01:44, 7 September 2009 (UTC)
- The lack of convincing scientific evidence supporting homeopathy's efficacy[24] and its use of remedies lacking active ingredients have caused homeopathy to be described as pseudoscience by several writers.[25][26][27][28][29]
- Dbrisinda (talk) 01:47, 10 September 2009 (UTC)
- How do you properly discuss sewage without discussing the smell? LeadSongDog come howl 02:08, 10 September 2009 (UTC)
- Dbrisinda (talk) 01:47, 10 September 2009 (UTC)
- The aside is definitely unencyclopedic style, and the by Holmes bit seems a bit too specific for the lead. He is way notable, but hardly unique. I would be okay with dropping those clauses independent of anything else this discussion decides. The Holmes reference is reproduced under #Rise to popularity and early criticism, so no need to move it anywhere. Writing described as pseudoscience or quackery would be a more accurate presentation of what those references state and summary of the body. I know the word quackery is the main point of discussion for this section, but it just turns up too regularly in our references to avoid. - 2/0 (cont.) 15:21, 10 September 2009 (UTC)
- Alright, I'll try amending it to keep the word "quackery" in there at first and see how it goes. Dbrisinda (talk) 05:50, 13 September 2009 (UTC)
- I've also trimmed some wording that was originally introduced along with the specific mention of Holmes (to differentiate him from "other more recent writers"), and is therefore now redundant. Brunton (talk) 11:11, 13 September 2009 (UTC)
- Alright, I'll try amending it to keep the word "quackery" in there at first and see how it goes. Dbrisinda (talk) 05:50, 13 September 2009 (UTC)
- Looks good to me, thanks. - 2/0 (cont.) 20:51, 13 September 2009 (UTC)
- It is not clear to me why the Holmes mention in the lead should be considered as any more redundant than other content in the lead. It is all supposed to be redundant. It summarizes the rest of the article. That is not a reason to remove it.LeadSongDog come howl 05:04, 14 September 2009 (UTC)
- Because Holmes was writing over a hundred years ago, and, notable as he may be, he's not by any means the most important source of those views today. Shoemaker's Holiday Over 205 FCs served 05:24, 14 September 2009 (UTC)
- The suggestion made by 2/0 (with which I agree) was that the mention of Holmes was more specific than the lead warrants. The "redundancy" was in some words which were no longer needed once Holmes had been removed (possibly "redundancy" wasn't quite the correct term). I also agree with Shoemaker's comment on Holmes. Brunton (talk) 07:49, 14 September 2009 (UTC)
- We normally attribute ideas to the originator and/or the populariser when possible. If someone earlier than Holmes can be shown to have applied the term, that would be fair game. That the term has retained currency for over all these years indicates something. That should not be masked by recentism.LeadSongDog come howl 15:48, 14 September 2009 (UTC)
- That degree of detail is better in the body than in the lead though, I think. Brunton (talk) 21:14, 14 September 2009 (UTC)
- We normally attribute ideas to the originator and/or the populariser when possible. If someone earlier than Holmes can be shown to have applied the term, that would be fair game. That the term has retained currency for over all these years indicates something. That should not be masked by recentism.LeadSongDog come howl 15:48, 14 September 2009 (UTC)
- The suggestion made by 2/0 (with which I agree) was that the mention of Holmes was more specific than the lead warrants. The "redundancy" was in some words which were no longer needed once Holmes had been removed (possibly "redundancy" wasn't quite the correct term). I also agree with Shoemaker's comment on Holmes. Brunton (talk) 07:49, 14 September 2009 (UTC)
- Because Holmes was writing over a hundred years ago, and, notable as he may be, he's not by any means the most important source of those views today. Shoemaker's Holiday Over 205 FCs served 05:24, 14 September 2009 (UTC)
- It is not clear to me why the Holmes mention in the lead should be considered as any more redundant than other content in the lead. It is all supposed to be redundant. It summarizes the rest of the article. That is not a reason to remove it.LeadSongDog come howl 05:04, 14 September 2009 (UTC)
- Looks good to me, thanks. - 2/0 (cont.) 20:51, 13 September 2009 (UTC)
Association between homeopathic physicians and regular physicians
Here is an interesting historical reference in a book about the physicians to Presidents. It also mentions that the first presidential physician was a homeopath. -- Brangifer (talk) 06:04, 4 September 2009 (UTC)
- Assuming you are talking about the AMA code of ethics mentioned on pp 49-50, which prohibited consultations between AMA members and homoeopaths etc., it is probably worth including a brief mention in the "Rise to popularity and early criticism" section (it doesn't seem to have had much effect on homoeopathy at the time though - although it was adopted in 1847, the article currently indicates that homoeopathy's decline in the US didn't start until around the end of the 19th century). If other examples can be found beyond this and Wilk v. American Medical Association, it might be possible to mention something about the American Medical Association's historical (i.e. non-current) attitude to alternative medicine in the AMA article, where this might be more appropriate (I notice that it already has a note in its "History" section: "1849: AMA studies quack remedies and tells the public about the dangerous effects of such treatments."). The first presidential physician might also be worth a very brief mention, although it looks a little like an appeal to authority (I'm sure it'll be in Dana's book as well). None of this is really relevant to homoeopathy itself, or its current practice, of course. Brunton (talk) 09:46, 4 September 2009 (UTC)
Interesting research by Luc Montagnier
Dilution and succussion
I've done a little rearranging of this section. I've moved the paragraph about analogies used for homoeopathic dilutions out of the "dilution debate" subsection, where they don't really belong, and replaced them immediately above this subsection.
I've also moved the paragraph about the Horizon tests from "dilution debate/Preparation of remedies", where I don't think it really belongs, to the "High dilutions" subsection under "Medical and scientific analysis". I'm adding a sentence about the high dilutions making homoeopathy implausible to the "dilution and succussion" section in its place. The source I've used for this sentence states: "Although the basic idea of homeopathy is similarity, the most controversial and, for many, implausible claim concerns the properties of the ultramolecular dilutions characteristic of it." Brunton (talk) 19:03, 17 September 2009 (UTC)
I've added a fact tag to the comment about Oscillococcinum - while this may well be a fair comment (the dilution involved is greater by a factor of well over 10300 than the number of particles in the known universe) we really ought to have a source for it. Brunton (talk) 19:23, 17 September 2009 (UTC)
I also feel that the subsections headed "Provings" and "Repertory" should be moved from "Preparation of Remedies" to the end of the "General philosophy" section, since they're not really to do with the actual preparation process. Does anyone have any objection to this? Brunton (talk) 19:28, 17 September 2009 (UTC)
- I've been thinking again about this, in particular the organisation of the section "Preparation of remedies", with a view to arranging it in a more logical order.
- What I propose is:
- 1) Renaming the "Preparation of remedies" section "Remedies";
- 2) Moving the subsection "Remedies" from "Treatments" to the start of this section;
- 3) Following this with the first paragraph of the current "Dilution and Succussion" subsection, renamed "Preparation of Remedies";
- 4) Second paragraph onwards of this subsection to be renamed "Dilutions", to be followed by current "Dilution debate", "Provings" and "Repertory" subsections;
- 5) Remainder of "Treatments" section to be renamed "Related treatments".
