Individualised trial of homeopathy

Discussion in 'Health and medical' started by Peter Moran, Feb 6, 2004.

  1. Peter Moran

    Peter Moran Guest

    Here is an example of a trial of homeopathic medicine where the homeopaths were given the
    opportunity to individualise treatment, as some homeopaths claim is necessary to their "art".

    Thorax 2003;58:317-321

    Individualised homeopathy as an adjunct in the treatment of childhood asthma: a randomised

    placebo controlled trial

    A White, P Slade, C Hunt, A Hart and E Ernst

    Complementary Medicine, Peninsula Medical School, Universities of Exeter and Plymouth, Exeter

    EX2 4NT, UK

    Background: Homeopathy is frequently used to treat asthma in children. In the common classical form
    of homeopathy, prescriptions are individualised for each patient. There has been no rigorous
    investigation into this form of treatment for asthma.

    Methods: In a randomised, double blind, placebo controlled trial the effects of individualised
    homeopathic remedies were compared with placebo medication in 96 children with mild to moderate
    asthma as an adjunct to conventional treatment. The main outcome measure was the active quality of
    living subscale of the Childhood Asthma Questionnaire administered at baseline and follow up at 12
    months. Other outcome measures included other subscales of the same questionnaire, peak flow rates,
    use of medication, symptom scores, days off school,

    asthma events, global assessment of change, and adverse reactions.

    Results: There were no clinically relevant or statistically significant changes in the active
    quality of life score. Other subscales, notably those measuring severity, indicated relative
    improvements but the sizes of the effects were small. There were no differences between the groups
    for other measures.

    Conclusions: This study provides no evidence that adjunctive homeopathic remedies, as prescribed by
    experienced homeopathic practitioners, are superior to placebo in improving the quality of life of
    children with mild to moderate asthma in addition to conventional treatment in primary care.
     
    Tags:


  2. Rod

    Rod Guest

    Thanks Peter, I do note that the study concludes that the homeopathic treatment is no better than
    the Placebo (I shall please) treatment. The problem is that the Placebo effect is rather major as it
    is used by science as the measure against "known/suspected" possible treatments. The problem I have
    is, why Science would use a measure of the "placebo effect" which is an accepted method for the
    basis of study and result. Is that not like saying " that we know that this will also influence the
    problem but we do not know why"

    How science can measure against a " Do not know why" is somewhat of a mystery, which of course is
    the "placebo effect"

    Cheers Rod. "Peter Moran" <[email protected]> wrote in message news:[email protected]
    02.brisbane.pipenetworks.com.au...
    > Here is an example of a trial of homeopathic medicine where the homeopaths were given the
    > opportunity to individualise treatment, as some homeopaths claim is necessary to their "art".
    >
    > Thorax 2003;58:317-321
    >
    > Individualised homeopathy as an adjunct in the treatment of childhood asthma: a randomised
    >
    > placebo controlled trial
    >
    >
    > A White, P Slade, C Hunt, A Hart and E Ernst
    >
    >
    > Complementary Medicine, Peninsula Medical School, Universities of Exeter
    and
    > Plymouth, Exeter
    >
    > EX2 4NT, UK
    >
    >
    >
    >
    > Background: Homeopathy is frequently used to treat asthma in children. In the common classical
    > form of homeopathy, prescriptions are individualised for each patient. There has been no rigorous
    > investigation into this form
    of
    > treatment for asthma.
    >
    >
    > Methods: In a randomised, double blind, placebo controlled trial the
    effects
    > of individualised homeopathic remedies were compared with placebo
    medication
    > in 96 children with mild to moderate asthma as an adjunct to conventional treatment. The main
    > outcome measure was the active quality of living subscale of the Childhood Asthma Questionnaire
    > administered at baseline
    and
    > follow up at 12 months. Other outcome measures included other subscales of the same questionnaire,
    > peak flow rates, use of medication, symptom
    scores,
    > days off school,
    >
    > asthma events, global assessment of change, and adverse reactions.
    >
    >
    > Results: There were no clinically relevant or statistically significant changes in the active
    > quality of life score. Other subscales, notably
    those
    > measuring severity, indicated relative improvements but the sizes of the effects were small. There
    > were no differences between the groups for other measures.
    >
    >
    > Conclusions: This study provides no evidence that adjunctive homeopathic remedies, as prescribed
    > by experienced homeopathic practitioners, are superior to placebo in improving the quality of life
    > of children with mild to moderate asthma in addition to conventional treatment in primary care.
    >
    >
     
  3. Baldrick

    Baldrick Guest

    They will compare apples with black matter. Placebo fx is to posology like gravity to physics, it is
    everywhere and affect everything, so it is also included and perhaps considered if not expected. But
    as it´s spectrum of function is not quantifiable, it can as well be the drug itself. Paradoxically
    science wouldn´t be able to prove that healing comes from chemical reactions triggered by their
    drugs, until they explain scientifically placebo fx and disassociate it from those of the drugs.

    "Rod" <[email protected]> wrote in message news:[email protected]
    server.bigpond.net.au...
    > Thanks Peter, I do note that the study concludes that the homeopathic treatment is no better than
    > the Placebo (I shall please) treatment.
     
