American Journal of Public Health publishes irresponsible article touting "potential public health benefits" of homeopathy

American Journal of Public Health publishes irresponsible article touting "potential public health benefits" of homeopathy

Just as homeopathy is approaching death's door in the United States, Australia and the U.K., up pops this last-ditch effort at resuscitation in none other than the highly respected American Journal of Public Health:

"Because of potential public health benefits associated with the use of homeopathy, further research on this modality and targeted studies of users are warranted."

How did the authors come to this conclusion? The ususal: by ignoring basic principles of science and cherry-picking studies.

First, as Edzard Ernst, MD, himself trained in homeopathy, says

"Homeopaths have claimed for the last 200 years that science was not yet able to explain how it works. In other words, they believe they're ahead of their time. However, scientists have always been perfectly able to affirm that there cannot be an explanation for homeopathy that does not fly in the face of science."

But you won't find this acknowledgement anywhere in Dossett, ML, et al, Homeopathy Use by US Adults: Results of a National Survey, in the April, 2016, issue of the American Journal of Public Health. (Ted Kaptchuk is among the authors.) In fact, if one were unaware of homeopathy's scientific implausibility (impossibility, really) one would be wholly unenlightened by this article. There is not a whiff of an acknowledgement that basically the entire scientific community readily discounts its proposed mechanism of action.

Instead, the authors cite British homeopath Peter Fisher and an article by him titled, What is homeopathy? An introduction. I don't have access to this article, but I do know Fisher's explanation of how homeopathy "works." Or, as Steve Novella, MD, described it in his decimation of another attempt by Fisher to explain homeopathy,

"Fisher tries desperately to rescue the 200 year old pre-scientific notions of homeopathy, but only reveals the intellectual bankruptcy of that profession."

What are the touted "potential public health benefits" of homeopathy?

"Reductions in unnecessary antibiotic use, reductions in costs to treat certain respiratory diseases, improvements in peri-menopausal depression, improved health outcomes in chronically ill individuals, and control of a Leptospirosis epidemic in Cuba."

That's it. Now, I'm no scientist, but let's see how this conclusion holds up under my feeble skills in scientific analysis. Here, in the same order, is my view of the evidence on which the authors hang their collective hats.

Reductions in antibiotic use: a survey, not a study.

Reductions in costs to treat respiratory diseases: in Homeopathy journal; no access, but consider the source.

Peri-menopausal depression: no no-treatment group, so improvements could be attributable to other factors.

Improved outcomes chronically ill: even study authors themselves acknowledge "must not be attributed to homeopathic treatment alone."

Leptospirosis epidemic: Orac has already demolished this study.

But allow me to add my take on that last one. The cited article is Golden I, Bracho G. A reevaluation of the effectiveness of homeoprophylaxis against leptospirosis in Cuba in 2007 and 2008, J Evid Based Complementary Altern Med. 2014; 19(3):155-160.  Here is the conclusion:

"The results support the previous conclusions that homoeoprophylaxis can be used to effectively immunize people against targeted infectious diseases such as leptospirosis."

That's right. The premier public health journal in the U.S. published an article touting homeopathic vaccines for infectious diseases. Whoever the peer reviewers are on this one should be called out and the article should be retracted for that reason alone. "Potential public health benefits" indeed.

Having reviewed the authors' research and found it wanting, let me suggest a report the authors should have read and included in their consideration of just how much "potential" homeopathy offers. Oddly, this very report was available before their article was accepted for publication on November 27, 2015. Wonder why it wasn't included in the discussion?

The Australian Government National Health and Medical Research Council assessed the evidence of the effectiveness of homeopathy for treating health conditions based on an overview of published systematic reviews by an independent contractor and other information that included an independent evaluation of information provided by homeopathy interest groups and the public, as well as clinical practice guidelines and government reports. The Council concluded:

"Based on the assessment of the evidence of effectiveness of homeopathy, NHMRC concludes that there are no health conditions for which there is reliable evidence that homeopathy is effective."

The AJPH article was funded, in part, by the NCCIH, whose embarrassing, and much criticized, foray into homeopathic research makes it doubtful they will take the bait and, as the authors suggest, fund "further research on this modality and targeted studies of users." The ostensible purpose of the NCCIH's funding was to review homeopathy use by U.S. adults based on the National Health Survey. I wonder if this detour into homeopathic boosterism came as a surprise to the folks at NCCIH. My bet is that it did.

And what is that stat on homeopathic use? Only 2.1% of U.S. adults used homeopathy within the last 12 months. Or, put another way, 97.9% did not use homeopathy. Looks like the American public is a whole lot smarter than the authors of this article.

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