- Any comments? Brunton (talk) 12:49, 20 September 2009 (UTC)
- Oh well, I suppose I'll go for it. I'm sure it'll get reverted if people object. Brunton (talk) 11:26, 22 September 2009 (UTC)
- Agree in principle, but have a couple of minor quibbles. The section titles should use sentence case, so "Dilution and succussion" or "Preparation of remedies" would be correct. Because the word "remedy" has a more common non-homeopathic meaning of "cure", we need to be careful to avoid an accidental endorsement of the homeopaths' implicit claim that a homeopathic "remedy" is a cure. I suggest we could avoid that error without excess controversy by simply calling them "homeopathic remedies" in full.LeadSongDog come howl 15:44, 22 September 2009 (UTC)
Case in Australia
I'm not sure if this deserves mention or not, so I'll just post it here. An Australian homeopath and his wife have just been jailed for criminal negligence for treating their child with homeopathic remedies instead of seeking conventional medical treatment (the child died). From the article... "Justice Johnson said Thomas Sam displayed "an arrogant approach to what he perceived to be the superior benefits of homeopathy compared with conventional medicine". Here's the link for the sentencing and links to associated articles can be found there as well. Manning (talk) 07:15, 28 September 2009 (UTC)
- There has already been discussion of this case here, with consensus to add it as a footnote (currently ref 138 - "Case of Baby Gloria, who died in 2002") but not to make specific mention of it in the article. See http://en.wikipedia.org/wiki/Talk:Homeopathy/Archive_39#Baby_Gloria. Possibly a note of the sentence could also be added. Brunton (talk) 11:32, 28 September 2009 (UTC)
Bad science vs crackpot pseudoscience
Yeah, verifiability and all, but this is no reason to promote fringe theories, such as that the universe does not exist:
"As there are only about 1080 atoms in the entire observable universe, a dilution of one molecule in the observable universe would be about 40C. Oscillococcinum would thus require 10320 more universes to simply have one molecule in the final substance."
I don't know how many batches of Oscillococcinum are sold every year, but the stuff is reportedly popular in some circles, so I suppose it's not a few. Let's also give the homeopaths the benefit of doubt and assume that some genuine duck liver actually went into the preparation in the first step.
The above claim, from a logical standpoint, consequently falsifies the existence of one of the following things:
- The universe
- Oscillococcinum
Note that I did not say "Oscillococcinum as that what it purportedly is". Since the actual duck liver they presumably one diluted a hundredfold (or rather its constituent molecules) cannot disappear as long as the First Law of Thermodynamics holds (which was still the case last time I checked...), the stuff has got to be somewhere. It cannot be evenly distributed, though - not in this universe it don't.
The caveat is that the statistics prove that 200C dilutions are impossible, while both the universe and Oscillococcinum do exist. The "Oscillococcinum would thus require..." part is demonstrably misleading, if not outright false.
Presumably the dilution process involves taking only a fraction of each preceding step and diluting it. (Homeopathic dilutions is basically a slant - in good faith, but a fairly noninformative slant regardless - instead of what ought to be a technical description a la Bookbinding, with some critique added for good measure)
That means that the an individual dosage of Oscillococcinum has either odds of containing anything beyond water that are precisely zero, or odds that are much higher than the statistics given. Consider:
Since even the longest-lived noncovalent structures in liquid water at room temperature are only stable for a few picoseconds, critics have concluded that any effect that might have been present from the original substance can no longer exist.
That also means that a homogenous distribution is not practically achievable. Anything hydrophobic in particular - and most organic macromolecules are hydrophobic to some extent - will inevitably aggregate. In a nutshell, what you dilute is not a solution, but an unstable emulsion.
The consequence is that the dilutions of homeopathic preparations even below 12C are almost certainly never what they claim to be. In many cases, the stuff is simply undiluted water that continues to be non-diluted with even more undiluted water in each successive step. In some - if a particularly "rich" drop of the preceding dilution step was picked - the concentration of whatever gunk went in it may be significant. I do not know if such a study has ever been conducted; most that went in that direction were a sort of show trial. If it had been done, using a low dilution (say 6C), I'd predict that in part of the batches the effective dilution would be infiniteC (i.e. pure water), in others it would be high enough to possibly have a therapeutic effect (say 4C or so). And that would explain a lot - the claim of therapeutic effects versus their general insignificance, and the bad reproducability of studies.
So it might be better to cut out the crappy statistics that assume that homeopathic dilutions are true solutions when they are not, and that they are homogenous solutions when not enough water exists on Earth to make them so even if they were solutions in the first place and thereby "prove" that "no" homeopathic solution contains anything but water or sugar. A rebuttal of homeopathy must not lower itself to the "standards" of these quacks with such flawed math; the claims should rather be tackled like in the "no stable water molecule clusters" example. Homeopaths are quacks, but even quacks deserve an empirical falsification rather than theoretic arguments based on demonstrably false assumptions.
Verifiability is our basic standard of Wikipedia, but empirical science demands more than just a citation. A lot of claims exist that fulfil WP:V, but have simply not been rebutted because scientists have better things to do with their time (the most common case are misreportings or misreadings of scientific studies in the news). At least when the empirical sciences are concerned, the "verifiability is enough" rule is simply not enough; Wikipedia cannot have lower standards than the subject matter it discusses. So "verifiability and truth" it must be in topics of an empirical nature. (Obliquely related but a must-read for anyone interested in this topic is this)
I say this because what concerns me is that the very same "statistically improbable" argument is advanced by creationists against an abiotic origin of life - and like here, it is intellectually vapid and scientifically bankrupt: it is true that a billion years from a molten ball of rock to poisonous oceans inhabited by rather complex bacteria is statistically unlikely if driven by chance alone. But with ribozymes and clay mineral adsorption (which the statistical trick does not care to figure in), the odds are actually pretty damn high.
(I have also added "almost certainly" to the intro pic, for even if the statistics were correct, odds even infinitesimally above zero are not zero odds. The claim that this particular product item is devoid of any therapeutically active substance violates WP:V.) Dysmorodrepanis (talk) 17:11, 7 October 2009 (UTC)
- Avogadro's number is fact. You seem to be forgetting that when producing homeopathic dilutions such that there wouldn't be one molecule in a volume of water the size of the solar system, they don't need to use water of the volume of the solar system. The trick is serial dilution. At each stage the bulk of the molecules from the duck's liver remain in the part that you don't dilute further, i.e. 99% of those in solution, until very quickly none remain at all in the portion you're diluting. It's not magic. Clumping just reduces the effective number of "molecules".
- Instead of a tl;dr post with a lot of personal opinion and speculation, why not present some sources that address this issue and suggest how we can better write that section? We don't need to speculate as to what homeopathic remedies contain in practice, as it's been studied:[4] Fences&Windows 22:38, 7 October 2009 (UTC)
- I did some calculating. 1g of duck liver might have say 3 x 10^19 molecules in it, I think that's 30 quintillion. Assume it is totally homogenised to give the most possible number of particles. At 200C, what is the probability that a single molecule remains in your sample? Answer:
0.00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000003 Or a 3 in 10^400 chance. To give an idea of how small a number this is, there have only been about 4.3 x 10^17 seconds since the universe began. Fences&Windows 01:37, 9 October 2009 (UTC) According to WP:Ifpeopledon’tbelieveinthisrubbishthenIwon’tbeabletosendmykidstogrammarschool it should be allowed in the article. People can decide for themselves whether it's true of not. 203.3.186.10 (talk) 11:39, 29 October 2009 (UTC)
Current Introduction
Excellent. The current top-level introduction to this topic is very well-written and researched. Hopefully, the wiki-editors monitoring this page will lock it down. Groovymaster (talk) —Preceding undated comment added 21:41, 8 October 2009 (UTC).