  4. Eric Bohlman

    Eric Bohlman Guest

    "Rod" <[email protected]> wrote in
    news:[email protected]:

    > Thanks Peter, I do note that the study concludes that the homeopathic treatment is no better than
    > the Placebo (I shall please) treatment. The problem is that the Placebo effect is rather major as
    > it is used by science as the measure against "known/suspected" possible treatments. The problem I
    > have is, why Science would use a measure of the "placebo effect" which is an accepted method for
    > the basis of study and result. Is that not like saying " that we know that this will also
    > influence the problem but we do not know why"
    >
    > How science can measure against a " Do not know why" is somewhat of a mystery, which of course is
    > the "placebo effect"

    Much of what's labelled "placebo effect" is quite well known; it's simply the ordinary natural
    history of various conditions, which is quite predictable on average for large groups but is quite
    unpredictable on the individual level. Let's say, for example, that you're trying to evaluate the
    effectiveness of a proposed treatment for bedwetting in children. You *really* need to use a control
    group, because around half of all children who wet their beds at a given age will be dry a year from
    now even if you do absolutely nothing. Or say you're looking at a treatment for multiple sclerosis
    symptoms. The fact is that MS exacerbations often spontaneously resolve, sometimes for years or
    decades, and that people seeking such treatments are likely to be in the middle of an exacerbation.
    In both cases, you can't conclude anything about the effectiveness of the treatment unless you
    compare the people treated with a similar group of people who aren't treated.

    As I've mentioned before, since I was quite young I would have several days in the summer/fall when
    my hay fever was nearly incapacitating. That started to change the year I had turned 30, and within
    a year or two I no longer had any such days. I didn't change anything I was doing at the time; I
    still lived in the same place, and ragweed pollen levels didn't go down. The condition just went
    away on its own. But what if, at the age of 29, I had tried some intervention in hopes of reducing
    my hay fever symptoms? I'd have been inclined (it actually takes a conscious effort to prevent such
    an attribution) to attribute the improvement at age 30 to that intervention. I'd have experienced
    Results, yet whatever I would have done wouldn't have been effective. If, for example, I had somehow
    gotten the notion into my head that eating a pound of sugar a day would make my hay fever go away,
    it would *feel* like that daily pound of sugar gave me Results, even though my knowledge of
    physiology tells me that it couldn't have and that indeed it would have been harmful to me.
     
  5. Peter Moran

    Peter Moran Guest

    "Rod" <[email protected]> wrote in message
    news:[email protected]...
    > Thanks Peter, I do note that the study concludes that the homeopathic treatment is no better than
    > the Placebo (I shall please) treatment. The problem is that the Placebo effect is rather major as
    > it is used by science as the measure against "known/suspected" possible treatments. The problem I
    > have is, why Science would use a measure of the "placebo effect" which is an accepted method for
    > the basis of study and result. Is that not like saying " that we know that this will also
    > influence the problem but we do not know why"
    >
    > How science can measure against a " Do not know why" is somewhat of a mystery, which of course is
    > the "placebo effect"

    Eric has eloquently explained to you (again) that what is commonly referred to as a "placebo effect"
    is mostly no "effect" at all, it is the natural progress of the illness. This explains why they
    don't work with serious illnesses like cancer or diabetes, although they can help make such patients
    feel better..

    Numerous other factors can make an inert treatment appear to "work" when it does nothing, such as
    patients wanting to oblige their doctor by giving what they think is the "right" answer, becoming
    habituated to symptoms, or simply focussing less upon symptoms when in a more supportive therapeutic
    environment..

    Also, as suggested by the ingenious study that follows, true placebo effects may be much weaker than
    is commonly thought. Note that only subjective aspects of illness (patient perceptions regarding
    symptoms) seem to be affected at all.

    I suspect, however, that in more emotionally charged therapeutic environments placebos may have
    stronger effects on symptoms than is shown in these controlled trials. An example might be someone
    frustrated with poor medical care finding a devoted and sympathetic "alternative" carer.

    N Engl J Med. 2001 May 24;344(21):1594-602.

    Is the placebo powerless? An analysis of clinical trials comparing placebo with no treatment.

    Hrobjartsson A, Gotzsche PC.

    Department of Medical Philosophy and Clinical Theory, University of Copenhagen, Panum Institute, and
    the Nordic Cochrane Centre, Rigshospitalet, Denmark. [email protected]

