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Evidence, evidence all around, but no one wants to look...


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Initial post: 13 Feb 2013 10:05:14 GMT
Homeopathy for childhood diarrhea: combined results and metaanalysis from three randomized, controlled clinical trials.

Jacobs J, Jonas WB, Jiménez-Pérez M, Crothers D.

Source

Department of Epidemiology, University of Washington School of Public Health and Community Medicine, Seattle, WA, USA. jjacobs@igc.org

Abstract

BACKGROUND:

Previous studies have shown a positive treatment effect of individualized homeopathic treatment for acute childhood diarrhea, but sample sizes were small and results were just at or near the level of statistical significance. Because all three studies followed the same basic study design, the combined data from these three studies were analyzed to obtain greater statistical power.

METHODS:

Three double blind clinical trials of diarrhea in 242 children ages 6 months to 5 years were analyzed as 1 group. Children were randomized to receive either an individualized homeopathic medicine or placebo to be taken as a single dose after each unformed stool for 5 days. Parents recorded daily stools on diary cards, and health workers made home visits daily to monitor children. The duration of diarrhea was defined as the time until there were less than 3 unformed stools per day for 2 consecutive days. A metaanalysis of the effect-size difference of the three studies was also conducted.

RESULTS:

Combined analysis shows a duration of diarrhea of 3.3 days in the homeopathy group compared with 4.1 in the placebo group (P = 0.008). The metaanalysis shows a consistent effect-size difference of approximately 0.66 day (P = 0.008).

CONCLUSIONS:

The results from these studies confirm that individualized homeopathic treatment decreases the duration of acute childhood diarrhea and suggest that larger sample sizes be used in future homeopathic research to ensure adequate statistical power. Homeopathy should be considered for use as an adjunct to oral rehydration for this illness.

Posted on 13 Feb 2013 12:07:55 GMT
Luddite Joe says:
A steady stream of diarrhea...how apt.

In reply to an earlier post on 13 Feb 2013 13:34:15 GMT
easytiger says:
Yep, he got there eventually.

Posted on 13 Feb 2013 19:11:13 GMT
What a loono. Wibble.

Posted on 13 Feb 2013 23:14:49 GMT
[Deleted by Amazon on 14 Feb 2013 00:04:23 GMT]

In reply to an earlier post on 14 Feb 2013 10:55:21 GMT
Drew Jones says:
"Homeopathy should be considered for use as an adjunct to oral rehydration for this illness."
Isn't 'oral rehydration' or drinking water the same thing as homeopathy?

Posted on 16 Feb 2013 03:57:32 GMT
H. J. Do says:
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In reply to an earlier post on 16 Feb 2013 10:38:53 GMT
Ian says:
The Queen can afford whatever she likes. If she chooses to waste her money on one to one consultations with somebody who will give her sugar pills she is welcome to (and a 1 to 1 consultation is what it should be; homeopaths claim that each treatment is individual, just selecting your own sugar pills from Boots won't work). I don't know what qualities you think the Queen has which makes her particularly discerning when it comes to choosing medical treatment.

That is how most marketing works; choose a celebrity you think you can trust to be the face of a product and most people won't be interested in evidence.

"It worked for me" is much harder to determine than you imagine; with no control group you have no idea how your condition would have progressed without the homeopathy. Many people turn to alternative therapies such as homeopathy when they have self-limiting conditions (so they were going to get better anyway) or when a long term condition is at its worst (the symptoms of long-term illnesses usually vary in severity; take a pill when you're feeling really bad and you start to feel a bit better, but that's just the normal pattern).

By all means spend your money on homeopathic pills (they're not expensive to make as they don't contain any active ingredients and as such they also have no side effects, apart from a tiny sugar rush and some minor damage to your teeth. And Simon will grateful for your money.) but a single person feeling better is not evidence. Medicines are tested on very large numbers of patients using placebo controlled trials to compare the effect of the treatment; the smaller the effect the larger the number of patients required to produce satisfactory evidence. The few trials that do support homeopathy are invariably tiny sample sizes and showing a very small benefit, larger trials show no benefit from homeopathy. Simon's post above describes a homeopathic trial like this which involved 242 patients (who may have recovered 16 hours faster as a result of their sugar pills) - I wouldn't place much faith in any medicine which had such flimsy evidence to support it.