I think the current introduction violates NPOV. Granted, I'm new here.
Jim Steele (talk) 23:46, 15 October 2009 (UTC)
- Good luck convincing opinionated editors of that one - ʄɭoʏɗiaɲ τ ¢ 00:36, 16 October 2009 (UTC)
- Could you give a concrete example of what you think is POV? That would be really helpful. --Six words (talk) 16:15, 16 October 2009 (UTC)
- The edit summary of Jim Steele's comment says "shouldn't the first paragraph avoid discarding it's use?". --Enric Naval (talk) 09:22, 21 October 2009 (UTC)
- Sure, but what sentence(s)? If the question is "should the lead only contain homeopaths' view" then the answer is definitely no (see also the FAQs at the top of this page). The lead summarizes the whole article, so criticism belongs there, too. I don't think the lead violates NPOV, but in order to explain that (or to rethink it) I'd like to see examples. --Six words (talk) 13:16, 21 October 2009 (UTC)
- Setting aside that Jim's triple-negative leaves his intent unclear, it seems to me that we've "buried the lead" in the third para. That may be a compromise to limit disputes here, but I don't believe that it serves the topic well. The euphemism alternative medicine when it is an alternative to medicine is almost as bad a choice.LeadSongDog come howl 13:41, 21 October 2009 (UTC)
I agree that the introduction to this page is excellent. One of the best examples of any "Fringe Theory" intro I have seen. --Jaxpac (talk) 22:53, 20 October 2009 (UTC)
Weird
"n 1978, Anthony Campbell, then a consultant physician at The Royal London Homeopathic Hospital, criticised statements by George Vithoulkas claiming that syphilis, when treated with antibiotics, would develop into secondary and tertiary syphilis with involvement of the central nervous system. This conflicts with scientific studies, which indicate that penicillin treatment produces a complete cure of syphilis in more than 90% of cases.[39] Campbell described this as "a thoroughly irresponsible statement which could mislead an unfortunate layman into refusing orthodox treatment".[6]"
This seems kind of out of place in the Miasms and Disease section (it's also echoed almost word for word in the Ethical and safety issues section). It just seems to pick out a single person that made a statement and then another person that made a counter statement. It is rather randomly placed and without context. Is it really necessary at all in the article seeing as it doesn't seem to contribute greatly to the rest of the sections or article? - ʄɭoʏɗiaɲ τ ¢ 01:47, 27 October 2009 (UTC)
- Ah, the joys of editing by committee. The first sentence of that paragraph should probably stay, but it needs a better source than just that two homeopaths espoused conflicting views. There is an article in the July issue of Homeopathy that looks useful. - 2/0 (cont.) 04:56, 27 October 2009 (UTC)
- Full text available here. Brunton (talk) 09:03, 27 October 2009 (UTC)
"treat" or "attempt to treat"
We have had this discussion before. "Treat" in a medical context has mild connotations of effectiveness simply because treatment is often effective. But clearly not every treatment is effective and some treatment is even harmful. Treatment consists in giving the patient pills etc., operating them or applying various techniques. That's not something homeopaths 'attempt', that's something they do.
By saying they "attempt to treat" we would set this article up as a debunking article as opposed to a scientifically sound article. It would be about as bad as writing "Homeopaths 'treat' their 'patients'...". Hans Adler 22:44, 1 November 2009 (UTC)
- I was absolutely sure that we had this particular edit before and that the outcome was what we have now. But I can't find it in the archives, and WikiBlame isn't much help for this huge and active article. Did I misremember, or does someone else recall this as well? Hans Adler 23:05, 1 November 2009 (UTC)
- It certainly does feel familiar, but nothing jumps out at me scanning the most recent few sections in the index. I think that the meaning of the sentence is clearer using "treat" rather than "attempts to treat". As it is a bit of a run-on at present, we might rephrase as
“ | ... Samuel Hahnemann in 1796. |
” |
- or something along those lines, with the obvious tweak to the subject of the next sentence. - 2/0 (cont.) 07:19, 2 November 2009 (UTC)
- I was about to implement this boldly, but when I saw the result I noticed two problems: 1) Homeopaths claim to treat the patient, not the disease. Of course regular doctors really do the same, so it's nothing special. Yet it's good to have this key point (to homeopaths) included in the lead in an unobtrusive way. It would be a shame to lose this. 2) Homeopathy consists (almost?) exclusively in administering the remedies. In the current version this is hinted at since the definition says they do it and doesn't mention anything else. In your proposed version a reader might wonder why we suddenly change the topic and talk about what might be only one aspect of homeopathy.
- Therefore, unless anyone still thinks "treat" is a burning problem here I would prefer to leave it as it is. But please keep in mind that we can't write an intelligible article on such a topic if even the simplest fundamental terms aren't allowed for fear of giving credibility. We have had similar discussions for "remedy", "medicine" and "potentisation", and that's OK. But we should really restrict these discussions to words that homeopaths use in a non-standard way. Like all CAM, homeopathy shares some terminology with regular medicine. I can understand why some people don't like this, but Wikipedia is not the right place for instituting a monopoly of regular medicine on such terms. (I am thinking of terms like "treatment", "symptom" or "patient".) The best we can do is make sure that we use these terms in their standard meanings, or if we must use a different definition current among homeopaths to make this very clear. Hans Adler 10:39, 2 November 2009 (UTC)
- The word "treat" certainly has implications of successful treatment. For example, the (UK) Advertising Standards Authority, a body set up by the advertising industry to police itself, would probably regard the current wording of the first paragraph as implying efficacy, and require robust supporting evidence if it was quoted in an advert. On the other hand we have a reasonable assessment of efficacy in the third paragraph of the lead, so the first paragraph can probably stand as it is. Brunton (talk) 13:33, 2 November 2009 (UTC)
- I totally agree with that in an advertising context. Whether you say it explicitly or not: If you advertise something and suggest using it to treat cancer, then everybody will see the implication that it's supposed to have a beneficial effect. On the other hand, if a public prosecutor says that the defendant treated a heart attack with a homeopathic pill, there is no such implication. We are in a neutral context here, so it seems to me that the effectiveness connotation is rather weak and certainly doesn't need immediate contradiction. Hans Adler 14:25, 2 November 2009 (UTC)
- While the topic of efficacy is up, I think that the lead paragraph itself should end with a sentence mentioning that the scientific community does not accept homeopathy as effective (or something similar). The lead paragraph should, "establish the context in which the topic is being considered, by supplying the set of circumstances or facts that surround it" (Wikipedia:Lead_section#Opening_paragraph). The context and facts about homeopathy are incomplete without mentioning if "serial dilution" described in the opening paragraph has any proven effectiveness by scientific means. A line regarding this is needed, which should then be expounded upon as the last paragraph of the lead. Jason Quinn (talk) 13:52, 2 November 2009 (UTC)
- The word "treat" certainly has implications of successful treatment. For example, the (UK) Advertising Standards Authority, a body set up by the advertising industry to police itself, would probably regard the current wording of the first paragraph as implying efficacy, and require robust supporting evidence if it was quoted in an advert. On the other hand we have a reasonable assessment of efficacy in the third paragraph of the lead, so the first paragraph can probably stand as it is. Brunton (talk) 13:33, 2 November 2009 (UTC)
