http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/ in health, homeopathy, and life en john@vitalpatterns.net Copyright 2008 by the respective commenters 2008-04-04T06:58:00-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#4 Even if you’re going on observation, it seems like you should be able to do some kind of controlled observation-based study. In a controlled study, you’re still observing results. It just means that you’ve held some things constant and the only variable is what you’re testing. How else can you tell if something really works? There’s got to be some way to do that. {categories backspace="1"}{category_name}, {/categories} 2007-11-30T08:59:43-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#5 I think you have it backwards: when you want to study a single variable, you need to hold everything else constant. There are two assumptions in your comment: 1. That you can only really test a single variable. 2. That by reducing to a single variable you haven’t become so disconnected from the real life object of study that the conclusions still apply. Single variable studies are certainly important and necessary for many things, but I disagree that they are the end-all. Pattern is also a valid object of investigation, in my opinion, although the rules are different. (More on that to come.) I do believe that you need some level of control in science. That’s a given. But I claim that the level and type of controls can vary with the situation. And getting back to the point I am making here, I can know something for myself with a different level of control than I need to convince others who lack the direct experience. {categories backspace="1"}{category_name}, {/categories} 2007-11-30T13:52:33-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#6 I hope you won’t mind me asking you a question I have asked other homeopathic bloggers, but it’s a good way of judging how willing you are to engage in healthy debate. I have a simple question for you (and for all other supporters of homeopathy). It’s this: I can tell you, in one sentence, what it would take to convince me that homeopathy works; can you tell me what it would take to convince you that it doesn’t? All I would need is this: a properly conducted, double blind, randomised controlled trial, published in a respected, peer-reviewed journal, with results that showed an inarguable difference between homeopathic treatment and placebo in both the original trial and repeats of the trial by other researchers. Granted, it’s a long sentence. But that, just that, would cause me to change my mind completely and utterly about homeopathy (or indeed, any other contentious treatment). And I would expect it to change the minds of pretty much the entire scientific community too. Science is open-minded and good scientists are always willing to change their opinion totally if compelling evidence is presented that what they thought was true, isn’t. There would be no need to prove that all homeopathic remedies work, or that homeopathy works for all conditions. Just one remedy and/or one condition would suffice. There would be no need to explain how it works; the fact that the results were positive, clear and reproducible would be sufficient. You think homeopathy works. I think it doesn’t. We can’t both be right. This, above, is all that is needed to make me eat humble …(more) {categories backspace="1"}{category_name}, {/categories} 2007-11-30T14:06:03-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#9 Why is it so difficult for those of us who are homeopaths to explain, and those of us who are skeptics to understand, that the proof of the efficacy of homeopathy does not fit the scientific model? It functions in a separate paradigm which cannot be contorted into the narrow framework of reproducible results. When an individual is ill, in order to be restored to optimal functioning he requires a remedy specific to him, not to his disease or the part of him that is malfunctioning. The homeopath indulges his curiosity, experience and intuition to uncover the unique nature of the suffering within this individual, then matches that complex pattern of qualitative idiosyncrasies to a remedy known to have the same pattern. This knowledge is where the art of homeopathy lies, and is why we are having such a difficult time accepting each others point of view. An artist has to have sophisticated technical skills in order to produce a work of art. No one asks a painter to prove he can paint the exact same picture more than once according to a prescribed method ...and why would he want to? The homeopath is looking for uniqueness, not reproducible outcomes. I so appreciate the effort that honest skeptics expend to try and understand why those of us who respect this amazing medicine do so on what appears to be faith alone. Most of us arrive at our understanding through the direct experience of healing; having debilitating and life-long suffering disappear after taking a well-selected remedy, or watching a loved one recover completely from a severe trauma with unbelievable rapidity. None of this is scientifically verifiable, but is …(more) {categories backspace="1"}{category_name}, {/categories} 2007-11-30T17:24:18-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#14 Yes, doesn’t it often seem more difficult to explain than it should be? Your comment, “None of this is scientifically verifiable,” really got to the core of it for me, and what I’m fumbling about trying to say in