I don’t know why the blogosphere wastes so much time and effort on discussing homeopathy. The jury’s back, and homeopathy has been found guilty of being crap.
However, the subject is like onion-weed which keeps popping up in the fairway of common sense, on the golf course of life. (Can you tell my annual golf trip is coming up?)
You just have to keep spraying.
This time, with his finger on the spray trigger, it’s Orac, with a terrific little piece (well, ‘little’ by Oracian standards), discussing a recent article he found trying to defend homeopathy yet again. In demolishing the article, he also provides a nice summary of the history and key claims of proponents.
The article he reviews actually takes the tack of criticising western medicine (I take ‘western medicine’ to mean ‘medicine that works’) for something they call ‘plausibility bias’, and making the point that requesting plausibility is somehow an unfair requirement. In other words, the bar is set too high. See one of my earlier posts on Bayesian analysis, which discusses how prior probability (aka plausibility) is relevant to assessing claims.
To help lower the bar, the article which Orac analyses proposes ‘pragmatic’ clinical trials – in other words, trials freed from those tiresome constraints of blinding and controls. Orac goes on to make the point that:
As I and others have pointed out before, “pragmatic” trials represent an inappropriate methodology to determine if a therapy works, because they are not blinded, often not well controlled, and therefore subject to all the biases to which less rigorous clinical trials are subject. Rather, the purpose of pragmatic trials is to test a therapy in “real world” conditions after it’s been demonstrated to be safe and efficacious in proper randomized clinical trials in order to see how much its efficacy and safety decline away from the ivory tower environment under which many clinical trials are run. Even then, there are lots of problems with pragmatic trials due to their less rigorous nature. In any case, using pragmatic trials to test efficacy is a blatant attempt to lower the standard of evidence
I think that says it all, and elegantly.
I’m ready to tee off now, but well aware that the weeds will be back.