- I made the original change of "treats" to "attempts to treat". I still dislike "treats" but am less against it than I was now that I have read your points of view. I still think that "treats" confers more authority to homeopathy than it deserves and is therefore potentially dangerous to lives. The term "treatment" — like it or not — also connotes effectiveness in vernacular usage, so while "treatment" may mean simply giving pills, etc., there is clearly some equivocation here to worry about. A particular solution might be to change the lead sentence to this: "Homeopathy (also spelled Homoeopathy or Homœopathy) is a form of alternative medicine, first proposed by German physician Samuel Hahnemann in 1796, that administers heavily diluted preparations to patients which are thought to cause effects similar to the symptoms presented." This avoids the multiple connotations of "treats". (Actually, why would you want to cause effects similar to symtoms? That makes no sense to me. Is that really how homeopaths say their craft works? Weird.) Jason Quinn (talk) 13:40, 2 November 2009 (UTC)
- "Administer" looks like an excellent solution for the problem. (Thanks for spotting the garbled sentence. Most of the regulars here are so familiar with the text that we don't spot such things any more. I am sure it once said that they take substances that are thought to cause the symptoms and dilute them. That makes more sense, because they believe that the dilution has some paradoxical effects. On the other hand the current phrasing, although misleading, is technically not completely wrong since they also believe in an initial aggravation of symptoms that precedes healing. I will try to find out what happened and fix the text.) Hans Adler 14:17, 2 November 2009 (UTC)
- OK, the counterintuitive stuff is a result of this edit by Brunton. Now I remember: It's technically correct because the homeopaths do their "provings" with diluted substances. What you normally hear about homeopathy makes it appear that it's the dilution that sort of reverses the effect. But the real idea is that initially it's the same effect in everybody, and in an ill person the remedy dislodges the illness: First it takes its place and causes the same symptoms; when the direct effect of the remedy stops, the illness can't return. The effect of the dilution is supposed to be that the primary effect gets weaker (the remedy that replaces the illness produces less severe symptoms) while the secondary effect of dispelling the illness gets stronger (counterintuitively). Hans Adler 14:40, 2 November 2009 (UTC)
- Replying to Jason: "Actually, why would you want to cause effects similar to symptoms? That makes no sense to me. Is that really how homeopaths say their craft works? Weird." That is what homoeopathy tries to do - hence the derivation of the name from the Greek for "same suffering". Hahnemann originally proved and treated with material doses, but changed to using diluted remedies because he found that the material doses tended to be toxic. He also prescribed conducting provings using 30C remedies. What Hans says just above is correct (and fits neatly into the 18th century medical paradigm in which, for example, the externalisation of symptoms in gout was held to be a good sign) - I'd add that another explanation given is that symptoms are said to be part of the body's healing process (rather than specifically part of the disease), therefore aggravating the symptoms stimulates healing. Brunton (talk) 15:36, 2 November 2009 (UTC)
The article itself goes into great lengths to define and show the efficacy/lack thereof. I see no need to change the wording. Yobol (talk) 23:22, 2 November 2009 (UTC)
Recent Rephrasing
I've reverted recent rephrasing of certain things. Problems I saw with them were;
- "which
are thought tocause effects" - obviously a disputed fact - "some homeopaths have been criticized
for putting patients at risk withgiving advice to avoid" - rephrasing avoids the point of the criticism. It is centred on the risk resulting from the advice, not the giving of advice itself - "the laws that govern the regulation and testing of conventional drugs
do not apply toare different from homeopathic" - problem is that often there are no laws applicable to homeopathic treatment, not that they are different - "
unsupported by the collective weightcontroversial because of scientific and clinicalevidenceexperiments" - this edit changed the meaning and conclusions of the argument presented to make it appear much weaker. - "While
somemany studies have positive results, systematic reviews ofall thesome published trials" - reversed the argument without any change to the cite, they can't both be right. - "the current understanding of the physics of water are unaware of any
well understood, and no knownmechanism that permits such a memory" - suggests that there is something not "currently" understood, without any cite or evidence to support this speculation. - "The inconsistency of
lack of convincingscientific evidence" - clear change to the meaning, without a change to the cite.
--Escape Orbit (Talk) 17:35, 2 December 2009 (UTC)
Updating the section of a potential biological effect of high dilutions
The following cites a pay-wall article done by a homeopathy clinic and I don't believe merits any consideration with regards to this article. --XaXXon (talk) 11:11, 7 December 2009 (UTC)
Dear Co-authors,
with respect to recently published studies on the biological effect of high dilutions, the following line should be considered to be updated:
'..Homeopathic remedies generally contain few or no pharmacologically active molecules,[21] and for such remedies to have pharmacological effect would violate fundamental principles of science...'
One recent study confirm in an observer-independent approach a differential effect of a high dilution of histamine on the basophil activation of mast cells in comparison to water (1; PMID 19945674). Another preceding study had demonstrated a similar effects in a multi-center and blinded approach (2; PMID 15105967). Obviously, these results should be reported within the section on a potential pharmacological effect of high delusions. Because I am not native to english I leave it up to You to rephrase the relevant lines but supply You (see below) with the formatted citation of these two papers. From a purely scientific point of view these studies open up new avenues in defining methods to deepen our understanding of a potential effect of high dilutions. Clearly, this needs to be communicated to the interested reader.
Thank You very much, Thomas Schönecker Charité University Medicin Berlin
(1) http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WXX-4XT3B9H-3&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=667eb1c501be4ae7a35c19cfc77ff066 (2) http://www.ncbi.nlm.nih.gov/pubmed/15105967?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_SingleItemSupl.Pubmed_Discovery_RA&linkpos=1&log$=relatedarticles&logdbfrom=pubmed —Preceding unsigned comment added by 89.247.52.200 (talk) 00:12, 7 December 2009 (UTC)
- Regarding the sentence in the lead that you suggest needs to be changed, these possible anomalies don't change the scientific principles. That would require better confirmation of the results, and some actual principles explaining what is going on (assuming that something actually is going on). Brunton (talk) 11:58, 7 December 2009 (UTC)
- Owing to the language difficulty, I suspect the following is just an interesting anomaly, rather than a Freudian slip, that needs to be fixed: "a potential pharmacological effect of high delusions." ;-) -- Brangifer (talk) 06:44, 8 December 2009 (UTC)
Refutation in the 3rd paragraph of the lead?
Why do I have to wait until the 3rd of 4 lead paragraphs to read that bullshit is bullshit? Can't that be moved up a bit? 218.25.32.210 (talk) 05:16, 8 December 2009 (UTC)
- You have a point. This is a fringe and pseudoscientifc subject and the mainstream POV should be moved up. I'll start a subsection below to show a possibility. No changes have been made other than rearranging the paragraphs. -- Brangifer (talk) 06:31, 8 December 2009 (UTC)
- I appreciate your alacrity, and V1 suits me fine. It gives the historical background & a bit of methodology first, then the scientific consensus. 218.25.32.210 (talk) 07:29, 9 December 2009 (UTC)
I am not too concerned about the order, but I am opposed to giving the debunking paragraph more weight so long as it contains unacceptably strong language:
- "For such remedies to have pharmacological effect would violate fundamental principles of science".
- Gratuitous use of the word "quackery".
