Talk:Homeopathy/Archive 53

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Warning Tag?

This is the banner across the Italian homeopathy page.

Le pratiche qui descritte non sono accettate dalla scienza medica, non sono state sottoposte alle verifiche sperimentali condotte con metodo scientifico o non le hanno superate. Potrebbero pertanto essere inefficaci o dannose per la salute. Le informazioni hanno solo un fine illustrativo. Wikipedia non dà consigli medici: leggi le avvertenze.

Which translates to...

The practices described here are not accepted by medical science, have not been subjected to experimental tests conducted with the scientific method or have not overcome. May therefore be ineffective or harmful to health. The information for illustrative purposes only. Wikipedia does not give medical advice: Read the warnings.

http://it.wikipedia.org/wiki/Omeopatia

In then Netherlands the page reads with a tag... 'Neem het voorbehoud bij medische informatie in acht. Raadpleeg bij gezondheidsklachten een arts." Take the reservation to medical information into account. Consult with a physician health.

Just saying that maybe in English we are just too careful? Remember over 600 people a day are looking on this page for information, do we have ANY responsibility to keep readers safe? People will do what they will do, even with warning labels people still smoke, but maybe we need to be more clear? Sgerbic (talk) 15:35, 20 September 2012 (UTC)

I've seen that someplace for medical articles. I'll try to find it. But because none of us consider homeopathy "medical", I guess we don't consider it necessary here. :) SkepticalRaptor (talk) 16:06, 20 September 2012 (UTC)

Seems like overkill. This article and those variants clearly state that it's bullshit in the lede. TippyGoomba (talk) 04:11, 21 September 2012 (UTC)

I would be opposed to a warning tag. This is not WebMD or Instructibles, and it would be overkill since the article does not purport to offer a cure for anything. – MrX 04:45, 21 September 2012 (UTC)

English Wikipedia has a WP:NODISCLAIMERS policy. Mkweise (talk) 00:00, 22 September 2012 (UTC)

I agree - we don't have disclaimers in English Wikipedia - it is assumed that the disclaimers linked at the bottom of every page should suffice.

As for the 600 people who come here every day. Even if they only read the first paragraph - it contains three sentences which can be summarized as:

1. This is what Homeopathy claims to be...
2. ...but it doesn't work...
3. ...and the people who practice it are either frauds or incompetent.

If they read no further, then they already know at least as much as the warning label would have told them. Here on English Wikipedia, we prefer to state the facts and let the reader decide for him/herself.

SteveBaker (talk) 00:38, 22 September 2012 (UTC)

Like -- Brangifer (talk) 03:26, 22 September 2012 (UTC)

Proposed mechanisms for homeopathy are physically impossible

New article in the alternative medicine journal Focus on Alternative and Complementary Therapies:

• Proposed mechanisms for homeopathy are physically impossible. by David Robert Grimes, Focus on Alternative and Complementary Therapies, Volume 17, Issue 3, pages 149–155, September 2012

Brangifer (talk) 22:00, 23 September 2012 (UTC)

"Homeopathy is a system of complementary and alternative medicine based on a belief that a malady can be treated by the administration of an extreme dilution of an agent thought to cause the physical signs of that malady." That explains a lot. My usage of the term is a little more inclusive than it, due to its popular use in Brazilian Portuguese. Obviously it doesn't work, it it had any logic then seawater would be a cure for nearly everything. I would read the article, and maybe even translate and distribute it since this quackery is so common down here, but I don't have an account. Lguipontes (talk) 22:29, 23 September 2012 (UTC)

Another massive change without consensus

Once again, I had to make a revert because an editor took upon himself to make a massive change without gaining a consensus amongst the editors here. If anything, evidence should be moved up. If a bunch of editors want to make the change, fine, let's do it, but I hope a consensus of editors are on board first. SkepticalRaptor (talk) 16:23, 26 September 2012 (UTC)

These are the changes[1][2]. They shift the focus from "it's scientifically unproven" to "it's based on magic and spiritual belief".

I am not sure that this is due weight. After all, in Hanemann's times they still believed in stuff like Aether (classical element), and they didn't know about germ theory, Avogadro's number or washing your hands to prevent infections. --Enric Naval (talk) 10:43, 27 September 2012 (UTC)

Indeed, but note that my addition mentioning magical thinking was under "Revival in the late 20th century" in the "History" section. Facts: (1.) 19th century homeopathy was based on a scientific theory that later turned out to be erroneous; (2.) Belief in homeopathy today requires magical thinking. Mkweise (talk) 15:20, 28 September 2012 (UTC)

It's certainly not within the scope of WP:FRINGE or the 2009 ArbCom ruling. We are supposed to reflect the mainstream scientific viewpoint. There is no scientific evidence that homeopathists are using magic and spiritual belief. There most certainly IS evidence that homeopathy doesn't work - and that's the mainstream view. So this shift in focus is entirely contrary to due weight. I strongly support reverting pending a consensus to put it back in. SteveBaker (talk) 13:27, 27 September 2012 (UTC)

The comment that modern homoeopathy "relies heavily on magical thinking to rationalize itself in spite of scientific invalidation" would need a source. Brunton (talk) 16:57, 27 September 2012 (UTC)

The exact phrasing may be a bit SYN, but these ([3] [4]) all make the essential point. More formal publications such as doi:10.1111/j.2042-7166.2010.01052.x say much the same thing.LeadSongDog come howl! 17:44, 27 September 2012 (UTC)

Shaking and Diluting

I heard a story passed down from my friend's great grandfather, who travelled around the American West selling snake oil remedies and pills that cured everything. His young son (who later told us this story) asked what was in the pills. "Sugar" was the reply. "Why do you charge money for them" the boy asked. "They don't work if I give them away" he replied.

If, as I believe, Homeopathic remedies "work" because of the placebo effect, then this story makes me think that the dilution and shaking rituals may be important because they (together with the purchase price) represent an "investment" by the patient. If the snake oil salesman was right, placebos will work better psychologically if the patient has invested something of value in them. This might explain why homeopathy outperformed placebos in a few trials - maybe the placebos involved no dilution and shaking. Are there any scientific studies to test this? If so someone please add them to the article. I couldn't find any. Mrdavenport (talk) 04:29, 27 September 2012 (UTC)

An article by Homer Sheard and Jones () suggests that recipients of surgery may report more benefits if the surgery caused pain and inconvenience, because to admit that the surgery was not beneficial would create cognitive dissonance. This is slightly supportive of my suggestion that Shaking and Diluting with amplify the placebo effect. Mrdavenport (talk) 04:44, 27 September 2012 (UTC)

The patient does not do the shaking and diluting. It is done by whoever makes up the remedy. As long as allocation to the groups is adequately blinded, and the subject cannot tell whether or not the remedy they are given has been shaken and diluted, the shaking and diluting is not a problem. There is no way of telling homoeopathic remedies that have been shaken and diluted from simple sugar pills (other than by looking at the label), so there is no way the subjects in a blinded trial can tell whether or not they have been given something that has been diluted and shaken.

Remember also that the statement that someting works no better than placebo does not mean that it works through the placebo effect. It could just mean that it doesn't work at all, and any apparent effects are the result of all the factors other than the placebo effect that a placebo control controls for. You can see some of them listed in this abstract, which also calls into doubt the idea of the "powerful placebo". See also this article, which analyses comparisons of placebo with no treatment, and this review, which found that the size of the placebo effect in trials of homoeopathy was no bigger than that in trials of medicines.

This is probably all a bit off-topic unless you have any proposals for changes to the article. Brunton (talk) 13:22, 27 September 2012 (UTC)

There is a lot of confusion about the placebo effect. It is extremely deceptive to say "Treatment 'X' works because of the placebo effect" - that's not how mainstream science says things.

I once had a friend with a pounding headache - he asked if I had any Tylenol...I didn't, so I lied and gave him two Tic Tac mints instead (they look just like Tylenol pills!) - and within 10 minutes, the headache got better. It probably would have gotten better anyway - and if it was some kind of stress-induced thing, perhaps he was de-stressed a little by knowing that his headache was going to go away soon. So, here is the question: "Do tic tacs cure headaches?" No! What (sometimes) cures or reduces some kinds of headache is the conviction in the patient that the pain will soon get better. Do you expect us to edit the Tic Tac article to say "Tictacs cure headaches via the placebo effect"? It's a true statement - if scientists did a controlled, double-blinded experiment, their findings would say that they cure headaches just as well as sugar pills and just as well as homeopathic Gelsemium pills and maybe 10% as well as Tylenol.

Homeopathic treatments don't cure a damned thing - they do absolutely nothing! The convincing presentation of some kind of inert treatment can sometimes either improve or cure some kinds of condition. But you don't need to pay $20 (http://www.abchomeopathy.com/shop.php) for a diluted 10¹⁰⁰ times, succussed, dropped-onto-a-lactose pill infusion of some weird plant or other. A 60 cent packet of tic tacs is exactly as effective. There is no need for all of the homeopathic bullshit that goes along with that - it's a total waste of human existence.

Worse still, invoking the placebo effect as the mechanism by which homeopathy "works" is highly deceptive. It suggests that homeopathic cures are (say) 90% effective and that this is "because of the placebo effect". That's extremely deceptive. They work exactly as well as any sugar pill, mint candy or other 'treatment' that the patient would find credible.

Caveat: My story about the friend, the headache and the tic tacs is not true - it never happened and it only worked as an argument because you believed in it...by the placebo effect if you like! :-)

SteveBaker (talk) 13:59, 27 September 2012 (UTC)

I knew you were pulling the wool over our eyes SteveBaker because tic tacs look (and taste) nothing like a aspirin. But your analogy is a good one. This article should clearly reflect this distinction.Sgerbic (talk) 16:01, 27 September 2012 (UTC)

Hmmm - the bottle of Tylenol (not "aspirin") that we have in the medicine cabinet has little oval pills that are almost the exact same shape & size as tic tacs. You don't really get to taste them much when you swallow them whole. But yes, it's not a true story. SteveBaker (talk) 01:36, 28 September 2012 (UTC)

"A 60 cent packet of tic tacs is exactly as effective." A $6 pack of Tic Tacs would probably be even more effective (if you told them it cost $6). Brunton (talk) 16:54, 27 September 2012 (UTC)

Since the use of any placebo whatever entails a lie of some description, sure, go ahead and tell them they cost $20. SteveBaker (talk) 01:36, 28 September 2012 (UTC)

Homeopathic treatments don't cure a damned thing I think we are all agreed on that. But it seems possible that the mumbo jumbo around a placebo brings psychological benefits to some. And if so, I wonder if more mumbo jumbo, perhaps coupled with "cognitive dissonance" bring more relief? But I'm not really interested in opinions on this - just wondering if there are any scientific measurements of this. Sounds like Baker and Brunton know of none Mrdavenport (talk) 17:36, 27 September 2012 (UTC)

Verify it with reliable sources that meet the standards of WP:MEDRS. SkepticalRaptor (talk) 17:40, 27 September 2012 (UTC)

There's a fair literature on this relation between "conditioning" of expectations and the amount of placebo effect. Reviews at PMID 19338509, PMID 20968195, PMID 22367630 all pertain. LeadSongDog come howl! 18:41, 27 September 2012 (UTC)

Indeed. Our article on placebo touches on a number of useful sources. One of my favorites is this 2008 report in JAMA, which showed that placebos became significantly more effective at deadening pain when study participants were told that they contained a more-expensive ($2.50 per pill) ingredient versus a less-expensive ($0.10 per pill) ingredient. (85% of participants reported a benefit from the 'expensive' sugar pill, versus just 61% in the 'discount' pill group.) The effect existed even though the participants didn't have to pay anything for the 'treatment'; I can't imagine that it would get weaker if they were paying large sums out of pocket. TenOfAllTrades(talk) 19:50, 27 September 2012 (UTC)

@LeadSongDog: None of the papers you listed mentions homeopathy. Please read WP:NOR. Dominus Vobisdu (talk) 19:59, 27 September 2012 (UTC)

I don't think LSD said or implied that they did. It's ok to say things in talk that wouldn't necessarily go straight into the article. Ben Goldacre's extract in the Guardian doesn't mention homoeopathy either, but it's also a point in the debate if anyone is interested. --John (talk) 20:13, 27 September 2012 (UTC)

I'm about as skeptical of the placebo "myth" as a person can be. I think there's more of observation bias than there is an effect. This discussion does a disservice to the total lack of any real effect of homeopathy, and the invented, mythical, and imaginary effect that people claim exist, that we bundle into something called "placebo" is just plain frustrating. A placebo effect cannot cure cancer. It cannot regrow limbs. It cannot do anything therapeutic. There is no "mind over matter" effect. Please show me one peer reviewed paper where some real chronic or acute disease clinical state was changed significantly with a so-called placebo effect and I'll eat my computer. You guys are conflating bullshit statistical anomalies with some myth. We ought to just start talking about religious miracles then. Sigh. SkepticalRaptor (talk) 20:25, 27 September 2012 (UTC)

@John et al.: We're not here to debate. This is not a forum. Nor are we here to conduct original research. I'm still not seeing a concrete proposal to change the text of this article backed up by relliable sources. Without that, there is no reason this thread should no be terminated. There are other venues on the internet for off-topic debate and disussion. Dominus Vobisdu (talk) 20:33, 27 September 2012 (UTC)

@Raptor: There are lots of recent papers on modification of neurotransmission by various placebos and shams, using fMRI imaging techniques. The effect is real, measurable, neurologically localized, reproducible, and dependent on treated individual's belief in the intervention used (whether that be an expensive sugar pill or sham brain surgery). Almost by definition a placebo does nothing specific to modify fundamental organic disease processes, but it does modify a clinical state. Pain is real and has real clinical import, no matter how many times you've been told it's all in your head. If that wasn't the case we would class analgesics as placebos too. The ethical difficulty surrounding the use of deliberate deception in medicine makes any such research work extraordinarily difficult, but there is a real need to better understand the phenomenon.

@Dom: The question raised by MrD is an interesting one, for which we should continue to try and find an answer in the literature. Discussion to that end is useful. LeadSongDog come howl! 21:29, 27 September 2012 (UTC)

Interesting or not, it's useful only if it has something to do with the topic of this article, which is homeopathy, not the placebo effect. Perhaps you should consider moving this discussion to the talk page of that article, or let us in on why you think this has something to do with improving THIS article. Right now, I see a discussion that's veered wildly off topic. Dominus Vobisdu (talk) 21:55, 27 September 2012 (UTC)

The links between homeopathy and the placebo effect are pretty major. If anybody sees it as being off-topic, perhaps they need to understand the topic better and/or not comment here. --John (talk) 22:50, 27 September 2012 (UTC)

Yes, it's totally off topic, and reeks of OR and synth. Unless you provide a concrete proposal for improving this article, which is on homeopathy specifically, and not the placebo effect in general, you are using this talk page as a forum. Dominus Vobisdu (talk) 23:05, 27 September 2012 (UTC)

I couldn't disagree more. I feel sorry for your apparently very simplistic worldview. Just because you don't understand something doesn't mean you need to insult others who do. I'm guessing you are very young; if not you are acting it. One way or another, grow up. --John (talk) 16:06, 28 September 2012 (UTC)

See WP:NPA. Talk about the article and not the editor. If you don't have a proposal to improve the article, I would suggest you turn around, open the door, and slowly walk out. It would be the nice way to leave the room. SkepticalRaptor (talk) 17:31, 28 September 2012 (UTC)

That's a good idea. And remember to close the door behind you when you leave. You are adding more noise than signal at this point. --John (talk) 18:36, 28 September 2012 (UTC)

Obviously, you're too busy to have reviewed WP:NPA. May I suggest you take another shot at it. :) SkepticalRaptor (talk) 19:17, 28 September 2012 (UTC)

The importance for this article is that we should not confuse the following two statements:

1. "Homeopathy improves the prognosis in some diseases by creating a placebo effect."
2. "Homeopathy has no effect whatever, with trials showing it to be no better than placebo."

They aren't quite the same thing - (1) says that it's OK to use homeopathy because it works (albeit not in the way that proponents claim), (2) says you're better off prescribing a sugar pill because homeopathy flat out doesn't work. SteveBaker (talk) 01:48, 28 September 2012 (UTC)

1 is basically sophistry, because exactly the same thing can be said for beads and rattles, drinking horse piss, selling your grandmother's soul to Pazuzu, or repeating to yourself "I don't really have cancer. I don't. I don't".

2 is a misstatement. It should read "There is no evidence that the effectiveness of homeopathy can be attributed to anything else than a placebo effect". Your interpretation is also a bit off, as it means that you are just as well off prescribing a sugar pill. It does not imply that a sugar pill is more effective than homeopathy, just that homeopathy is no more effective that prescribing a sugar pill (or selling your grandmother's soul to Pazuzu). Dominus Vobisdu (talk) 02:18, 28 September 2012 (UTC)

What the article already says is "the most reliable evidence – that produced by Cochrane reviews – fails to demonstrate that homeopathic medicines have effects beyond placebo."[113]

I happen to think that's excellent wording. Dom's criticism of (1) and (2) is correct, but his proposed text is not: there is evidence, it is just bad evidence, based on flawed or cherry-picked small studies. LeadSongDog come howl! 18:24, 28 September 2012 (UTC)

Yes, exactly. And as the link I posted backs up, one could make the same criticism of some aspects of Western medicine. --John (talk) 18:38, 28 September 2012 (UTC)

You mean medicine that has been supported by peer reviewed evidence. OK, point taken. SkepticalRaptor (talk) 19:15, 28 September 2012 (UTC)

Refocus on the Article

Sorry - I wasn't clear. Let me try again. This article lacks a satisfactory discussion of why the shaking and dilution have remained part of homeopathy, or were ever part of homeopathy. I know that the article mentions the original legends of succussion and water memory which sound like fairy tales to me. I thought there might be a scientific explanation (whether pharmaceutical, psychological, sociological, or even anthropological) for why those fairy tales were invented and if so it would be interesting to mention it in the article. I offered the snake-oil salesman's remark as one possible explanation, and the JAMA study seemsto have proven scientifically that shaking and dilution might add value to the product for some consumers, but no one has made the scientific (or historical) connection between JAMA and homeopathy so apparently it is not usable in this article. Thanks for trying folks, and although the editor thinks the discussion was inappropriate, I found it interesting. Mrdavenport (talk) 04:57, 28 September 2012 (UTC)

Just to be clear, I thought it was inapproriate exacly because no one produced a source that made a scientific (or historical) connection between the JAMA article and homeopathy. Without that, there's really nothing to discuss.

