There’s nothing to it
From the Herald, in a good article about the Australian report on homeopathy
Auckland homeopath Suzanne Hansen said the treatments could not be measured in the same way medical treatments were.
“When you research it against a medical paradigm it will fail because you treat in a completely different way.”
This is probably true, but it’s a major concession that should be noted for the record.
The`medical paradigm’ of randomised controlled trials doesn’t need treatment to be the same for each person, it doesn’t need the benefits to be the same for each person, it doesn’t need the biological mechanism to be known or even plausible. All they need is that you can identify some group of people and a way of measuring success so that getting your treatment is better on average for your chosen group of people with your chosen way of defining ‘better’. This isn’t just about homeopathy — the whole field of personalised genomic medicine is based on individualising treatment, and this doesn’t introduce any difficulties for the medical paradigm.
If an intervention can’t beat fake pills that do nothing, on its choice of patient group and outcome measurement, it will fail when you `research it against a medical paradigm.’ If you’re fine with that, you should be fine with not using any advertising terms that suggest the intervention has non-placebo benefits.
Thomas Lumley (@tslumley) is Professor of Biostatistics at the University of Auckland. His research interests include semiparametric models, survey sampling, statistical computing, foundations of statistics, and whatever methodological problems his medical collaborators come up with. He also blogs at Biased and Inefficient See all posts by Thomas Lumley »
I have long wondered whether randomization to paradigm might be an interesting trial. Follow-up one group with traditional Western medicine and the other group with homeopathy. There’d be a lot of misclassification as the benefits of different paradigms might only really show up in corners cases (and the inability to blind makes me think that Patient Reported Outcomes won’t work).
At the very least it would put evidence forward as to whether seeing a homeopath as a routine primary care doctor does actual harm or not.
10 years ago
I’ve seen one (going from memory, since the Uni is closed today) where people were randomised to homeopathic consultation or not, and then those who got the consultation were randomised to get what was prescribed or placebo. The consultation made a difference but the treatment didn’t. There was also a British trial in the late 80s of randomisation to chiropractic vs ordinary care for back pain.
For conditions where there is no effective treatment this sort of trial is fairly easy. If randomising general care you’d worry about diagnosis and treatment for conditions where there is an effective treatment and it’s relatively urgent.
10 years ago