These two items do not reflect the consensus of the (mainstream) scientific literature related to homeopathy. They have been cherry-picked in order to make it easier for simple-minded "sceptics" of the less rational type to identify with this article, and they make it appear sectarian and untrustworthy to readers with a generally positive attitude to CAM. (Before attacking me for my opinion, look into a proper encyclopedia such as Britannica.)
As to WP:FRINGE, Arbcom has made it clear that words such as "alternative medicine" (they used different examples, something like "medium") in the first sentence are sufficient framing. Hans Adler 07:55, 9 December 2009 (UTC)
- I have no objection to the current order, which sets out what homoeopathy is (or claims to be) and then gives the mainstream viewpoint. Moving the current second paragraph to the end of the lead makes it read in a less coherent way. I would not agree that the statements attributed to the "mainstream" viewpoint have been cherry-picked. While there is much literature on homoeopathy, it is in the nature of fringe subjects that they don't generally generate much input from the mainstream (see for example the lack of response - Wallace excepted - to John Hampden's Flat-Earth wager). The reason that most of the published literature is positive is that it is written by homoeopaths, or at least people sympathetic to homoeopathy. Brunton (talk) 14:33, 9 December 2009 (UTC)
- Let's not get embroilled in this again. If anyone actually reads the para and the archives of this talk page they will see that the use of "quackery" is anything but "gratuitous". It is in fact very deliberate, considered here at ridiculous length, and referenced to no less than four sources. Even so, it is not stated as fact. Although "Homeopathy is a form of quackery" would be a more direct and honest statement, it could never gain consensus here, despite the most impeccable references. LeadSongDog come howl 17:49, 9 December 2009 (UTC)
Rearranging the LEAD in honor of FRINGE: version 1
- This moves the second paragraph to the end and moves the third and fourth up: -- Brangifer (talk) 06:31, 8 December 2009 (UTC)
Homeopathy (also spelled Homoeopathy or Homœopathy) is a form of alternative medicine, first proposed by German physician Samuel Hahnemann in 1796, that treats patients with heavily diluted preparations which are thought to cause effects similar to the symptoms presented. Homeopathic remedies are prepared by serial dilution with shaking by forceful striking, which homeopaths term "succussion," after each dilution under the assumption that this increases the effect of the treatment. Homeopaths call this process "potentization". Dilution often continues until none of the original substance remains.[6]
Claims of homeopathy's efficacy beyond the placebo effect are unsupported by the collective weight of scientific and clinical evidence.[7][8][9][10][11] While some studies have positive results, systematic reviews of all the published trials fail to conclusively demonstrate efficacy.[12][13][14][15][2] Furthermore, higher quality trials tend to report less positive results,[14][16] and most positive studies have not been replicated or show methodological problems that prevent them from being considered unambiguous evidence of homeopathy's efficacy.[7][10][17][18]
Homeopathic remedies generally contain few or no pharmacologically active molecules,[19] and for such remedies to have pharmacological effect would violate fundamental principles of science.[11][20] Modern homeopaths have proposed that water has a memory that allows homeopathic preparations to work without any of the original substance; however, the physics of water are well understood, and no known mechanism permits such a memory.[20][21] The lack of convincing scientific evidence supporting homeopathy's efficacy[22] and its use of remedies lacking active ingredients have caused homeopathy to be described as pseudoscience or quackery.[23][24][25][26][27]
Apart from the symptoms of the disease, homeopaths use aspects of the patient's physical and psychological state in recommending remedies.[28] Homeopathic reference books known as repertories are then consulted, and a remedy is selected based on the totality of symptoms. Homeopathic remedies are considered safe, with rare exceptions.[29] However, some homeopaths have been criticized for putting patients at risk with advice to avoid conventional medicine such as vaccinations,[30] anti-malarial drugs,[31] and antibiotics.[32] In many countries, the laws that govern the regulation and testing of conventional drugs do not apply to homeopathic remedies.[33]
Rearranging the LEAD in honor of FRINGE: version 2
Merger proposal
I have made a merger proposal to bring in the Homeopathic dilutions article back into the main article. The only way to preserve the separate dilution article was to copy significant content from the main article. I don't see much value in the dilution article in addition, but have preserved everything that it said in order to be gentle to the original author, whose opinions I do share. I just don't think the separate page is valuable unless it is filled with Homeopathy related content, which no one has done for months.
There might be one reason to keep the separate page, i.e., if there is some significant body of opinion or evidence that could be summarized here on how the "potencies" of the different dilutions compare. Because I have some serious concerns with the table presented here (and now in the two articles). Gschadow (talk) 05:11, 4 January 2010 (UTC)
Significant criticisms noted
A very significant failing of this article is that it has included nicely hidden criticisms without them being noted in a single heading. To deal with that problem I have made a few changes so that the undue weight caused by hiding those criticisms has been balanced to some degree. One shouldn't hide scientific criticisms in an article about what mainstream science and medicine considers the most absurd of all forms of alternative medicine. That's their opinion, like it or not, and it's well-documented by numerous V & RS.
In three edits I added a word to one heading, changed the level of another heading to reflect its actual content, and added very condensed quotes from a new article. The article has been termed (by the most notable expert on quackery and healthfraud) "one of the most important articles ever published" [on the subject]. The authors are both very significant, one of them (Ernst) having been a practitioner of homeopathy. -- Brangifer (talk) 05:07, 20 January 2010 (UTC)
- He is also currently on the editorial advisory board of Homeopathy. Brunton (talk) 14:23, 21 January 2010 (UTC)
- Interesting! I added another ref to bolster the fact of his former practice and training in the use of several alternative methods. -- Brangifer (talk) 15:40, 21 January 2010 (UTC)
- I'm not entirely convinced about the need for the additions at the end of the lead though. While they are appropriately in the article, with good sourcing, perhaps "pseudoscience or quackery" is adequate in the context of the sort of summary we should be providing in the lead - it's beginning to look a little like a thesaurus. Brunton (talk) 16:36, 21 January 2010 (UTC)
- You have a point. When one steps back and looks at it, it's a bit too much. I have now taken off a few of them. -- Brangifer (talk) 18:41, 21 January 2010 (UTC)
Homeopathy by the (mind-boggling) numbers
Interesting article:
With these quotes:
- "So why are Boots putting their trusted name on pills that are labelled as a medicinal product, but contain nothing other than sugar? They’ve come out and said that there is no evidence to suggest that homeopathic remedies are efficacious but they will sell them if people believe they work."
IOW ,they're selling religion! It's all about the money.
And this punchline:
- "They are an insult to the herbal remedies on the shelf next to them at Boots; at least snake-oil has the decency to contain some snake."
Brangifer (talk) 15:43, 21 January 2010 (UTC)
- Nice. Bookmarked for future reference. :) — NRen2k5(TALK), 18:13, 23 January 2010 (UTC)
Worth mentioning?
