If only the debate were really over

[P. G. Tipps]

Good job you aren't a surgeon

Why do you now illogically assume (without a shred of scientific evidence) that I am not? ...

[MrGongGong]

Why do you now illogically assume (without a shred of scientific evidence) that I am not? ...

You don't believe in evidence

[french frank]

admit that we're conning the naive and gullible, but always in their best interests.

Even 'evidence-based' medical treatments can be severely harmful to individuals, especially when GPs are dealing with newly-developed medications and are unclear of the nature of the risks.The extent of the risk becomes clear only as more and more patients are adversely affected. Isn't it better to accept that medecine is not an exact science, and keep things in perspective? If you're going to drag 'belief systems' into the debate, start with belief in 'evidence-based' science.

"Taylor (1994) in his analysis of studies conducted here in the United Kingdom, suggested that as many as 20% of hospital patients in the British Isles suffer from some form of iatrogenic disease, further commenting that more people in Great Britain die from adverse reactions to medical drugs each year, than are killed on the roads.

However, at the start of this year the BMJ News article reports that the number of patients who die in this country after errors in drug prescribing or from an adverse drug reaction is showing a ‘marked upward trend‘ (BMJ, 2002).

The problem as the reports author concedes, is that “nobody really knows the extent of the problem” which by all accounts is, well, a problem."

http://www.bmj.com/rapid-response/2011/10/28/continuing-problems-clinical-iatrogenesis-pertaining-pharmaceutical-drugs

[aka Calum Da Jazbo]

despite his insights &c i often feel a similar mistrust of Freudian Psychoanalysis and French Philosophy in general [and especially combinations thereof]... two streams of ideas which seem similarly unburdened by evidence ...... i do believe in the waiting list [ a potent therapeutic force as much as 70% recovery rates in personal distress ] and so clearly does the NHS

wicki offers

Hróbjartsson and Peter Gøtzsche published a study in 2001[17] and a follow-up study in 2004[78] questioning the nature of the placebo effect. The studies were performed as two meta-analyses. They found that in studies with a binary outcome, meaning patients were classified as improved or not improved, the placebo group had no statistically significant improvement over the no-treatment group. Likewise, there was no significant placebo effect in studies in which objective outcomes (such as blood pressure) were measured by an independent observer. The placebo effect could be documented only in studies in which the outcomes (improvement or failure to improve) were reported by the subjects themselves. The authors concluded that the placebo effect does not have "powerful clinical effects," (objective effects) and that patient-reported improvements (subjective effects) in pain were small and could not be clearly distinguished from reporting bias. Other researchers (Wampold et al.) re-analysed the same data from the 2001 meta-analysis and concluded that the placebo effects for objective symptom measures are comparable to placebo effects for subjective ones and that the placebo effect can exceed the effect of the active treatment by 20% for disorders amenable to the placebo effect,[79][80] a conclusion which Hróbjartsson & Gøtzsche described as "powerful spin".[81] Another group of researchers noted the dramatically different conclusions between these two sets of authors despite nearly identical meta-analytic results, and suggested that placebo effects are indeed significant but small in magnitude.[82]

nowt is ever clear cut eh .... presumably homoeopathic remedies work when the patient wants them to and has a 'top down' problem [just as placebos do] ....

i do recall the Prof Eysenck was not so nuanced in his promulgation of the waiting list over Psychoanalysis ....

for my part i would hold that the current fashion for economic policies of 'austerity' is in the same class as homoeopathic prescriptions

[umslopogaas]

For those like me who are not sure what iatrogenic means:

"a disease or symptoms induced in a patient by the treatment or comments of a physician." (Chambers Dictionary)

Interesting that it is recognised that you can get ill by listening to your doctor ...

But these figures need to be kept in perspective: 80% of patients do not show an adverse reaction, and of the 20% who do, we cannot assume that the drug does not also have a beneficial effect. Even if you were one of unfortunate 20% who came out in a rash as a result of a new drug, it might still have cured your problem and you might well think the cure was worth some discomfort.

[aeolium]

"Taylor (1994) in his analysis of studies conducted here in the United Kingdom, suggested that as many as 20% of hospital patients in the British Isles suffer from some form of iatrogenic disease, further commenting that more people in Great Britain die from adverse reactions to medical drugs each year, than are killed on the roads.

