More Fun with Homeopath Dana Ullman, MPH(!)

[Gord_in_Toronto]

True. I think you are right about that.

However, we also have the WGBO, this is a law that regulates the agreement between patients and doctors about their treatment. It has a lot of duties for doctors, but one right. The right to determine the treatment for the patient. If the doctor decides to give blood anyway in case of emergency, he can't be touched. In general any doctor will do everything to keep their word to their patient. The Jehova's in the Netherlands have already stated that if the doctor makes this decision against their wishes they will accept it, but they can not accept it in advance, willingly. Doctors try to take other precautions to avoid giving blood and choose conditions that will avoid the necessity of supplementing blood. If he refuses to give blood because of the patient's religion this needs to be recorded, argumented and defended. He can still be judged by his peers.

SYL

Ah. TWIVP (the World is a Very Big Place). This is a very much different legal approach than in Canada. Even in the case of the children of JWs, there has to be a court order transfering responsibilty of the children to the state. The law does make an exception in the case of a life threatening emergency, however.

If only the wooish altmed providers kept good records, some of their claims could be tested. I wonder why they don't maintain such records?

 

[krazyKemist]

In the Netherlands it is largely frowned upon in palliative care, but a trial as complementary treatment could be conceivable. As an alternative treatment, replacing pain medication, it is hardly ethical, so that in my opinion is a definite No No. I don't know how things works in the US and Canada, but I imagine the sentiment would be the same. Homeopaths in the Netherlands have told some of their patients after they had already left the hospital that paracetamol is enough to kill the pain in combination with the homeopathic treatment. To say this to a slowly dying terminal patient in severe pain... Well, I think you can imagine what I what I would like to do (and I'm not just talking about the patient).


Actually, you just mentioned an illness that will clear up by itself and for which there is no treatment of the cause but only supportive treatment. So test away...
The timeline of the test needs argumentation, as would the reason to treat a patient.
The argument is, you need to show that there is a reason to test a drug on a patient. The reason (most often) could be that laboratory test showed a promising effect of the drug on animals or cell culture. Another reason could be that the drug was designed for another illness but has shown a promising effect that had not been recognized before. Yet another reason could be that many case reports led to a small patient group presenting beneficial effects of an formerly unknown substance. This has happened in the case of homeopathy, but the following trials failed to show a conclusive or even promising result under careful scrutiny by peers in the medical world. This normally means further research is shelved. But you don't start testing on patients first and analyze later. That is something you do in the lab on animals or cell culture. Even if the new drug is only a derivative of a already known drug, testing normally starts in the lab. I understand very well that you believe it is all bunk and they are only getting water anyway, so there would be no problem. But by subjecting patients to a trial, they have to follow the trial protocol. This means the patients are subjected to tests and a regimen that is often an infringement on the normal care given by their physician. For a benign problem (something you would encounter in a General Practitioner's office on a Monday morning) this can probably be done and the burden of the trial can be minimized. For more serious disease it becomes another story and I would have serious problems with the reasons for such a trial.

In general: A drug that does not work in the lab, does not make it to the patient.

( On a side note: I think some of the few exceptions where shortcuts were taken and testing in humans started long before labtests were finished were trials done by Bayer in WWII and more recently trials done on HIV patients in Africa, but I think we can agree this should not be considered normal )

SYL

Things work a little differently in US and Canada (actually, canadian drugs are usually FDA-tested; they are then approved about 5 years after US approval, without any additional testing). And laetrile assays were not that conclusive in the lab, in addition to suspision about a serious risk of cyanide toxicity... I guess popular pressure is what actually pushed that protocol. I'm not particularly fond of this kind of thing myself. After all, even after showing that 1) it didn't work and 2) it did have cyanide toxicity, laetrile is still one of the most popular cancer-related health fraud.