Apparently, critics of homeopathy are planning a mass overdose of homeopathic ‘remedies’ to protest Boots’ selling it. I’m thinking this will be notable and relevant for inclusion to the article, and wanted to bring it to the attention of other editors and hear your opinions before trying to work it in. — NRen2k5(TALK), 20:44, 22 January 2010 (UTC)
- I suspect that after the fact there'll be more coverage and it will be notable enough for mention. "Suicides" using homeopathic "remedies" has been done before to demonstrate it's lack of any effect. It is risky business because in some cases there is deliberate adulteration of products that are misleadingly labelled "homeopathic", but which include real drugs or other undiluted substances that can have real effects. -- Brangifer (talk) 00:38, 23 January 2010 (UTC)
- It's really just to publicise the real nature of homoeopathy, in particular the dilutions - much of the general public seems to think it is more or less synonymous with herbal medicine (you'll probably have noticed that homoeopaths often don't seem to like having attention drawn to the degree of dilution involved). I don't really think it will be notable enough in the context of the article for inclusion. In particular, the fact that an "overdose" has no effect will be brushed aside with the excuse that any number of pills taken at roughly the same time counts as a single dose. Brunton (talk) 11:49, 23 January 2010 (UTC)
Post-event details here: http://news.bbc.co.uk/1/hi/england/merseyside/8488946.stm
89.240.7.86 (talk) 12:42, 30 January 2010 (UTC)
Objection to a phrase
The article reads in part: "Some homeopaths have, however, been criticized for putting patients at risk with advice to avoid conventional medicine ....."
I object to the phrase "conventional medicine." There is medicine and non-medicine, but there is no such thing as conventional medicine or unconventional medicine. The sentence should read "Some homeopaths have, however, been criticized for putting patients at risk with advice to avoid medicine ....." --Desertphile (talk) 15:59, 27 January 2010 (UTC)
- I beg to differ. Removing the word "conventional" makes it unclear what they've been told to avoid. "Conventional" is a best compromise between the more proper "real" (which I'm sure the quacks will object to) and "allopathic" (which is obviously unacceptable for reasons of POV and clarity). — NRen2k5(TALK), 21:40, 27 January 2010 (UTC)
- I agree with NRen2k5. Brunton (talk) 22:03, 27 January 2010 (UTC)
- What NRen2k5 said. I couldn't have said it so clearly. --Enric Naval (talk) 23:47, 27 January 2010 (UTC)
Cleaning
How is the equipment used in the manufacture Homeopathic remedies cleaned? Cleaning using Ethanol or water would actually mean more potent remedies if Homeopathy is real? 86.145.150.245 ([[User talk:86.145.150.245|talk]]) 22:18, 30 January 2010 (UTC)
- From what I understand, the drying process is the most important part for most homeopaths. Remember, homeopaths believe in the strength of the succussed solvent, not the solute. ScienceApologist (talk) 23:37, 4 February 2010 (UTC)
Does it work?
From the "Complete Works of Nash" comes an interesting observation from a Dr. E.B. Nash who had to contend with the opinions of some physicians at this time as well. He makes an interesting observation, one, fittingly, in his description of the remedy of diluted table salt:
Common salt. A gentleman once said to me when I prescribed a dose of Sulphur 30th, "Pshaw, I get more sulphur than that in every egg I eat. How can that do me any good?" My answer was, wait and see. And he was cured of both doubts and disease... It is a hard thing to be confronted by such facts against our prejudices.
"Oh, well," said one of these doubters, "people sometimes get well without medicine." So do they with, I replied.
Isn't it curious how some physicians will hoot at a potency and fly like a frightened crow from a bacillus varying in size from 0.004 millimeters to 0.006 m.m. They can hardly eat, drink or sleep for fear a little microbe of the fifteenth culture will light on them somewhere, but there is nothing in a potency above the 12th. Oh, consistency! When prejudice gives way to honest, earnest investigation for truth, the world may be better for it.
(page 532, 2001 edition, compliled by P. Sivaraman) —Preceding unsigned comment added by 76.10.142.241 (talk) 18:18, 6 February 2010 (UTC)
- “People can get well with or without medicine” is the reason why placebo controlled trials are done. So what is this source telling us that we didn't know before? (By the way: “Common salt” and sulphur are two entirely different substances.)--Six words (talk) 18:34, 6 February 2010 (UTC)
- Congratulations, that is just about the most horrible non-math and non-logic I have ever seen. The only way that's ever getting back into the article is if we dedicate a section to the nutty things some homeopaths say. And that's not very likely.... — NRen2k5(TALK), 22:06, 6 February 2010 (UTC)
Collective weight vs. majority
As much as I appreciate keeping things simple, "majority" is not an adequate alternative to "collective weight". The former implies that it is (just) about the number of positive/inconclusive vs. negative. It's not. The studies are of varying quality and, as is later explained in the article, higher quality studies tend to be more negative, so I'm going to restore the previous wording.--Six words (talk) 11:12, 20 February 2010 (UTC)
15C is that enough ?
The illustration for Marsh Labrador Tea says that a 15C dilution containsno molecules of the original. Assuming that they started with about a mole of it, there is a chance that the phial contains an original molecule, which will be roughly ten billion to one against. OK, that is not a big probability, but the strong assertion made is that it is zero. —Preceding unsigned comment added by DominicConnor (talk • contribs) 17:20, 22 February 2010 (UTC)
Even that is lower than the probability of contamination, if one was trying to absolutely guarantee that not one molecule was there, you'd require vastly more stringent condition than used in the factories making this stuff. I cvan't see a way of working out that probability, but it's far from zero.DominicConnor (talk) 17:23, 22 February 2010 (UTC)
Status of homeopathic research - Nccam
"The Status of Homeopathy Research Most analyses of the research on homeopathy have concluded that there is little evidence to support homeopathy as an effective treatment for any specific condition, and that many of the studies have been flawed. However, there are some individual observational studies, randomized placebo-controlled trials, and laboratory research that report positive effects or unique physical and chemical properties of homeopathic remedies." NCCAM has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your primary health care provider. We encourage you to discuss any decisions about treatment or care with your health care provider. The mention of any product, service, or therapy is not an endorsement by NCCAM This publication is not copyrighted and is in the public domain. Duplication is encouraged.. http://nccam.nih.gov/health/homeopathy/#contoversies —Preceding unsigned comment added by Altamiraoriole (talk • contribs) 22:51, 2 February 2010 (UTC) I think this a more neutral approach. —Preceding unsigned comment added by Altamiraoriole (talk • contribs) 22:36, 2 February 2010 (UTC)
- Yes, some "individual observational studies, randomized placebo-controlled trials, and laboratory research" (my emphasis) have reported positive results - we're back to cherry-picking, using uncontrolled observational studies (which often seem to amount to little more than customer satisfaction surveys), and in vitro anomalies. The article (and NCCAM's basic conclusion, perhaps) uses reviews of all the evidence, concentrating specifically on properly conducted RCTs, and the fact that homoeopaths can cherry-pick individual studies that support them doesn't contradict their, and the article's, conclusions. Brunton (talk) 15:32, 4 February 2010 (UTC)
- Hi there. Most likely you did not notice that the following is the actual quote from the source - it is the entire paragraph regarding homeopathy research. I paste the entire paragraph to avoid cherry picking as user brunton says. I assume that everybody regards Nccam as a reliable source otherwise you would object the use of its quotes in the Homeopathy article.I will insert the quote again.
- "The Status of Homeopathy Research Most analyses of the research on homeopathy have concluded that there is little evidence to support homeopathy as an effective treatment for any specific condition, and that many of the studies have been flawed. However, there are some individual observational studies, randomized placebo-controlled trials, and laboratory research that report positive effects or unique physical and chemical properties of homeopathic remedies."
