Comments on homeopathic paper please

Isn't homeopathic paper where you put one printed page into a ream, shuffle it repeatedly, take the printed page out, and voila! All the other pages are now also printed?
 
theprestige said:
Isn't homeopathic paper where you put one printed page into a ream, shuffle it repeatedly, take the printed page out, and voila! All the other pages are now also printed?
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No. You're forgetting the law of similars/opposites/whatever part. You have to put the mandible of a silverfish into the ream and shuffle it. The rest is correct.
 
Dr. Imago said:
Yes. I inherently agree with what you are saying.

The problem with the meta-analysis methodology is that it can take several negative studies and find a positive result.
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I do fancy that I'm a bit beyond needing a basic primer in what a meta-analysis is.

You can't add negative numbers to get a positive number. If you add up any number of studies that say X correlates positively with Y and get a total that says X correlates negatively with Y, I think your maths just have to be wrong.

If someone with a relevant Ph.D. can show me otherwise I'll be very surprised indeed, and I'll admit I'm wrong... but I can't see it happening.

A single study, at least a well-controlled one, is structured to test a premise and determine, within its parameters, whether that premise is proven. When you pair studies that have different methodologies you have to make concessions that were not inherent in the original study. This further "dirties" the data, and it can make the conclusions drawn by a particular meta-analysis actually less robust, not more.
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This is assuming that you're doing the maths suboptimally, right? The only way a properly conducted meta-analysis will make you less certain than before is if you ought to be less certain than before.
 
Kevin_Lowe said:
If someone with a relevant Ph.D. can show me otherwise I'll be very surprised indeed, and I'll admit I'm wrong... but I can't see it happening.
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It all depends on how you "re-structure" the data to fit the meta-analysis.

Here from a very controversial paper published in the Lancet in 1997:

The results of our meta-analysis are not compatible with the hypothesis that the clinical effects of homeopathy are completely due to placebo. However, we found insufficient evidence from these studies that homeopathy is clearly efficacious for any single clinical condition. Further research on homeopathy is warranted provided it is rigorous and systematic.
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http://www.ncbi.nlm.nih.gov/pubmed/9310601

Essentially, when pooled the researchers said that homeopathy had some effect, yet the individual studies on single conditions were not positive.

Perhaps you would chalk this up to bad methodology, but that's precisely what I'm talking about... and this paper was deemed "good enough" to get published in the Lancet.

Baby or bathwater?

~Dr. Imago
 
Dr. Imago said:
It all depends on how you "re-structure" the data to fit the meta-analysis.

Here from a very controversial paper published in the Lancet in 1997:



http://www.ncbi.nlm.nih.gov/pubmed/9310601

Essentially, when pooled the researchers said that homeopathy had some effect, yet the individual studies on single conditions were not positive.

Perhaps you would chalk this up to bad methodology, but that's precisely what I'm talking about... and this paper was deemed "good enough" to get published in the Lancet.

Baby or bathwater?

~Dr. Imago
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In that case, weren't their inclusion/exclusion criteria not stringent enough? In a later analysis they looked at what happened if they restricted themselves to the better studies: http://www.ncbi.nlm.nih.gov/pubmed/9884175
...when the analysis was restricted to the methodologically best trials no significant effect was seen.
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They also published a paper on impact of study quality: http://www.ncbi.nlm.nih.gov/pubmed/10391656
Studies that were explicitly randomized and were double-blind as well as studies scoring above the cut-points yielded significantly less positive results than studies not meeting the criteria.
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BTW, where in the paper you link to does it say that the individual studies on single conditions were not positive? I can't access the full text. Are you able to quote from it so I can see the relevant excerpt or would that be a problem re copyright?

I like the Cochrane approach to meta analysis in systematic reviews but I'm not sure how widely it's used by other researchers: http://www.thecochranelibrary.com/view/0/AboutCochraneSystematicReviews.html

Not every review in the Cochrane Database of Systematic Reviews contains a meta-analysis. This might not be appropriate if the designs of the studies are too different, if the outcomes measured are not sufficiently similar, or if there are concerns about the quality of the studies, for an average result across the studies to be meaningful.
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Dr. Imago said:
It all depends on how you "re-structure" the data to fit the meta-analysis.

Here from a very controversial paper published in the Lancet in 1997:

http://www.ncbi.nlm.nih.gov/pubmed/9310601

Essentially, when pooled the researchers said that homeopathy had some effect, yet the individual studies on single conditions were not positive.

Perhaps you would chalk this up to bad methodology, but that's precisely what I'm talking about... and this paper was deemed "good enough" to get published in the Lancet.

Baby or bathwater?

~Dr. Imago
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Sorry I don't have time this morning to go over that one in detail, but the "garbage in, garbage out" rule still applies. My guess is that publication bias alone could account for such a result, in which case the problem isn't with their maths it's with the collectively published data.