    BACKGROUND: Placebo treatments have been reported to help patients with many diseases, but the
    quality of the evidence supporting this finding has not been rigorously evaluated. METHODS: We
    conducted a systematic review of clinical trials in which patients were randomly assigned to either
    placebo or no treatment. A placebo could be pharmacologic (e.g., a tablet), physical
    (e.g., a manipulation), or psychological (e.g., a conversation). RESULTS: We identified 130 trials
    that met our inclusion criteria. After the exclusion of 16 trials without relevant data on
    outcomes, there were 32 with binary outcomes (involving 3795 patients, with a median of 51
    patients per trial) and 82 with continuous outcomes (involving 4730 patients, with a median of
    27 patients per trial). As compared with no treatment, placebo had no significant effect on
    binary outcomes (pooled relative risk of an unwanted outcome with placebo, 0.95; 95 percent
    confidence interval, 0.88 to 1.02), regardless of whether these outcomes were subjective or
    objective. For the trials with continuous outcomes, placebo had a beneficial effect (pooled
    standardized mean difference in the value for an unwanted outcome between the placebo and
    untreated groups, -0.28; 95 percent confidence interval, -0.38 to -0.19), but the effect
    decreased with increasing sample size, indicating a possible bias related to the effects of
    small trials. The pooled standardized mean difference was significant for the trials with
    subjective outcomes (-0.36; 95 percent confidence interval, -0.47 to -0.25) but not for those
    with objective outcomes. In 27 trials involving the treatment of pain, placebo had a beneficial
    effect (-0.27; 95 percent confidence interval, -0.40 to -0.15). This corresponded to a
    reduction in the intensity of pain of 6.5 mm on a 100-mm visual-analogue scale. CONCLUSIONS: We
    found little evidence in general that placebos had powerful clinical effects. Although placebos
    had no significant effects on objective or binary outcomes, they had possible small benefits in
    studies with continuous subjective outcomes and for the treatment of pain. Outside the setting
    of clinical trials, there is no justification for the use of placebos.

    Peter Moran
     
  6. Jan

    Jan Guest

    >Subject: Individualised trial of homeopathy From: "Peter Moran" [email protected] Date: 2/5/2004
    >11:44 PM Pacific Standard Time Message-id: <[email protected]
    >02.brisbane.pipenetworks.com.au>
    >
    >Here is an example of a trial of homeopathic medicine where the homeopaths were given the
    >opportunity to individualise treatment, as some homeopaths claim is necessary to their "art".
    >
    >Thorax 2003;58:317-321
    >
    >Individualised homeopathy as an adjunct in the treatment of childhood asthma: a randomised
    >
    >placebo controlled trial
    >
    >
    >A White, P Slade, C Hunt, A Hart and E Ernst
    >
    >
    >Complementary Medicine, Peninsula Medical School, Universities of Exeter and Plymouth, Exeter
    >
    >EX2 4NT, UK
    >
    >
    >
    >
    >Background: Homeopathy is frequently used to treat asthma in children. In the common classical form
    >of homeopathy, prescriptions are individualised for each patient. There has been no rigorous
    >investigation into this form of treatment for asthma.
    >
    >
    >Methods: In a randomised, double blind, placebo controlled trial the effects of individualised
    >homeopathic remedies were compared with placebo medication in 96 children with mild to moderate
    >asthma as an adjunct to conventional treatment. The main outcome measure was the active quality of
    >living subscale of the Childhood Asthma Questionnaire administered at baseline and follow up at 12
    >months. Other outcome measures included other subscales of the same questionnaire, peak flow rates,
    >use of medication, symptom scores, days off school,
    >
    >asthma events, global assessment of change, and adverse reactions.
    >
    >
    >Results: There were no clinically relevant or statistically significant changes in the active
    >quality of life score. Other subscales, notably those measuring severity, indicated relative
    >improvements but the sizes of the effects were small. There were no differences between the groups
    >for other measures.
    >
    >
    >Conclusions: This study provides no evidence that adjunctive homeopathic remedies, as prescribed by
    >experienced homeopathic practitioners, are superior to placebo in improving the quality of life of
    >children with mild to moderate asthma in addition to conventional treatment in primary care.

    A recent review of placebo controlled homoeopathic clinical trials in general concluded that the
    effects of treatment cannot be attributed entirely to a placebo response." Linde K, Clausius N,
    Ramirez G, Melchart D, Eitel F, Hedges LV, et al. Are the clinical effects of homoeopathy placebo
    effects? A meta-analysis of placebo-controlled trials. Lancet 1997; 350: 834-843

    "What is already known on this topic: Homoeopathic remedies probably have an effect that is greater
    than placebo" Editorial comment in BMJ 2002;324:520

    BMJ 2000;321:471 476 (19 August) Randomised controlled trial of homoeopathy versus placebo in
    perennial allergic rhinitis with overview of four trial series Morag A Taylor, research associatea,
    David Reilly, honorary senior lecturer in medicinea, Robert H Llewellyn-Jones, lecturerb, Charles
    McSharry, principal immunologistc, and Tom C Aitchison, senior lecturer in statisticsd aUniversity
    Department of Medicine, Glasgow Royal Infirmary, Glasgow G31 2ER, bDepartment of Psychological
    Medicine, University of Sydney, New South Wales 2006, Australia, cUniversity Department of
    Immunology, Western Infirmary, Glasgow G11 6NT, dDepartment of Statistics, University of Glasgow,
    Glasgow G12 8QQ Abstract

