Sir, in his letter Personal diatribe (BDJ 2011; 210: 291–292) S. Farrer chastises the BDJ for allowing an article with a claimed lack of scientific content, but then goes on to state that 'Homeopathic medicines are a valuable tool in the practitioner tool kit', a statement quite devoid of any objective scientific merit.
In citing Linde in the Journal of Alternative and Complementary Medicine, Farrer shows familiarity with Linde's work. He also expresses awareness of the importance of impact factor. Why, then, did he not cite the much more significant work by the same author, in a much higher impact factor journal: the Journal of Clinical Epidemiology.1 This concludes that the better a study is conducted, the less likely it is to support the efficacy of homeopathy. This is one of four meta analyses in high impact factor journals to reach the same conclusion, the others being published in The Lancet, British Medical Journal, and European Journal of Clinical Pharmacology.2,3,4
The House of Commons Science and Technology Committee's Evidence Check 2: Homeopathy, you may recall, recommended that the NHS stop funding homeopathy absent of credible evidence of efficacy.5
Scientifically the consensus is that homeopathy is fundamentally implausible, based on axioms which are not empirically valid for the assumed general case and founded on a 200-year-old reaction to the system of 'heroic medicine' which thankfully died out in the nineteenth and twentieth centuries. Homeopathy is just one of many fields of what might be termed proto-medicine. In the Western mainstream these have been replaced by the painful birth and steady flowering of evidence-based medicine: medicine based on experiments which are both robustly verifiable and consistent with other branches of knowledge.
Any homeopath who can objectively prove the merit of the field stands to become very rich thanks to rewards totalling over a million dollars offered by Simon Singh and James Randi among others.6,7 In the meantime the BDJ can probably safely leave questionable assertions such as 'a valuable tool in the practitioner tool kit' to the very much lower impact factor journals which specialise in alternatives-to-medicine.
References
Kleijnen J, Knipschild P, Ter Riet G . Clinical trials of homoeopathy. BMJ 1991; 302: 316–323.
Linde K, Clausius N, Ramirez G et al. Are the clinical effects of homoeopathy placebo effects? A meta-analysis of placebo-controlled trials. Lancet 1997; 350: 834–843.
Linde K, Scholz M, Ramirez G, Clausius N, Melchart D, Jonas W B . Impact of study quality on outcome in placebo-controlled trials of homeopathy. J Clin Epidemiol 1999; 52: 631–636.
Cucherat M, Haugh M C, Gooch M, Boissel J P . Evidence of clinical efficacy of homeopathy. A meta-analysis of clinical trials. HMRAG. Homeopathic Medicines Research Advisory Group. Eur J Clin Pharmacol 2000; 56: 27–33.
House of Commons Science and Technology Committee, Evidence Check 2: Homeopathy, HC 45, Fourth Report of Session 2009-10.
Ernst E, Singh S . Trick or treatment: the undeniable facts about alternative medicine. W. W. Norton & Company, 2008.
James Randi's Challenge to Homeopathy Manufacturers and Retails Pharmacies. 5 February 2011. Available at: http://www.randi.org/site/index.php/jref-news/1208-feb5video.html
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Chapman, G. Proto-medicine. Br Dent J 211, 6 (2011). https://doi.org/10.1038/sj.bdj.2011.531
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DOI: https://doi.org/10.1038/sj.bdj.2011.531