Jaw Droppingly Stupid: Worst Homeopathy Study Ever.

Jaw Droppingly Stupid: Worst Homeopathy Study Ever.

I run across a lot of information in my feeds that I need to save for further evaluation. The study Does additional antimicrobial treatment have a better effect on URTI cough resolution than homeopathic symptomatic therapy alone? A real-life preliminary observational study in a pediatric population, I saved with the file name, 'jaw droppingly stupid'.

Background: cough is common in children. Cough is usually viral and/or asthma. Viruses do not respond to antibiotics. Duh. Giving antibiotics for a viral infection is, from the perspective of an infectious disease doctor, stupid. Patients often expect antibiotics and responsible/ethical physicians resist the pressure, since antibiotics cost money, have side effects and, when given inappropriately, help breed antibiotic resistance, a growing problem.

This approach is often referred to as the inappropriate use of antibiotics,

Antibiotics should be used only for bacterial infections and are not effective against the viruses that cause many illnesses including influenza and most upper respiratory tract infections, including the common cold, or fungal infections like those caused by yeast. The inappropriate use of antibiotics for these types of infections as well as the more frequent use of broad-spectrum antibiotics has caused the emergence of newer strains of bacteria that are resistant to many antibiotics. 

but in 2015 is either incompetent and/or stupid.

This study took children with a cough. Arguing that patients parents expect antibiotics, they decided to do a study comparing homeopathy to homeopathy plus antibiotics. 

That is what made this the most jaw droppingly stupid study ever. The did not compare homeopathy with or without standard therapy. No.They compared the use of homeopathy with or without inappropriate unethical antibiotics. Or you could say they compared pseudo-medicine to  pseudo-medicine combined with the the deliberate practice of bad medicine.

Quite a feat when you think of it.  It is not often that a study is deliberately designed to provide and reinforce bad care. 

The results? Remember: no placebo group. Well, no deliberate placebo group. Both interventions were in reality placebo.  And there was no difference in time to resolution of cough. What a surprise. Treat a self-limited disease with two useless and one inappropriate intervention and pateints get better at the same rate.

Their conclusion? The discussion says

The data of the present study also indicate that adding antimicrobial agents to the homeopathic syrup does not in any way benefit the symptomatic treatment

and then suggest in the conclusion

Our data confirm that the homeopathic treatment in question has potential benefits for cough in children as well

It does nothing of the sort.  It demonstrated that cough gets better when you give one of two placebos.  Did the reviewers even read this paper? Another example of peer review, as in peer: look keenly or with difficulty at someone or something. Someone peered at the paper and suggested publication.

Remember that 24% of the children had a side effect to the antibiotics, an intervention that none of them would, or at least should, have received under appropriate medical care.  The interventions in this study ONLY caused harm.

This study was approved, with another fail, by an institutional review board. They note the study

was conducted according to the Helsinki declaration, which is here.

Since it is a homeopathy study they immediately fail

Medical research involving human subjects must conform to generally accepted scientific principles

and since the use of antibiotics in this study would, in the real world, be considered awful practice that should only give side effects without benefit, I do not see how they pass

The Declaration of Geneva of the WMA binds the physician with the words, "The health of my patient will be my first consideration," and the International Code of Medical Ethics declares that, "A physician shall act in the patient's best interest when providing medical care."

Not only jaw droppingly stupid, but jaw droppingly unethical, even for a pseudo-medicine study.This is a run up to a larger, and probably even more jaw dropping study

It should be pointed out that this

was a pilot study conducted before starting a larger trial on the role of antitussive and mucolytic drugs in children; however, the results of this preliminary study can provide valuable information for the sizing of future rigorous controlled studies

So except more of the same, only bigger. But I bet not better.  They will only harm more children without any potential benefit.

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Points of Interest 09/10/2015

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