this post. Any single case isn’t 100% verifiable, unless you impose an absurd amount of controls, but the bigger picture or pattern is quite verifiable. The problem is that conventional medicine tries to gather numbers of the same thing in its verification process, but we have to gather instances of a pattern, which they reject as being unscientific. My claim is that this shows a defect in how we conduct science. {categories backspace="1"}{category_name}, {/categories} 2007-12-01T10:35:39-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#15 I think thats very keen of you to distinguish John. It gets to the heart of the matter, which those M.Simpson types who cut and paste their “properly conducted blah blah, blah..” comments don’t seem to want to do. Another way of saying what you’re saying John is that, the research that supports reductionistic generalizations, i.e, finding out what can generally be true about something by narrowing it down into bits, DOESN’T support the verification of homeopathy since homeopathy is the antithesis of reductionism, its THE most holistic kind of therapy I know of. So lets see, can I think of a kind of antithetical research?… holistic research should be specific, which in turn finds out what is true for a particualr pattern, i.e. whether or not it is changing by looking at the whole pattern itself - seeing if the disapearrance of many symptoms and not just the ones that the disease can be labelled by, and the overall experience the person is having relative to their environment, to their condition, etc., if ALL that is leading to something greater than simply the disappearance of a symptom or condition (but including the disappearance of the condition) by taking something for IT. - yes that would be the perfect research study for homeopathy. Hey wait! Thats what homeopaths inherently do in their practices. Wow! That means that the practice itself of homeopathy IS a science, and a holistic one at that! And we’ve done 2 things at once! So I actually think the defect in how we conduct science, is that we can’t apply reductionisitc research to holistic healing action, which …(more) {categories backspace="1"}{category_name}, {/categories} 2007-12-01T11:22:39-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#16 M. Simpson’s challenge on this and other blogs is that s/he would believe homeopathy works if the following conditions were met: a properly conducted, double blind, randomised controlled trial, published in a respected, peer-reviewed journal, with results that showed an inarguable difference between homeopathic treatment and placebo in both the original trial and repeats of the trial by other researchers. Sounds simple enough. There are plenty of studies in alternative medical journals with positive results for homeopathy from double blind, randomized controlled trials. Since these don’t count for Simpson, is it the case that ‘properly conducted’ means that the people conducting the trials need to be allopathic doctors? And in order to be ‘respected’, would the journal need to be one of the major allopathic medical journals and would the ‘peers’ also need to be allopaths? This list of conditions is similar to the following: Ford will believe that BMW makes superior cars when the following conditions are met: 1) A bunch of engineers from Ford examine several BMWs and proclaim them to be better made than their own cars. 2) More engineers from Ford, plus some from GM and Honda, agree that BMW makes the better car. 3) The engineers convince the executives of Ford to publish a brochure about how well-made BMWs are. Can you say, “When pigs fly?” How many doctors out there are going to use up valuable research funds to submit studies to allopathic journals in order to support the competition? Not a good career move for those folks. The debate over whether homeopathy works seems to be …(more) {categories backspace="1"}{category_name}, {/categories} 2007-12-01T12:02:41-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#17 “The open-minded skeptic will need to keep this in mind when looking for evidence that supports homeopathy in journals that represent a community with a vested interest in invalidating this alternative approach to health.” What vested interest do journals such as Science and Nature have in denying scientific progress? If a paper were submitted to them, such as I described, which presented inarguable proof of the efficacy of homeopathy, sufficient to end all this squabbling by making anyone who continued to deny that homeopathy worked look like an intransigent fool, it would be the wonder of the age. It would be the greatest scientific breakthrough since Watson and Crick. It wouldn’t matter who wrote the paper as long as it was robust enough in both its methodology and its analysis to withstand any criticism from sceptics. Any major scientific journal would jump at the chance to publish such a paper. Do you really think that Science and Nature are part of some medical/scientific conspiracy to ensure that a phenomenon as earth-shatteringly important as the transmission of properties from solute molecules to water molecules, something which could potentially benefit mankind in a million ways, is kept secret from people and restricted to a fringe minority view. What would these journals gain from that? In any case, my description of what would satisfy me enough to cause a complete reversal of my opinion is not the crux of my post. What I would like to know, since