As for the why, apply Occam's razor: the shaking and dilution are still performed today because practioners and/or manufacturers still genuinely believe in Hahnemann's disproven principles or in "water memory" or the like. They seriously believe the shaking and dilution are doing something, and believe they are acting in good faith. There's really no compelling reason to seek an explanation beyond or apart from that. Dominus Vobisdu (talk) 05:24, 28 September 2012 (UTC)

I disagree with Dominus Vobisdu. I don't think we are here to theorise about why people hold particular beliefs; it is enough that we describe what they believe and what they do, while being guided by reliable sources. It was an interesting suggestion and i's a pity if we can't find a source that explicitly makes the connection. --John (talk) 19:10, 28 September 2012 (UTC)

People believe in lots of stuff. Not our job to talk about them. We only spend our precious time writing about what we can support with reliable sources. :SkepticalRaptor (talk) 19:19, 28 September 2012 (UTC)

If we have reliable sources about why people hold particular beliefs, and they have sufficient due weight, then the article can be expected to cover that. For example, For example, an interesting presentation by Chris French about how some groups of people are susceptible to pseudoscientific ideas and conspiracy theories, and believers tend to believe in a set of contradictory fringe ideas: "The single strongest predictor of whether you believe in a conspiracy theory is whether you believe in other conspiracy theories, even when there is no connection". IRWolfie- (talk) 17:08, 29 September 2012 (UTC)

Exactly. Our article on Jesus would be a lot shorter if we weren't allowed to mention belief. Well-attested and well-referenced belief is a perfectly fitting subject for us to cover, however misguided it looks to those who do not share the beliefs. --John (talk) 08:30, 30 September 2012 (UTC)

Once again, we're dealing with different categories here. Jesus is the central figure of a religion, so people's beliefs about him are vitally important - they are what the religion is based on. Homoeopathy purports to be a system of medicine, not a religion, so it needs to be treated here as medicine, not as a belief system. People's beliefs will not make homoeopathy effective, apart from via the placebo effect which is present in any supposed medical treatment - homoeopathy isn't special in this regard. The Medicine article doesn't discuss its subject as a belief system; neither should this article. Brunton (talk) 12:23, 30 September 2012 (UTC)

While it's interesting to read your opinion on the efficacy of homoeopathy, it isn't any more relevant here than my opinion on the "efficacy" of Christianity would be on the Jesus article. We do not enforce our opinions, but merely report what sources say. We should absolutely not treat homoeopathy as medicine, because it is not medicine, but we must not debunk it in the article either. We are not here to debunk homoeopathy any more than we are here to debunk Christianity. It's a belief system and we need to report fairly and neutrally on it as such. --John (talk) 12:30, 30 September 2012 (UTC)

We already report what the sources say. They say, overwhelmingly, that there is no good evidence for its efficacy. The question of efficacy is absolutely relevant in an article about a purported system of medicine, bacause treating diseases is the primary function of medicine - it is homoepathy's core claim, without which it would not exist. We can stop treating it as a system of medicine when homoeopaths stop claiming to treat disease. We can then remove the opening statement that homoeopathy is a system of alternative medicine, and report whatever homoeopaths are then saying they believe about it (although without the medical claims I doubt that there would be anything left), but until then we can't treat it as a belief system with no reference to reality. Brunton (talk) 14:13, 30 September 2012 (UTC)

I sympathise with your opinion but you are still not quite getting the subtlety here. Christianity claims to offer a guarantee of eternal life; should we be debunking that as well? Perhaps in some sense we "should", but that does not tend to be the line we take. You are seeing things in terms that are too absolutist. Peer-reviewed medicine suffers from problems of reliability too; the difference is a matter of degree; it's not much of an exaggeration to say that western medicine is mostly useless or indeed harmful (yet many people without an obvious vested interest report cures from it), while homoeopathy is wholly useless but at least does no harm (yet many people without an obvious vested interest report cures from it). A good encyclopaedia article on homoeopathy encompasses this tension, does not (obviously) endorse it, but does not go out of its way to debunk it either. --John (talk) 18:58, 30 September 2012 (UTC)

Sorry John - but I disagree with everything you said:

• The christian claim of eternal life is unfalsifiable. Therefore we cannot usefully debate it's truth or falsehood and belief (or disbelief) in is purely a matter of personal faith. Homeopathy is easily falsified...and it has been, on many occasions. Therefore your analogy is totally invalid.
• Peer reviewed medicine isn't perfect - but it is peer reviewed, and that happens to be Wikipedia's standard for writing about something as "truth". Please read WP:MEDRS if you are in any doubt about that point.
• Mainstream medicine is also not infallible - it does work most of the time though. But homeopathy always fails. 100% of the time. Through many carefully researched experiments, it consistently fails to produce any statistical improvement in patient outcome that is better than plain water or sugar pills. Mainstream medicines that are that ineffective are not approved by the FDA and other similar authorities.
• A good Wikipedia article on Homeopathy follows all Wikipedia guidelines - including WP:MEDRS, WP:FRINGE and WP:UNDUE. You can argue whether Wikipedia's guidelines do or do not produce a great encyclopedia (although not on this talk page!) - but you don't get to argue against us following those guidelines.

SteveBaker (talk) 21:56, 30 September 2012 (UTC)

"It's"?! You may take it as read that I am familiar with any longstanding WP:WXYZ and you may also take it that I support all of our core policies. The essential misunderstanding you exhibit is in your statement "it consistently fails to produce any statistical improvement in patient outcome that is better than plain water or sugar pills"; did you see just up a bit where we were talking about the placebo effect? And did you also see where we were discussing how a lot of mainstream medicine's peer reviews are invalid as they are based on skewed data? Don't get me wrong, I am definitely not advocating for homeopathy as a treatment method, but you are doing the subject a disservice if you treat it in such a reductionist way. Homeopathy, like religion (and to some extent mainstream medicine as well) exists at the intersection of science and society, and it requires a nuanced approach befitting such. --John (talk) 22:09, 30 September 2012 (UTC)

The placebo effect applies to any treatment. We don't seem to have any review articles that say that homoeopathy is somehow special as far as the placebo effect is concerned, and at least one recent systematic review which concluded that it isn't.

And the fact that a therapy works as well as placebo in controlled trials doesn't actually mean that it has a placebo effect. Apparent improvements cannot be concluded to be the result of the placebo effect, because they could equally be due to other nonspecific effects such as those listed in this abstract. In a placebo controlled trial there is no way of knowing which of these factors is in play. All we can conclude from such a trial of homoeopathy is that the remedies themselves don't make any difference to the outcome. Brunton (talk) 22:34, 30 September 2012 (UTC)

Is there a proposed change being discussed here? I may have missed it. TippyGoomba (talk) 00:50, 1 October 2012 (UTC)

From what I can tell, someone wants to turn this article into a religious one. Or something like that. It is one of the more creative ways to push a POV onto this article. SkepticalRaptor (talk) 02:27, 1 October 2012 (UTC)

The cult of homeopathy, sounds good to me. All we need now is a source... TippyGoomba (talk) 03:24, 1 October 2012 (UTC)

I've been dealing with the cult of anti-vaxxers for the past few years. I'm almost certain they share tactics. We'll see something soon. SkepticalRaptor (talk) 04:29, 1 October 2012 (UTC)

I understand that Mrdavenport has proposed that we add an explanation of why dilution and succussion are part of homeopathy, and has offered the hypothesis that they strengthen the placebo effect by the mechanism found in cognitive dissonance. While I would certainly welcome an explanation of why dilution and succession are part of homeopathy, naturally such an explanation would need to summarize reliable published sources, not our own speculations. If anyone can find any research on psychological mechanisms that have shaped homeopathic theory and practice, please summarize them in the article or post the reference information here to invite others to summarize them. Until then, I don't think anything more needs to be said on this topic. --Ben Kovitz (talk) 13:32, 1 October 2012 (UTC)

Immunization vs. homeopathy

this is ridiculous. the entire concept of immunizations and vaccines in western medicine is exactly the same idea as what is described in this article as being the basis of homeopathic thought. A flu vaccine has small parts of the flu virus so that the body is able to take the small amount of poison and fight it. Homeopathy gives a small amount of the material. It is exactly the same idea — Preceding unsigned comment added by 77.125.243.129 (talk) 14:15, 1 September 2012 (UTC)

In fact, homeopathy gives none of the material. It is composed entirely of water. This is why homeopathy is complete and utter nonsense. TippyGoomba (talk) 18:29, 1 September 2012 (UTC)

That's an amusing and complete misunderstanding of how immunization works. First, the flu virus is not a poison. Second, the flu virus is still alive, since it is a live, attenuated form of the virus, so that it evokes an immune response that is remembered by the immune system. Third, the amount of virus in the vaccine is sufficient to evoke the response, and is not so dilute as to disappear into nothingness. Fourth, before the vaccine is released to the general market, it undergoes clinical trials to determine its safety and efficacy. Fifth, it is approved for used by the FDA and CDC, two governmental agencies that certifies its safety and efficacy. Evidence based medicine and homeopathy have as much in common as say a computer and the random arrangement of rocks after an earthquake. SkepticalRaptor (talk) 18:38, 1 September 2012 (UTC)

I think you are a little ill-informed. There are vast distinctions to be made between immunization and homeopathy:

1. Immunization has undergone rigorous scientific testing - and it has been shown to work spectacularly well. Homeopathists do no organized testing - and when mainstream science does the testing, it's always found to be ineffective (no more effective than placebo).
2. The mechanism behind immunization is well understood. None of the theories for how homeopathy work stand up to close scrutiny.
3. Immunization is not about low/dilute doses of live virus - it's about fairly large quantities of killed or weakened virus, or some close analog of the virus that does not produce adverse symptoms.
4. In homeopathy, dilution is taken to the extreme where there are ZERO molecules of the original substance left in the treatment. In immunization, there is a large quantity of material present.
5. Immunization doesn't claim to "cure" anything - it merely primes the body so that it can subsequently cure itself. If someone has some disease, then immunizing them against it won't do a thing. This is not what Homeopathy claims - all of homeopathy starts from someone diagnosing a symptom, then choosing a homeopathic "treatment" to fix it..
6. Immunization claims only to prevent things that the human immune system can deal with (eg Viruses). Homeopathy admits no such limits.

SteveBaker (talk) 18:44, 1 September 2012 (UTC)

(ec) There are (at least) two fatal problems with that sort of analogy. As TippyGoomba notes, the first is that 'small' isn't a precise measure of quantity. (One cent and ten dollars are both relatively 'small' amounts of money, but they're not the same amount—and I know that I'd be more likely to look for a ten-dollar bill in the couch cushions.) The 'small' amount of material in a typical influenza vaccine is on the order of a hundred micrograms of protein. If you were to dry it out and pack it into a tight blob, it would be about the same size as a single grain of table salt. On the other hand, the amount of 'active' ingredient in a typical homeopathic remedy has been diluted so far that there probably isn't a single molecule of the purported ingredient left.

The second problem is that while a flu vaccine contains components of the flu virus, a homeopathic flu remedy contains nothing remotely resembling influenza virus. The immune system won't learn to recognize flu virus from exposure to any quantity – small or large – of the plant extracts and minerals used to prepare most homeopathic remedies. TenOfAllTrades(talk) 19:02, 1 September 2012 (UTC)

Immunization involves giving the subject a vaccine containing antigens specific to the infectious agent of a disease, to "prime" the immune system to recognise and fight it in future. Any symptoms that a vaccine produces are unwanted side-effects.

Homoeopathy concerns itself entirely with symptoms. It does not involve giving the patient "a small amount of the material" that causes the disease, and doesn't even recognise infectious agents other then the imaginary "miasms". A "correctly" prescribed homoeopathic remedy will be one that supposedly produces similar symptms to those the patient is suffering, including feelings and symptoms that are nothing to do with the actual disease. It will never be anything to do with whatever actually caused the patient's condition, other than by accident. The immune response that vaccination produces cannot be produced by homoeopathy.

These are not the same principle. Brunton (talk) 13:58, 2 September 2012 (UTC)

A source to clarify the difference?

We've now had several users asking whether or arguing that homeopathy is based on the same principle as vaccination. Presumably there are many more people who harbor the same confusion, that we don't hear from. Is there a good source that explains the difference in principle between homeopathy and immunization? It sounds like the article could use a summary of such a source. —Ben Kovitz (talk) 05:35, 19 September 2012 (UTC)

So far, looking on books.google.com, I haven't had much luck. I don't think either Shelton or Bausell mentions it. I've found three books that give this topic roughly a paragraph each:

…there is a major difference between homeopathy and vaccination. The amounts of active ingredient used in vaccines might be tiny, perhaps just a few micrograms, but this is still vast compared to a homeopathic remedy. A vaccine contains billions of viruses or virus fragments, whereas most homeopathic remedies do not contain a single molecule of active ingredient. Trick or Treatment, by Singh & Ernst

…proponents of homeopathy sometimes point out that the principle of "like cures like" was the basis for the development of vaccines and allergy desensitization treatments. This analogy, though, is not really accurate, since the substances used in immunization and desensitization are identical or similar to the disease-causing agents, whereas homeopathic remedies are usually substances different from those that cause disease. The Best Alternative Medicine, by Pelletier & Weil

Supporters of homeopathy sometimes claim that it has a philosophical link with vaccination, in which minute quantities of a substance stimulate the immune system to protect the body against infection. In reaity the fields of immunology and homeopathy are very different. Unlike most homeopathic medicines, vaccinations do actually contain something other than water—a measurable volume of molecules of dead or weakened organisms which incidentally become less, not more potent at greater dilution. Called antigens, these are related to the known causative agents of the diseases they prevent, such as the smallpox vaccine that is made from live vaccinia, another 'pox' type virus. Those antigens are what stimulate the production of measurable antibodies that protect the body if it encounters the dangerous smallpox virus. Crucially, viruses are designed to prevent diseases, not to treat them or provide symptom relief as homeopathy claims to do. Suckers, by Rose Shapiro

Each of the off-the-cuff explanations above was better than any of these. The principle of how viruses work is covered in elementary school (at least in the U.S.). The homeopathic ideas of miasms and incompatibility between two diseases in the same person at the same time are not well known, but it can't be hard to explain how they're different from training the immune system to create antibodies to a virus. Surely someone must have written a thorough explanation of this. Is there a better place to look? —Ben Kovitz (talk) 07:23, 19 September 2012 (UTC)

The problem is that this argument is so silly that no medical science journal would find it worthy of discussion, so the best thing you could hope for is a popular science book or magazine to discuss this, and I wouldn't want to include this argument based on pop science alone.

I've re-read the explanations above and think there's still one thing missing: It's not only that the amount of virus present in a shot is huge compared to that of a typical homeopathic dilution (“high potencies”), there's also the fact that (lay) homeopaths often don't even accept the germ theory of disease (according to them the presence of a virus is a symptom, not a cause of disease). I've actually had conversations where homeopaths argued both that a) vaccination was like homeopathy so the fact that vaccinations work was proof for homeopathy and b) that viruses don't cause diseases, not even acknowledging that these are mutually exclusive positions. --Six words (talk) 08:54, 19 September 2012 (UTC)

It's starting to sound like we need a section about the homeopathic theory of disease. The end of that section could explain the difference between homeopathy and immunization. What would you say is the best book that explains the homeopathic theory of disease? —Ben Kovitz (talk) 10:32, 5 October 2012 (UTC)