Ironically adding a small amount sugar to water is the conventional treatment for diarrhoea! So the study was comparing something which is pretty similar to the conventional treatment for diarrhoea (but the sugar had been dipped in a mix or sugar and alcohol = homeopathy, whereas the control was exactly the same but the sugar pills had been dipped in pure alcohol without the magic homeopathic water).

Homeopathy is largely harmless (as I said, there are no active ingredients in it) except when homeopaths overstep the mark and start making exaggerated claims. In the trials above any children who became seriously ill were hospitalised, but there are many instances of people avoiding conventional medicine because they have so much misplaced faith in alternative therapies. In the UK homeopathy is effectively self-regulating and instances of homeopaths being disciplined for breaking the rules (such as selling treatments for cancer or malaria vaccines) are as rare as hen's teeth (although several homeopaths have been shown to behave in this way). Perhaps buying your homeopathic pills from Boots or Simon's shop is safer if it means you avoid the dodgy advice. Personally I prefer Smarties.

In reply to an earlier post on 16 Feb 2013 10:46:20 GMT
K. Hoyles says:
Homeopathic Chocolate works for me.

Posted on 16 Feb 2013 11:31:14 GMT
easytiger says:
An ex of mine paid £35 about 30 yrs ago for a consultation with a homeopath about period pains. He told her she was allergic to her glasses and should change to contact lenses. Man that guy deserves his big house.

Posted on 16 Feb 2013 11:33:27 GMT
Ian says:
Smarties aren't homeopathic chocolate (that wouldn't have any chocolate in it, just sugar which had been soaked in alcohol and magic water).

Red smarties contain homeopathic aconite (or no aconite at all as allopaths call it) for flu and fevers (it used to contain Oscillococcinum for flu but this was replaced following complaints from imaginary vegetarians who weren't happy about eating imaginary duck liver), the purple ones contain arnica (for bruises) and the delicious orangey ones contain Ignatia amara which cheers you up (try one - they work!). Also they're very good for preventing Dementor attacks (I've never been attacked while carrying a tube of Smarties or within 2 years of eating some).

I discovered the mystery that is homeopathy when I was recommended Arnica tablets by a dentist after having an impacted wisdom tooth removed. I was surprised when I compared the Arnica tablets my wife had bought in Boots to the Arnica cream she used on the kid's bruises (it might work, it might not; it's probably about as effective as kissing it better). The cream is 0.9% Arnica which is supposed to reduce bruising, the homeopathic tablets are a 30c dilution (1x 10^−60, or none at all in each and every pill). It seems odd that Arnica is sold as both a herbal remedy for bruising (as a cream with actual Arnica in it) and as a homeopathic remedy. If the theory behind homeopathy being that you should take a minute dose of something that causes the symptoms you have how can Arnica both cause and cure bruising?

Posted on 16 Feb 2013 11:37:01 GMT
easytiger says:
Dunno. Maybe you could ask those gals on the front line to do some trails with whatever it is. That should keep 'em out of mischief.

In reply to an earlier post on 16 Feb 2013 11:45:53 GMT
Ian says:
And that's exactly why it's important to have a proper consultation with a qualified homeopath. Had she gone to a shop she would probably have purchased some homeopathic cuttlefish ink (a cuttlefish did die to make this, but a single cuttlefish can produce enough ink for several billion doses so unlike Chinese medicine it doesn't decimate the populations of endangered species) which wouldn't have helped at all. And then she would foolishly have believed that homeopathic remedies don't work.

I assume she got some contact lenses and felt better almost instantly? (I wear contact lenses and have never had period pains in my entire life - so it must be true.)

In reply to an earlier post on 16 Feb 2013 13:48:17 GMT
easytiger says:
Yes indeed. I forgot to mention that she wore glasses in place of underpants so nobody would recognise her.