But consider testing the homeopathic remedy for flu in about the same way as tamiflu and relenza (flu antiviral therapies). What those do is that they shorten the actual period of time/severity of flu symptoms. Same test, without the need for toxicology/pharmacokinetics. Financed by a homeopathic remedy manufacturer.

oh, I know it won't stop the homeopathy trade. They'll have a lot of fighting over the way the remedy was made, that results were loaded against them by pharmas and new wacky theories as to why the test cannot be right, ect. But maybe, just maybe, it'll open some eyes.

the Kemist

 

[krazyKemist]

If only the wooish altmed providers kept good records, some of their claims could be tested. I wonder why they don't maintain such records?

Well, duh.

the Kemist

 

[fls]

But consider testing the homeopathic remedy for flu in about the same way as tamiflu and relenza (flu antiviral therapies). What those do is that they shorten the actual period of time/severity of flu symptoms. Same test, without the need for toxicology/pharmacokinetics. Financed by a homeopathic remedy manufacturer.

oh, I know it won't stop the homeopathy trade. They'll have a lot of fighting over the way the remedy was made, that results were loaded against them by pharmas and new wacky theories as to why the test cannot be right, ect. But maybe, just maybe, it'll open some eyes.

the Kemist

Like these?

http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=2655683&dopt=Abstract
http://www.sciencedirect.com/scienc...serid=10&md5=595be723c5173e8b1cbaa97deb3ea544
http://www.cochrane.org/reviews/en/ab001957.html

Linda

 

[manioberoi]

No, you repeat the same supposed treatment over and over again. When it fails, you let conventional medicine fix the problem. When you succeed by chance, you say the new medication did the trick. If there is a chance of the problem clearing up without any help, you take the credit.

You have to show the benefit of what you offer, objectively, controllable, not make believe. If you can not do that, conventional medicine will not accept it. The effect of the physician is always there and plays a big part in the perception of the patient, but the real reason they get better is because they are offered a cure. Demonstrate in a controlled trial, that homeopathy can objectively offer that cure. Repeat it, make it reproducable, so other doctors can be certain they have a cure they can trust. So far homeopathy has failed on all fronts in basic science and in clinical trials.

Why doesn't this worry you...
Trying homeopathy first is not safe because it has no side-effects, it is potentially dangerous because it offers no real benifits to conventional medicine thereby postponing treatment and aggravating the patients condition.

Can you subscribe to that?

SYL

That is correct.

 

[manioberoi]

To the risk of repeating myself (and other people here), there is no need for a chemical analysis at this time. If you can prove that it works, using a double blind experiment with a placebo, then we can begin to work on what could be happening physically in the dilution ! Working the other way around is a loss of time and money, especially as we would have to look at an unknown piece of physics/chemistry !

An acceptable placebo would have to be unidentifiable by both the tester and patient as such. Plain, double-distilled, or reverse-osmosed water, the very same that is used for the dilutions without succussion, would be all right for me. Would it be for you ?

the Kemist

Yes.

 

[SYLVESTER1592]

That is correct.

Do you realize what you just agreed with? I hope you do.

I'm glad. I guess this means you are leaving homeopathy behind until there may be some compelling evidence and reason to look at it again in a different light.

Thank you

SYL

 

[manioberoi]

HIV and Homeopathy

Especially since Dana Ullman claims that homeopathy is a viable treatment for HIV/AIDS:
Controlled clinical trials evaluating the homeopathic treatment of people with human immunodeficiency virus or acquired immune deficiency syndrome.

He really needs to answer to this claim!

Dana Ullman has NOT claimed that homeopathy has a viable treatment or cure for HIV/AIDS. So far neither does conventional medicine claim to have a cure for HIV/AIDS.

All that Dana Ullman has said is that Homeopathic treatment holds promise for such cure / treatment and proper trials need to be carried out so as to establish this. He has at no time stated that patients should abandon conventional treatment and look for homeopathic treatment for HIV/AIDS.

Do you find this objectionable?

 

[manioberoi]

Do you realize what you just agreed with? I hope you do.

I'm glad. I guess this means you are leaving homeopathy behind until there may be some compelling evidence and reason to look at it again in a different light.

Thank you

SYL

Oops!That was meant for the post by kemist.

 

[SYLVESTER1592]

Oops!That was meant for the post by kemist.