Isn't there a potential problem with that kind of statistic, though, in that it relies on an assumption that those patients would not have died (prematurely) had they not received the medication. But in many cases, surely, they are taking the medication for some known, perhaps very serious, illness. Would the statistics also include trial medication for serious diseases like cancer, where the prognosis without any treatment is very poor? And there is a risk that such statistics obscure (by not comparing) the many beneficial outcomes of evidence-based medicines.

Are we seriously saying that a belief in faith-based treatment (with no evidential basis of benefit whatsoever) is on a par with a belief in evidence-based treatment? Isn't evidence and experimentation the only possible scientific basis for medical advance?

[aka Calum Da Jazbo]

i would not rule out genius, chance and serendipity aeolium

[french frank]

The statistics themselves come from peer-reviewed publications, so it's not for me to know how misleading they are :-)

'On a par'? perhaps not. What I am suggesting, cautiously, is that the effects of 'poorly' prescribed medicines can be more harmful that homoepathic remedies.

I just feel rather strongly about this having been a double victim of iatrogenesis. I could have got by without any remedy at all - and been better off than I am now. Purely anecdotal 'evidence', of course.

Isn't there a potential problem with that kind of statistic, though, in that it relies on an assumption that those patients would not have died (prematurely) had they not received the medication. But in many cases, surely, they are taking the medication for some known, perhaps very serious, illness. Would the statistics also include trial medication for serious diseases like cancer, where the prognosis without any treatment is very poor? And there is a risk that such statistics obscure (by not comparing) the many beneficial outcomes of evidence-based medicines.

Are we seriously saying that a belief in faith-based treatment (with no evidential basis of benefit whatsoever) is on a par with a belief in evidence-based treatment? Isn't evidence and experimentation the only possible scientific basis for medical advance?

[aeolium]

i would not rule out genius, chance and serendipity aeolium

Yes indeed calum, but even then you need to test the results.

[ahinton]

There is no 'scientific proof' of lots of things which, in the context of the Universe, are probably infinite. Lack of scientific proof does not necessarily mean something is false, though in the absence of such proof at least a degree of scepticism is wise.

I didn't suggest either that everything is currenlty provable or disprovable or that absence of proof does not necessarily mean that something might not work in certain cases, but the purpose of my reference here was to respond to a post from you in which it seemed that you do not either perceive or accept a relationship between to belief systems, of which and belief in the potential or actual beneficial effects of homœopathy is one such for those who hold it. That said, belief in, for example, a deity is not of itself necessarily harmful to the believer, whereas practical application of a belief in a system of "medicine" whose beneficial effects are not only unsupported by scientific proof but also unamenable to incontrovertible historical evidence risks such harm.

There have been countless examples in history of patients with terminal illnesses making remarkable recoveries, baffling medical scientists in the process. If the patients themselves put these recoveries down to the power of prayer or homoeopathic treatments, whether others believe it or not is completely irrelevant. 'It' has worked for them (or so they believe) and that is all the proof they will need!

So it might seem rather arrogant and indeed silly for others to insist they are wrong when they have just jumped out of their sick-beds ... ?

I don't know about "countless"; have you ever tried to count them and failed? There have indeed been some, but the point here is that a medically unqualified and inexperienced patient, whilst he/she will know that he/she has somehow effected a recovery that "baffles medical scientists", he/she will have no more idea of what brought about that recovery than will those medical scientists; such a patient might "believe" that it was down to homœopathic treatment, but that "proves" nothing that would be of any use to anyone else suffering from the same condition.

[Pabmusic]

...What I am suggesting, cautiously, is that the effects of 'poorly' prescribed medicines can be more harmful that homoepathic remedies.

I just feel rather strongly about this having been a double victim of iatrogenesis. I could have got by without any remedy at all - and been better off than I am now. Purely anecdotal 'evidence', of course.

No-one, surely, could doubt the truth of the first sentence. However, it is not the same as saying that homoepathic remedies are somehow of equal standing and therefore should be welcomed because they're less dangerous. They are indeed less dangerous; because they contain nothing that could be harmful - often not a single molecule of the active ingredient. That's not true of medicines.