homeopaths are open-minded, is what hypothetical evidence would be sufficient for YOU to admit you were mistaken. And it would be unfair of me to ask this without volunteering a …(more) {categories backspace="1"}{category_name}, {/categories} 2007-12-01T12:53:02-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#18 Then homeopathy is a science. I guess if M Simpson et al aren’t really listening to whats being said, even though it doesn’t seem that difficult to grasp, then they fall in the religious category, grasping dogmatically to they’re point of view not able to hear anything else. {categories backspace="1"}{category_name}, {/categories} 2007-12-01T14:39:10-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#19 Homeopathy is not a religion. Religion requires faith, and remedies work whether you believe in them or not. Homeopathy is a science, but the scope of the study required to duplicate results would be so large and deep that it would be unmanageable logistically. {categories backspace="1"}{category_name}, {/categories} 2007-12-01T15:17:46-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#20 To clarify what Nancy said, the fact that homeopathic remedies can be shown to be more effective than placebo in general or for certain (generally self-limiting acute) conditions has long been demonstrated in clinical trials. One example is Oscillococinum for flu symptoms. However, the testing of the more profound results that can be obtained when a homeopath takes the time to carefully match remedy to patient doesn’t fit the “Give remedy X for condition Y” clinical trial model. (This is a longer topic for a later posting.) {categories backspace="1"}{category_name}, {/categories} 2007-12-01T16:45:35-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#21 M Simpson said: what hypothetical evidence would be sufficient for YOU to admit you were mistaken. Perhaps I’m mistaken, but this seems like you are trying to get me to say that I am not willing to accept that homeopathy might not work and thereby demonstrate that homeopathy is a pseudo-science because science involves being willing to accept the null hypothesis, or indeed trying to prove yourself wrong? Can you tell me what it would take to convince you that randomized, double-blind, controlled trials don’t work, i.e. you can’t trust the results you get from them? I’d like to clarify that I am not against controlled studies being used for research on homeopathy. In fact, I’d love to see some studies get to the bottom of some theories that homeopaths have. In other words, there are lots of things within homeopathy that I would be willing to change my mind about. I also view each remedy choice I make as a hypothesis and I try to prove myself wrong. I’m not saying that is equal to a clinical trial. I’m just saying that in my work I try to prove myself wrong all the time. But “accepting” that homeopathy is just placebo? That would be denying my reality. I understand that other people don’t have my experiences and so may be skeptical. That’s okay. The main point that I tried to make in this post is that anecdotal evidence does count. It can count when viewed collectively or in a holistic way. And it counts to the individual who has the experience. Society at large wants more studies? Okay. But I don’t …(more) {categories backspace="1"}{category_name}, {/categories} 2007-12-01T17:41:32-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#22 Regarding Charlie’s comment and M Simpson’s response: I’m not a conspiracy theorist, but I agree that the homeopathy/placebo debate is more political and economic (and religious-like) than scientific. If someone were to discover the mechanism of action of homeopathic remedies, that would be the great scientific breakthrough that anyone would publish. A study where a homeopathic remedy shortens the average duration of flu symptoms by a day? I think that you have to already be alternative to do that one. Why would a leading convensional medical researchers risk their reputations for that? But the journals themselves? Well, studies with pro-homeopathy results have in fact been published in non-alternative peer-reviewed journals over the years, including the British Medical Journal, Pediatrics, the Journal of Pain Management, and the Lancet (before it adopted it’s current anti-homeopathy bias). {categories backspace="1"}{category_name}, {/categories} 2007-12-01T19:39:07-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#23 Thanks for the great comment, Marty. That’s sums it up pretty well: you can’t use reductionistic methods to determine the true efficacy of holistic healing methods. Hey wait! Thats what homeopaths inherently do in their practices. Wow! That means that the practice itself of homeopathy IS a science, and a holistic one at that! That’s exactly how I feel. When I hear a claim that homeopathy is not scientific, it’s like someone playing a wrong note: it’s discordant with my experience. When I see a single symptom improvement, or someone talks about having more energy, I look for other possible causes and I look for other changes to their pattern in order to judge whether the remedy might have worked or not. That might sound very odd to a scientific researcher, but there is a similarity. It’s certainly more like doing research on the behavior of wild animals than lab work. Hey, that’s a nice metaphor, given that we are essentially gathering data about the way all kinds of animals, plants, and substances interact with the