    Objective: To test the hypothesis that homoeopathy is a placebo by examining its effect in patients
    with allergic rhinitis and so contest the evidence from three previous trials in this series.
    Design: Randomised, double blind, placebo controlled, parallel group, multicentre study. Setting:
    Four general practices and a hospital ear, nose, and throat outpatient department. Participants: 51
    patients with perennial allergic rhinitis. Intervention: Random assignment to an oral 30c
    homoeopathic preparation of principal inhalant allergen or to placebo. Main outcome measures:
    Changes from baseline in nasal inspiratory peak flow and symptom visual analogue scale score over
    third and fourth weeks after randomisation. Results: Fifty patients completed the study. The
    homoeopathy group had a significant objective improvement in nasal airflow compared with the placebo
    group (mean difference 19.8 l/min, 95% confidence interval 10.4 to 29.1, P=0.0001). Both groups
    reported improvement in symptoms, with patients taking homoeopathy reporting more improvement in all
    but one of the centres, which had more patients with aggravations. On average no significant
    difference between the groups was seen on visual analogue scale scores. Initial aggravations of
    rhinitis symptoms were more common with homoeopathy than placebo (7 (30%) v 2 (7%), P=0.04).
    Addition of these results to those of three previous trials (n=253) showed a mean symptom reduction
    on visual analogue scores of 28% (10.9 mm) for homoeopathy compared with 3% (1.1 mm) for placebo
    (95% confidence interval 4.2 to 15.4, P=0.0007). Conclusion: The objective results reinforce earlier
    evidence that homoeopathic dilutions differ from placebo
     
  7. Gymmy Bob

    Gymmy Bob Guest

    You just hypnotized yourself into not noticing the symptoms anymore. You still have the allergy.

    "Eric Bohlman" <[email protected]> wrote in message
    news:[email protected]...
    > "Rod" <[email protected]> wrote in news:[email protected]:
    >
    > > Thanks Peter, I do note that the study concludes that the homeopathic treatment is no better
    > > than the Placebo (I shall please) treatment. The problem is that the Placebo effect is rather
    > > major as it is used by science as the measure against "known/suspected" possible treatments. The
    > > problem I have is, why Science would use a measure of the "placebo effect" which is an accepted
    > > method for the basis of study and result. Is that not like saying " that we know that this will
    > > also influence the problem but we do not know why"
    > >
    > > How science can measure against a " Do not know why" is somewhat of a mystery, which of course
    > > is the "placebo effect"
    >
    > Much of what's labelled "placebo effect" is quite well known; it's simply the ordinary natural
    > history of various conditions, which is quite predictable on average for large groups but is quite
    > unpredictable on the individual level. Let's say, for example, that you're trying to evaluate the
    > effectiveness of a proposed treatment for bedwetting in children. You *really* need to use a
    > control group, because around half of all children who wet their beds at a given age will be dry a
    > year from now even if you do absolutely nothing. Or say you're looking at a treatment for multiple
    > sclerosis symptoms. The fact is that MS exacerbations often spontaneously resolve, sometimes for
    > years or decades, and that people seeking such treatments are likely to be in the middle of an
    > exacerbation. In both cases, you can't conclude anything about the effectiveness of the
    treatment
    > unless you compare the people treated with a similar group of people who

    > aren't treated.
    >
    > As I've mentioned before, since I was quite young I would have several
    days
    > in the summer/fall when my hay fever was nearly incapacitating. That started to change the year I
    > had turned 30, and within a year or two I no longer had any such days. I didn't change anything I
    > was doing at the time; I still lived in the same place, and ragweed pollen levels didn't go down.
    > The condition just went away on its own. But what if, at the age
    of
    > 29, I had tried some intervention in hopes of reducing my hay fever symptoms? I'd have been
    > inclined (it actually takes a conscious effort to prevent such an attribution) to attribute the
    > improvement at age 30 to
    that
    > intervention. I'd have experienced Results, yet whatever I would have
    done
    > wouldn't have been effective. If, for example, I had somehow gotten the notion into my head that
    > eating a pound of sugar a day would make my hay fever go away, it would *feel* like that daily
    > pound of sugar gave me Results, even though my knowledge of physiology tells me that it couldn't
    > have and that indeed it would have been harmful to me.
     
  8. Eric Bohlman

    Eric Bohlman Guest

    "Gymmy Bob" <[email protected]> wrote in
    news:eek:[email protected]:

    > You just hypnotized yourself into not noticing the symptoms anymore. You still have the allergy.

    If I could do it when I was 30, why couldn't I have done it several years before? I was quite
    surprised at what happened. Yes, I still get *mild* hay fever symptoms in the fall, but nothing
    like before.
     
  9. Gymmy Bob

    Gymmy Bob Guest

    This is quite weird but happens to many people with many symptoms. Magnesium intake removes almost
    all my allergies until I stop. I believe this is a pH level thing. Perhaps a slight diet change?

    "Eric Bohlman" <[email protected]> wrote in message
    news:[email protected]...
    > "Gymmy Bob" <[email protected]> wrote in news:eek:[email protected]:
    >
    > > You just hypnotized yourself into not noticing the symptoms anymore. You still have the allergy.
    >
    > If I could do it when I was 30, why couldn't I have done it several years before? I was quite
    > surprised at what happened. Yes, I still get *mild* hay fever symptoms in the fall, but nothing
    > like before.
     