Perhaps you could have got by with no medical intervension. People probably can in many instances, because there's much we don't understand (or rather, understand imperfectly) about the mind and the body. But there is another phenomenon, that people tend not to respect doctors who do nothing. Even a telephone service telling one just to "take two paracetemol, plenty of water, and keep warm" for a cold are not trusted - it's clearly a cost-cutting exercise, with no thought for the patient.

There's good evidence that merely taking part in a drug trial does you good - even where the subject knows they have been given a placebo. Conversely, in the largest trial of the efficacy of prayer yet conducted, the only seriously ill patients (cancer, mainly) who differed significantly from their control group were those who knew they were being prayed for. (Presumably this knowledge caused a higher level of anxiety.)

I'm reminded of an early psychology test in Iowa schools (I can't give a reference till we're back home). This was the 1890s, I think. The researchers told the schools they were conducting a test of academic ability, set the pupils an exam, and gave the school principal the results. The schools had to agree that they'd not pass the results on to the pupils, but the teachers were told the scores of the top 15 pupils in their school. The truth was that the researchers had awarded marks randomly to 15 randomly selected pupils in each case. At the end of the school year, after the 'real' exams, all the 'top' pupils did well above average, often being in the top 15 in each school. What had occurred? The various teachers, believing they were dealing with acknowledged 'bright' pupils, unconsciously gave them advantages - extra attention mainly - in class. This experiment has been repeated and refined many times, with consistent results.

[ahinton]

The statistics themselves come from peer-reviewed publications, so it's not for me to know how misleading they are :-)

'On a par'? perhaps not. What I am suggesting, cautiously, is that the effects of 'poorly' prescribed medicines can be more harmful that homoepathic remedies.

I just feel rather strongly about this having been a double victim of iatrogenesis. I could have got by without any remedy at all - and been better off than I am now. Purely anecdotal 'evidence', of course.

Firstly, I'm very sorry to hear about what happened to you. That said, however, mistakes made by doctors and other medical professionals in hospitals or elsewhere provide no excuse for the promulgation of "medicines" such as homœopathic ones which, when prescribed instead of conventional medicines, can provide no demonstrable benefit in and of themselves and can at the same time leave the patient in a vulnerable state without the correct medication. The amounts spent by NHS on homœopathic treatment may be a vanishingly small proportion of its overall budget, but it is still a waste of taxpayers' funds and will remain so until and unless specific provable beneficial effects can be identified and peer-reviewed; what other medicines provided by NHS are untested and whose effects are accordingly unproven?

[MrGongGong]

No-one, surely, could doubt the truth of the first sentence. However, it is not the same as saying that homoepathic remedies are somehow of equal standing and therefore should be welcomed because they're less dangerous.

THIS

https://www.youtube.com/watch?v=heGsFpG4up4&spfreload=10

Is one reason why it's not harmless

"They make it so your energy doesn't have a malaria-shaped hole in it so the malarial mosquitos won't come along and fill that in."

[ahinton]

THIS

https://www.youtube.com/watch?v=heGsFpG4up4&spfreload=10

Is one reason why it's not harmless

"They make it so your energy doesn't have a malaria-shaped hole in it so the malarial mosquitos won't come along and fill that in" really does take the biscuit, n'est-ce pas? Never mind "there's a hole in my bucket", this is a supposed case of "there's a hole in my energy"; now what on earth is one of those and how can it be identified? The notion that anything, be it a hole or otherwise, can be "malaria-shaped" merely adds to the risibility. The final coup de grace of mozzies filling in holes might be side-splittingly funny were it not for the dangers spread by such nonsense.

[Ferretfancy]

There's a simple experiment that anyone can try. Seek out as many friends as you can find who happen to take homoepathic remedies. Ask them if they can tell you "What is homoeopathy?"
The majority will be unable to tell you the absurd principle on which it is based. Instead they will say " Well, it's more natural isn't it ? " Very frequently they get homoeopathy confused with herbalism or other similar remedies.

Ignorance is a great danger, as I witnessed myself when being with a friend who died of AIDS at a time when there was very little treatment available. He spent a great deal of money visiting a quack clinic in Mexico who fed him on all sorts of rubbish which eventually hastened his death by starvation. If he had lived on a normal diet he might have survived long enough to benefit by modern treatments, but, clutching at straws did not work for him.

We might think that quackery is mostly harmless, but it really isn't so.