human life force. {categories backspace="1"}{category_name}, {/categories} 2007-12-01T20:01:24-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#26 All I would need is this: a properly conducted, double blind, randomised controlled trial, published in a respected, peer-reviewed journal, with results that showed an inarguable difference between homeopathic treatment and placebo in both the original trial and repeats of the trial by other researchers. So how does surgery work with this demand? MANY surgical techniques are developed through trial and error and oh my Gosh! through seeing patient satisfaction. Homeopathy has many satisfied patients and its safety and efficacy has been proven mainly through that. So why should surgery, (a much more invasive medical modality) have this as a standard of efficacy and not homeopathy? {categories backspace="1"}{category_name}, {/categories} 2007-12-02T05:23:08-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#27 “M Simpson said: what hypothetical evidence would be sufficient for YOU to admit you were mistaken. Perhaps I’m mistaken, but this seems like you are trying to get me to say that I am not willing to accept that homeopathy might not work and thereby demonstrate that homeopathy is a pseudo-science because science involves being willing to accept the null hypothesis, or indeed trying to prove yourself wrong?” I’m not trying to get you to say anything specific. I’m simply asking you (and other homeopathic supporters) an open question: whether there is anything that could make you change your mind. Some people have said yes there is, some have said no there isn’t. The latter group clearly do have a quasi-religious faith in homeopathy rather than a scientific approach (and debating with them becomes rather pointless). Those who say yes demonstrate that they are open-minded. I do want to stress that Charlie rather misrepresented me earlier: I am in no way asking people to provide evidence of the sort that I described in my original post. I’m merely demonstrating that there is a hypothetical type of evidence which would persuade me to alter my own view by 180 degrees, to show that I’m not asking you to do something I wouldn’t do myself. “Can you tell me what it would take to convince you that randomized, double-blind, controlled trials don’t work, i.e. you can’t trust the results you get from them?” Certainly. It would take stronger evidence in the opposite direction. If there was an instance where, despite rigorous, repeated RCTs showing that X = Y, there was stronger …(more) {categories backspace="1"}{category_name}, {/categories} 2007-12-02T05:38:15-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#28 As bloggers know I am fond of quotes:  “All truth passes through three stages: First, it is ridiculed; Second, it is violently opposed; and Third, it is accepted as self-evident.” --Arthur Schopenhauer {categories backspace="1"}{category_name}, {/categories} 2007-12-02T06:25:19-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#31 I think that RemedyReality put his/her response to M Simpson very well: Accepting the reality of nature’s laws is not so much close-minded but rather observant. {categories backspace="1"}{category_name}, {/categories} 2007-12-02T09:15:08-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#32 Okay, M Simpson. Yesterday I gave you my honest answer to your question: that I have no more reason to question the existence of homeopathy than I do gravity. However, I like “what if”s and philosophical questions (up to a point). I’ve been talking about the value of experience and anectodal evidence. Okay, now I’ll turn it around. So what if I were willing to consider that homeopathy “doesn’t work,” i.e. is just a ritualized placebo effect? Then what? What first comes to my mind is the idea that if only I didn’t believe in gravity, then I could fly. Next I think, what are the consequences of being willing to deny one’s reality? Sounds like pathology (i.e. psychosis) to me. But I’m game. What difference would that make to you? As I said before, I don’t have any more studies up my sleeve than what you already have access to in your quest for evidence that homeopathy “works.” If those weren’t enough for you, you won’t be changed by what I have to say. In any case, my intention with this blog is not to rehash the minutiae of those studies. There may not be published scientific proof up to the extremely high “extraordinary proof for extraordinary claims” standard that you would like, but there is ample evidence to raise sufficient doubt even in skeptical minds that there is something to homeopathy and it might be worth checking out personally if you are interested in health care alternatives. {categories backspace="1"}{category_name}, {/categories} 2007-12-02T09:30:08-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#37 “ I have no more reason to question the existence of homeopathy than I do gravity.” The difference is that gravity fits into humankind’s current understanding of how the universe works without contradicting any of the other fundamental laws of the universe. Homeopathy on the other hand, to be true, would require large parts of our current understanding of the universe to be false (which they may be, but the more theories which have to be rejected to allow one new theory to stand, the less plausible the new theory becomes). Also our understanding of gravity is sufficient to make very specific and extremely accurate predictions which can