  10. Anth

    Anth Guest

    I had allergies - every few months I would come down with terrible stuffy nose that stopped me from
    breathing through my nose. I had my amalgams removed for cosmetric purposes and the stuffy nose is
    no longer there. I also changed my diet. Anth

    "Eric Bohlman" <[email protected]> wrote in message
    news:[email protected]...
    > "Rod" <[email protected]> wrote in news:[email protected]:
    >
    > > Thanks Peter, I do note that the study concludes that the homeopathic treatment is no better
    > > than the Placebo (I shall please) treatment. The problem is that the Placebo effect is rather
    > > major as it is used by science as the measure against "known/suspected" possible treatments. The
    > > problem I have is, why Science would use a measure of the "placebo effect" which is an accepted
    > > method for the basis of study and result. Is that not like saying " that we know that this will
    > > also influence the problem but we do not know why"
    > >
    > > How science can measure against a " Do not know why" is somewhat of a mystery, which of course
    > > is the "placebo effect"
    >
    > Much of what's labelled "placebo effect" is quite well known; it's simply the ordinary natural
    > history of various conditions, which is quite predictable on average for large groups but is quite
    > unpredictable on the individual level. Let's say, for example, that you're trying to evaluate the
    > effectiveness of a proposed treatment for bedwetting in children. You *really* need to use a
    > control group, because around half of all children who wet their beds at a given age will be dry a
    > year from now even if you do absolutely nothing. Or say you're looking at a treatment for multiple
    > sclerosis symptoms. The fact is that MS exacerbations often spontaneously resolve, sometimes for
    > years or decades, and that people seeking such treatments are likely to be in the middle of an
    > exacerbation. In both cases, you can't conclude anything about the effectiveness of the
    treatment
    > unless you compare the people treated with a similar group of people who aren't treated.
    >
    > As I've mentioned before, since I was quite young I would have several
    days
    > in the summer/fall when my hay fever was nearly incapacitating. That started to change the year I
    > had turned 30, and within a year or two I no longer had any such days. I didn't change anything I
    > was doing at the time; I still lived in the same place, and ragweed pollen levels didn't go down.
    > The condition just went away on its own. But what if, at the age
    of
    > 29, I had tried some intervention in hopes of reducing my hay fever symptoms? I'd have been
    > inclined (it actually takes a conscious effort to prevent such an attribution) to attribute the
    > improvement at age 30 to
    that
    > intervention. I'd have experienced Results, yet whatever I would have
    done
    > wouldn't have been effective. If, for example, I had somehow gotten the notion into my head that
    > eating a pound of sugar a day would make my hay fever go away, it would *feel* like that daily
    > pound of sugar gave me Results, even though my knowledge of physiology tells me that it couldn't
    > have and that indeed it would have been harmful to me.
     
  11. Anth

    Anth Guest

    Placebo's are not always inactive. This is demonstrated in a cheeky way with chelation for heart
    disease. Both groups witnessed much improvement, showing that the 'active chelator' agent was
    useless. Anth

    "Peter Moran" <[email protected]> wrote in message news:[email protected]
    01.brisbane.pipenetworks.com.au...
    >
    > "Rod" <[email protected]> wrote in message news:[email protected]
    > server.bigpond.net.au...
    > > Thanks Peter, I do note that the study concludes that the homeopathic treatment is no better
    > > than the Placebo (I shall please) treatment. The problem is that the Placebo effect is rather
    > > major as it is used by science as the measure against "known/suspected" possible treatments. The
    > > problem I have is, why Science would use a measure of the "placebo effect" which is an accepted
    > > method for the basis of study and
    result.
    > > Is that not like saying " that we know that this will also influence the problem but we do not
    > > know why"
    > >
    > > How science can measure against a " Do not know why" is somewhat of a mystery, which of course
    > > is the "placebo effect"
    >
    > Eric has eloquently explained to you (again) that what is commonly
    referred
    > to as a "placebo effect" is mostly no "effect" at all, it is the natural progress of the illness.
    > This explains why they don't work with
    serious
    > illnesses like cancer or diabetes, although they can help make such
    patients
    > feel better..
    >
    > Numerous other factors can make an inert treatment appear to "work" when
    it
    > does nothing, such as patients wanting to oblige their doctor by giving
    what
    > they think is the "right" answer, becoming habituated to symptoms, or
    simply
    > focussing less upon symptoms when in a more supportive therapeutic environment..
    >
    > Also, as suggested by the ingenious study that follows, true placebo
    effects
    > may be much weaker than is commonly thought. Note that only subjective aspects of illness (patient
    > perceptions regarding symptoms) seem to be affected at all.
    >
    > I suspect, however, that in more emotionally charged therapeutic environments placebos may have
    > stronger effects on symptoms than is shown
    in
    > these controlled trials. An example might be someone frustrated with
    poor
    > medical care finding a devoted and sympathetic "alternative" carer.
    >
    > N Engl J Med. 2001 May 24;344(21):1594-602.
    >
    > Is the placebo powerless? An analysis of clinical trials comparing placebo with no treatment.
    >
    > Hrobjartsson A, Gotzsche PC.
    >
    > Department of Medical Philosophy and Clinical Theory, University of Copenhagen, Panum Institute,
    > and the Nordic Cochrane Centre,
    Rigshospitalet,
    > Denmark. [email protected]
    >
    > BACKGROUND: Placebo treatments have been reported to help patients with
    many
    > diseases, but the quality of the evidence supporting this finding has not been rigorously
    > evaluated. METHODS: We conducted a systematic review of clinical trials in which patients were
    > randomly assigned to either placebo or no treatment. A placebo could be pharmacologic (e.g., a
    > tablet),
    physical
    > (e.g., a manipulation), or psychological (e.g., a conversation). RESULTS:
    We
    > identified 130 trials that met our inclusion criteria. After the exclusion of 16 trials without
    > relevant data on outcomes, there were 32 with binary outcomes (involving 3795 patients, with a
    > median of 51 patients per trial) and 82 with continuous outcomes (involving 4730 patients, with a
    > median of 27 patients per trial). As compared with no treatment, placebo had no significant effect
    > on binary outcomes (pooled relative risk of an unwanted outcome with placebo, 0.95; 95 percent
    > confidence interval, 0.88 to 1.02), regardless of whether these outcomes were subjective or
    > objective. For the trials with continuous outcomes, placebo had a beneficial effect (pooled
    > standardized mean difference in the value for an unwanted outcome between the placebo and
    > untreated groups, -0.28; 95 percent confidence interval, -0.38 to -0.19), but the effect decreased
    > with increasing sample size, indicating a possible bias related to the effects of small trials.
    The
    > pooled standardized mean difference was significant for the trials with subjective outcomes (-
    > 0.36; 95 percent confidence interval, -0.47
    to -0.25)
    > but not for those with objective outcomes. In 27 trials involving the treatment of pain, placebo
    > had a beneficial effect (-0.27; 95 percent confidence interval, -0.40 to -0.15). This corresponded
    > to a reduction in the intensity of pain of 6.5 mm on a 100-mm visual-analogue scale. CONCLUSIONS:
    > We found little evidence in general that placebos had
    powerful
    > clinical effects. Although placebos had no significant effects on
    objective
    > or binary outcomes, they had possible small benefits in studies with continuous subjective
    > outcomes and for the treatment of pain. Outside the setting of clinical trials, there is no
    > justification for the use of placebos.
    >
    > Peter Moran
     