- NCCAM has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your primary health care provider. We encourage you to discuss any decisions about treatment or care with your health care provider. The mention of any product, service, or therapy is not an endorsement by NCCAM This publication is not copyrighted and is in the public domain. Duplication is encouraged.. http://nccam.nih.gov/health/homeopathy/#contoversies--69.125.0.149 (talk) 22:27, 23 February 2010 (UTC)
- See my comment above. Brunton (talk) 00:07, 24 February 2010 (UTC)
- By the way, "cherry-picking" refers to the process of selecting or emphasising positive reports rather than looking at the totality of the available reports; it isn't the same thing as quote-mining.
- Regarding cherry-picking, see also the comment in the report of the House of Commons Science and Technology Committee into the evidence for homoeopathy, at paragraph 73: "We regret that advocates of homeopathy, including in their submissions to our inquiry, choose to rely on, and promulgate, selective approaches to the treatment of the evidence base as this risks confusing or misleading the public, the media and policymakers." Brunton (talk) 00:25, 24 February 2010 (UTC)
Please do not delete my edits
http://en.wikipedia.org/w/index.php?title=Talk:Homeopathy&action=historysubmit&diff=342181985&oldid=342181463 I would like to see suggestions to the users who did that.--69.125.0.149 (talk) 22:34, 23 February 2010 (UTC)
- What kind of “suggestions” do you expect? If I had seen those edits I probably wouldn't have spotted the difference either and reverted the second one because in large part you merely repeat what you already wrote before under a different heading. Instead of quoting the same passage twice you should have answered under the same heading, addressing Bruntons argument that individual studies may have had positive results but this article mostly uses reviews (articles that compile the results of a large number of trials on a given subject and evaluate them), to which “but I'm quoting the source” (I'm paraphrasing here) isn't an answer.--Six words (talk) —Preceding undated comment added 23:10, 23 February 2010 (UTC).
UK House of Commons Science and Technology Committee's Evidence Check: Homeopathy
The "Evidence Check" by the UK House of Commons Science and Technology Committee into the evidence regarding homoeopathy is probably the most thorough examination of the subject by any scientific government body, and has resulted in the most authoritative mainstream scientific consensus statements ever written. I have never seen such a total debunking of homeopathy from any scientific government source. There was an abundance of sources used, with the full weight of all homeopathic organizations represented, and with them providing the majority of the testimony submitted. They cannot claim that they were not heard. They presented the best they have. Skeptics also weighed in.
These sources need to be gone through with a fine tooth comb, as they are all V & RS:
The scientifically validated entries came from these skeptical sources (and possibly others). The skeptics' entries are RS for the opinions of notable skeptics, and can be used as such if there is need for some of the ideas they express:
The rest are from believers who do their best to whitewash homeopathy and twist the weak or even debunked "evidence" into something they call "favorable". Ernst does a very good job of picking their "evidence" apart. The believer's entries are RS for the opinions of notable believers, and can be used as such if there is need for some of the ideas they express.
The BMA's entry is a very short, weak and pitiful statement that reveals a spineless approach, and which also reveals that they are attempting to protect their members' ability to make money, regardless of the evidence. That's political medicine, not scientific medicine. Their entry seems to have been written by someone with a spin doctor's mentality. A sad situation. -- Brangifer (talk) 06:39, 24 February 2010 (UTC)
- There's some quality sarcasm in there, isn't there? Guy (Help!) 19:40, 25 February 2010 (UTC)
- I wish I could claim that ;-) Unfortunately there doesn't seem to have been much "active ingredient" that could have been diluted to a "weak" version.... Medical societies like the BMA and AMA are primarily political organizations, and only secondarily scientific ones. If they really did take a strong stand, like the AMA did with chiropractic, it would firstly be for political reasons, and secondly (if the science backed up their political agenda, as it did against chiropractic) for scientific reasons. (See Wilk v. American Medical Association). OTOH, members of those societies can be very active promoters of science, with skeptics being the most vocal promoters of the scientific POV. They are the ones who take the scientific POV to the trenches where it is being disputed and scorned. Other scientists and MDs who aren't in the trenches hardly feel or realize there is a war of lies being waged against them and their POV, which is the same scientific POV as the one being advocated by their activist skeptical colleagues. It takes cases like the Simon Singh lawsuit to bring ordinary MDs and scientists out into the streets to support their activist colleagues. The British Chiropractic Association shot themselves in the foot in a big way that will really hurt their profession. When one lives in a glass house, one should not cast stones. They attacked, and their lack of evidence has been exposed. The emperor has no clothes. - Brangifer (talk) 05:42, 26 February 2010 (UTC)
Assertion of OR
An editor has tagged as WP:OR the statement "10−60 Dilution advocated by Hahnemann for most purposes: on average, this would require giving two billion doses per second to six billion people for 4 billion years to deliver a single molecule of the original material to any patient". It is not clear what he considers to be research as opposed to arithmetic. The calculation is simply: 1e-60*2e9*6e9*4e9*365*24*60*60*6e23 ~= 0.9 Perhaps the implicit "when starting with one mol of original material" should be made explicit? User:LeadSongDog come howl 14:56, 24 February 2010 (UTC)
- Or maybe find a source that says something similar. I’m pretty sure I’ve seen some funny descriptions of homeopathic dilutions in the writings of Drs. Harriet Hall and Stephen Barrett. Unfortunately I can’t seem to conjure any of them up at the moment. — NRen2k5(TALK), 06:56, 25 February 2010 (UTC)
- I have requested an explanation from him, but he's not responding, so I'm going to remove the tag. That doesnt' mean that the content can't be improved. -- Brangifer (talk) 20:06, 28 February 2010 (UTC)
Strong Bias?
I see that many users have expressed their disagrement with the article point's of view. why only the negative part of the reviews and references are being used?
From the archives of your forum there are users who write correctly that the Shang reviews ( "negative" for Homeopathy ) were *heavily* criticized by a large numbers of researchers, including Linde, Ludtke, Rutten, Frass, Bellavite and others. Linde and Ludtde are extensively quoted for debunking Homeopathy but not when they object to the Lancet that : "Given these limitations, Shang and colleagues' conclusion that their findings “provide support to the notion that the clinical effects of homoeopathy are placebo effects” is a significant overstatement."..." The conclusion that physicians should tell their patients that “homoeopathy has no benefit” and that “the time has passed for … further investment in research” is not backed at all by the data. "
This is not a neutral approach. Read the britannica entry ( Homeopathy )to see the difference.Greetings. --70.88.10.190 (talk) 01:19, 1 March 2010 (UTC)
- Don't confuse our WP:NPOV policy for neutrality. While Wikipedia itself has no opinion, articles are required to document all significant opinions found in verifiable and reliable sources (V & RS), and give weight to them according to their "fringeness". The scientific consensus is very clear, so their POV gets more weight. That naturally reveals the existing bias that exists among reliable sources. The latest is rather astounding. See below for the British House of Commons Science and Technology Committee report. -- Brangifer (talk) 02:58, 1 March 2010 (UTC)
- This is not honest: If the one sided anti homeopathy bias appearing in these sources requires the complete elimination of the other side which is published in the same sources ( Linde case for instance)of course it should not be adopted at least to justify this elimination. This is not the spirit of WP NPOV.--70.88.10.190 (talk) 09:57, 1 March 2010 (UTC)
- If well founded, scientifically based sources that support Homeopathy are available they can be added. The 'bias' in the article is simply a reflection of the studies that have been done and are properly sourced. Bevo74 (talk) 12:59, 1 March 2010 (UTC)
- Since Linde's meta-analysis (“Linde 1997”) is used as a source in the article I guess you're complaining about not using “Linde 2005”. Whether you like it or not, this is a matter of weight. “Linde 2005” isn't a new study but a comment on the meta-analysis Shang et al. did. Comments aren't subject to peer review, so they're not a reliable source per WP:MEDRS.--Six words (talk) 14:45, 1 March 2010 (UTC)
British House of Commons Science and Technology Committee report
In the United Kingdom, MPs inquired into homeopathy to assess the Government's policy on the issue, including funding of homeopathy under the National Health Service and government policy for licensing homeopathic products. The decision by the House of Commons Science and Technology Committee follows a written explanation from the Government in which it told the select committee that the licensing regime was not formulated on the basis of scientific evidence. "The three elements of the licensing regime (for homeopathic products) probably lie outside the scope of the ... select committee inquiry, because government consideration of scientific evidence was not the basis for their establishment," the Committee said. The inquiry sought written evidence and submissions from concerned parties.[34][35]
In February 2010 the House of Commons Science and Technology Committee concluded that:
... the NHS should cease funding homeopathy. It also concludes that the Medicines and Healthcare products Regulatory Agency (MHRA) should not allow homeopathic product labels to make medical claims without evidence of efficacy. As they are not medicines, homeopathic products should no longer be licensed by the MHRA.