Latest bone of contention

Degenerated into off-topic forum discussion
The following discussion has been closed. Please do not modify it.
Harmless or not? - that is the question. The ref - ^ a b c Altunc, U.; Pittler, M. H.; Ernst, E. (2007), "Homeopathy for Childhood and Adolescence Ailments: Systematic Review of Randomized Clinical Trials", Mayo Clinic Proceedings 82 (1): 69–75, doi:10.4065/82.1.69, PMID 17285788, - Doesn't state any of this in the abstract, does someone have the full text? The summary given - at end of ref "However, homeopathy is not totally devoid of risks… it may delay effective treatment or diagnosis" seems to support BenK's sentence. Let the discussion begin! --Daffydavid (talk) 10:37, 11 October 2012 (UTC) "Non-toxic" or "not toxic" would be correct to distinguish from the associated risks, not directly involving the remedies themselves. —MistyMorn (talk) 12:45, 11 October 2012 (UTC) But that would be a banal and misleading statement, as water is "non-toxic". Dominus Vobisdu (talk) 14:07, 11 October 2012 (UTC) Actually excess water could be fatal, but I guess technically it is not toxic. SkepticalRaptor (talk) 15:34, 11 October 2012 (UTC) Not at the usually prescribed doses, at least... —MistyMorn (talk) 15:47, 11 October 2012 (UTC) True. SkepticalRaptor (talk) 15:49, 11 October 2012 (UTC) The avoidance or delay of access to accurate diagnosis and effective treatment is a real and substantially independent risk fromapart from the toxicity of low-dilution homeopathic "remedies".LeadSongDog come howl! 14:02, 11 October 2012 (UTC) Yes, preparations that are highly diluted, as they usually are, do not present toxicity concerns. But that doesn't imply that relying on homeopathy is "harmless". Harm can indeed occur indirectly through missed diagnosis and treatment of serious diseases. —MistyMorn (talk) 14:44, 11 October 2012 (UTC) Exactly. A homeopath, whose only prescription is water, tends to find every client needs water, even if the real issue is an acute bacterial infection. We also have the whole issue of products labelled as homeopathic which in fact have significant amounts of toxic content, e.g. the Zicam case. Then there's the whole ugly issue of homeopaths and naturopaths discouraging vaccinations. It is far from harmless. LeadSongDog come howl! 15:33, 11 October 2012 (UTC) I think there are three issues here, but to claim homeopathy is dangerous without putting the dangers in context and perspective and proportion eg compare them with the dangers of "mainstream medicine" and the well documented massive iatrogenic effects is not giving the article NPOV. Its important the article doesn't fall into rhetoric. 1) If a remedy is made with significant material doses, then for sure it can be harmful. However, this is a minute proportion of homeopathy and to not say this, and indeed specify where this is the case, is not NPOV. 2) If someone is delayed from seeking other medical treatment by their homeopath, that can be considered a danger, but that is a danger from the homeopath, not from homeopathy. Perspective is important again here. The amount of documented times this has caused a danger is minute. To not clarify this is not NPOV. 3) The number of homeopaths telling their patients not to vaccinate is minute. I've never met one, and I have met many hundreds. There is no valid research I have seen that shows different. What homeopaths may do is suggest their patients look at the whole picture. In the UK at least, GP's give out information that is one sided and is driven by money - ie if they don't hit targets they don't get money. Strange then that a sceptic may suggest its not good to look at all the evidence and then twists what a homeopath may advise to suggest its dangerous and not about open information.Cjwilky (talk) 12:55, 12 October 2012 (UTC) Let's address these points one-by-one: 1) Bullshit. Your personal opinion does not qualify as a reliable source. 2) Moar bullshit. We have ample sources describing homeopaths discouraging treatment of serious disease. The government of Australia's inquest regarding the woman in who died in great pain from treatable cancer - after being explicitly advised by a homeopath not to undergo surgery and chemo - was especially horrifying. 3) Layer after layer of bullshit, spread thickly with a mortar and trowel. Your isolated, self-reported anecdote is not sufficient proof of the stance of homeopaths towards vaccination. You have repeatedly argued that only "minute proportions" of homeopaths do (insert ethically questionable thing here) whereas we have many, many reliable sources in the article describing modern homeopathy's commonplace antipathy to vaccination and conventional treatment. It's rather tiresome to listen to this over and over again. Skinwalker (talk) 13:27, 12 October 2012 (UTC) (edit conflict) 1)Minute? Perhaps, I'd need to see evidence. But that risk is offset against zero benefit. 2)There is of course no need to see a homeopath in the process of obtaining homeopathic products in many jurisdictions. 3)We have statements such as PMID 12228144 and denials such as PMID 12531857, but the issue raised at PMID 16112852 is perhaps more relevant: homeopathic remedies used in lieu of real vaccines. LeadSongDog come howl! 14:12, 12 October 2012 (UTC) Wow. I prefer both of these deconstructions of Cjwilky's misleading and rather humorous POV pushing statements. I enjoyed it. Let's see if he'll throw his passive aggressive crap at you like he did with me. SkepticalRaptor (talk) 18:43, 12 October 2012 (UTC) Oh dear :( Lots of pseudo-sceptoid POV supported by use of sparse citations and generalising them, rhetoric, aggression and just plain bullying and insults going on here from the sceptic sect, especially sceprap who seems to have an aversion to co-operating in discussion. 1)The need for evidence lies with those that wish to say it is dangerous. Leadsong, you make a claim that your opinion is made up despite any evidence - or do I misunderstand you? Skinwalker - I think you need to show the amount of dangerous remedies and qualify them or your opinion of "bullshit" doesn't hold up. To do otherwise is to misinform. 2)You have exactly how many examples of homeopaths advising against seeing a mainstream doctor? I suppose you also have evidence of Harold Shipman homeopaths? Either way, they are homeopaths, not homeopathy. 3)You say I have an anecdote, do illustrate your point with evidence, and please spare us the anecdotal anti-homeopathy POV Eddie Ernst "surveys", the one you cite and the other letter in a journal. It says letters were sent out - in fact they were emails, pedantic maybe, but were into accuracy, aren't we? He says in that "survey" that a mother asked for advice about vaccinating a one year old. The email was more than that. To summarise, the mother (research assistant) was very (or some expression of very) concerned about vaccinations and wondered what other options there were. So she was told of other options. Most responses were giving her other leads, and not, as Eddie claims, advising her not to vaccinate. The man doesn't tell the whole truth, he exagerates, he is biased. And his is the evidence and quotations scepto's most rely on. I look forward to constructive replies :) Cjwilky (talk) 04:04, 13 October 2012 (UTC) See #1,2,3 above. You have no evidence whatsoever that homeopathy does anything. So your tendentious replies do not invalidate #1, 2, 3 above from both LeadDogSong and Skinwalker. In addition, you completely fail to understand what constitutes pseudoskepticism. Pseudoskepticism is actually denialism, which is the refusal to accept reality despite strong levels of evidence. We are not the pseudoskeptics, since we clearly understand that homeopathy is lacking evidence, we know that there is vast mountains of evidence that homeopathy doesn't have evidence (funny that), and we have written an article that states that. So, just by calling someone a pseudoskeptic, and not understanding what it means, doesn't allow you to actually use the label. The Australian Vaccination Network has tried that. They failed. Amusing. SkepticalRaptor (talk) 04:56, 13 October 2012 (UTC) Alternatively, skeprap could stay on topic and reply to the points without the rhetoric eg "no evidence whatsoever that homeopathy does anything", "just by calling someone a pseudosceptic..." Cjwilky (talk) 05:08, 13 October 2012 (UTC) Are you under the impression you made additional points? Or do you just not like his reply to the nonsense you posted earlier? TippyGoomba (talk) 05:28, 13 October 2012 (UTC) "Nonsense - what exactly? Cjwilky (talk) 13:52, 13 October 2012 (UTC) Alternatively, Cjwilky could stop spouting bullshit and participate in an intellectually honest conversation over how to improve the article. He could also drop the patronising habit of referring to others in third person. I realize he is probably a professional homeopath defending his trade - perhaps Citizendium would be a better place for that? Skinwalker (talk) 11:29, 13 October 2012 (UTC) Its always good if you refrain from bullying and discuss the article, which you fail to do in your last comment - "honest" meaning what exactly? Not meaning, as per "skeptic" dogma is it? Come on, less messin around, lets get on with it :) Cjwilky (talk) 13:52, 13 October 2012 (UTC) This is getting nowhere. But for Cjwilky's benefit, skepticism is the noble art of constantly questioning and doubting claims and assertions, and holding the accumulation of evidence as of fundamental importance. It forms part of the scientific method, which requires relentless testing and reviewing of claimed facts and theories. You want to make it a dogma, as do creationists, or global warming denialists, or vaccine denialists, or the vast majority of anti-science types. Skeptics don't ignore evidence, they constantly weigh it with an open mind. But they don't want the mind so open that the brain falls out onto the ground. And I believe that we have far exceeded WP:NOTAFORUM. Shouldn't this discussion be hatted now? SkepticalRaptor (talk) 15:01, 13 October 2012 (UTC) One word: Zycam. SteveBaker (talk) 16:50, 13 October 2012 (UTC) Technically, Zycam isn't a homeopathic solution, it was a method for an unethical company to get around FDA regs by claiming it was homeopathic. Moreover, it goes to prove that a product that has marginal effectiveness (if you read all of the meta reviews zinc marginally decreases course of a cold, barely more than placebo, barely shows fewer colds), while a much higher risk of losing your sense of smell. Not worth it. SkepticalRaptor (talk) 17:40, 13 October 2012 (UTC)

"Within the medical community homeopathy is generally considered quackery.[6]"

Individual chat show masquerading as a content dispute
The following discussion has been closed. Please do not modify it.
I propose that this is removed from the lead because of the use of "generally" and "quackery", and the misleading concept of "medical community". 1) I don't see the evidence for the statement. I don't have the book, so can someone cite me exactly what the figures are and how they were arrived at? Or are we going on a general statement from someone here? 2) Quackery is an emotive term and is certainly not used by ANY medics I have ever spoken to or hear speak out except when trying to make an emotive point. 3) That homeopathy may be considered unproven by the medical community, is not necessary to have in the lead as it already refers to the sceintific research perspective. 4) "medical community" - homeopaths, acupuncturists, midwives, nurses, etc etc make up the medical community, not just medical journalists. Cjwilky (talk) 12:29, 17 October 2012 (UTC) You're barking up the wrong tree. You'e not even in the right forest. Your proposal has no merit. At all. Dominus Vobisdu (talk) 12:41, 17 October 2012 (UTC) Homoeopaths aren't part of the medical community. They don't practice medicine. AndyTheGrump (talk) 12:42, 17 October 2012 (UTC) I forgot to mention, can we actually debate this, and stick to the point :) It seems to me that the sentence has little to back it up, so if you can't back it up, it follows it should be removed. Cjwilky (talk) 12:49, 17 October 2012 (UTC) The sentence has scientific evidence to back it up. Homoeopathy doesn't. AndyTheGrump (talk) 12:53, 17 October 2012 (UTC) The evidence is where? Cjwilky (talk) 13:06, 17 October 2012 (UTC) Here: [5]. AndyTheGrump (talk) 13:13, 17 October 2012 (UTC) What evidence are you referring to?Cjwilky (talk) 14:08, 17 October 2012 (UTC) Where's the evidence? I can't hear you. skinwalker maybe you could sign your posts in future? So thats 3 sceptics giving their best, any more?Cjwilky (talk) 15:00, 17 October 2012 (UTC) When it comes to homoeopathy, I'm not 'sceptical' about it at all. I know for a fact it doesn't work... AndyTheGrump (talk) 16:10, 17 October 2012 (UTC) "I don't see the evidence for the statement. I don't have the book..." It strikes me that we can – and we should – just stop the discussion right there. Cjwilky doesn't like the conclusions (or our summary of them) of an article that he apparently hasn't read, and on that basis argues for its removal. He is not going to be a credible advocate for his position as long as he isn't willing to do his own research—indeed, particularly as long as he demands that other editors do the homework for him. Saying I just don't like it once is a poor editing practice and to be discouraged; repeating it over and over again – as seems to be happening here – crosses into tendentious editing, and may draw sanctions. At this point, there seems nothing to be lost from hatting this thread, and absent any additional substantive new material I'll probably do so later today. In the meantime, can everyone please refrain from decorative ducks and goading or taunting of other editors? Thanks. TenOfAllTrades(talk) 16:55, 17 October 2012 (UTC) Alternatively, we could encourage the editor to actually follow the links provided in the citation rather than ask that others do his homework for him. The linked PMID 17719708 takes him to http://www.ncbi.nlm.nih.gov/pubmed/17719708 where he'll find an abstract and a link to the article on Elsevier's website at http://linkinghub.elsevier.com/retrieve/pii/S0277-9536(07)00420-0 If he chooses, the article is available to him there. If he can't afford their price, he can go to a library. Many are listed at ISSN 0277-9536. LeadSongDog come howl! 17:17, 17 October 2012 (UTC) Still no evidence offered, just an introduction in an article that uses "quackery" several times. The use of which has little to do with the actual content of the article. This is an important point and so far the sceptics have no evidence - strange another sceptic should come along and suggest the discussion be hatted, or maybe not so strange. It seems we're swamped in unsubstantiated assumptions here.Cjwilky (talk) 19:56, 17 October 2012 (UTC) It uses the word quackery. That's sufficient. Or are you inferring that you don't understand the word quackery? Or how to look up journals in a medical library? SkepticalRaptor (talk) 20:01, 17 October 2012 (UTC) One person, oh and of course the ever present Eddie Ernst, writes an article and uses the word quackery like s/he's trying to get the summary to the top of google searches, and thats "sufficient" evidence? I fear your sceptic powers are being caught in the tidal rip of slack POV, sir! Cjwilky (talk) 20:10, 17 October 2012 (UTC)

Misunderstanding the Placebo Effect

OK, I'm wading back in here. The first paragraph of the article mis-represents at least one of the references (Reference [4]). The sentence says "Scientific research has found homeopathic remedies ineffective..." but Reference [4] says "the clinical effects of homeopathy are placebo effects." and two paragraphs down the article says "systematic reviews of published trials have failed to demonstrate efficacy" and again references [4]. But Reference [4] (at least the abstract) clearly says that homeopathy does have clinical effects - just like placebos. Science recognizes that placebo effects are measurable, or scientists would not bother using placebos when assessing new drugs. Furthermore the Wikipedia article on Placebo gives good references to indicate that placebos are widely used by doctors. Check also [6] where it states:

Here’s a secret, though: doctors do indeed prescribe placebos, every day. Whether knowingly or not, doctors suggest and prescribe things to patients that have been proven to be essentially placebos—that is, to work only as well as a sugar pill. That antibiotic for bronchitis? Placebo. Often physical therapy, or antacid medicines, or pain medicine, or medicine to help you sleep—for almost all of these, the “effect” is only a little bit better than a placebo, though they’re all more effective than doing nothing. In other words, most of the effectiveness of many medical treatments is your own mind deciding that you feel better, encouraging you to act more healthy.

So we have (a) a solid reference [4] affirming that "the clinical effects of homeopathy are placebo effects" and (b) many solid references in placebo that the placebo effect is real and useful. Thus perhaps this article should make it clear that "homeopathy is an over-the-counter distribution system for placebo therapy" that operates in parallel to physician-prescribed placebo therapy. Which brings me back to my snake-oil salesman story 100 feet above this comment.

Right now the article has a very strong anti-homeopathy slant. But the placebo article is more balanced. I think this article could find a more even-handed view of the value of over-the-counter placebos. But I support the citation of strong scientific arguments debunking all the mumbo jumbo about shaking and diluting. Unless of course it can be shown that the shaking and diluting makes the placebo effect more effective. — Preceding unsigned comment added by Mrdavenport (talk • contribs) 23:21, 1 October 2012 (UTC)

You're conflating neutrality with anti-homeopathy. There's no evidence that homeopathy works. That's not anti-homeopathy. You're also missing that Wikipedia doesn't have to give undue weight to fringe ideas. But someone has already mentioned this. Please, this isn't a forum for you to express your beliefs. You have to bring reliable sources. You're not. You're proposing to created some original research, which is expressly not allowed. SkepticalRaptor (talk) 02:02, 2 October 2012 (UTC)

You also have a very bizarre concept of what "effective" and "placebo" mean, or why placebos are included in drug testing, so what you're saying is basically gibberish, as well as rather inept synthesis. In medicine, anything that works no better than a placebo is, by definition, not effective at all. See my comments above about selling your grandmother's soul to Pazuzu. Your understanding of core policies like WP:NPOV and WP:NOR is also sorely lacking. And yes, you are misusing this talk page as a forum. This isn't the place to "philosophize". Dominus Vobisdu (talk) 03:45, 2 October 2012 (UTC)

Specifically, please review WP:OR#Synthesis_of_published_material_that_advances_a_position. TippyGoomba (talk) 04:18, 2 October 2012 (UTC)

• Support changing the wording to align more closely with the reference. Remind all editors that proposing a change that you do not like does not automatically breach WP:NOTAFORUM. --John (talk) 05:37, 2 October 2012 (UTC)

Reference [4] doesn't say that "the clinical effects of homeopathy are placebo effects"; it says that its "finding is compatible with the notion that the clinical effects of homoeopathy are placebo effects." That is not quite the same thing. Note also that "placebo effects" are not the same thing as the placebo effect. And in the context of placebo controlled trials (which is what the reference was looking at) "no better than placebo" means "no better than a dummy treatment", not "it has a placebo effect". A placebo controlled trial cannot distinguish between the placebo effect itself and any other nonspecific factor. Brunton (talk) 09:40, 2 October 2012 (UTC)

That's not true. You misunderstand what's going on here. If placebo alone produced (say) a 5% recovery rate for some condition and some other treatment that is presented to the patient in an identical double-blind fashion also produces a 5% cure rate - then that treatment must be acting by the placebo mechanism alone and not by some "other nonspecific mechanism" that just happens to cure 5% of patients. If homeopathy acted to cure 5% of the patients then it would get close to a 10% effectiveness rate (actually more like 9%). That's 5% due to the placebo effect and 5% due to the treatment itself. So we absolutely can tell the difference between a placebo and a weak "nonspecific factor" of similar magnitude to the placebo effect. The only way to wiggle out of that result is if you claim that somehow the homeopathic treatment cancels out the placebo effect and replaces it with some actual active treatment of it's own that just happens to have the same effectiveness. Is that what's being claimed here? It's one hell of a stretch! If the homeopathic treatment had any positive effect whatever on the human body, you'd still expect some measurable improvement over placebo alone. Homeopathy does no worse than placebo and no better than placebo precisely because it does nothing whatever. SteveBaker (talk) 16:50, 2 October 2012 (UTC)

No, in a placebo controlled trial you cannot separate the placebo effect from any other nonspecific effects. You could only do that if you ran a three armed trial, with one group given the actual treatment, one given a placebo treatment, and the third group given no treatment. Even there you can't eliminate apparent subjective improvements resulting from the patients being polite and reassuring the doctor that their treatments did something (athough I suppose a desire to please the doctor could be considered part of the placebo effect). There are few trials comparing placebo to no treatment, and even if there was one for a particular condition, combining its result with the result of a trial of homoeopathy to state that homoeopathy had a 5% (or whatever) recovery rate caused by the placebo effect would be WP:SYN.

I think we agree on the basic point that the article needs to state, that if homoeopathy works no better than placebo then it doesn't work. All this is rather obscuring that. Brunton (talk) 08:02, 3 October 2012 (UTC)

The misunderstanding is all on your part - efficacy in the context of medicine is always efficacy beyond placebo; if it wasn't, the pharmaceutical industry would happily provide us with hundreds of inert treatments claiming efficacy. You're suggesting that we create a false balance by combining a source that says "homeopathy=placebo" and sources that say "placebos=sometimes useful" to claim homeopathy is a useful system. That's not just wrong, it's also against policy. Yes, placebo is part of every (and I mean every) medical intervention, but it's in addition to the intervention's effect.

You're also forgetting that homeopathy (as practised by homeopaths) is not OTC pills - according to them you have to repertorise(?) the patients symptoms (personal circumstances, etc.) to find their simillimum. --Six words (talk) 13:01, 2 October 2012 (UTC)

The reference doesn't state an effect. It states that there isn't an effect. It's original research to state that there is one. Besides, what are we supporting? No one has proposed anything. And we don't vote, we come to consensus, and there's nothing to which to come to consensus. SkepticalRaptor (talk) 14:34, 2 October 2012 (UTC)

There is a misunderstanding of the placebo effect here - Mrdavenport conflates effectiveness with efficacy. We will not do the same in the article. Skinwalker (talk) 16:42, 2 October 2012 (UTC)

It's a bit frustrating to read comments such as "efficacy in the context of medicine" and "In medicine, anything that works no better than a placebo is, by definition, not effective at all." This isn't medicine folks, it's homeopathy - so why interpret words such as "efficacy" using medical definitions? I get the feeling this is a very emotionally-weighted talk page that has strayed far from no point of view. It's like everyone is afraid that if we discuss this calmly, we will be sanctioning homeopathy. I suggest that once the article has stated up front (as it very nearly does now) "despite claims by some homeopathic practitioners [citation needed], homeopathy has been proven to be not medically effective (or efficatious or whatever)" then the article should discuss known medical dangers and known non-medical benefits (the only one that I can think of is the placebo effect). Or better still, just reference the placebo article, because the non-medical effects are identical to the placebo. And before you start screaming that placebos have no non-medical benefits, go read Benedetti's 310 page book on the subject [7] which says "we now know that there is a genuine neurobiological basis to this phenomenon." Mrdavenport (talk) 21:44, 2 October 2012 (UTC)

See WP:NOR. You're inventing stuff that's not here. Give us a reliable medical citation, then let's talk. Otherwise, you're synthesizing stuff. And yes, you're trying to make homeopathy into medicine, by giving it a medical effect. You can't have your cake and eat it too. So either it's just water, or you're making a medical claim. If it's water, then we're done. If it's got some effect, then prove it, which you can't. And we're done here. Just because you can show us what the placebo effect is, you can't invent a tie to homeopathy, by writing a doctoral dissertation, because that's not the purpose of Wikipedia. Well, you could write a doctoral dissertation, but still, that's not the purpose here.SkepticalRaptor (talk) 21:48, 2 October 2012 (UTC)

Nope - Mrdavenport still isn't getting it. The trouble with "then the article should discuss known medical dangers and known non-medical benefits (the only one that I can think of is the placebo effect)" - is that providing the effect of a placebo isn't a "benefit" of homeopathy because you get the exact same effect using just the water, without the one molecule of duck liver extract and all the mumbo-jumbo about shaking and whacking of the resulting liquid. The "homeopathy" part confers no benefit whatever. You can just leave all of that nonsense out of the picture entirely and you still get precisely the same placebo effect. So this article cannot truthfully say that there is any "benefit" to the addition of all that homeopathy is and does. Saying that homeopathic practices confer a placebo effect when applied to a vial of plain old water is untrue because the placebo benefit is there without it.