  12. Eric Bohlman

    Eric Bohlman Guest

    "Anth" <[email protected]> wrote in
    news:[email protected]:

    > I had allergies - every few months I would come down with terrible stuffy nose that stopped me
    > from breathing through my nose. I had my amalgams removed for cosmetric purposes and the stuffy
    > nose is no longer there. I also changed my diet.

    It's remarkable to me how everybody missed the point of what I wrote. I didn't change *anything*,
    and yet my allergies got less severe. My point, which I think at least both you and Gym Bob
    deliberately don't want to get, is that it's a logical fallacy to leap directly from "I did this,
    and that happened" to "that happened because I did this." Because I gave one example of a case where
    there was a "that" but never a "this." And when alties talk about evaluating a treatment by its
    "results" they simply mean "did that happen or didn't it." Such a process is called "jumping to
    conclusions" and really should be an Olympic sport.

    The whole *purpose* of the scientific method is to restrain our natural tendency to jump to
    conclusions. Jumping to conclusions *feels* good, but then not everything that feels good is good
    for us. That's why we need things like control groups, randomization, blinding and even placebos.
     
  13. Gymmy Bob

    Gymmy Bob Guest

    Something **DID** change and it may have just been your immune system due to some diet change or
    environmental change that you did years before. Just because you didn't perceive any change doesn't
    make it true.

    You are now telling us you did this whole "what's happening to me" scenario just to ridicule people
    trying to help you?

    "Eric Bohlman" <[email protected]> wrote in message
    news:[email protected]...
    > "Anth" <[email protected]> wrote in news:[email protected]:
    >
    > > I had allergies - every few months I would come down with terrible stuffy nose that stopped me
    > > from breathing through my nose. I had my amalgams removed for cosmetric purposes and the stuffy
    > > nose is no longer there. I also changed my diet.
    >
    > It's remarkable to me how everybody missed the point of what I wrote. I didn't change *anything*,
    > and yet my allergies got less severe. My point, which I think at least both you and Gym Bob
    > deliberately don't want to
    get,
    > is that it's a logical fallacy to leap directly from "I did this, and that happened" to "that
    > happened because I did this." Because I gave one example of a case where there was a "that" but
    > never a "this." And when alties talk about evaluating a treatment by its "results" they simply
    > mean "did that happen or didn't it." Such a process is called "jumping to conclusions" and really
    > should be an Olympic sport.
    >
    > The whole *purpose* of the scientific method is to restrain our natural tendency to jump to
    > conclusions. Jumping to conclusions *feels* good, but then not everything that feels good is good
    > for us. That's why we need things like control groups, randomization, blinding and even placebos.
     