Yeah, I thought so

I never saw it happen before and it really sounded too good to be true

SYL

 

[manioberoi]

Concretising a homeopathic trial

It would need to be a test of treatment of the same condition in each case. Trials would need to be sufficiently large (I'm sure someone else with more expertise will tell us how large they should be), and I'm afraid you couldn't do all the replications yourself. They would need independent replication by someone unconnected with you. Oh, and they would all need to be published...

If all those conditions were met, I would be well on the way to being convinced that there was indeed something in it (even though there is nothing in it...).

I'm sorry, you can't use the excuse "we can't afford to do trials". Many trials HAVE been done. They have either been of low quality, had negative results, or been one of the few flukes to show positive results.

No, you repeat the same supposed treatment over and over again. When it fails, you let conventional medicine fix the problem. When you succeed by chance, you say the new medication did the trick. If there is a chance of the problem clearing up without any help, you take the credit.

You have to show the benefit of what you offer, objectively, controllable, not make believe. If you can not do that, conventional medicine will not accept it. The effect of the physician is always there and plays a big part in the perception of the patient, but the real reason they get better is because they are offered a cure. Demonstrate in a controlled trial, that homeopathy can objectively offer that cure. Repeat it, make it reproducable, so other doctors can be certain they have a cure they can trust. So far homeopathy has failed on all fronts in basic science and in clinical trials.

Why doesn't this worry you...
Trying homeopathy first is not safe because it has no side-effects, it is potentially dangerous because it offers no real benifits to conventional medicine thereby postponing treatment and aggravating the patients condition.

Can you subscribe to that?

SYL

I am beginning to understand your objections and I sort of get the feeling that you are genuinely concerned that homeopathic remedies do nothing, perhaps the homeopaths have great convincing powers - I can assure you that most homeopaths are not good at convincing people - they prescribe for 100 to 150 people daily, at least 80 percent come again, get better / benefit, are cured etc. Homeopaths do not get the severely ill cases except those told to go home and wait for....good homeopaths send the serious cases for conventional medical consultation in the first instance.

Where is the time to conduct strict trials? Homeopaths traditionally were trained in conducting provings NOT double blind trials. That seems to be changing but ever so slowly. The Government of India is pouring money into reaching homeopathy across the breadth and length of India. And a very very small amount is being spent on training homeopaths to conduct double blind trials - but I wonder if they are aware that a flu trial or a diarhhoea trial could backfire, since these are inherently self limiting conditions.

So the right kind of homeopathically treatable conditions (which will also not be life threatening conditions - at least to start with) say chronic arthritis of the small joints - fingers, toes and wrists with Caulophyllum 6C water potency repeated as required over 6 months (maximum once daily - repetition to be decided by homeopath on homeopathic indications) DNA sample be obtained at start and end of trial from control and trial group.

9 such trials starting every 15 days, with small groups (10 to 12?) to cut the cost and learn how to avoid bias, errors, fraud etc.

Cost would be high but reasonable.

 

[manioberoi]

Since this still isn't an answer to the question, I will ask again:

Quote: "The rest of the physical world is certainly applicable".
What does that mean?
1) the rest of the world is applicable: you choose to apply the world??? I recon this qoute was ment in a different way. Please correct it or explain.
2) There are non-physical influences? What are they? Do you have evidence of them?
Quote:"physical ONLY as in "chemical composition" of the diluted remedy beyond 12C or 24X.
1)What non-physical evidence proves homeopathy works?

can the effects of homoeopathy be tested or not?

Straight forward answer please. Explain why or why not...

SYL

Proof of effect of remedy has to be physically verifiable in the patient. Remedy must be certified by the manufacturer and his process of manufacture be open to third party audit and the same standards should be applied to conventional medicine.

 

[SYLVESTER1592]

<snip>...
So the right kind of homeopathically treatable conditions (which will also not be life threatening conditions - at least to start with) say chronic arthritis of the small joints - fingers, toes and wrists with Caulophyllum 6C water potency repeated as required over 6 months (maximum once daily - repetition to be decided by homeopath on homeopathic indications) DNA sample be obtained at start and end of trial from control and trial group.