Let me put this another way. If we looked at the world through Mrdaverport-colored-glasses, then to be consistent, we'd have to say that adding a teaspoonful of salt to a bucket of water and not shaking or whacking it or diluting it multiple times produces the exact same effect as a homeopathic cure. Should we go to the sodium chloride page and say that "salt produces non-medical benefits in the form of a placebo effect"? If so, then we'd have to describe this property in the Wikipedia page for pretty much every substance known to mankind. That's a rather weird place to be! No, we say that very dilute saline has no effect whatever on the human body...even though it most certainly would produce a placebo effect. How far should we go with this? If I wish for magic to embue a bucket of water at midnight under the first full moon after midsummer - and that produces the very same placebo effect (which it would) - then does this too produce "non-medical benefits"? The fact is that it doesn't matter a damn what you do to the water...it's still just water (which has a placebo effect if presented to the patient as a treatment) - what I do to the water has no benefit whatever...zip...nada...nil! And that's where homeopathy stands. If you could find some base substance that somehow didn't confer a placebo effect (maybe something that looks and smells like dog poop!) then if homeopathy could make that cure at the rate that a placebo does, then maybe you'd be on to something - but you can't and it doesn't. SteveBaker (talk) 01:23, 3 October 2012 (UTC)

I must be having deja vu, but haven't we had this discussion going back many years, according to the archives that I've took the time to read? SkepticalRaptor (talk) 02:44, 3 October 2012 (UTC)

I've formally warned Mrdavenport about using the article talk page as a forum to discuss original research. There is no point in continuing this thread unless he makes a proposal that conforms to WP policies and guidelines and is backed up by reliable sources, and no point in responding to him if he does not. That just perpetuates a dead horse argument. Dominus Vobisdu (talk) 03:15, 3 October 2012 (UTC)

Mrdavenport: Regarding This isn't medicine folks, it's homeopathy - so why interpret words such as "efficacy" using medical definitions?, homeopathy makes medical claims, and we need to summarize medical research on its effectiveness. Calling homeopathy "ineffective" in the first para of the lead sounds to me like a fair summary of the research, even though the research uses the jargon term "efficacy"; see WP:EXPLAINLEAD. Certainly later on, the article should explicitly spell out the comparison with placebo effects. I think your suggestion of linking to placebo and efficacy is a good one. The section titled "Efficacy" explains how medical research assesses treatments, but it could be made a lot more accessible to a lay reader. That sounds like a lot of work, though! —Ben Kovitz (talk) 11:08, 5 October 2012 (UTC)

Seeking clear wording

From the discussion above, especially the remarks from Brunton and Six words, it sounds like the lead would be clearer to a lay reader if it said explicitly that homeopathy is no more effective than a placebo. The current wording in the 4th para is:

While some individual studies have produced positive results, systematic reviews of published trials have failed to demonstrate efficacy.

That seems pretty opaque to me. It uses the jargon term "efficacy" in the lead, and it's a weaker claim than the actual finding. Neutral wording should be clear and forthright even if it's saying something that many people disagree with. We used to have:

These studies have generally found that homeopathic remedies perform no better than placebos, although there have been a few positive results.

Are there any objections to this attempt to combine the virtues of both?

Some trials have seen positive results, but systematic comparisons of many trials have found that homeopathic remedies perform no better than placebos. The apparently positive results came from chance effects and biases in research methods.

Note the link to Meta-analysis. —Ben Kovitz (talk) 12:08, 5 October 2012 (UTC)

It's not bad - but the message about how a few trials seem to show positive results is kinda split between the beginning and the end. How about we get the mainstream message across first, then add the qualification for the few outliers:

"Systematic comparisons of many trials have found that homeopathic remedies perform no better than placebos. A small number of positive results have subsequently been shown to have come about from chance effects and biases in research methods."

SteveBaker (talk) 13:31, 5 October 2012 (UTC)

I suggest we describe the type of biases that might have been used whether confirmation bias, observation bias or whatever. Some of the metareviews do describe them. SkepticalRaptor (talk) 15:41, 5 October 2012 (UTC)

This definitely sounds like a good idea for the body of the article. The "Evidence" section should describe the specific biases actually found. (It already does this some, but it could do more.) However, I think we'd be unwise to go into further detail in the lead. The more complex the description, the less likely it will be understood or even read. The lead is the place to boil all the stuff about meta-analyses down to its essence. Such a summary promises that the body will flesh out the details, and the body does indeed fulfill the promise. —Ben Kovitz (talk) 17:04, 5 October 2012 (UTC)

One more thing: effectiveness and efficacy are two different things. We shouldn't interchange them as if they are. SkepticalRaptor (talk) 15:43, 5 October 2012 (UTC)

I think we have that problem solved: just don't say "efficacy" in the lead. It's pretty confusing jargon for a lay reader, and not necessary to get the main fact across. —Ben Kovitz (talk) 17:08, 5 October 2012 (UTC)

Excellent. I just was throwing out a suggestion, so that's good that we aren't interchanging them haphazardly. A researcher knows the difference, but a lay reader would conflate them easily. SkepticalRaptor (talk) 17:53, 5 October 2012 (UTC)

Yes, efficacy is a technical term (rather than jargon), and as such isn't widely understood. If a treatment has no efficacy, then it's not going to have any effectiveness beyond a placebo effect. So I agree it's fine to speak of effective/ness in the Lead. —MistyMorn (talk) 18:04, 5 October 2012 (UTC)

Steve: good point about splitting the message about positive results. Another flaw of my version is simply that by mentioning the positive results first, they can "stick" in the memory better than a fact in the middle (due to the serial position effect). OK, new proposal (remember, it's the second sentence of the paragraph):

These trials overall have found homeopathic remedies no more effective than placebo. Some individual trials saw positive results, but systematic comparisons across many trials have found that these results came from chance and biased research methods.

This one puts the main finding first, in a simple sentence that doesn't talk about anything else. That comes at the expense of making the second sentence compound-complex. I'm thinking this gets the emphasis just right, while meeting the objection from pro-homeopathy editors that the lead doesn't address the positive results. What do you think? —Ben Kovitz (talk) 18:14, 5 October 2012 (UTC)

When the results of these trials are analyzed together, homeopathic remedies turn out to be no more effective than placebo. Although some individual trials produced positive results, systematic review of the various trials (including meta-analysis of the best conducted ones) reveals that the positive results were the product of chance or flawed research methods.

I hope this version may be a bit more technically correct; for instance, defective research methods need not themselves be "biased" (the researchers may be in complete good faith), but the flaws allow various forms of bias to manifest. —MistyMorn (talk) 19:49, 5 October 2012 (UTC)

Unless there's a good reason, we should not substitute "no more effective than" for "indistinuishable from". It's a weasel, which opens the door to the question "Is it less effective?". LeadSongDog come howl! 21:26, 5 October 2012 (UTC)

In which case: When the results of these trials are analyzed together, the effects of homeopathic remedies turn out to be indistinguishable from placebo. Although the results of some individual trials seemed to favor homeopathy, systematic review of the various trials (including meta-analysis of the best conducted ones) reveals that the positive results were the product of chance or flawed research methods. —MistyMorn (talk) 22:06, 5 October 2012 (UTC)

I still prefer that the it state "product of chance, research bias, and flawed methodologies." SkepticalRaptor (talk) 00:07, 6 October 2012 (UTC)

MistyMorn, I'm not sure what advantage you have in mind, but I can see lots of disadvantages: the word "meta-analysis" is technical, "are analyzed together" and "systematic review of the various trials" are hazy compared to "systematic comparisons across many trials", "flawed" is less clear than "biased", it has a parenthetical comment, and it gets into the secondary matter of distinguishing between better and worse trials. It's just wordier and harder for a lay reader to understand. Remember, in the lead, we summarize the entire article—omitting all but the very most essential points. The body of the article can and should provide these additional details and subtleties; in a top-level summary, they throw fog around the main point. (The body is itself a summary of the sources, so the lead is a summary of a summary.) —Ben Kovitz (talk) 00:50, 6 October 2012 (UTC)

Ben, while fully recognizing the point you make about the role of the lead (an issue I recognize and am sensitive too), I'm afraid I can't agree with your specific comments on the wording.

Talking about the trials being biased invites a popular misconception. As I said above, the people who do the trial needn't be actively biased in any way (though they sometimes are), but any methodological flaw can introduce bias into a trial. Furthermore, one of the major issues is publication bias, a phenomenon which doesn't regard individual studies at all, but rather the disproportionate overall representation (publication) of those studies which turn out to provide positive ("attractive") results.

Also, "distinguishing between better and worse trials" isn't a secondary matter at all. If all the available trials are "analyzed together" in a meta-analysis, you can come up with a false-positive result due to a) the inclusion of low quality trials and b) publication bias. Something which was happening back in the early 1990s, for instance. To reach a correct result, you first have to filter out all but the high quality studies during the systematic review process and then, if appropriate, conduct a meta-analysis of the high quality trials (including a control for possible publication bias). The Cochrane Collaboration implements particularly rigorous processes to do this, which is why evidence on treatments provided by Cochrane reviews is commonly considered "best evidence".

These concepts aren't the easiest to put into simple words, I concede, but I feel we should try to get it right in the lead, as elsewhere. —MistyMorn (talk) 10:14, 6 October 2012 (UTC)

This tweak looks like a synthesis of the positions. Ben, I removed the word "many" when attempting to add your point to avoid weasel and "flawed" and "biased" are two different things as per SkepticalRaptor suggestion. "Turn out to be" replaced with "are" for clarity. How's this? - "When the results of these trials are analyzed together, the effects of homeopathic remedies are indistinguishable from placebo. Although the results of some individual trials seemed to favor homeopathy, systematic review of the trials reveals that the positive results were the product of chance, research bias or flawed methodologies."--Daffydavid (talk) 06:00, 6 October 2012 (UTC)

Daffydavid, actually, "many" is not a weasel word here in the lead (please see WP:WEASEL). The body spells out what that "many" is, in marvelous, non-weaselly detail (largely provided by MistyMorn, by the way!). However, I do agree that it's better to take it out. "Systematic comparisons across trials" is clearer, less wordy, and maybe even more accurate! :) —Ben Kovitz (talk) 02:04, 7 October 2012 (UTC)

BenKovitz, Yes I misused weasel but I see you understood my point - "many" allowed to many grey areas - were these POV trials, why not all, how many is many?, and the list would go on. Better without it. --Daffydavid (talk) 13:21, 9 October 2012 (UTC)

I think that could be the best proposal so far. Though I'm not so sure about the usage of "methodologies" (the flaws are in the 'methods' rather than the 'methodological approaches'). Perhaps something like "or other methodological issues"? Or maybe avoid the term 'methodology' altogether by saying something like "...were the product of chance or research bias." Thus: "When the results of these trials are analyzed together, the effects of homeopathic remedies are indistinguishable from placebo. Although the results of some individual trials seemed to favor homeopathy, systematic review of the trials reveals that the positive results were the product of chance or research bias." Or perhaps (to address the other legitimate question, why do some of the systematic reviews give positive results?):
When the results of these trials are analyzed together, the effects of homeopathic remedies are indistinguishable from placebo. Although the results of some individual trials seemed to favor homeopathy, high quality systematic reviews reveal that the positive results were the product of chance or research bias. —MistyMorn (talk) 10:26, 6 October 2012 (UTC)

MistyMorn and Daffydavid: First, some points of agreement. I agree that a lay reader is likely to think "bias" describes the attitude of the researchers. While the body of the article clarifies that, I think your proposal of "research bias" solves the problem nicely. (The link to Reporting bias doesn't exactly cover the kinds of bias described in the body, but I don't think that's worth worrying about right now. It's way better than the very hazy word "flawed".) I'm happy with "indistinguishable from placebo". I'm happy with linking to Systematic review rather than Meta-analysis (though a little disappointed). And, I think your "reveal" is much clearer than my "found". This updates the proposed "short version" to:

These trials overall have found homeopathic remedies indistinguishable from placebo. Some individual trials saw positive results, but systematic comparisons across trials revealed that these results came from chance and research bias.

Our remaining disagreement seems to be only over the following small changes, which seem to me to increase wordiness and haziness:

"When the results of these trials are analyzed together…" vs. "These trials overall…

"Although the results of some individual trials seemed to favor homeopathy…" vs. "Some individual trials saw positive results, but…"

"high-quality systematic reviews" vs. "systematic comparisons across trials"

"the positive results were the product of…" vs. "these results came from…"

I might be misunderstanding your reason for favoring these, so I'll ask: Are you thinking that a reader who sees "results … are analyzed together" will be informed and enlightened in a way that a reader who only sees "overall" and the next sentence's description of looking at many trials won't? Also, are any of these different wordings actually not that important to you? —Ben Kovitz (talk) 03:08, 7 October 2012 (UTC)

Briefly, my main concern is that, technically speaking, systematic reviews do not entail any form of 'comparison' (and meta-analyses synthesize, rather than compare, findings/data). Also, imo it's important to specify that it's the 'high quality' systematic reviews that provide the true answer: as I tried to explain above, just as there have been many positive trials, there have been several systematic reviews which turned out positive because of flaws (the correct term [8]) in their methods. Otherwise, I feel pretty comfortable with your wording, except perhaps with "These trials overall have found..." which seems to me to put the cart a bit before the horse. To reach that conclusion you have to do a lot of careful work (systematic review), which actually involves excluding many low-quality trials which found the opposite. I'd prefer something more like:
Appraisal of this body of evidence shows that homeopathic remedies are indistinguishable from placebo. Although some individual trials produced positive results, high quality systematic reviews reveal that these results came from chance and research bias. —MistyMorn (talk) 07:55, 7 October 2012 (UTC)

Thanks, MistyMorn. Looks like we're almost there. Certainly both proposals are already much better than our current "failed to demonstrate efficacy".

Regarding "comparison": This particular word isn't important to me. I hope we can use a strong, concrete word to suggest the simultaneous consideration of many trials that enables one to see the patterns that are really there and that can't be seen just by looking at one trial: patterns of bias as well as the marks of genuine causal connections. I realize this might not be possible, though. "Systematic review" makes me cringe a little, but it might be the best we can do. It could be worse, much worse.

Regarding the sequence of cart and horse: I'd like to see the conclusion stated right away, in a short sentence that doesn't talk about anything else. That can be followed by a long sentence or two about subtleties and reasons. This makes the main conclusion clearer and more likely to be read and remembered. Is there a way to do this? Above, I've proposed a common (and admittedly unimaginative) technique: defer the subtleties to the second sentence by referring to them in the first sentence with the word "overall". There must be other ways to achieve this level of clarity, too, though. Following the chronological sequence of steps of observation and reasoning that led to the conclusion may or may not work. Usually in a high-level summary, putting the justification before the conclusion obscures the conclusion—usually, but not necessarily, and you may find a way to make it work.

Here's my understanding of the main facts we're trying to summarize here, in descending order of importance:

1. The overall finding is that homeopathic remedies work only about as well as placebos.
2. This finding does not follow from any individual trial; it's implied by the totality of many or all trials.
3. In fact, some individual trials got positive results.
4. The positive results came partly from chance, partly from a variety of systematic errors that tend to produce spurious positive results.
5. To figure all this out, people sorted through lots of trials, distinguishing the good ones from the bad ones and finding patterns and problems.
6. Some of the early studies where people sorted through lots of trials actually concluded that homeopathy performs a little better than placebo.
7. Those early studies of many trials were themselves later found to give too much weight to trials run in ways that tend to produce spurious positive results.

We have to omit facts that are below some cut-off point, of course. My feeling right now is that #1 through #5 are all we need, and adding more facts would obscure the main facts, either by talking too long or by trying to pack too many ideas into too few words. I think an acceptable lead must make #1 stand out very clearly, and present #2–#5 clearly enough that people get the basic idea. Anything less would omit one of the main "takeaways" of the whole article. Do we agree about that? Of course, if you can find a way to get all the way to #7 without obscuring #1–#5, that would be great, and I'd support that. —Ben Kovitz (talk) 19:18, 7 October 2012 (UTC)

Yes, I follow pretty much all of that. I agree it's not possible to go into too much detail in the lead. I've tried to make that reasoning/history clearer in the Evidence section, but there's still considerable room for improvement, certainl (Also, eventually, I'd like to see a more succinct Evidence section, with an extended subpage, per Wikipedia summary style, to allow clearer, more pithy communication of the key points.)

The sticking point I struggle to understand is the reluctance to use the key term 'systematic review': unlike 'intention to treat analysis' or 'type 2 error', the term is, I believe, genuinely descriptive, corresponding fairly closely to the plain English phrase 'systematic' + 'review'. And as we're on Wikipedia, we also have a nice blue link to explain its meaning further (for the same reason, I liked the idea of using the plain English word 'appraisal'). Trying to find synonyms which simply don't exist is always going to be problematic, imo. For example, your simple English explanation ("sorted through lots of trials, distinguishing the good ones from the bad ones and finding patterns and problems") makes this highly systematic process sound much more exploratory than it actually is. If a systematic review isn't conducted really rigorously (exhaustively, and frankly often quite exhaustingly!) it isn't methodologically credible. To get an idea, take a look, if you can bear to do so, at the PRISMA reporting guidelines [9] or the Cochrane Handbook [10]. In brief I feel we really do need to retain the term "systematic review" in the lead. After all, there's also Simple Wikipedia, which has a complementary role.

For the rest (excuse the Italianism), I'd rather back down for now as I feel I've gone about as far as I can go for the moment. —MistyMorn (talk) 20:26, 7 October 2012 (UTC)

Sorry I wasn't clear: I'm willing to go along with "systematic review". If you're also not so concerned about facts #6 and #7, then it sounds like we almost have consensus. Anyway, yes, let's let it rest a day or two. There is no deadline. —Ben Kovitz (talk) 20:57, 7 October 2012 (UTC)

Yes, I think your points 6 and 7 capture the gist of what happened. Of course there are technical reasons for that (evaluation of publication bias, etc) which I think can be omitted until the main text. I agree about the need for a break. It's good to distance oneself mentally from anything one's been involved in writing. —MistyMorn (talk) 21:06, 7 October 2012 (UTC)

I think that the sentence should mention the apparent positive ones first, explain why they were in error and then explain that the "effectiveness" is the same as placebo. "Systematic comparisons across trials revealed that although some individual trials saw positive result, these results came from chance and research bias. With these trials excluded, the evidence shows that homeopathic remedies are indistinguishable from placebo." It's basically just a re-ordering of the sentence, but I'll look at it again later. I also wonder if we shouldn't put "flawed methodologies" or something like it back in since research bias doesn't explain it adequately.--Daffydavid (talk) 13:21, 9 October 2012 (UTC)

Here's why I favor "bias" over "flawed": "flawed" is just about the vaguest criticism one can make about a way of coming to a conclusion, and all the flaws we are referring to are in fact tendencies to make too much of positive results like people getting cured—in other words, bias. Like "many", "flawed" is not a weasel word in this context, because the body of the article fleshes it out very well, but it's another "natural" weasel word, which we should avoid if we can. That said, "…came from chance, flawed research methods, and reporting bias" is way better than our current "failed to demonstrate efficacy". If that's the best we've got, I'm willing to go along with it. (The plain word "methods" is better than its puffed-up cousin "methodologies", of course, but I understand that there is no strong disagreement about that.) —Ben Kovitz (talk) 19:37, 10 October 2012 (UTC)

Consensus wording

How about this?

In these trials, homeopathy performed no better than placebo. Some trials saw positive results, but systematic review revealed that the positive results came from chance, flawed research methods, and reporting bias.

Some advantages of this wording: the main conclusion is stated first, and is stated succinctly and without simultaneously talking about other things. By wording it in terms of the performance of homeopathy, we describe only what the systematic reviews concluded, not how they concluded it. The second sentence summarizes the main facts about how they concluded it. Some disadvantages: "systematic review" is a technical term, which doesn't suggest to a lay reader the simultaneous consideration of many trials (see fact #2 above), and my above complaints about "flawed".