In reply to an earlier post on 16 Feb 2013 21:42:49 GMT
Roma says:
Re arnica. My Gp recommended i take arnica prior to an operation for the repair of a deviated septum. After the op the surgeon remarked that he was amazed to note i had no bruising, as all the other patients with similar procedures had severe facial bruising. Not scientifically verifiable but nevertheless it was convincing enough for me to give one of my sons the recommended dosage for acute use prior to a hernia op. It was supposed to be an in and out on the same day up, but he was kept in an extra day because of a high temperature. It wasn t until later i realised i had been giving him sulphur by mistake. I don t know if this had any negative effect but it allows him to take about the time his mum tried to poison him. Oops!

In reply to an earlier post on 16 Feb 2013 22:15:50 GMT
Ian says:
Arnica confuses me; I've heard lots of anecdotal evidence that it reduces or prevents bruising but studies seem to show it doesn't. Possibly rubbing cream into an injury reduces bruising so the arnica is irrelevant, possibly it doesn't work and we just keep hearing about the occasions when people had lest bruising than they expected. How many people talk about the time they used arnica and had terrible bruising anyway? And who looks at post arnica treated bruising and says "Yes it's bad, but it'd be even worse if I hadn't used arnica"?

It's the fact that even many of the shops don't seem to know the difference between arnica as a herbal remedy which contains some arnica extract and homeopathic arnica tablets - which are just sugar pills. There are even some brands of cream which call themselves homeopathic but contain almost 1% arnica extract - suggesting even the manufacturers don't know the difference between a herbal remedy and a homeopathic one!

In reply to an earlier post on 16 Feb 2013 22:30:23 GMT
Roma says:
My GP prescribed Arnica homeopathic tablets for me. She was a qualified homeopathist and often prescribed homeopathic remedies. She once referred me to a Homeopathic Clinic in Glasgow. Arnica, i did find work well, others for a limited time and once aggravated the condition so much I had to stop taking the tablets. It s worth trying different things, I think.

In reply to an earlier post on 16 Feb 2013 22:43:14 GMT
Ian says:
The problem with homeopathic tablets is that they are all identical. If your condition improved after taking homeopathic arnica (or you did not suffer bruising) then it was going to improve anyway (or you just weren't going to be bruised). If you condition became aggravated after taking a homeopathic remedy (and then improved when you stopped) it would have done so without the sugar pills.

Rest assured that if you gave your son homeopathic sulphur tablets they did not cause his raised temperature because they contained not a single atom of sulphur. Had you given him the arnica tablets instead they would have been just as (in)effective because they are identical and do not contain a single molecule which came from an Arnica plant.

In reply to an earlier post on 16 Feb 2013 23:02:12 GMT
Roma says:
If this is the case, why do you think a GP would prescribe them and why would the NHS fund clinics and pay for NhS prescriptions? I m not asking rhetorically. It s just all very confusing.

In reply to an earlier post on 16 Feb 2013 23:22:55 GMT
Ian says:
Homeopathic hospitals existed in the UK before the NHS, they were absorbed into the NHS in the 1940s. This decision may have been influenced by the wife of Aneurin Bevan, the health minister. Some stories say she was a proponent of homeopathy (Tony Blair's wife apparently uses crystal healing, so it's surprising we don't have that on the NHS). Homeopaths make exaggerated claims about Aneurin Bevan's statements on homeopathy claiming he was a supporter and wrote into legislation a guarantee of funding. he didn't; what he did do was take specialist hospitals (including homeopathic and Catholic hospitals) into the NHS without changing them.

The cost to the NHS of homeopathic hospitals (such as the one in Glasgow beside Gartnavel hospital) is tiny compared to the running cost of the NHS. In the case of patients with chronic conditions there is certainly no harm in referring to a homeopath (apart from cost, which is small); as there are no active ingredients in their treatments there are no side effects.

Several doctors refer patients to the homeopathic hospitals or have studied homeopathy themselves; unfortunately a doctor believing something doesn't make it true.

In reply to an earlier post on 17 Feb 2013 05:04:55 GMT
A clinical trial was carried out to look at the effectiveness of a gel made from fresh, organic Arnica Montana flower heads, against one of the leading pharmaceutical gels, Ibuprofen, with very positive results.