9 such trials starting every 15 days, with small groups (10 to 12?) to cut the cost and learn how to avoid bias, errors, fraud etc.

Cost would be high but reasonable.

Why DNA? Not ANA serology (or RF auto-antibodies)? Just curious...

Thought of taking an X-ray? What other tests would you do?...

SYL

 

[SYLVESTER1592]

Proof of effect of remedy has to be physically verifiable in the patient. Remedy must be certified by the manufacturer and his process of manufacture be open to third party audit and the same standards should be applied to conventional medicine.

OK, so your answer is YES
I think similar conditions apply to conventional medicine, but they have basic research that backs up the mechanism of action. I know you think this is nitpicking, but it enhances the value of the results achieved from a trial.

SYL

 

[manioberoi]

Yep. Definitely delving into conspiracy theory . That is a more than a little disappointing.

As we're speaking of monetary interest, do you think homeopaths would benefit if homeopathy is once and for all proven to be only placebo ?

the Kemist

There is no conspiracy. Its all about money.

Homeopaths would lose but the public would lose much much more.

1 in 100 people using homeopathy always go to a homeopath for the remedy. The rest only consult a homeopath for an intractable problem and use the remedy kits for routine problems.

 

[manioberoi]

Clinical trials for homeopathic remedies would be a lot cheaper. A read through of "An introduction to clinical trials". For the Phase II trials they sum it up as "the experimental study drug or treatment is given to a larger group of people (100-300) to see if it is effective and to further evaluate its safety." (my bold). Repeat a couple of times to ensure the results are correct and you'll still have change from half a million, and given how much profit the manufacturers and manufacturers do make a year there must be a reason why the excuses get dragged out every time.

If you follow the thread you will see that what you are suggesting is unsuited to a double blind homeopathic trial.

 

[manioberoi]

In the Netherlands. 3 doctors have recently been suspended for life, they didn't cure their patient and did not offer the conventional treatment but agreed to let the patient get the alternative treatment elsewhere instead. The patient died. The civil suit is still pending. If there will be a criminal suit is not clear.

I highly object to experimenting on patients without proper argumentation and supporting basic research. Our patients are not labrats. There are reasons why we make our clinical trials follow the phase I step first. You do not want to expose patients to something that is potentially harmful or has no effect. Placing it at an equal standard to conventional effective drugs will give doctors the opportunity or even the obligation to consider this unproven drug or treatment above other treatments and thereby denies the patient the proven cure.

Observation in clinical cases that show an effect, may lead to further investigation. This is how sometimes unproven drugs are rolled into a medical experiment anyway to confirm the effects. If they succeed in repeating the effects, further research is done to identify why it works. If the effects are not repeated, the treatment is rejected, end of story. To get it back of the ground again, you have to start at the basis and show how it could work, a probable mechanism and go through the phase I trial after doing all the basic science leg work. If patients choose to use a drug or it's used in experimental conditions overlooked and approved by the ethics committee with proper medical evaluation and back-up care to step in if the trial goes wrong, then maybe this is something that can be discussed. There has to be a reason to try it first.

I don't want to step on anyone's toes, but the question: "can the effects of homeopathy be tested or not?", still stands.

SYL

High ethical standards demand that patients rights be respected.

Agreed that effects of homeopathic remedies on patients need be tested.

Since homeopathy works, there is absolute certainty that its effects can be tested.

 

[SYLVESTER1592]

Since homeopathy works, there is absolute certainty that its effects can be tested.

Saying that it works does not make it so...
Either present the proof or retract the statement. I think by now you understand what we mean by proof.

SYL

 

[SYLVESTER1592]

High ethical standards demand that patients rights be respected.

We have legalized abortion and even allow active euthanasia at the patients request.
I think their rights are respected just fine over here, so I think you got the wrong adversary again. They also have the right to proper care and that's not what you are presenting.

SYL

 

[Pipirr]

High ethical standards demand that patients rights be respected.

Agreed that effects of homeopathic remedies on patients need be tested.

Since homeopathy works, there is absolute certainty that its effects can be tested.

How can you be so certain?