We haven't had success finding clear, succinct wording to fix these last two disadvantages. I'd be happy if we post this version and hope it spurs someone to think of a better way to summarize the systematic reviews and the research bias. —Ben Kovitz (talk) 19:37, 10 October 2012 (UTC)

Looks good to me. Phew! :-) —MistyMorn (talk) 19:51, 10 October 2012 (UTC)

A consensus may be upon us! What sayest thou, Daffydavid? —Ben Kovitz (talk) 20:13, 10 October 2012 (UTC)

Looks good to me too, print it!--Daffydavid (talk) 20:39, 10 October 2012 (UTC)

Hooray! Just sent it to press. :) —Ben Kovitz (talk) 21:00, 10 October 2012 (UTC)

I changed it to "reviews" because it's a plural. Isn't it? And trials don't "see". I changed it to a proper verb "demonstrate". You can change it to whatever word you want, but we should use whatever you want, but trials don't see anything. :) SkepticalRaptor (talk) 21:07, 10 October 2012 (UTC)

I agree on both counts. When one stares at similar wording for too long, one becomes blind to it. A good reason for getting others to proofread! —MistyMorn (talk) 21:11, 10 October 2012 (UTC)

Misty changed it to produced. Works for me. Sorry that I didn't get involved with the consensus building, which probably would have helped, but I saw "reviews" all along, which seems like it was just a cut and paste error. I like what happened. Ironic that the individuals who started this whole thing didn't help out at all. SkepticalRaptor (talk) 21:22, 10 October 2012 (UTC)

I changed the clause dependency to give precedence to the systematic reviews, and got rid of some redundant wording. Dominus Vobisdu (talk) 21:26, 10 October 2012 (UTC)

BTW, it's fine and proper that the people who started the discussion about the comparison with placebo, and even brought it to resolution, didn't participate in the discussion of how to word it. That's part of the glory of wikis! Each person contributes according to their own strengths and inclinations. (Regarding "reviews": not a cut-and-paste error; see below.) —Ben Kovitz (talk) 03:01, 11 October 2012 (UTC)

SkepticalRaptor, I'm not going to fight this, because the present version is still a big improvement over what we had last week, but I think there is no reason to bring the writing in Wikipedia down to dull bureaucratese. The word "see", and the English language generally, are much more flexible and expressive than you suggest. From the OED's entry for see:

To ascertain by inspection, inquiry, experiment, or consideration. …

To known by observation, to witness…

To observe, find…

To be contemporary with and in the neighborhood of, to be the scene of (an event)…

—Ben Kovitz (talk) 22:40, 10 October 2012 (UTC)

Maybe. But not when I write. SkepticalRaptor (talk) 06:39, 11 October 2012 (UTC)

Regarding "systematic review" vs. "systematic reviews": both are correct. The singular makes it a mass noun, and the plural makes it a count noun. (Do you really not know this?) The singular emphasizes overall result, and the plural emphasizes multiplicity of reviews. I think the former emphasis is slightly better since we are explaining a single, overall conclusion (in the previous sentence). But that's a very fine point, and both are acceptable. There may be a way to exploit the fact that we have a choice between singular and plural here to word the second sentence more gracefully, but if there is, I haven't spotted it yet. Maybe someone else can. —Ben Kovitz (talk) 02:50, 11 October 2012 (UTC)

Reviews is the only way to write it, your rude retort "do you really not know this" notwithstanding. If you're going to get defensive about tiny changes in writing, you might not want to edit Wikipedia. SkepticalRaptor (talk) 06:43, 11 October 2012 (UTC)

Would you please answer my question: Did you already know about mass nouns and count nouns in English? I feel silly and condescending explaining basic English grammar and vocabulary here. (I find your "defensive" remark uncalled-for.) But you just demonstrated two fairly basic misunderstandings of English grammar and vocabulary, and this is not the first time you've made mistaken pronouncements you could check for yourself in a dictionary. If I understood your situation, maybe I could see a better way to address it. Are you a non-native speaker? —Ben Kovitz (talk) 07:39, 11 October 2012 (UTC)

Stop the bickering, Ben is right about the "review vs reviews" position SkepRap, but neither of you are acting very mature right now. Can we concentrate on the article please? --Daffydavid (talk) 10:46, 11 October 2012 (UTC)

I didn't post here about "demonstrated" vs "produced" ("generated" would be the term I'd normally use, but I'm not suggesting it here) because I was busy stirring a risotto at the time. But hey, I thought this discussion was pretty well al dente. Can we avoid overcooking it?

On reflection, I think employing "systematic review" as a collective noun is actually quite an elegant solution as far as the underlying meaning is concerned. Though I doubt general readers (our main target readership here) will pick up on the subtleties of the distinction. One question I hear asked a lot, not just in relation to the subject of this page, is how come systematic reviews and meta-analyses provide conflicting results. I guess it's idle expecting the lead to answer the question as far as homeopathy is concerned. My 2 cents: "systematic review", in the singular, is perhaps conceptually better, though I'm not sure whether it's more intuitive to the general reader. —MistyMorn (talk) 12:10, 11 October 2012 (UTC)

• I tweaked this to: "These trials failed to prove any effect beyond placebo", which is more precise. Even where tests have apparently shown a positive effect, they have failed to prove the case, which is the real issue. It's easy to design a test that will give a positive result for homeopathy, but impossible to come up with one that proves homeopathy has any effect other than placebo, for the obvious reason. Guy (Help!) 07:04, 24 October 2012 (UTC)

Can we speak of "mainstream medicine"?

(continued from "arbitrary break" far above)

Dominus, we might be misunderstanding each other, so let me ask just to be sure: Are you saying that the sentence "Within the mainstream medical community, homeopathy is generally considered quackery" would unduly lend the semblance of credibility to a thoroughly discredited movement? —Ben Kovitz (talk) 20:32, 10 October 2012 (UTC)

Yes, because it suggests that the homeopathic community is part of the medical community, just not part of the "mainstream". The qualifier is not necessary, and it's misleading. Dominus Vobisdu (talk) 20:56, 10 October 2012 (UTC)

Thanks for clarifying. OK, maybe this will uncover something more about where we agree and where we disagree. How do you answer this argument: If homeopathy isn't medicine, then how can it be ineffective medicine, quack medicine, tested as medicine, and opposed to mainstream medicine? —Ben Kovitz (talk) 21:34, 10 October 2012 (UTC)

In exactly the same way that pseudoscience is not science. Your error was that you failed to recognize logical negators ("innefective" and "quack"). "Inneffective medicine" and "quack medicine" mean "not medicine", because they fail the tests that would qualify them as medicine. Something that's not medicine can be tested as medicine, and fail, proving that it's not medicine. And something doesn't have to be medicine to be opposed to mainstream medicine. Dominus Vobisdu (talk) 22:05, 10 October 2012 (UTC)

Thanks, Dominus. I think I understand better now what your thinking is. I'll try to put it in my own words: "'Medicine' by definition means 'effective medicine'. This is different from a word like 'pen', which does not include effectiveness in its definition, so that a broken pen that can't write is still a pen. Consequently, a community that collects broken pens collects pens, but a community that practices ineffective medicine does not practice medicine." Does that represent your current view accurately? —Ben Kovitz (talk) 06:33, 11 October 2012 (UTC)

You could use that line of reasoning, too, and it's just as valid, as it's essentially the same. However, I was talking about you missing the negative value (in logical terms) of the words "ineffective" and "quack". Analogous qualifiers here would be "former", "ex-", "future", "aspiring", "wannabee", "sham", "fake", "phony", and the like. For some reason, "broken" doesn't always work like this, although if someone asked you for a pen, and you (purposely) gave them a broken pen, it would not fit his operational definition of pen, and you'd end up getting a nasty stare, if not one upside the head.

Or you could treat it as a quibble, as you propose: a spin doctor is not a doctor, a road apple is not an apple, a silverfish is not a fish, creation science is not science, etc. Six of one, half dozen of the other. Either way, classifying homeopathy as medicine would be a categorical error.

The essence of quackery is presenting something as medicine that isn't medicine. And yes, the default meaning of medicine in by far most peoples minds is "mainstream medicine". And yes, quacks do try to legitimize their dubious craft by trying to blur the boundary of "medicine" and "not medicine". Dominus Vobisdu (talk) 07:08, 11 October 2012 (UTC)

Well, now I'm more confused than I was before. Unlike the genuinely negating terms you listed, "ineffective" normally doesn't mean "not an instance of". For example, an ineffective teacher is still a teacher; an ineffective procedure is still a procedure. I thought you were saying that "medicine" is unusual in this respect, in that it's effective by definition. Could you please clarify? If medicine is not effective by definition, then "homeopathic medicine" is not a contradiction in terms. But you didn't say "contradiction in terms", you said "categorical error". Did you mean category error? A category error would be something like "jazz medicine", because medicine isn't a kind of thing that can be jazz/rock/classical/etc. (whereas "jazz improvisation" and "jazz rendition" are not category errors), or holding mathematical theorems to the standards of WP:MEDRS (because math is not medicine: not effective, not ineffective, not mainstream, not alternative, not traditional, and not any other sort of medicine). Maybe it would be simplest just to start over: How can homeopathy be ineffective medicine, meaningfully testable by the same methods and against the same criteria as effective medicine, and found by medical standards to work only about as well as placebo (that is, slightly better than no treatment at all), if it isn't medicine? —Ben Kovitz (talk) 08:49, 11 October 2012 (UTC)

By the way, let's try to avoid using "mainstream medicine." This is a pejorative term, which always implies "close-minded medicine," to the regular reader. SkepticalRaptor (talk) 06:38, 11 October 2012 (UTC)

Agree. It's one of the dishonest tactics used by quacks to discredit real medicine in the eyes of the gullible public, and tehy do use it pejoratively in this case. Dominus Vobisdu (talk) 07:08, 11 October 2012 (UTC)

So how would you distinguish between say Herbalism and erm... "mainstream medicine"? Think back to venn diagrams - if "mainstream medicine" = "medicine", then that makes herbalism part of "mainstream medicine". Quite clearly it isn't. Cjwilky (talk) 12:48, 11 October 2012 (UTC)

The term evidence based medicine serves well in contrast to homeopathy, but does not completely exclude herbal medicine, there is certainly overlap. In the context of this article, though, "evidence based medicine" is sufficiently distinct. LeadSongDog come howl! 13:52, 11 October 2012 (UTC)

Yeah, but even in herbal medicine on a portion of it is real medicine. Much of it is junk. SkepticalRaptor (talk) 15:37, 11 October 2012 (UTC)

EBM doesn't cover all of what we may otherwise call mainstream/western/conventional etc medicine. There are gaps eg many treatments are under researched, partially researched, there is a tie gap from when eg drugs are available and used to when there is a true assessment of their efficacy, in general its a theory of practice that doesn't always result in EB practice.Cjwilky (talk) 16:24, 11 October 2012 (UTC)

Citation please. SkepticalRaptor (talk) 17:14, 11 October 2012 (UTC)

Oh, SkepticalRaptor—surely you've read Smith & Pell "Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials" BMJ 2003; 307:1459. TenOfAllTrades(talk) 19:25, 11 October 2012 (UTC)

No, I haven't, but I'm going to be using it somewhere. I just choked down an apple seed, which obviously has some benefit. SkepticalRaptor (talk) 23:35, 11 October 2012 (UTC)

Whatever homeopathy may be, it most certainly isn't evidence based! —MistyMorn (talk) 18:03, 11 October 2012 (UTC)

Unconstructive
The following discussion has been closed. Please do not modify it.
So Skeprap, no indication what you're referring to there. Whats your contribution to this - what would you have mainstream medicine called? Mistymorn - not sure what you said there adds to anything. Mainstream medicine, allopathy, Big Pharma Medicine Inc... come on people must be something. Clearly its not EBM.Cjwilky (talk) 23:12, 11 October 2012 (UTC) This looks to me like trolling. No thank you. I have better things to do, User:Cjwilky. —MistyMorn (talk) 23:32, 11 October 2012 (UTC) Not trolling MM, emphasising that you said that homeopathy isn't EBM. We may disagree about that and who chooses to judge that and for what reasons, but the point was about mainstream medicine not being EBM entirely, maybe you could reply to that point I raised? Or come up with an alternative description for it? :) Cjwilky (talk) 00:01, 12 October 2012 (UTC) MistyMorn, you should see the discussions with Dana Ullman, Tenpenny, Mercola on Twitter. Similar quality of discussion that Cjwilky brings. SkepticalRaptor (talk) 23:38, 11 October 2012 (UTC) Pass [11]. —MistyMorn (talk) 23:56, 11 October 2012 (UTC) skeprap, the contribution towards a healthy debate with that is what exactly? If you have an on topic opinion voice it, otherwise I don't see the point of you wasting your time typing. Cjwilky (talk) 00:01, 12 October 2012 (UTC) Looking up irony in the dictionary. Hmmmm. SkepticalRaptor (talk) 00:25, 12 October 2012 (UTC) Not sure what your view of irony has to do with anything either, would be good if you stick to the topic and discuss it constructively, skeprap. So EBM can't be the term as it doesn't cover all "mainstream medicine". The other issue in this thread is about whether homeopathy is a medicine. People go to homeopaths and claim they get better. There is research to show this eg the Bristol hospital research. Then we get the same discrediting of this research, which as usual, shows research design flaws to explain the results. This doesn't mean that research has no validity, just as much of research into pharma drugs is poorly designed and less criticised by sceptics. In terms of basic catergorising, homeopathy comes into the realm of medicine. Quackery - yes it is used in the UK, but not often outside the sceptic community. I haven't seen evidence that a significant majority of the medical community say homeopathy is "quackery". Its a pejoritive term that sceptics like to use - ie NPOV. Its possible that many of the medical community say its unproven, though who are we including in the medical community? Specific people who speak out against homeopathy? I know there are many nurses and midwives who not only claim homeopathy is positive, but actually use homeopathy within their mainstream medical practice. I don't know what the figures are for this. But here I'm asking for evidence of that statement in the article. Cjwilky (talk) 12:40, 12 October 2012 (UTC) See below. Quack. SkepticalRaptor (talk) 18:45, 12 October 2012 (UTC) But it's only a minute proportion! Late in the day, I know, but the term we are looking for here is "medicine". Homeopathy is an alternative to medicine, and medicine is what people avoid when they use homeopathy. Guy (Help!) 06:53, 24 October 2012 (UTC) This is rhetoric again. Cjwilky (talk) 08:21, 24 October 2012 (UTC) No, it's a simple statement of fact. Homeopathy is an alternative to medicine, it is not a system of medicine because it has no medicine, it is merely a system of "healing rituals" like reiki, faith healing and so on. The scientific evidence is quite unambiguous. It's OK, though, I would never expect a believer to accept this. Guy (Help!) 15:24, 24 October 2012 (UTC) CJWilky is trying to bait people into specious debates over the efficacy of homeopathy - c.f. the collapsed threads below. I'd recommend ignoring him. Skinwalker (talk) 15:41, 24 October 2012 (UTC)

Failed to prove vs. showed

There are some trials of homeopathy that do show an effect beyond placebo. There are a number of reasons for this including bad design, experimental bias and pure chance (P=0.05 means one in twenty will be wrong on average). However, there are no trials which prove homeopathy. In my view the most accurate way of stating it is probably to say that there are no studies which refute the null hypothesis in respect of homeopathy, but that's a bit nerdy. However, in order not to offer hostages to fortune we should probably address the fact that it's not strictly true to say no trials show benefit beyond placebo. Guy (Help!) 22:32, 27 October 2012 (UTC)

How's that [12]? —MistyMorn (talk) 22:57, 27 October 2012 (UTC)

Actually, one in 20 will show a positive result in the absence of any therapeutic effect including placebo. Brunton (talk) 09:40, 28 October 2012 (UTC)

Yes, fair comment. (If the study participants are blinded, then we can expect placebo effect to apply in the same way in both the control and 'intervention' arms.) —MistyMorn (talk) 09:57, 28 October 2012 (UTC)

Just a moment. Surely the phrase "...in the absence of any therapeutic effect including placebo" seem to imply absence of the placebo effect too -- ie that placebo wasn't operative either, which of course it was. Given an equivalent placebo effect in both arms, it actually seems to me correct to say "about 1 in 20 tests can be expected to show a positive result in the absence of any therapeutic effect [other than placebo]." Fwiw, I felt the "other than placebo" rider (or "apart from placebo" perhaps) needed to be specified to avoid quibbles. —MistyMorn (talk) 10:40, 28 October 2012 (UTC)

No, including placebo. In perfectly blinded trials, where there is no difference in placebo effect between the two arms, one in 20 will still come up with a statistically significant result by pure chance. And even if there was no placebo effect in play (I'm not sure how this could be achieved - perhaps by not telling the subjects that they were being treated for a condition?) one trial in 20 would still produce a statistically significant result purely by chance. It's a statistical test; the potential reasons for any apparent effect have no bearing on it. You could just as validly say that one in 20 will produce a significant result in the absence of any reason for this other than regression to the mean, or other than any of the other factors that a placebo control controls for. The words "other than placebo" are unnecessary; one in 20 will produce a significant result in the absence of any therapeutic effect. Brunton (talk) 12:46, 28 October 2012 (UTC)

You're missing the point of the syntax. Once again... If you say "about 1 in 20 tests can be expected to show a positive result in the absence of any therapeutic effect including placebo", what you're actually saying is: "in the absence of both a) an active (viz pharmacological) effect and b) the placebo effect. This assertion simply doesn't fit the methodological context. Outside a framework of "natural", Mendelian randomization (not the case here), it is indeed not ethically feasible (to my knowledge, at least) to design a clinical randomized trial of this sort without invoking the placebo effect. So what we need to say is that in the absence of any active therapeutic effect one out of 20 of the best designed, appropriately powered superiority trials will still generate a "positive result" due to the play of chance. Please note that's not at all the same as saying "in the absence of the placebo effect": in a well-designed and conducted trial with correct allocation concealment (not always the case), the placebo effect is there, but it should be equivalent in both study arms. So the statistical test is being conducted on groups of data (ie the outcome measures) which have been similarly influenced by the placebo effect (and not by any active therapeutic effect).