Twenty doctors in Switzerland undertook a strictly controlled study involving 204 patients using A.Vogel Arnica Gel and Ibuprofen gel. Improvement in two main areas had to be achieved for the study to be successful, and in both cases Arnica Gel proved to be as effective as the pharmaceutical pain-killer.

In addition, of the patients who assessed efficacy as 'very good' or 'good', more patients in the Arnica group (64.0%) expressed satisfaction with their gel than in the Ibuprofen group (58.8%). The investigators also generally evaluated the efficacy of the Arnica Gel as better than that of the Ibuprofen gel.

[Reference: Choosing between NSAID and arnica for topical treatment of hand osteoarthritis in a randomised, double-blind study by Reto Widrig, Andy Suter, Reinhard Saller and Jörg Melzer Rheumatology International Volume 27, Number 6 / April 2007]

In reply to an earlier post on 17 Feb 2013 05:12:04 GMT
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In reply to an earlier post on 17 Feb 2013 09:25:44 GMT
Roma says:
Thanks for that.i foun d it very interesting and informative. I tried crystal therapy ONCE. The correct chakras for me where identified and appropriate chakras placed. so far so good. The student therapist then sat beside me and told me to report any physiological changes i noticed. Obviously i didn t notice any, other than the coloured lights as a result of closing my eyes after staring at a strong fluorescent lights. I then became quite agitated as I felt i was letting the therapist down by experiencing no significant changes. However, this led to an increase in my heart rate which i was pleased to report so i had something to say. The therapist was delighted as she had placed rose quartz on my heart chakra. I would have enjoyed just lying there if she had left me alone.

There are some crystals that do make me feel good, but this is because of the beauty of the colours. I was given a small rose quartz to take away, and still like to touch from time to time. Would I pay for a treatment again. No!

Posted on 17 Feb 2013 09:43:08 GMT
easytiger says:
Crystal-meth, now yer talkin.

In reply to an earlier post on 17 Feb 2013 10:56:35 GMT
Ian says:
As I said Simon, there is some evidence for Arnica (but it's extremely weak) but what is being offered to consumers is very confusing. Most people are unaware of the difference between herbal Arnica gel (contains Arnica which might work as an anti-inflammatory - the trial you posted above used a high strength Arnica gel, much of what's on sale contains far less) and homeopathic Arnica (which contains nothing whatsoever).

To make matters more confusing there seems to be at least one brand of Arnica cream which is labelled as homeopathic but actually contains active ingredients AND some brands of homeopathic Arnica cream (so no Arnica) do contain extracts of other plants (so there may well be other active ingredients).

Many of people I've spoken to who have bought homeopathic remedies did so thinking they're herbal remedies and are astounded to find they're been sold something that has been diluted so far that there are no active ingredients in it (I always apologise for having robbed them of a placebo which probably won't work now they know it doesn't work).

Here's a trial which shows Arnica doesn't work: http://jrsm.rsmjournals.com/content/96/2/60.abstract Ironically it has been criticised by homeopaths because they used a cream which actually contains Arnica! And here's the response from the Daily Mail (http://www.dailymail.co.uk/health/article-160090/Does-Arnica-really-work.html) which trots out the usual tales of "I took Arnica and got better" or "I took Arnica and didn't get ill". All the comments in the Daily Mail article are from homeopaths or about homeopathic Arnica tablets or cream; which is odd because it wasn't a trial of homeopathic Arnica it was a trial of herbal Arnica.

Consumers are already uninformed about what homeopathy is and are then being mi-sold remedies. It doesn't help when journalists and homeopaths respond to a trial without bothering to check what it is they're responding to (though not surprising in the case of Daily Mail journalists). The DM article begins "One of the most popular homeopathic remedies is a waste of money, a study claims" - the article is correct as far as that first comma, everything else is nonsense.
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Discussion in:  politics discussion forum
Participants:  10
Total posts:  25
Initial post:  13 Feb 2013
Latest post:  17 Feb 2013

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