  14. Peter Moran

    Peter Moran Guest

    "Jan" <[email protected]> wrote in message
    news:[email protected]...
    > >Subject: Individualised trial of homeopathy From: "Peter Moran" [email protected] Date: 2/5/2004
    > >11:44 PM Pacific Standard Time Message-id:
    >
    ><[email protected]rks.com.au
    >
    > >
    > >Here is an example of a trial of homeopathic medicine where the
    homeopaths
    > >were given the opportunity to individualise treatment, as some homeopaths claim is necessary to
    > >their "art".
    > >
    > >Thorax 2003;58:317-321
    > >
    > >Individualised homeopathy as an adjunct in the treatment of childhood asthma: a randomised
    > >
    > >placebo controlled trial
    > >
    > >
    > >A White, P Slade, C Hunt, A Hart and E Ernst
    > >
    > >
    > >Complementary Medicine, Peninsula Medical School, Universities of Exeter
    and
    > >Plymouth, Exeter
    > >
    > >EX2 4NT, UK
    > >
    > >
    > >
    > >
    > >Background: Homeopathy is frequently used to treat asthma in children. In the common classical
    > >form of homeopathy, prescriptions are individualised for each patient. There has been no rigorous
    > >investigation into this form
    of
    > >treatment for asthma.
    > >
    > >
    > >Methods: In a randomised, double blind, placebo controlled trial the
    effects
    > >of individualised homeopathic remedies were compared with placebo
    medication
    > >in 96 children with mild to moderate asthma as an adjunct to conventional treatment. The main
    > >outcome measure was the active quality of living subscale of the Childhood Asthma Questionnaire
    > >administered at baseline
    and
    > >follow up at 12 months. Other outcome measures included other subscales
    of
    > >the same questionnaire, peak flow rates, use of medication, symptom
    scores,
    > >days off school,
    > >
    > >asthma events, global assessment of change, and adverse reactions.
    > >
    > >
    > >Results: There were no clinically relevant or statistically significant changes in the active
    > >quality of life score. Other subscales, notably
    those
    > >measuring severity, indicated relative improvements but the sizes of the effects were small.
    > >There were no differences between the groups for
    other
    > >measures.
    > >
    > >
    > >Conclusions: This study provides no evidence that adjunctive homeopathic remedies, as prescribed
    > >by experienced homeopathic practitioners, are superior to placebo in improving the quality of
    > >life of children with
    mild
    > >to moderate asthma in addition to conventional treatment in primary care.
    >
    > A recent review of placebo controlled homoeopathic clinical trials in
    general
    > concluded that the effects of treatment cannot be attributed entirely to a placebo response."
    > Linde K, Clausius N, Ramirez G, Melchart D, Eitel F,
    Hedges
    > LV, et al. Are the clinical effects of homoeopathy placebo effects? A meta-analysis of placebo-
    > controlled trials. Lancet 1997; 350: 834-843

    Linde et Al dissociated themselves from that conclusion, and later study of the same data
    suggested publication bias accounted for most of the supposed effect. A lot of negative trials
    have surfaced since.

    >
    > "What is already known on this topic: Homoeopathic remedies probably have an effect that is
    > greater than
    placebo"
    > Editorial comment in BMJ 2002;324:520
    >
    >
    > BMJ 2000;321:471 476 (19 August) Randomised controlled trial of homoeopathy versus placebo in
    > perennial
    allergic
    > rhinitis with overview of four trial series Morag A Taylor, research associatea, David Reilly,
    > honorary senior
    lecturer in
    > medicinea, Robert H Llewellyn-Jones, lecturerb, Charles McSharry,
    principal
    > immunologistc, and Tom C Aitchison, senior lecturer in statisticsd aUniversity Department of
    > Medicine, Glasgow Royal Infirmary, Glasgow G31
    2ER,
    > bDepartment of Psychological Medicine, University of Sydney, New South
    Wales
    > 2006, Australia, cUniversity Department of Immunology, Western Infirmary, Glasgow G11 6NT,
    > dDepartment of Statistics, University of Glasgow, Glasgow
    G12
    > 8QQ Abstract
    >
    > Objective: To test the hypothesis that homoeopathy is a placebo by examini
    ng
    > its effect in patients with allergic rhinitis and so contest the evidence
    from
    > three previous trials in this series. Design: Randomised, double blind, placebo controlled,
    > parallel group, multicentre study. Setting: Four general practices and a hospital ear, nose,
    > and throat
    outpatient
    > department. Participants: 51 patients with perennial allergic rhinitis. Intervention: Random
    > assignment to an oral 30c homoeopathic preparation of principal inhalant allergen or to placebo.
    > Main outcome measures: Changes from baseline in nasal inspiratory peak
    flow and
    > symptom visual analogue scale score over third and fourth weeks after randomisation. Results:
    > Fifty patients completed the study. The homoeopathy group had a significant objective improvement
    > in nasal airflow compared with the
    placebo
    > group (mean difference 19.8 l/min, 95% confidence interval 10.4 to 29.1, P=0.0001). Both groups
    > reported improvement in symptoms, with patients
    taking
    > homoeopathy reporting more improvement in all but one of the centres,
    which had
    > more patients with aggravations. On average no significant difference
    between
    > the groups was seen on visual analogue scale scores. Initial aggravations
    of
    > rhinitis symptoms were more common with homoeopathy than placebo (7 (30%)
    v 2
    > (7%), P=0.04). Addition of these results to those of three previous trials (n=253) showed a mean
    > symptom reduction on visual analogue scores of 28%
    (10.9
    > mm) for homoeopathy compared with 3% (1.1 mm) for placebo (95% confidence interval 4.2 to 15.4,
    > P=0.0007). Conclusion: The objective results reinforce earlier evidence that
    homoeopathic
    > dilutions differ from placebo
    >

    Reilly is the only person who has been able to get consistent positive results from homeopathy, and
    that only in allergies. When weighed against negative trials by others trying to repeat his
    findings, the innumerable negative trials in other conditions, and the fact that better quality
    trials are usually negative, this is very weak evidence for a very improbable thesis.