Having said all this, on editorial grounds it scarcely matters until someone jumps up and asks us what we mean by the term "therapeutic effect". Hence my clarification [13]. —MistyMorn (talk) 17:25, 28 October 2012 (UTC)

Need to apply the same standards of NPOV and respectful phrasing as we would for a religion

Wow, things sure have gotten a lot uglier since I last visited this article 6 or 7 years ago. Let's all keep in mind here that the objective is to DESCRIBE AND EXPLAIN something that comes down BELIEFS, not to argue for or against it. Compare the article on scientology to see what respectful, NPOV treatment of a controversial subject looks like. Mkweise (talk) 02:55, 19 September 2012 (UTC)

Homeopathy makes testable claims that have been demonstrated in numerous studies to be false. This is not a matter of "belief" in some vague sense but rather a matter of looking at the evidence. Believing in things that are no true does not merit that those beliefs be respected, nor are all beliefs equally valid as you seem to imply. Some beliefs are wrong and it is not the purpose of an encyclopedia of knowledge to publish misinformation uncritically. Sædon^talk 03:16, 19 September 2012 (UTC)

Looking at the evidence is the reader's job; ours is to present it in an appropriate (neutral and respectful) fashion. Whether you personally respect the subject is immaterial in encyclopedic writing. Mkweise (talk) 03:43, 19 September 2012 (UTC)

I agree with you, but note that being neutral does not mean giving WP:FRINGE beliefs undue weight and attempting to achieve a false balance between WP:PSEUDOSCIENCE and science. But really this is academic unless you have specific changes in mind which you'd like to discuss. For all I know you and me share the same idea of what an NPOV article would look like. Sædon^talk 03:57, 19 September 2012 (UTC)

For example, the last two sentences of the lead paragraph say essentially the same thing: Homeopathy conflicts with science. The reader probably already knows this—and if not, he does after we said it the first time. Let's try to say more with fewer words, and avoid the derogatory ones. Mkweise (talk) 04:36, 19 September 2012 (UTC)

The last two sentences in the lead are " Patients who choose to use homeopathy rather than normal medicine risk missing timely diagnosis and effective treatment of serious conditions" and "The regulation and prevalence of homeopathy vary greatly from country to country." Perhaps I'm looking at the wrong sentences? Sædon^talk 02:15, 20 September 2012 (UTC)

No...I was talking about the lead (first) paragraph. I reworked it earlier today to make it coherent and concise; check it out. I did retain "quackery" as the last word since many here seem to feel strongly about that. Mkweise (talk) 03:17, 20 September 2012 (UTC)

The article should look more like Fan death and less like scientology. TippyGoomba (talk) 03:26, 19 September 2012 (UTC)

Both of those articles are similarly structured, the difference lies in the complexity of subjects. And Homeopathy is even more complex a subject than Scientology. Mkweise (talk) 03:50, 19 September 2012 (UTC)

"Homeopathy is even more complex a subject than Scientology". Citation needed. AndyTheGrump (talk) 04:15, 19 September 2012 (UTC)

Homeopathy has been around for over 300 years, had several significant contributors and was once very much in the mainstream. Mkweise (talk) 04:45, 19 September 2012 (UTC)

Housebricks have been around for longer. That doesn't make them 'more complex'. Provide a source for your earlier assertion. AndyTheGrump (talk)

"Homeopathy has been around for over 300 years", boy time flies I didn't notice it was 2097. --Daffydavid (talk) 06:28, 19 September 2012 (UTC)

200 years, 300 years pfft. Our old friend Ullman reckons it was mentioned in the bible. Acleron (talk) 10:19, 19 September 2012 (UTC)

Actually I noticed my math error right after posting that, and was quite surprized Andy started talking about bricks rather than picking up on it. Mkweise (talk) 14:24, 19 September 2012 (UTC)

What exactly is derogatory about the article? And the reader probably does not know that homeopathy conflicts with science. For instance, many certainly do not know there is zero active material present in most of the preparations. Acleron (talk) 10:19, 19 September 2012 (UTC)

First and foremost, Quackery is a pejorative and implies bad faith on the part of the practitioner. There is no basis for that assumption. I'd like to replace that word in the intro with the NPOV "ineffective" or, better yet, "ineffective other than by means of the placebo effect".

No, it doesn't imply bad faith, just horribly bad medicine. Many, maybe even most, quacks act out of profound ignorance or delusion. And it would not be NPOV to water down what the reliable sources say, and plenty exist that use the word "quackery" to describe homeopathy. Good faith does not make good medicine, nor offsets in the least degree the enormous harms quacks visit upon the public at large. Dominus Vobisdu (talk) 14:36, 19 September 2012 (UTC)

Agreed -- Wiktionary defines "Quack" as: "A fraudulent healer or incompetent doctor of medicine, an impostor who claims to have qualifications to practice medicine."...notice specifically: "fraudulent" or "incompetent". Someone who prescribes homeopathic treatments (which are known not to work - per many scientific studies) either:

1. Is aware of those studies and believes them - yet continues to prescribe those treatments anyway...which is "fraudulent"...or...
2. Is aware of those studies and does not understand them - which shows a total ignorance of science...which is "incompetence"...or...
3. Is unaware of those studies and despite continued and widespread criticism of homeopathy hasn't bothered to check them...which is "incompetence".

Since homeopaths are therefore either frauds or incompetent healers - then (per Wiktionary's definition) we are perfectly justified in using the term "quack" to describe any and all homeopaths who have been practicing since scientific testing has proven it wrong and the knowledge of the molecular nature of substances clearly explains why it cannot work. We might argue that it's wrong to label someone like Hahnemann as a quack because he couldn't have been aware of science that had not yet been done. Making the assertions that he did without scientific evidence that could have been obtained by experiment makes him decidedly incompetent by modern standards, but judged by the standards of medicine around 1800, perhaps he gets to dodge the "quackery" bullet.

Fortunately, our article says "Within the medical community homeopathy is generally considered quackery."...that's "is" rather than "was" or "has been"...and notes that this "quackery" label is generally applied "within the medical community". In modern times - and judged by the science-based ethos of the medical community - it is true to say that homeopaths are quacks. That is not an incorrect statement, and the word "quack" is a useful shorthand. I would support a change that said: "Within the medical community homeopaths are generally considered to be either fraudulent or incompetent."...but that's just a long-winded way of saying "quack". So I think our lede is entirely correct. The facts are indisputable, we have a solid reliable-source to back up this claim - so it is not a "point of view" matter and WP:NPOV does not apply.

SteveBaker (talk) 13:44, 20 September 2012 (UTC)

We've been through the "homeopathy as religion" debate before. Here is the cliff-notes version: Religions mostly talk about "unfalsifiable" things such as the existence of beings with unlimited/infinite magical powers...gods. Since their arguments are cleverly constructed such that they can never be disproven - belief in them requires a measure of simple, blind faith. Belief or disbelief in a religion can never be a certainty and those who proclaim themselves as atheists (myself included) do so because of relatively weak arguments such Occam's razor and Russel's teapot. Homeopathy isn't like that. It's not "unfalsifiable" - it's actually very easy to falsify. You take a large number of sick people - and selecting them at random, you secretly give one half sugar pills or water as treatment and the other half an identical-looking/tasting/smelling homeopathic "cure" - and then you count how many of them get better, and how quickly - if homeopathy works, then a statistically significant percentage of the ones that took that treatment will get better sooner than the ones to whom we sneakily gave nothing more than sugar pills or water. If it doesn't work then there will be no statistical difference between the results for the two groups. As a society, we've done those tests. Many times. And every time, there is zero measurable difference between the outcomes for the two groups. Not only is Homeopathy easily falsifiable - it's actually false! So belief in it doesn't have to be a matter of faith - you can test it and know for sure. So, no - homeopathy doesn't get to be let off the hook by playing the "religion" card. Even religions don't get a free ride here on Wikipedia. A specific religious belief that can be falsified - and which has been proven to be false is as much covered by WP:FRINGE and WP:UNDUE as any other topic in the encyclopedia. So, for example, our "Efficacy of prayer" article says that double-blind studies of the efficacy of praying to various gods has shown that it has no effect. Sorry that your religion says that it works...it simply doesn't and Wikipedia makes no exceptions for that. SteveBaker (talk) 14:11, 20 September 2012 (UTC)

It appears that User talk:Mkweise chose to ignore all of the comments in this discussion and made wholesale changes to the lead anyways to make a POV change in support of homeopathy. I reverted it as mentioned in the next section. Comparing homeopathy to a religion is amusing because, as you say, it can be tested experimentally. And failed. Excellent takedown of of the religion card for homeopathy. I'm cutting and pasting it for future use. :) SkepticalRaptor (talk) 16:11, 20 September 2012 (UTC)

Nonsense. There was no change in POV, unless you think repetition strengthens the point we both agree belongs in the lead paragraph. I'm not going to revert you, but I urge you to think about how to eliminate the redundancy of two essentially identical statements following each other in the lead paragraph. Also, what was your rationale for reverting my other contributions, including the missing comma I inserted? Mkweise (talk) 01:55, 21 September 2012 (UTC)

Substituting "Homeopathic philosophy holds that ailments of the body are caused by disturbances of the spirit, and that spiritual disturbances can be treated with remedies containing no chemically active ingredients" for "Scientific research has found homeopathic remedies ineffective and their postulated mechanisms of action implausible", in the opening paragraph of the lead, certainly involves a change in POV. Brunton (talk) 08:11, 21 September 2012 (UTC)

I agree. And so the editor because he alone disagrees with the POV, files a GAR. What a waste of our time here as volunteers. SkepticalRaptor (talk) 03:11, 22 September 2012 (UTC)

Be careful making assumptions as to what my personal POV on the subject might be. Mkweise (talk) 17:45, 22 September 2012 (UTC)

Your POV is clearly stated above. Be care about making assumptions about someone's ability to read what someone has written. :) SkepticalRaptor (talk) 17:50, 22 September 2012 (UTC)

My POV on homeopathy is not revealed above, only my POV on what constitutes good encyclopedic writing. Mkweise (talk) 20:27, 22 September 2012 (UTC)

Whatever dude. Your points were dismissed pretty easily as POV nonsense. SkepticalRaptor (talk) 22:27, 22 September 2012 (UTC)

Right, because you say so. Mkweise (talk) 00:00, 23 September 2012 (UTC)

No dude, because at least 5 other editors said so. But you keep pushing a point. See, I can do the passive aggressive shit too. :) SkepticalRaptor (talk) 00:32, 23 September 2012 (UTC)

Well, thanks for setting me straight. Gee, now I'm starting to feel like I know you...were we once involved in a brief and disastrous marriage? :-) Mkweise (talk) 01:53, 23 September 2012 (UTC)

One was not a substitution for the other; these were two separate edits. I added some crucial details on the theory of homeopathy. Then I deleted a redundant statement--there's no need to say "it doesn't work" twice in a row (albeit citing two different authorities) in the opening paragraph. Mkweise (talk) 17:45, 22 September 2012 (UTC)

There is no repetition in the first paragraph. As I explained below, it contains three sentences which can be summarized as:

1. This is what Homeopathy claims to be...
2. ...but it doesn't work...
3. ...and the people who practice it are quacks.

The second and third sentences are not tautology or redundancy. They convey two ideas that are (a) different, (b) backed by WP:RS and (c) summaries of discussion elsewhere in the article (which is appropriate because this is the lede). There are plenty of examples of situations where something "doesn't work" but where the people who hold those ideas are neither frauds not incompetent. There are also areas where something does work (eg, some kinds of herbal medicine) where the majority of practitioners are quacks. So the third sentence expands on the second - it's most certainly not redundant.

Your addition (which, I too view as a highly POV "replacement", no matter that you made a second edit to insert it) was entirely inappropriate because it violates WP:UNDUE as seen through the lens of WP:FRINGE. We are not allowed (by Wikipedia policy) to give that much weight to something that has been determined to be false by the scientific mainstream. SteveBaker (talk) 17:59, 22 September 2012 (UTC)

Though I didn't go into as much detail as you, I summarized your points in making the revert of the edits. There are no cases, however, where homeopathy could possibly work, unless we need to completely change our understanding of chemistry and physics, so anyone using it are quacks, are incompetent, and it doesn't accidentally work, like some herbal medicines.SkepticalRaptor (talk) 18:24, 22 September 2012 (UTC)

Yes, there are! Mkweise (talk) 20:15, 22 September 2012 (UTC)

The placebo effect is not evidence of something working. --Daffydavid (talk) 22:10, 22 September 2012 (UTC)

No, it's a mechanism by which it sometimes works. Mkweise (talk) 23:37, 22 September 2012 (UTC)

I agree Daffydavid. In fact, in medicine, the placebo effect is evidence of failure. The FDA does not approve of medications or devices that show nothing more than a placebo effect. SkepticalRaptor (talk) 22:21, 22 September 2012 (UTC)

You mean in drug trials. In medicine, success is when the patient gets better. Mkweise (talk) 23:30, 22 September 2012 (UTC)

Because people randomly get better, so placebos are a myth. Period, end of story. However, you're cherry picking when the vast, and when I mean vast, I mean like just about 99% of randomized clinical trials, show that homeopathy is shit. Shall we move on? This conversation is hysterical. You haven't made one logical point that would stand up to ANY Wikipedia standard. None. I mean you're reaching with the placebo effect, which you couldn't even prove if you spent 5000 words wasting the project's volunteer time. SkepticalRaptor (talk) 00:28, 23 September 2012 (UTC)

The fact that it's scientifically impossible can be stated without being inflammatory, argumentative or (here in the lead section) unnecessarily elaborate. Mkweise (talk) 20:15, 22 September 2012 (UTC)

Before people judge me, I am not saying I'm trying to change Wikipedia content with my comment because it is obviously doubted by hundreds of thousands of scientifical evidence, and I'm an atheist that is generally pretty skeptical about things, but I once had major health hazards when I was 1, 2 and 3 years old (I didn't even know what was happening and I don't think I had consciousness of medicine for it having an impact on my health because of psychological effects such as placebo, BTW I was having serious inffections, allergies, fevers and gastrointestinal problems all the time) that actually turned out to be way lesser with my mom's consistent, time-checked, year-round use of homeopathy. She remembers and told me once that it included relatively high concentrations of dead Stafilococcus sp. and Streptococcus sp. or so but I don't know much more. Lguipontes (talk) 22:17, 22 September 2012 (UTC)

Not even sure what you're saying. But it sounds like an anecdote. SkepticalRaptor (talk) 22:23, 22 September 2012 (UTC)

Hehe, use of homeopathy and relatively high concentrations, hilarious. TippyGoomba (talk) 22:52, 22 September 2012 (UTC)

• takes a breath* I am no expert about homeopathy or anything else, ok? And if you want to know, the last time I read this article, it was 2 years ago, and all this skeptical information was then ignored by me because I was/am anti-corporate, anti-capitalist and as lots of people I know well that labs manipulate research if it is according to their interests (you can laugh more on me, I won't hear it anyway). I'm just saying it actually worked because there's no such thing as placebo in babies. The doctor that worked on it with me was allopathic too. It is not unusual at all in Brazil, actually those of low-quality work are the least likely to recommend it including the bigot responsible for my closest moment to death. The best physician people in my family ever had contact with that saved my life and much of my health before movign away used homeopathy, so I wouldn't be so savvy about it despite being skeptic too (about everything). Lguipontes (talk) 23:16, 22 September 2012 (UTC)

Personal anecdotes are of no relevance to Wikipedia article content: see WP:NOTFORUM. AndyTheGrump (talk) 23:21, 22 September 2012 (UTC)

I'm not treating it as if it was Orkut. I'm serious here, Mkweise had the point that despite having tons of scientifical evidence against, it is seen as serious by communities, even some connected to traditional Western health care, and so should be treated in a light of minority view/technique rather than pseudo-science. If I wasn't seeing it as something that will help the discussion, I would rather shut up as I am used to in other minority viewpoints treated without neutrality. Lguipontes (talk) 23:28, 22 September 2012 (UTC)

Homoeopathy is pseudoscience. The English-language Wikipedia has well-established policies regarding pseudoscience. If you wish to see the policies changed, you will have to argue for it in the appropriate place. This talk page isn't the appropriate place. AndyTheGrump (talk) 23:54, 22 September 2012 (UTC)

This isn't going anywhere. Were you suggesting an edit? If so, can you restate it? I've forgotten. TippyGoomba (talk) 03:48, 23 September 2012 (UTC)

It was just an inconsequent way of trying to add arguments to the discussion. Pardon my immaturity. Lguipontes (talk) 22:10, 23 September 2012 (UTC)

arbitrary break

I'd like to see the lead section restored to a proper wp:summary style. The entire pro/con debate can be summarized in a neutral statement of its conclusion: "Homeopathy has been largely disproven by science." Detailed arguments should be reserved for a later section. Additionally, as per Q11 in the FAQ at the top of this talk page, there was a consensus against using the inflammatory word "quackery". Mkweise (talk) 16:43, 23 September 2012 (UTC)

We don't call it quackery in the Wikipedia voice, but we do report that RS call it pseudoscientific quackery. Don't interpret Q11 as a call to violate policy. There is no consensus against following our policies on reporting what RS say. Since mainstream sources pretty much universally identify it as one of the most notable examples of pseudoscience and quackery, we shouldn't shy away from quoting them and summarizing what they say. If we were writing an article about a well-known prostitute, we would likely also cite sources that called her a whore. Same thing here. We're actually being quite merciful. -- Brangifer (talk) 17:42, 23 September 2012 (UTC)

I agree with BullRangifer that we report what the secondary sources say, especially when the reliable sources are practically unanimous in their rejection of homeopathy as both peudoscience and quackery. In fact, a very large part of what the reliable sources say is exactly that. Watering it down to a terse understatement would be a less than honest summary of what the sources actually say, and would violate WP:WEIGHT. Also agree that the FAQ question has no bearing on the present discussion. Dominus Vobisdu (talk) 17:57, 23 September 2012 (UTC)

So you agree with me that reliable sources are practically unanimous. Good. How would you suggest that the unanimous expert opinion could be summarized in a single statement? Mkweise (talk) 18:42, 23 September 2012 (UTC)

How about as it currently is in the lede. TippyGoomba (talk) 19:09, 23 September 2012 (UTC)

Exactly. The main elements are there: 1) there is little evidence that it is effective, and what little there is hasn't been confirmed or replicated; 2) there is no plausible or conceivable mechanism as to why it should work any better than a placebo; 3) it maquerades as science and medicine, though qualifying as neither, making it pseudoscience; at best it does no good, and in fact can do a great deal of harm, including early death; and 5) it is a harrifiaclly bad sham of real medicine, and exploits the gullibility, ignorance and wishful thinking of the uneducated and often desperate public, which makes it quackery. Dominus Vobisdu (talk) 19:22, 23 September 2012 (UTC)

So, there seems to be a consensus. The same consensus that has existed for years. The lead works. SkepticalRaptor (talk) 21:45, 23 September 2012 (UTC)

I'd like to add a 1a) The evidence is supported by secondary reviews published in peer-reviewed high-impact journals. SkepticalRaptor (talk) 21:47, 23 September 2012 (UTC)

Q11 may need to be tweaked a bit to avoid future misunderstandings. It's a bit awkwardly stated. -- Brangifer (talk) 22:16, 23 September 2012 (UTC)

I just wanted to say that professional doctors in Brazil often use it along traditional Western health care (generally after, prescribing together with allopathic treatment, NEVER as medicine). There is an idea here of people of using it in the same way a vaccine could do good i.e. that thing I mentioned earlier with my experience, a really great quantity (in terms of homoeopathy, that is nearly nothing – that former doctor of mine explained the most common homoeopathy to my mother using the joke of the comparison to seawater) of dead ill-bearing beings together with herbal medicine. But I think no sane person would qualify it as cure anywhere, even in the limited demographics that homoeopathy, to say, can improve 5-20% of their immune system functioning (but all immune systems are different because every human is a universe, perhaps in most people something so light that is reason of mockery such as hpthy is likely worthless). Alternative medicine approach is not something to trust (much less alone) in case of death-threatening diseases – in the immune system example, homoeopathy would be used in light to mid allergies such as the source of my rhinitis, with a grain of salt in more serious conditions (together with traditional treatment – like what cured me from chronic sinusitis and otitis, and I attribute it more to the non-homoeopathic treatment), but I don't expect an effect at all with auto-immune conditions. If someone offers it as medicine, it is obviously quackery, but I think that the point of Mkweise is not how homoeopathy can kill by the ignorance of some users and/or shamelessness of quackers, but how it is said to not work in every situation, with nobody, and all scientific research adequately using methods of demonstrating it, what millions of people that are not necessarily ignorant (including 3 former doctors that saved my life that hadn't no profit with the so-called quackery) would disagree to. BUT I don't have sources to reivindicate my claims unlike the other side, so I will neither change content nor ask someone to do it. Lguipontes (talk) 22:10, 23 September 2012 (UTC)

Please review WP:NOTFORUM. Also, actually read the article. Your suggestion that homeopathy can be used in the same way a vaccine is absurd, the homeopathic material is composed entirely of water. TippyGoomba (talk) 00:15, 24 September 2012 (UTC)

It was a translation error, I understand it now. The popular use of the word homoeopathy in my country is a little different. Even Bach flowers are called homeopatia here, and I believe that the herbal remedies that people had given to me when I was a little child included it and similar techniques, although I [vainly] had true homoeopathy 6 years ago (that my father started to believe) for rhinitis – my mother then bought me to another real doctor and vaccines are working. Anyway, I didn't referred to that water. I know what it is and obviously don't believe it, and didn't meant to support it. I read it two years ago, back at the day when my English was below basic. Sorry for all the confusion. Lguipontes (talk) 02:25, 24 September 2012 (UTC)

Bach flower remedies are usually counted as homoeopathic in the UK, too. And are bogus for all the same reasons. Mistaking homeopathy for herbal medicine is one of the commonest errors and probably accounts for a large proportion of retail sales of homeopathic products. When I have explained to people how homeopathy differs from naturopathy, and what homeopathic remedies actually are, it generally prompts a "WTF?" reaction - few people I have met are sufficiently scientifically illiterate to accept homeopathy once they know what it actually means. Guy (Help!) 12:19, 25 September 2012 (UTC)

Yeah - I've noticed that exact same thing. Talking to many friends and relations about homeopathy reveals that almost all of them thought it was synonymous with herbal medicine. They are universally outraged to learn that they have been tricked into spending money on water and sugar pills for all those years. SteveBaker (talk) 13:27, 25 September 2012 (UTC)

You lot have been having fun here I see - whilst the cats away... Okay, what is the evidence for "Within the medical community homeopathy is generally considered quackery."