The Committee concurred with the Government that the evidence base shows that homeopathy is not efficacious (that is, it does not work beyond the placebo effect) and that explanations for why homeopathy would work are scientifically implausible.
The Committee concluded - given that the existing scientific literature showed no good evidence of efficacy - that further clinical trials of homeopathy could not be justified.
In the Committee’s view, homeopathy is a placebo treatment and the Government should have a policy on prescribing placebos. The Government is reluctant to address the appropriateness and ethics of prescribing placebos to patients, which usually relies on some degree of patient deception. Prescribing of placebos is not consistent with informed patient choice-which the Government claims is very important-as it means patients do not have all the information needed to make choice meaningful.
Beyond ethical issues and the integrity of the doctor-patient relationship, prescribing pure placebos is bad medicine. Their effect is unreliable and unpredictable and cannot form the sole basis of any treatment on the NHS.[36]
The Committee also stated:
- "We conclude that placebos should not be routinely prescribed on the NHS. The funding of homeopathic hospitals — hospitals that specialise in the administration of placebos — should not continue, and NHS doctors should not refer patients to homeopaths."[37]
That's pretty powerful language from such an authoritative source. It's time for believers in homeopathy to show that they can learn and change their opinions. Otherwise they are true believers. For more, see this section above. -- Brangifer (talk) 02:58, 1 March 2010 (UTC)
why the article is not neutral- explanation
The scientific consensus is not very clear. If it were clear other encyclopedias like Britannica would heave adopt it. I read above that NCCAM ( American ) does not share this view as well. They accept that there is some inconclusive evidence for homeopathy and they do refund Homeopathy's research which is important.
This is not about weight. The writers of the article have not included very significant members of the Scientific Community who as active researchers published in major medical journals ( Lancet ) object to this point of view ( debunking homeopathy). You could have included their opinion in the article at least. But you don't even refer to these passages.
So you did not address my concerns and other users concerns about the neutrality of the current approach.You are repeating the one sided view.
Articles from different major reliable sources which have a different point of view on Homeopathy have been completely excluded. As I said these researchers are quoted only when they write negatively about the subject. --70.88.10.190 (talk) 03:37, 1 March 2010 (UTC)
- Have a look at reference 3 below, Evidence check: Homeopathy, House of Commons Science and Technology Committee, 20 October 2009, parliament.uk. Verbal chat 08:20, 1 March 2010 (UTC)
- It seems that the problem with this discussion is that people don't rationally respond to what has been said or argued. There is a "I did hear what you said" thing. It is evident from the archives. I just asked for the second or third time why the previous important sources have been completely eliminated instead of given a limited space and weight and I get not response. --70.88.10.190 (talk) 09:38, 1 March 2010 (UTC)
The scientific consensus is extremely clear. There is no evidence of any effect beyond a (subjective) placebo effect. (There is no evidence of any significant objective effects from the placebo effect.) It's a "pure placebo", so it's unethical to use it on humans outside of a research setting, but it would be the ideal placebo in laboratory research. As a placebo it would only "work" if all subjects receiving it believed it was an active treatment. If they knew it was homeopathic, then some of them, knowing that homeopathy is a placebo, would not be deceived and therefore it wouldn't work as a placebo for them. -- Brangifer (talk) 15:15, 1 March 2010 (UTC)
- ^ Mathie RT, Fisher P, "Homeopathy is safe and does not lack positive evidence in clinical trials," Br J Clin Pharmacol. 2007 September; 64(3): 396–397.
- ^ a b c Mathie RT (2003), "The research evidence base for homeopathy: a fresh assessment of the literature", Homeopathy, 92 (2): 84–91, PMID 12725250
- ^ Montagnier L, Aïssa J, Ferris S, Montagnier J-L, Lavalléee C (June 2009). "Electromagnetic signals are produced by aqueous nanostructures derived from bacterial DNA sequences". Interdiscip Sci Comput Life Sci. 1 (2). International Association of Scientists in the Interdisciplinary Areas, co-published with Springer-Verlag GmbH: 81–90. doi:10.1007/s12539-009-0036-7.
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- ^ "Dynamization and Dilution", Complementary and Alternative Medicine, Creighton University Department of Pharmacology, retrieved 2009-03-24.
- ^ a b Ernst E (2002), "A systematic review of systematic reviews of homeopathy", Br J Clin Pharmacol, 54 (6): 577–582, doi:10.1046/j.1365-2125.2002.01699.x, PMID 12492603
- ^ "Homeopathy - Issues", National Health Service http://www.nhs.uk/Conditions/Homeopathy/Pages/Issues.aspx, retrieved 2009-07-30
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However, homeopathy is not totally devoid of risks ... it may delay effective treatment or diagnosis.
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- ^ Oliver Wendell Holmes, Sr. (1842), Homoeópathy and its kindred delusions: Two lectures delivered before the Boston Society for the Diffusion of Useful Knowledge, Boston as reprinted in Oliver Wendell Holmes, Sr. (1861). Currents and Counter-currents in Medical Science. Ticknor and Fields. pp. 72–188. OCLC 1544161.
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- ^
Chakraborti D, Mukherjee SC, Saha KC, Chowdhury UK, Rahman MM, Sengupta MK (2003), "Arsenic toxicity from homeopathic treatment", Clin Toxicol, 47 (1): 963–967, PMID 14705842
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- ^ Legal Status of Traditional Medicine and Complementary/Alternative Medicine: A Worldwide Review, World Health Organization, 2001, ISBN 978-9241545488.
- ^ "News in brief: Homeopathic assessment". Times Higher Education. 29th October 2009.
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: Check date values in:|date=
(help), timeshighereducation.co.uk - ^ Evidence check: Homeopathy, House of Commons Science and Technology Committee, 20 October 2009, parliament.uk
- ^ UK Parliamentary Committee Science and Technology Committee - "Evidence Check 2: Homeopathy"
- ^ Evidence Check 2: Homeopathy, Fourth Report of Session 2009–10, House of Commons Science and Technology Committee, 20 October 2009, parliament.uk