    Peter Moran
     
  15. "Eric Bohlman" <[email protected]> wrote in message
    news:[email protected]...
    > "Anth" <[email protected]> wrote in news:[email protected]:
    >
    > > I had allergies - every few months I would come down with terrible stuffy nose that stopped me
    > > from breathing through my nose. I had my amalgams removed for cosmetric purposes and the stuffy
    > > nose is no longer there. I also changed my diet.
    >
    > It's remarkable to me how everybody missed the point of what I wrote. I didn't change *anything*,
    > and yet my allergies got less severe. My point, which I think at least both you and Gym Bob
    > deliberately don't want to
    get,
    > is that it's a logical fallacy to leap directly from "I did this, and that happened" to "that
    > happened because I did this." Because I gave one example of a case where there was a "that" but
    > never a "this." And when alties talk about evaluating a treatment by its "results" they simply
    > mean "did that happen or didn't it." Such a process is called "jumping to conclusions" and really
    > should be an Olympic sport.
    >
    > The whole *purpose* of the scientific method is to restrain our natural tendency to jump to
    > conclusions. Jumping to conclusions *feels* good, but then not everything that feels good is good
    > for us. That's why we need things like control groups, randomization, blinding and even placebos.

    What you describe is often called a 'logic trap'. And yours worked, thus proving two things.
     
  16. Nope. he is telling you that he did it to show the fallacy of AltLogic.

    "Gymmy Bob" <[email protected]> wrote in message news:[email protected]...
    > Something **DID** change and it may have just been your immune system due
    to
    > some diet change or environmental change that you did years before. Just because you didn't
    > perceive any change doesn't make it true.
    >
    > You are now telling us you did this whole "what's happening to me"
    scenario
    > just to ridicule people trying to help you?
    >
    >
    > "Eric Bohlman" <[email protected]> wrote in message
    > news:[email protected]...
    > > "Anth" <[email protected]> wrote in news:[email protected]:
    > >
    > > > I had allergies - every few months I would come down with terrible stuffy nose that stopped me
    > > > from breathing through my nose. I had my amalgams removed for cosmetric purposes and the
    > > > stuffy nose is no longer there. I also changed my diet.
    > >
    > > It's remarkable to me how everybody missed the point of what I wrote. I didn't change
    > > *anything*, and yet my allergies got less severe. My
    point,
    > > which I think at least both you and Gym Bob deliberately don't want to
    > get,
    > > is that it's a logical fallacy to leap directly from "I did this, and
    that
    > > happened" to "that happened because I did this." Because I gave one example of a case where
    > > there was a "that" but never a "this." And when alties talk about evaluating a treatment by its
    > > "results" they simply
    mean
    > > "did that happen or didn't it." Such a process is called "jumping to conclusions" and really
    > > should be an Olympic sport.
    > >
    > > The whole *purpose* of the scientific method is to restrain our natural tendency to jump to
    > > conclusions. Jumping to conclusions *feels* good,
    but
    > > then not everything that feels good is good for us. That's why we need things like control
    > > groups, randomization, blinding and even placebos.
     
  17. "Jan" <[email protected]> wrote in message
    news:[email protected]...
    > >From: "Peter Moran" [email protected] Date: 2/7/2004 1:05 PM Pacific Standard Time Message-id:
    >
    ><[email protected]rks.com.au
    >
    >
    > >Linde et Al dissociated themselves from that conclusion, and later study
    of
    > >the same data suggested publication bias accounted for most of the
    supposed
    > >effect.
    >
    > Nah,,,,,,,biased?!?! Why we have never heard of that,,,,here.
    >
    > OH YEAH,,,,,,,,,,,,,,,,we can't see any at quack quack.

    Peter forgot Rule #1 when posting to Jan. Use small concepts and explain everything.

    > Sure thing.
    >
    > >Reilly is the only person who has been able to get consistent positive results from homeopathy,
    > >and that only in allergies. When weighed
    against
    > >negative trials by others trying to repeat his findings, the innumerable negative trials in other
    > >conditions, and the fact that better quality
    trials
    > >are usually negative, this is very
    > weak evidence for a very improbable
    > >thesis.
    > >
    > LOLOLOLOLOLOL!!!!!
    >
    > *Substantial* *real* *solid* *convincing* *hard* *clear-cut* *reasonable* *significant*
    > *credibile* *compelling* *thin* *weak*
    >
    ZZzzEEeeRRrrOO IQ by Jan.
     
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