For one, its not a term is common usage at all in the UK amongst medics. It is amongst sceptics, so thats probably one of the corrections that should be made in the lead - "Within the sceptic community homeopathy is generally considered quackery." Cjwilky (talk) 17:32, 10 October 2012 (UTC)

Um no. Homoeopathy is generally considered quackery by both, in as much as they consider it at all. The same could be said for the scientific community generally. Suggesting that only 'sceptics' consider it quackery is dubious to say the least. AndyTheGrump (talk) 17:38, 10 October 2012 (UTC)

• See Quackery. Given that the claims made by homeopaths are scientifically implausible and there is no evidence of clinical effectiveness, there is an unbridgeable credibility gap. (The only credible rationale for prescribing homeopathic remedies is as a placebo treatment—a different matter altogether.) —MistyMorn (talk) 19:26, 10 October 2012 (UTC)

I would feel better saying "quackery" if we had some strong sourcing for that particular word. Our current source is an argument against "medical pluralism" in the UK (written by an author in the UK, so I'm disinclined to think that "quackery" isn't a UK usage). The body does go into more detail, though, with more sources. Certainly it violates NPOV to say that "the medical community" considers homeopathy to be quackery. The mainstream medical community rejects homeopathy; some parts of the alternative medicine community thinks it works—practitioners of homeopathy, for example. Refusing to even call the community surrounding homeopathy a medical community seems like the kind of childish rhetoric where one won't even use clear language to state the agreed facts, lest one "concede" even one millimeter to one's opponent. It undermines the credibility of the article. Could we fix this by briefly describing the controversy—say, by broadly characterizing who favors and who opposes homeopathy? I don't think the body covers this very clearly, though, so updating the lead to summarize it might have to wait. —Ben Kovitz (talk) 20:08, 10 October 2012 (UTC)

No. That would violate WP:GEVAL, WP:UNDUE and WP:FRINGE. The claim that homeopathy is medicine, or that the community surrounding homeopathy is part of the medical community, is a fringe position, not merely a minority position, and is not supported by the reliable sources. Your proposal would unduly lend the semblence of credibility to a thoroughly discredited movement. Dominus Vobisdu (talk) 20:25, 10 October 2012 (UTC)

(thread moved to new section: Talk:Homeopathy#Can we speak of "mainstream medicine"?)

(edit conflict) I guess this all depends on one's definition of quackery. It fits definitions such as that adopted in the first sentence of the Quackery page, but that sort of definition may not be universally accepted (homeopaths, if not the companies that mass market remedies, do tend to act in good faith, however misguidedly). [14] The OED defines 'quackery' as "The characteristic practices or methods of a quack, charlatanry; (also) an example of this, a quack practice, remedy, etc." 'Quack', in turn, is defined as "A person who dishonestly claims to have medical or surgical skill, or who advertises false or fake remedies; a medical impostor." And 'charlatan' is defined as " An empiric who pretends to possess wonderful secrets, esp. in the healing art; an empiric or impostor in medicine, a quack." Homeopathic remedies are "false remedies". —MistyMorn (talk) 20:36, 10 October 2012 (UTC)

It is, I'm afraid, nearly impossible to distinguish the deliberate charlatan from the all-too-willing believer dabbling in this magic. I'm still fond though of the Oliver Wendel Holmes Sr source. Not much has changed about homeopathy in the many intervening years since that address. Several others addressed the quackery and pseudoscience terms in revision 434959490, though some have since been editwarred out. LeadSongDog come howl! 21:00, 10 October 2012 (UTC)

In the real world, it doesn't make the slightest bit of difference whether a quack is acting in good faith or bad. The results are the same: harm to the victim. Good faith doesn't make a quack any less a quack. Dominus Vobisdu (talk) 21:17, 10 October 2012 (UTC)

To say the medical community use this term more than other terms in relation to homeopathy is not proven at all - it is rhetoric. The term is used in the UK much as it is in the US, probably less so as the US. Its certainly not something I hear from anything but a tiny minority. The medical community may say its dubious, they may say its unproven, they may say they find it effective, they don't say its quackery - thats a sceptic term and really makes this article look as though its been written by the usual sceptic bunch, which indeed it is. Thats not to get at anyone, just that there's no point in beating about the bush. I suggest we change it to unproven, as that is what is the medical consensus.

Homeopathy is a medicine. The current line that says there's nothing in it is not relevant. There are of course many quality studies that show it does work. Just that Shang claims the weight is that it doesn't. Anyway, these issues aren't relevant to this particular discussion.Cjwilky (talk) 01:04, 11 October 2012 (UTC)

No, it's not medicine. Yes, the line is relevant. Could we have links to these "quality studies" please? --Daffydavid (talk) 03:51, 11 October 2012 (UTC)

So Daffy, you agree about the rhetorical use of the word quackery?

In what way isn't it medicine?

Quality as defined by Shang. Check out the studies he uses that are positive for homeopathy - presumably you do have the links to that. Cjwilky (talk) 12:32, 11 October 2012 (UTC)

Cjwilky, it's not medicine because it's simply purified water, but I know you disagree. How about some actual links so I don't look at the wrong ones and waste my time?--Daffydavid (talk) 18:18, 11 October 2012 (UTC)

Flatearth Daffy, first of all, thanks for not deleting my post on the talk page this time, I am indeed honoured by your approval, and would be interested to see where the wiki guideline is for deleting other editors talk posts?

Purified water can be medicne especially with a case taking that helps someone connect with their inner being and dynamics. Try again, and read the definition of medicine this time.

Links, not got them in front of me, but surely being so confident a proponent of the sceptic line you have your evidence sealed and sorted? No? I'm guessing that actually you haven't ever looked... but then most sceptics do simply follow the party line don't they.Cjwilky (talk) 23:26, 11 October 2012 (UTC)

Cjwilky, I have studied this in some depth. There are two sorts of studies of homeopathy: ones designed to support it, which all have profound methodological shortcomings, and ones which seek to test it, which find it to be an elaborate placebo. This applies even when the open studies are done by homeopaths (e.g. [15]). It is not a form of medicine, because it has no medicine, the laws of physics tell us that without any uncertainty. It is an elaborate placebo ritual, and a religion. This is entirely established from reliable sources in the article. Guy (Help!) 23:11, 6 November 2012 (UTC)

Sentence added to 4th paragraph of lead

On September 20, Drg85 added this sentence to the 4th paragraph of the lead:

A recent review regarding the proposed mechanisms for homeopathy found they were precluded by the laws of physics from having any effect.

with this comment:

Added a reference to recently published paper on physical and chemical analysis of homoepathy

On September 30, I removed it, with this comment:

"Laws of physics" point was made in 1st para, and confuses main point of 4th para, which is testing for mechanisms unknown to mainstream science.

Skinwalker put it back, with this comment:

rv removal of sourced text

I removed it again, with this comment:

Please discuss this on the talk page.

And then SkepticalRaptor put it back, with this comment:

Reverted to longstanding NPOV version.

The sentence is not longstanding. It was added 10 days ago. The point is made in the first paragraph. It confuses the 4th paragraph, which is about testing for effects of homeopathy that would come about through mechanisms unknown to science. I think repeating the point in the middle of the 4th paragraph is simply bad writing. If there is some reason for including this sentence in the 4th paragraph, would you please tell what it is? Then we can find a way to address that reason without gratuitous repetition, incoherent flow, or some other kind of other bad writing. —Ben Kovitz (talk) 06:42, 1 October 2012 (UTC)

• This is exactly the sort of thing we should avoid doing. To call this NPOV is a travesty. We are not here to debunk homeopathy. Support removal. --John (talk) 09:29, 1 October 2012 (UTC)

The placement in the fourth paragraph of this referenced material fits in naturally behind the sentence it follows. While I would agree that a minor tweaking of the whole lead would be good, to remove this info from where it is now is wrong.Support keep. John, the link to WP:GREATWRONGS is not applicable here since it's not OR. UPDATE- I somehow missed the original intent of the comment. The sentence is duplication of info in 1st paragraph. Strong Remove. --Daffydavid (talk) 22:28, 10 October 2012 (UTC)

GREATWRONGS relates not to OR but to TE, which I would argue this is coming close towards. Again, this is a complex and nuanced area and not for debunkers (or advocates). It's also under probation I believe so anybody joining in an edit-war could be under threat of immediate sanctions. Jut saying. --John (talk) 12:38, 1 October 2012 (UTC)

Daffydavid, would you please tell a reason why you think the sentence flows naturally in the 4th paragraph? Here on Wikipedia, we prefer to make decisions by consensus, not by voting. If we understand your reason, we can find a way to address that as well as the specific problems identified above. --Ben Kovitz (talk) 13:19, 1 October 2012 (UTC)

Ben Kovitz, don't be pedantic, you aren't the only one who understands the difference be consensus and voting. The sentence fits because - sentence 1 says trials investigated a possible unknown mechanism of action, sentence 2 says "sorry it doesn't work", sentence 3 says the reason no unknown mechanism is found and why the "medicine" doesn't work is a violation of scientific principals. To me this flows naturally. My comment about the lead is that paragraph one states that homeopathy doesn't work so there is a small degree of duplication. I however am not going to wade into that minefield and propose any changes. --Daffydavid (talk) 16:02, 3 October 2012 (UTC)

Daffydavid, thanks for explaining why you think the sentence flows naturally (but no thanks for the "pedantic" remark). I disagree, but I'll think on it further and see if I can come up with wording that addresses both of our concerns. I hope you will, too; the "minefield" need not be so frightening. —Ben Kovitz (talk) 11:15, 5 October 2012 (UTC)

" We can record the righting of great wrongs". It's not OR to include what is already published in a journal and WP:GREATWRONGS doesn't apply. THe issue with debunking is where people use synthesis to do it. IRWolfie- (talk) 10:10, 6 October 2012 (UTC)

Reading over the lead just now, I noticed that this point about violating the laws of science/physics/chemistry occurs in the 1st para, the 2nd para, and the 3rd para. Does anyone not agree that saying this three times in the lead is too many? —Ben Kovitz (talk) 20:19, 10 October 2012 (UTC)

I think paragraph 2 and 3 should be made into one paragraph because of duplicate and similar material. Paragraph 4 contains the duplication mentioned in the discussion at "Sentence added to 4th paragraph of lead" and needs that sentence removed. --Daffydavid (talk)

How about this?

para 1: definition and rejection by science

para 2: main homeopathic practices

para 3: zero dilution's clash with scientific theory

para 4: homeopathy's effectiveness in practice, regardless of theory

This is actually what we have now, except for the sentence in question. —Ben Kovitz (talk) 23:10, 10 October 2012 (UTC)

Homeopathy is not effective in practice. Just to be entirely clear on that. It appears effective due to the usual human inability to make rational observations about ourselves, but the evidence is pretty clear: homeopathy has no effect, but placebo does. Substituting any other worthless healing ritual for homeopathy would have exactly the same results. Guy (Help!) 07:30, 24 October 2012 (UTC)

Support Remove. Since the start of this discussion the phrase in the paragraph has been revised to say 'Homeopathy is precluded by the laws of physics from having any effect.'

1. This now grammatically unqualified statement is very misleading. It is a rewording of the source paper's title, not the papers contents. The claim as it stamds is not included in the papers summary: or in authors description of the paper:

A scientifically qualified statement, which is supported by the source paper might be that: 'The laws of physics indicate that any effect of homeopathy is physically impossible". However, as others have said, a revision to the lead as a whole would seem the best longer term option. And Para 4 might be used to cover: Scientific Studies that have observed the effectiveness of homeopathy, and how this compares with placebo studies (without going over the scientific theory issues already in previous paragraphs) Fuzzything (talk) 22:18, 7 November 2012 (UTC)

What? "Scientific Studies that have observed the effectiveness of homeopathy....."? Just say "Scientific studies of homeopathy...." Moriori (talk) 00:00, 8 November 2012 (UTC)

Indeed, randomized controlled trials are, by definition, not observational studies. —MistyMorn (talk) 10:46, 8 November 2012 (UTC)

Right. I would be very happy with Paragraph 4 being used to cover "Scientific Trials of homeopathy".

Basically, If the theory can be kept to the earlier paragraphs then I am completely happy to support it.

The phrase "The mechanisms of Homeopathy are precluded by the laws of physics from having any effect." would need to be removed from this part, in this case, but a revising of this sentace into a accurate representation of the citation would surely be placable elsewhere in the lead or body. What do you think? Fuzzything (talk) 20:51, 8 November 2012 (UTC)

I really don't see the problem. Paragraph 4 currently summarizes the large "Evidence" section. Scientifically, any biological plausibility is precluded by the laws of physics. So, even if randomized trials did, taken together, provide some apparent clinical evidence of effectiveness beyond placebo (as to some extent they seemed to around the 1990s), one would look for methodological flaws in the trials and their meta-analyses to explain false positive outcomes (a bit like in this lab case [16]). So the content is closely related and I can see no good reason to break it up. —MistyMorn (talk) 21:39, 8 November 2012 (UTC)

And in fact that is precisely what has been found in a series of meta-analyses and systematic reviews. Even the ones that have found some sort of positive result have said that more good quality research is needed, and as that work has been done the evidence in fasvour of homoeopathy has got weaker, from Kleijnen (1991) which said that the evidence was positive but "not sufficient to draw definitive conclusions because most trials are of low methodological quality and because of the unknown role of publication bias" and Linde (1997), which had a positive result qualified by a comment that there was "insufficient evidence from these studies that homeopathy is clearly efficacious for any single clinical condition" (and further qualified by the team's 1999 reanalysis which concluded that the 1997 paper had "at least overestimated the effects of homeopathic treatments"), to Linde (1999) and Cucherat (2000) both of which specifically found that better quality trials were more likely to be negative, through to Shang (2005). Brunton (talk) 12:20, 9 November 2012 (UTC)

Alternative medicine article discussion to restore MEDRS and NPOV content and sources such as Annals of New York Academy of Sciences and Journal of Academic Medicine

A discussion to restore the first 14 sources of this version, including Annals of New York Academy of Sciences, Journal of Academic Medicine, etc., to the Alternative medicine article is now going on here. ParkSehJik (talk) 02:57, 22 November 2012 (UTC)

"Miasms" - I'm afraid all of you are wrong there

Hahnemann neither introduced the theory, it's ancient (old greece ancient), nor did he come up with the idea that miasms were the cause of most illness - this was common thinking in his days! --Six words (talk) 20:12, 17 November 2012 (UTC)

I just had a look at the source for the sentence in question - it deals with chronic disease, which Hahnemann theorises is caused by "underlying ills", syphillis, sycosis and scabies. These at his time were thought to be caused by miasm. At the beginning of the book, he describes these three diseases as "miasmatic-chronic" and/or "chronic-miasmatic". Later in the book, the diseases themselves are called "miasms", so he's taking an (at his time) accepted concept and slightly re-defines it to primarily mean these three diseases. I think for now it might suffice to change the section title and the first sentence to read

Miasm and chronic disease
In 1828, Hahnemann introduced the concept of "miasms" as the supposed underlying cause of chronic diseases.[30]

but I'll try to find a source that discusses that miasm was a common concept back then. --Six words (talk) 20:55, 17 November 2012 (UTC)

What about: "Hahnemann proposed that "miasms" were the supposed underlying cause of chronic diseases. The "concept" part is redundant, actually, because "miasms" is defined in the next sentence. Dominus Vobisdu (talk) 21:05, 17 November 2012 (UTC)

I guess this is a bit more complicated than I at first thought. The next sentence doesn't really define "miasm" - it describes the homeopathic theory (or definition?) of disease. "Miasm" (used the way Hahnemann seems to define it - as syphillis, sycosis or psora/scabies) is a theoretical explanation for why chronic diseases re-appear or don't respond even though they're treated with a matching "simillimum" - if the disease is caused by a different underlying disease, it won't be healed even though you use the "right" "remedy". We should try to find a secondary source for the definition of "miasm", right now this section isn't sourced very well. --Six words (talk) 21:54, 17 November 2012 (UTC)

Aren't the references at Miasma theory sufficient?

Anyway, Hahnemann used the concept in a different way than they had previously been used - see his book "The Chrinic Diseases" Whilst acknowledging the way they can initially be contracted in a similar way to modern germ theory, he further proposed that once in the system they could be the root of all manner of symptoms - again not so different from germ theory. He didn't propose that they were the "supposed" cause, he proposed that they "were" the cause - unless you can show me differently. I think the sentence should be either left as is or: Hahnemann proposed that "miasms" were the underlying cause of chronic diseases.

When he talks of miasms in terms of them getting in the way of healing, he is referring to a condition returning after having been alleviated (also known as having been being cured), or a new condition arising after a previous one has been cured. His goal was permanent and lasting cure (see organon), so this is why he looked for other approaches. Re last para of the Miasms section, to suggest that he was using the miasms theory as being a reason for treatment failures is misrepresenting this. You could just as easily say use of anti-biotics are treatment failures because very often the same or similar or a further condition arises. That para in a very unclear way, also says Hahnemann used miasms in some way to cover the failure of homeopathy to understand "the unique disease history of each patient" - erm... a homeopath certainly looks at the unique disease history of someone more than conventional medicine does, even today. Its a very low quality reference to include in the article, and that para anyway is very vague and easily confused - needs a rewrite if it is to remain included, though not having the book I couldn't do that. I dare say its probably only a page or so (pp148-149?), so if anyone has access to it I'm happy to write a better summary of Sheltons view.