then be demonstrated to be true (for example the use of gravity to ‘slingshot’ space-probes around distant planets)? Can homeopathy be used to make any specific and accurate predictions like this? “So what if I were willing to consider that homeopathy “doesn’t work,” i.e. is just a ritualized placebo effect? Then what?” Personally I think that too much is made of the placebo effect on both sides of the argument. I have no doubt that it is a major factor in RCTs of homeopathy but in general homeopathic practice it seems fairly obvious that most recoveries are due to the conditions being self-limiting, ie. they will get better by themselves anyway. So yes, I think homeopathy doesn’t work but no, I don’t think it’s “just” a ritualised placebo effect. “what are the consequences of being willing to deny one’s reality? Sounds like pathology to me.” I don’t understand what you mean by ‘pathology’. Many years ago I worked in a pathology …(more) {categories backspace="1"}{category_name}, {/categories} 2007-12-02T12:06:11-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#38 Homeopathy on the other hand, to be true, would require large parts of our current understanding of the universe to be false Not so. (This was one of the first things I thought too, but then realized wasn’t the case, when I first got interested in homeopathy.) Homeopathy requires new understanding of the universe. I can’t think of one thing that would be false besides a purely materialistic understanding of reality. Also our understanding of gravity is sufficient to make very specific and extremely accurate predictions… Your point about gravity is true, of course. That’s the reason there is this epistemological problem in the first place. But my point is that my experience with homeopathy makes it as hard for me to deny as gravity. It’s part of my reality, based on what I’ve experienced. Not my faith—I have that too—but my reality. it seems fairly obvious that most recoveries are due to the conditions being self-limiting, i.e. they will get better by themselves Few of my patients have self-limiting conditions. I don’t understand what you mean by ‘pathology’. Many years ago I worked in a pathology laboratory. It involved testing blood and urine samples all day. What has that got to do with denying reality? Sorry, I meant psychosis. (I changed the post above.) “But I’m game. What difference would that make to you?” I’d like to answer this but grammatically I’m not sure what you’re referring to here. I guess you’re saying that as long as I state that I’m willing to be proved wrong that you are willing do the …(more) {categories backspace="1"}{category_name}, {/categories} 2007-12-02T12:40:23-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#39 Hi all. It is interesting that no one supporting homeopathy has been able to say what will change their mind. I am somewhat skeptical of homeopathy and think there is a very straightforward way that would convince me there was something in it. All you would have to do was tell me was a remedy was if I had taken the label off. You could do what you liked, any sort of anaysis, even swallow them. If you could tell me what it was then I think there would be no more skeptics. Has this experiment ever been done? Seems simple to me. {categories backspace="1"}{category_name}, {/categories} 2007-12-02T13:07:20-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#45 Something which I have seen elsewhere that would convince me that homeopathy works is a case (with references and evidence that conventional medicines were not being used) of a non-self limiting illness being cured by homeopathy. {categories backspace="1"}{category_name}, {/categories} 2007-12-03T06:00:13-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#46 All you would have to do was tell me was a remedy was if I had taken the label off. This is the same as saying that you will accept homeopathy as soon as the mechanism of action is discovered. (Because then it might be measured.) It also shows that you don’t understand homeopathy. #1. Not all remedies go beyond a material dose. The original homeopaths began with material doses. Low potency homeopathics still have original material left in them. So I could give you one of those and then get a chemical analysis done… I’m splitting hairs, because we more often do use highly potentized doses, and even when there is sufficient original material left, chemistry can’t account for the homeopathic effect. But I wish people would actually try to understand homeopathy instead of doing a drive-by criticism. #2. Have a look at my definition of homeopathy. Other homeopaths might break the essential elements up differently than I did (I’ve used 4), but note that there are several principles necessary for homeopathy. The potentized remedy is only one part of homeopathy; the only part most of the “skeptics” pay attention to. But the others are troubling to conventional medicine as well.  And those other things involve individualization, which means it would be extremely difficult to determine a remedy by its action on one person unless it profoundly curative for that individual. Another way of saying this is that you can’t determine a pattern from a single instance. {categories backspace="1"}{category_name}, {/categories} 2007-12-03T17:30:44-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#47 All you would have to do was tell me was a remedy was if I had taken the label off. Here’s an experiment that could be done: 1. Some homeopaths produce a list of homeopathic remedies that have fairly complete and well understood materia medica. That would give you at least several hundred to choose from. 2. An unbiased third party selects one. 3. A group of homeopaths (say about 30) takes that remedy (with blinding) and keeps journals for a month. 