Their maths will tell you what you ought to believe if you think the published data is representative of the real world. I tend to think it isn't, based on fundamental chemistry and biology and on the fact that the homeopathic literature is provably dodgy.
 
Yuri Nalyssus said:
Thanks folks, for the help. I'm now trying to wade through the paper but it seems to me, from the discussions, there are questions about what exactly the authors considered a good quality study, how many of the trials included were blinded or randomised and also about the independence of the lead author and the weight of the journal. Difficult things to overlook if you are claiming that plain water counterracts lethal toxins.

Those wiki discussions hurt my head :o but thanks for the links.

Cheers,

Yuri
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I'm not sure why you are actually giving this (homeopathy) the slightest bit of your time. Since I am in chemistry, I know why it can't work so I mostly ignore the terrible ignorance that keeps it around. Avogadro's number is key - though even knowing that should not be logically necessary as the concept that homeopathy is based on comes from old theories (and, here I use the word "theories" in the worst possible way) of sympathetic magic - and that doesn't work either.
 
fuelair said:
I'm not sure why you are actually giving this (homeopathy) the slightest bit of your time. Since I am in chemistry, I know why it can't work so I mostly ignore the terrible ignorance that keeps it around. Avogadro's number is key - though even knowing that should not be logically necessary as the concept that homeopathy is based on comes from old theories (and, here I use the word "theories" in the worst possible way) of sympathetic magic - and that doesn't work either.
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Here's my reasons for addressing homeopathy.

It's the major alt-med non therapy.

The practitioners are generally anti-medicine. They advise against safe effective treatment for dangerous diseases such as vaccination for measles, whooping cough etc. In Wales we have just had an epidemic of measles.

They have able spokesmen who advertise this nonsense and their highest ability is cherry picking. Therefore it is important to show the problems in each and every paper.

While the educated scientists can immediately see the nonsense in treating a disease state with nothing, the general public doesn't.
 
fuelair said:
I'm not sure why you are actually giving this (homeopathy) the slightest bit of your time. Since I am in chemistry, I know why it can't work so I mostly ignore the terrible ignorance that keeps it around. Avogadro's number is key - though even knowing that should not be logically necessary as the concept that homeopathy is based on comes from old theories (and, here I use the word "theories" in the worst possible way) of sympathetic magic - and that doesn't work either.
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Fuelair, I think you have to understand where some of us are coming from here.

People are recommending homoeopathic treatment to pet owners. Government bodies are recommending homoeopathic remedies to farmers in the context of "organic" certification. Qualified vets are pushing this woo, and the regulatory bodies are treating them with kid gloves. This apparent official sanction is being used by homoeopaths to justify their nonsense, and claim that it's a recognised, integral part of veterinary medicine. This confuses animal owners, and sends out decidedly mixed messages.

You are coming in at 101 and saying, well it's nonsense don't you know that? Why bother? The reason why is that somsone has to stand up for the animals and counter this insidious creeping woo within the profession. And to do that, unfortunately, one has to make rather more sophisticated arguments than "Avogadro's number, I win!"

Rolfe.
 
fuelair said:
I'm not sure why you are actually giving this (homeopathy) the slightest bit of your time. Since I am in chemistry, I know why it can't work so I mostly ignore the terrible ignorance that keeps it around. Avogadro's number is key - though even knowing that should not be logically necessary as the concept that homeopathy is based on comes from old theories (and, here I use the word "theories" in the worst possible way) of sympathetic magic - and that doesn't work either.
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As it happens the answer is expressed very succinctly in the first line of the abstract of the paper I've just linked to:

"Homeopathy seems scientifically implausible, but has widespread use."

That's it in a nut shell - people are being conned and people (like you and me), who know those people are being conned, need to keep banging the drum for the people being conned but who don't know they're being conned.

I hope that's cleared that one up.

:D

Yuri
 
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Essentially, when pooled the researchers said that homeopathy had some effect, yet the individual studies on single conditions were not positive.
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Actually, the individual studies for some single conditions were positive. Or, at least, there were more positive studies than inconclusive studies. E.g., for neurology, four studies were positive and three inconclusive. It looks to me like it was a similar story for allergy. And those studies grouped as 'miscellaneous'. And rheumatology.

The authors didn't actually say that the individual studies on single conditions were "not positive" as far as I can see but they did say that "there is insufficient evidence from these studies that any single type of homoeopathic treatment is clearly effective in any one clinical condition". Which may be true but is not the same as the claim Dr Imago made.

I don't think the Linde et al analysis shows the dangers of pooling results in a meta analysis, I think it shows (a) the dangers of including poor quality papers in such an analysis and (b) the effects of publication bias.

Basically, I think Kevin_Lowe is right. GIGO, publication bias, and the dodgy nature of homeopathic literature are the problems here.
 
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