Having said this, there are criticisms of miasm theory out there from other homeopaths we can include, as well as the development of the theory. Cjwilky (talk) 23:26, 17 November 2012 (UTC)

It's not a theory. You keep using that word. I don't think it means what you think it means. SkepticalRaptor (talk) 23:28, 17 November 2012 (UTC)

Hi skeprap :) Better to follow the thread of the discussion rather than sidestepping to over analysing words. But, try looking at Theory. Maybe you are meaning a specific branch of that known as Scientific Theory, in which case if you read the Chronic Dieases book you will find that Hahnemann did take it that far.

Please refrain, if you can, from derisory comments tucked away in the edit summary when you are posting :( "here we go again. Someone needs to read WP:NOTAFORUM" Cjwilky (talk) 23:48, 17 November 2012 (UTC)

See WP:NOTAFORUM. You're using this stage as your personal "Homeopathy works" forum. You never get anywhere, because you've brought absolutely nothing to the article. OK? Your personal attacks are so lame that they're laughable. SkepticalRaptor (talk) 21:53, 18 November 2012 (UTC)

(edit conflict) Wait, now the sentence should be left as-is? It was you who tried to change it (introducing the "supposed")! My contribution to this sentence was the "chronic" part. --Six words (talk) 23:54, 17 November 2012 (UTC)

Ooops! Nope, I didn't introduce "supposed", that was Dominus, and it doesn't make sense as a sentence if thats included. Yep, got caught too much into the whole section and forgot the chronic bit, that is crucial :) Cjwilky (talk) 01:28, 18 November 2012 (UTC)

No, I didn't. Get your facts straight before you say someone did something. Dominus Vobisdu (talk) 03:09, 18 November 2012 (UTC)

You're right, but no big deal eh? :) seems it was JzG. Cjwilky (talk) 18:37, 18 November 2012 (UTC)

No, it is a big deal, because I can count on one testicle the number of times you've been right about water, and that may be that it has two hydrogens and one oxygen in the molecule. But that's real science, so I'm skeptical about homeopaths even understanding that concept. SkepticalRaptor (talk) 21:55, 18 November 2012 (UTC)

Cjwilky, you left the sentence as "In 1828, Hahnemann introduced the concept of "miasms" as the underlying cause of chronic diseases". That is misleading and/or inaccurate. He introduced miasms as the supposed cause, but they are not the cause of anything at all, because they don't exist. Guy (Help!) 15:57, 22 November 2012 (UTC)

JzG/Guy - you can read that sentence two ways. He introduced the concept of miasms as the cause of chronic diseases (that continually returned after alleviation), he didn't introduce it as a supposed cause, he was very clear that it was "the cause" . The less amiguous version of this sentence would be "In 1828, Hahnemann introduced the concept of "miasms" as being what he saw as the underlying cause of chronic diseases."

Whilst I'd be happy to debate whether miasms exist or not, I don't think our take on them is relevant here. We are describing the philosophy and theory of homeopathy. Cjwilky (talk) 19:09, 24 November 2012 (UTC)

References

Adverse effects

Here's a systematic review that meets MEDRS:

• Adverse effects of homeopathy: a systematic review of published case reports and case series. P. Posadzki, A. Alotaibi, E. Ernst. International Journal of Clinical Practice, Volume 66, Issue 12, pages 1178–1188, December 2012. DOI: 10.1111/ijcp.12026

Brangifer (talk) 03:20, 30 November 2012 (UTC)

Despite the suspect nature of the author, Ernst, I agree with it being included, though only if its made clear that these are all cases where a material dose of the material suspected of causing the allergy/adverse reaction is used. I note that since 1978 30 cases have been found worldwide - perspective of this kind is relevant to the article - I'd say the same if we were talking about pharma med reactions, otherwise we are in danger of misleading. It would make sense to give examples of the potencies and substances concerned. Cjwilky (talk) 22:07, 2 December 2012 (UTC)

"homeopathy" or "homeopathic remedies"?

In this http://en.wikipedia.org/w/index.php?title=Homeopathy&diff=525999753&oldid=525973492 edit, skinwalker changed deleted some "citations needed" but also changed

Johnson was unable to find any evidence that homeopathic remedies contain any active ingredient.

to

Johnson was unable to find any evidence that homeopathy contains any active ingredient.

I suggest this is changed back.

I reverted it. Skeprap reverted it back to skinwalkers edit. I reverted this again and requested it be brought to talk if anyone had an issue. Skeprap reverted it again without saying why. I had corrected it again. I say corrected as explained in my edit notes ie that it makes no sense as homeopathy is a described process not a substance. Further, the youtube video cited claims:

"remedies contain well... nothing"

"common remedies are just sugar pills"

"even critics say this part of homeopathy (the consultation) may have some value, spending time with a patient, as for the remedies..."

"there's nothing to these homeopathic medicines"

"homeopathic medicines are sugar pills"

"there is no medicine in homeopathic medicine"

"the remedies largely have no active ingredient"

"when you get the remedies there's no active ingredient in there"

etc.

As you see, nothing whatsoever about "homeopathy contains no active ingredient", only that "remedies contain no active ingredient", and it does say "...this part of homeopathy (the consultation) may have some value". Seems that there's some inaccurate reporting going on by sceptics here. Skinwalker? Skeprap? Cjwilky (talk) 21:47, 2 December 2012 (UTC)

Calling these "remedies" is a bit stupid, since they don't do anything. (Military music, anyone?) But that's what the source calls them and I don't have a better name for it. Replacing "remedies" with something else throughout the article would be ideal. "substances" perhaps? TippyGoomba (talk) 22:08, 2 December 2012 (UTC)

And Cjwilky has a hissy fit when I do this by make some lame accusation about something regarding me. I'd be ok with "substances" or "potions." SkepticalRaptor (talk) 23:00, 2 December 2012 (UTC)

"Potions" is a good one. But more seriously, what about "preparations"? I agree that remedies makes it sound as if they actually are effective in some way, and should be avoided. Dominus Vobisdu (talk) 23:13, 2 December 2012 (UTC)

The problem is that "Johnson was unable to find any evidence that homeopathy contains any active ingredient" simply doesn't make sense: theology doesn't contain Gods, geography geology doesn't contain rocks, and homoeopathy doesn't contain remedies. "Preparations" sounds good though... AndyTheGrump (talk) 23:45, 2 December 2012 (UTC)

Oh, come on, let's use potions! But if that's just a bit POV, preparations sounds great. Good one Andy! SkepticalRaptor (talk) 03:33, 3 December 2012 (UTC)

Or "nostrums"! Or just plain "water"! But preparations seems the most realistic here. Dominus Vobisdu (talk) 03:43, 3 December 2012 (UTC)

I'd suggest that 'preparations' is precisely the term needed, in that homoeopathic practitioners seem to insist that how the substance is prepared is what matters, whereas both orthodox science and common sense will hold that 'preparing' something this way has no significant consequence beyond increasing the price of the 'active' ingredient - water. Both agree that 'preparation' occurs - the debate is over its effectiveness. AndyTheGrump (talk) 03:58, 3 December 2012 (UTC)

'Homeopathic preparations' works for me, I also wouldn't mind calling it 'homeopathic products'. --Six words (talk) 10:17, 3 December 2012 (UTC)

I'll go with "preparations" here too, although the source does say remedies and medicines repeatedly and never mentions preparations. In the past we have had similar discussions about words used and it has been said "thats what the source says", as though thats a definitive judgement, so useful to know thats definitely not the case in all your judgements. Cjwilky (talk) 13:39, 3 December 2012 (UTC)

Is there a homeopathic potion that you can concoct for passive aggressiveness? Damn, I'm funny. SkepticalRaptor (talk) 04:28, 8 December 2012 (UTC)

Propose Warning Label

Just thought that it might be a good idea to start every article such as this one with a warning label such as the one used on the Italian Wikipedia pages. It would keep the back and forth discussions over the lede to a minimum. Here is one example http://it.wikipedia.org/wiki/Agopuntura It translates to "The practices described here are not accepted by medical science, have not been subjected to experimental tests conducted with the scientific method or have not overcome. May therefore be ineffective or harmful to health. The information for illustrative purposes only. Wikipedia does not give medical advice: Read the warnings." So clearly there is precedent on Wikipedia for this. Sgerbic (talk) 14:22, 8 December 2012 (UTC)

Um, the English Wikipedia is no obligation to follow Italian Wikipedia precedent, or vice-versa. On the whole, consensus here seems to be that such custom disclaimers are best avoided, if for no other reason than that they might be taken to imply that where an article did not have such a disclaimer, Wikipedia was claiming to be a legitimate source for medical advice etc - which could have legal implications. Note also that every Wikipedia article carries a link to the Wikipedia:General disclaimer at the bottom of the page. AndyTheGrump (talk) 14:28, 8 December 2012 (UTC)

I understand Andy. Had not thought about the idea that people reading other medical pages might think that Wikipedia actually endorsed it. I think a banner could be used only on fringe/controversial topics like this one. Yes, I understand that just because the Italian pages do it does not mean that English has to do it, but this does show precedent. As far as worrying about legal implications, the disclaimer at the bottom of the page (that is unlikely to be read by the general public) would suffice. I still think that this is worthwhile for discussion. Personally I think that we editors have a responsibility to the readers, I have seen many people edit the talk page looking for medical advice, clearly not understanding the article. I know that we can't hope to educate everyone, some will just not "get it" but I think a clear warning message (on medical pseudoscience topics) is a responsibility to the 120K+ readers this page gets each month.Sgerbic (talk) 02:57, 9 December 2012 (UTC)

For what is forth, we have a no disclaimers in articles policy.--McSly (talk) 03:10, 9 December 2012 (UTC)

See also the recent discussion at Wikipedia talk:Fringe theories/Noticeboard#Pseudoscience 'warning' headers. AndyTheGrump (talk) 03:15, 9 December 2012 (UTC)

Thank you both for clearing that up. Completely unaware this had been brought up before, I've only been editing a couple years. I understand the reasons, don't completely agree, but abide by this. I remain hopeful that possibly this might change for certain pages. I suppose that we will have to go on discussing lede's and remain vigilant that the page reflects current scientific consensus. If for no other reason, but for the readers we are creating this encyclopedia for. Sgerbic (talk) 04:33, 9 December 2012 (UTC)

Adding sources and content to this article

Hello,

I am new to wikipedia and frankly don't undestand why the revision 528014790 had to be reverted. The editor said the number one source is wikipedia - yes, it is, it is a transcription of the talk - if the transcription is not good enough for you, please watch the original video and hear for yourself that homeopath Dr. André Saine, really says what I have included in the text, specifically "skeptics have not studied homeopathy sufficiently to be able to conduct trials, or simply to be able to criticize homeopathy fairly", as much of the research effort does not study homeopathy, but only "poor imitations" of it. André Saine is one of the most prominent homeopaths today and I believe his words can be taken as representing homeopaths.

Other sources are from peer-reviewed journals and they do not deal with medical efficacy of homeopathy, they deal with the nature of high dilutions, which is a crucial stumbling block of acceptance of homeopathy. Some of the sources are quite recent and therefore important for the topic.

Please explain why such material is not acceptable. I understand that similar such papers are included as proofs against homeopathy. — Preceding unsigned comment added by GhostOfLippe (talk • contribs) 14:49, 14 December 2012 (UTC)

GhostOfLippe (talk) 14:52, 14 December 2012 (UTC)

I don't think these sources are reliable per WP:MEDRS - the first wouldn't even pass WP:RS as it is a wiki. Primary sources shouldn't be used to support controversial statements, and the statements about high dilutions definitely are controversial. --Six words (talk) 14:56, 14 December 2012 (UTC)

WP:RS says "Each source must be carefully weighed to judge whether it is reliable for the statement being made and is the best such source for that context." I have added the original source - the video - and also the transcription of this video. The source is an excellent resource for the statement at hand as it is made by a prominent homeopath. As to the other sources, how else can it be proved that there is SOMETHING in homeopathic remedies other than by citing studies that rsearch the phenomena? GhostOfLippe (talk) 15:18, 14 December 2012 (UTC)

They're self-published sources; I doubt that the publisher is an expert on study design. That good quality studies conducted by/with homeopaths such as Peter Fisher haven't been able to produce positive results also weakens his position. The most you could do with that youtube video would be to say "homeopath XY says that ..."; in this case you'd have to prove it's appropriate to cite that specific person's opinion. --Six words (talk) 15:35, 14 December 2012 (UTC)

The publisher is an expert on homeopathy and when he says they are not testing homeopathy, I think we can believe him. Anyway, I can see that red tape also works on Wikipedia, so it's no wonder this article is in such a bad shape as it is - full of factual errors and imprecisions. GhostOfLippe (talk) 16:25, 14 December 2012 (UTC)

Hey, stay with it GhostOfLippe :) The essence here is that we're working here "within" the system only. Orthodox Journals have more weight as its considered they are are more rigorous, which in the main they are. Not that they are necessarily correct and free from various bias.

Its useful to make one change per edit. In one edit, as well as a significant addition (which is bound to be disputed), I notice you changed

"according to which a substance that causes the symptoms of a disease in healthy people will cure that disease in sick people."

to

"according to which a substance that causes the symptoms of a disease in healthy people will cure similar symptoms in sick people."

This is referenced to The Organon. Anyone with the basic knowledge of homeopathy knows that in a proving symptoms are collected and not disease names. The sentence curently in the article suggests that a remedy that causes symptoms of a disease will cure that disease. It is quite the opposite - a remedy that causes symptoms of a disease will cure anything which has a similar totality of symptoms. We maybe should then go on to specify what "totality of symptoms" means. In that version of the Organon cited, in the Preface, in reference to Hahnemanns initial experiments on himself and with others, Stratten says of Hahnemann, "In his investigations he arrived at this conclusion - that the substance employed possessed an inherent power of exciting in healthy subjects, the same symptoms which it is said to cure in the sick." Symptoms is what it is about, not disease names.

I see you since edited just this one part, which the zealous previous revertion appeared to have overlooked :) Cjwilky (talk) 20:37, 14 December 2012 (UTC)

Removed new source

A recent addition added this source, assuming this is MEDRS. I object, as this is an alt med study, published in an alt med journal, by an alt med practitioner. Alt med journals (such as Homeopathy) generally publish much more positive results than other journals, which is suggestive of bias - and part of the reason why we don't think journals like Homeopathy are reliable. I also tried to find if this had any impact in the medical literature - a google scholar citation search found few actual citations in the medical literature - some self citations by the author, other citations in other alt med journals, and mostly websites but no positive cites outside the alt med closed bubble. There was one letter to the editor by non alt med practitioners, but it was critical of the study. In other words, an alt med paper authored by an alt med practitioners in an alt med journal which has not had any impact whatsoever in the medical literature - probably shouldn't be used. Yobol (talk) 18:55, 14 December 2012 (UTC)

This Health Technology Assessment (HTA) report was compiled on behalf of the Swiss Federal Social Insurance Office as part of the Complementary Medicine Evaluation Project (PEK) in order to evaluate the speciality homeopathy (alongside four other complementary medical methods: phytotherapy, neural therapy, anthroposophically extended medicine and traditional Chinese medicine – phytotherapy) for their efficacy, appropriateness and cost-effectiveness. Next to the primary study carried out by the PEK, the HTA report was to provide the basis for the decision whether statutory health insurance compensation should continue beyond 30 June 2006.

The IMPACT you ask for was the continuation of reimbursement of homeopathy by Switzerland's national health insurance program. I believe this is an important impact and it should be included somewhere in the text.

I have also noticed that beside removing the source, you have also reverted the wording of the sentence back to its biased form. Why? GhostOfLippe (talk) 19:53, 14 December 2012 (UTC)

The impact which I care about is the impact on the medical literature, which outside the insular world of alt med journals has been unanimous in the conclusion that homeopathy doesn't work. We shouldn't alt med journals to debunk proper sourcing. I oppose the addition of it in this section as undue weight to a fringe position, but let's see what other editors think. Yobol (talk) 23:25, 14 December 2012 (UTC)

Yobol, careful of the words you use. Unanimous implies all, in fact try looking at the definition of it. Just an off the cuff look brings http://www.ncbi.nlm.nih.gov/pubmed/20673648 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2435338/ There's also the insular world of skeptics to consider if you're wanting to get picky... :-/ I suggest you look at more co-operative ways of working on this page, and avoid potential slurrs no matter how mild or appropriate you think they may be :)

There is a bias in that orthodox med journals will be more ready to publish something that may be of poor design but adheres to the norm. Homeopathy challenges the norm, massively. That doesn't mean its wrong, just that it, rightly, needs to prove itself more. So, whilst I acknowledge the need for evidence to come from the mainstream journals, for the article here the criticisms of the mainstream view from a persective that is sympathetic to homeopathy is also valid. eg the criticisms of many of the studies that clearly don't test homeopathy on a fair playing field like with the Randi attempt at replicating Ennis which failed on significant protocols (Ennis). Homeopathy isn't that easy to test. Cjwilky (talk) 00:22, 15 December 2012 (UTC)

I should have been more clear in stating that there is consensus in the secondary sources; clearly there are positive individual studies (as you would expect by mere chance if you test something often enough even if with something that is known not to work). Again, I don't think we should be using fringe alt med sources for a discussion of whether or not homeopathy actually works. Yobol (talk) 00:27, 15 December 2012 (UTC)

I agree with that Yobol, except the idea of the positives being just chance bit... but we'll get to that eventually, be warned there is a lot of homeopathy research on its way and its generally improving quality wise, Shangs gonna look a bit yellowed and frayed soon ;) Cjwilky (talk) 00:36, 15 December 2012 (UTC)

Replying to GhostOfLippe: "The IMPACT you ask for was the continuation of reimbursement of homeopathy by Switzerland's national health insurance program. I believe this is an important impact and it should be included somewhere in the text."

Actually, that isn't true. The "IMPACT" of the PEK, of which the HTA was part, was that funding of homoeopathy and the other four therapies was withdrawn. It was only reinstated, for a further trial period, after a referendum vote in 2009. This "important impact" is already covered in the first paragraph of the article's regulation and prevalence section. Brunton (talk) 12:01, 15 December 2012 (UTC)

Brunton is right - the decision to continue to reimburse the cost of "CAM" treatments was decided by popular vote. This decision will be reevaluated in 2015. --Six words (talk) 14:27, 15 December 2012 (UTC)

Brunton or Six words: Can you provide some reference for this? GhostOfLippe (talk) 14:53, 15 December 2012 (UTC)

Try the one already used in the article: "Back in 2005 the interior ministry rejected the therapies, arguing they failed to meet the legal requirement of “scientific proof” of the three efficacy criteria." The HTA was submitted to the Swiss government in early 2005 (along with the Shang analysis and other research), leading to the PEK report which withdrew funding. For further discussion (including translated passages from relevant Swiss government documents) see here. Brunton (talk) 15:29, 15 December 2012 (UTC)