4. Another smaller group of homeopaths (also blinded) analyzes the journals and tries to determine the remedy. It would be challenging, but it would have a decent likelihood of success. I imagine that if a large group of skeptics would agree to accept this experiment as validating homeopathy that we could easily find the people for the experiment. {categories backspace="1"}{category_name}, {/categories} 2007-12-03T17:49:18-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#48 John, The experiment is sort of beginning to look look like one that would convince me. It makes no claims to how homeopathy works, just that is does. Mechanisms can wait for proof that there is an effect! With this human test way of determining effectiveness, I would not care if the dilutions were low and had some residual material left. Usually, these are in miniscule proportions. It would still be amazing to detect their effect on human health. One would have to look at the statisitics a bit to ensure that a fluke result would not ‘prove homeopathy’, but that is fairly easy. For example, more than one remedy being tested on several groups. Now, if homeopathy has such powerful effects, this ought to be trivial. The experiment could be done (say) as a final year project at a homeopathy school as a fun investigation. No need for complex health consent forms, ethics issues about experimenting on sick people. It ought to be straightforward. This is enouraging. The funny thing is that I just cannot believe that it has not been done already and written up! It would make all those skeptics shut up immediately. Can any homeopaths think of any occasion where this has been done with a degree of rigour? And if not, why not? So why not do it? Get some trusted third party to supervise, get some help to define a protocol that avoids cheating and will produce the right level of statistical confidence and prove to the world the power of homeopathy. {categories backspace="1"}{category_name}, {/categories} 2007-12-03T22:01:35-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#50 Why would this convince you when positive results from randomized double-blind controlled trials have not? (Here is some of the research.) Now, if homeopathy has such powerful effects, this ought to be trivial. Trivial doesn’t follow from powerful. For one thing, it’s a more subtle effect. Imagine a new CEO comes to a company and you are observing the behavior of a group of employees without being able to see the memos calling for changes coming from the new leaders or being able to interview the employees. All you see is the improvement in morale following the change in management. What caused it exactly? Also, the effects of a remedy in a proving are not best described as “powerful.” That’s the whole point. In a homeopathic proving, we observe an echo of pathology, not the pathology itself. Think sensations, not tissue changes. That makes it subjective. (Most provings are done single or double blind because of this.) Perhaps this is a good place to bring up something about all these studies: they are clinically useless for homeopaths. (I’ll address this in a later post.) We aren’t looking to be convinced and we’d rather spend our energy advancing our art. My point is that such an experiment would be an academic exercise, only useful if it would in fact alter the perception of homeopathy in the wider world. The oversight would have to be very rigorous, since a positive result would likely be dismissed with claims of cheating. I mean, if clinical trials aren’t accepted now due to claims of bias, this would be worse. And practically, it would have to be done …(more) {categories backspace="1"}{category_name}, {/categories} 2007-12-04T10:14:09-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#52 “I mean, if clinical trials aren’t accepted now due to claims of bias, this would be worse.” No, they’re not accepted because of *possible* bias. No-one’s saying anyone’s cheating deliberately, but a rigorous and credible trial must remove any possibility of accidental bias. It must be Caesar’s wife. “I must say, however, that I believe the perception of homeopathy will shift when Oprah or Bill Gates or George W. Bush or someone like that has a cure in a non-self-limiting condition and speaks out about it” It wouldn’t need to be someone famous. As PV has repeatedly asked on pro-homeopathy blogs: ‘Give me one (just one) incontrovertible example, with references, of homeopathy curing a non-self-limiting condition.’ We’re still waiting for an answer… (And if you want famous people publicly supporting homeopathy, they don’t come much more famous than Prince Charles. But his outspoken support hasn’t strengthened homeopathy’s case, it has just made the Prince a figure of fun.) {categories backspace="1"}{category_name}, {/categories} 2007-12-04T11:46:32-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#54 I think the above idea is much simpler than a clinical trial and would undoubtedly make skeptics sit and take notice as they claim that all homeopathic remedies are the same - pretty much plain sugar pills. It removes much of the problems of clinical trials - you could use a fairly small group of people, they could all be trained homeopaths and so, hopefully, more aware of the subtelties and could be done in a few weeks. In short, it is a sort of test of provings. If provings work, then this test ought to. Take six well known and well characterised remedies with strongly different effects and see if you can tell the six apart. If this sort of test does not work, then I cannot see how provings work. {categories backspace="1"}{category_name}, {/categories} 2007-12-04T13:32:05-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#55 Take six well known and well characterised remedies with strongly different effects and see if you can tell the six apart. Only six, and I can pick the six? Are you speaking just for yourself, or can you get Ben Goldacre to publish a retraction in the Lancet? If he at least wrote that he might have been wrong about homeopathy, although he would like to see more research done, that would probably be enough, I think. {categories backspace="1"}{category_name}, {/categories} 2007-12-04T17:25:37-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#56 Give me one (just one) incontrovertible example, with references, of homeopathy curing a non-self-limiting condition. How about if you take my hypothetical case from the next posting? Imagine that patient hadn’t been on any other kind of treatment for at least three months prior to begining homeopathic treatment and didn’t do any other therapy during that time, and had an almost complete reversal of symptoms in a matter of weeks. Would that do it for you? What would you want besides a pre and post examination from a physician for clinical confirmation? they don’t come much more famous than Prince Charles. What I’m trying to say is if someone very respected or very unexpected speaks out about a cure of a non-self-limiting condition. {categories backspace="1"}{category_name}, {/categories} 2007-12-04T18:05:57-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#58 “What would you want besides a pre and post examination from a physician for clinical confirmation?” It would need to be ‘incontrovertible’ - there would need to be absolutely no possibility whatsoever that (a) the initial diagnosis was mistaken, (b) the subsequent diagnosis was mistaken or (c) any other factor could have caused the recovery. I can’t be more specific - that would depend on the case. But since your case is hypothetical, the point is moot. {categories backspace="1"}{category_name}, {/categories} 2007-12-04T22:52:10-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#59 John - I do not speak for Ben Goldacre - of course not. But getting 6 out of 6 right would be very impressive. I think (if my maths is ok) that the probability of getting six out of six right by chance would be 1 in 720. A medical trial typically has a 1 in 20 chance of being a fluke so this trial would be much stronger evidence of a homeopathic effect than any medical trial published so far. Of course, as with all good science, results would probably have to be replicated by other researchers to add to the confidence that things like cheating were not involved, but if you could pull of this test in a controlled way, then you would have the attention of every critic. People like Randi might insist on more than 6 to win a million. (odds of 720:1 might not be good enough for that sort of bet). But 10 might. And, yes, I see no reason why you could not be allowed to pick which remedies - make them as potentized and dissimilar as you like. The major condition would be though that all participants were blinded, both judges and gineau pigs. A trusted independent third party would be requited to take the labels off the remedies and put a code letter on - ths code not being opened until the very end of the trial. Do you think you could do this test? {categories backspace="1"}{category_name}, {/categories} 2007-12-05T06:35:42-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#61 if you could pull of this test in a controlled way, then you would have the attention of every critic Interesting. This is very much along the same lines as something I’d been thinking about. Trial takes a year. A dozen remedies are chosen by a panel of homeopaths for their clearly distinct symptom pictures. Potency 30C, so we’re clearly dealing with dilutions beyond the Avogadro limit. The remedy labels are replaced by the panel with numbers 1-12, and a list of the 12 remedies and their numbers is sealed and passed to an independent adjudicator. The bottles are then passed to another independent party who replaces the numbers on the bottles with a different coding system. The key to the codes is sealed and deposited with the adjudicator. Of these 12 coded remedies, 6 are selected at random by another independent party, and the remaining 6 destroyed. The 6 coded bottles are passed to the trial coordinator. Every 2 months, testers are sent one remedy from the set of six at random (ie. the testers will not all be testing the same remedy at the same time, though will have tested all six by the end of the year) and the record of who got which code every 2 months is sealed and passed to the adjudicator. At the end of the year, the adjudicator opens the original list of remedies and notifies the testers that they each were testing 6 of these 12 remedies. The testers then identify which 6 remedies they tested in what order and the adjudicator then breaks the codes and testing records and matches these to the testers’ submissions. …(more) {categories backspace="1"}{category_name}, {/categories} 2007-12-05T14:24:46-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#76 So maybe someone will actually perform this experiment… I still don’t see why this experiment would convince homeoapthy’s skeptics when the randomized double-blind controlled trials that have already been done do not. Perhaps it seems odd to me that you would prefer this because I know that it would really be testing the education and skills of the homeopaths in the test, not just testing remedy effects. But it is also a more interesting test to homeopaths because it involves full remedy “pictures,” whereas normal clinical trials focus on just a single symptom. I am a clinician, not a researcher, and this would be a large undertaking. Not my thing at all. However, if some prominent “skeptics” like Goldacre were to offer to publicly admit that homeopathy might work if such an experiment succeeded, I would personally find a way to perform it. {categories backspace="1"}{category_name}, {/categories} 2007-12-06T22:45:22-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#77 there would need to be absolutely no possibility whatsoever that ... (c) any other factor could have caused the recovery. There is a huge amount of wiggle room there. Perhaps we could agree on a more precise definition for a given case, but I have the feeling that I couldn’t meet your standard unless the patient was monitored 24/7. But since your case is hypothetical, the point is moot. That example is based on an actual case. I said “hypothetical” because I wanted the discussion to be about the value of personal experience, not about me trying to convince you with yet another anecdote. And I got the answer that I was looking for in your comment here. {categories backspace="1"}{category_name}, {/categories} 2007-12-06T23:01:16-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#93 Looks liek the quackometer has made a challenge… http://www.quackometer.net/blog/2007/12/simple-challenge-to-homeopaths.html {categories backspace="1"}{category_name}, {/categories} 2007-12-09T14:09:02-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#95 I left a comment on “quackometer” in support of the idea. I have to say that I have very mixed feelings about doing so. Whenever I look at blogs like that I don’t see science or anything resembling an open mind, I see scientistic zealotry, where conventional medicine is unfairly portrayed as “good” and homeopathy as “evil.” (See For the sake of science or Now They Tell Us if you want to read more on the subject.) I continue to hear so-called skeptics repeating false statements such as, “there is not one jot of evidence” about homeopathy. (See Lies, damn, lies, and socks or Null Balance, Null Fairness.) When you constantly hear your position misrepresented (putting it mildly), there’s not much reason for trust. With all this as a background, it’s extremely hard to believe that there is any good faith behind this “challenge.” I fear the rules of “acceptance” will change before the end and homeopaths will once again be falsely accused of not being willing to test their claims. Nevertheless, while the meanness and politics around it make me uncomfortable, I have no fear of the actual experiment. {categories backspace="1"}{category_name}, {/categories} 2007-12-09T19:12:51-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#103 Well I think we ought to do it. When we succeed, or if the kwakman changes the rules, then we can expose him as a fraud. {categories backspace="1"}{category_name}, {/categories} 2007-12-10T03:00:09-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#127 Here’s another anecdote for you. One of my teachers talked about the importance of using trusted pharmacies. There had been a fire in this person’s office and they had to buy new remedies. After that, they were not getting good results with the high potencies (200C and up). So they switched to a different pharamacy and voila, the results improved. And this wasn’t the wrong remedy, it was just a pharmacy using poor methods for running the remedies up to high potency. {categories backspace="1"}{category_name}, {/categories} 2007-12-17T06:56:30-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#139 John, firstly, thanks for pointing me in the direction of this thread. Your anecdote regarding the use of trusted pharmacies, I have to admit I’m missing the point which could be down to my ignorance but I assume is down to a typo. Anyway, that is an aside. What I am interested in is how quality control is achieved with homeopathic remedies. If I were to visit a homeopath I’d want to know that the remedies were manufactured by one of these pharmacies using good methods and not one using poor methods. I’d also want to know that they were using repeatable methods and that they knew when there process wasn’t working as they intend. {categories backspace="1"}{category_name}, {/categories} 2007-12-18T03:02:28-08:00 http://woowooscience.com/index.php/blog/post/how_do_you_know_it_works/#221 (Typo in my last comment fixed...) If I were to visit a homeopath I’d want to know that the remedies were manufactured by one of these pharmacies using good methods Countries usually have an official standard, called a Homeopathic Pharmacopeia. In the US, it’s part of the FDA. The pharmacy where most of my remedies come from is FDA licensed. {categories backspace="1"}{category_name}, {/categories} 2007-12-20T19:46:21-08:00