16 January, 2008

The Lancet Journal's Meta-analysis

When the Lancet’s meta-study analysis on Homeopathy was published in September last year, news of its conclusions reached homeopaths all over the world to find many of us in shock. Not because such negative “news” about homeopathy was unexpected or unheard of—but because the Lancet study’s findings were given top priority attention absolutely everywhere. Suddenly, local and national newspapers and magazines of all stripes all over the world -- papers which had never previously given homeopathy attention enough to fill a paragraph -- found space to print the news in prominent, often front page, articles. Suddenly, unlikely media such as msn.com homepages were making the Lancet’s findings known, despite the fact that their usual “scientific” news bits consisted of sports scores, diet tips, dating hotlines, and celebrity gossip. “News” sources which never gave homeopathy the figurative time of day gave the Lancet’s dismissive analysis the spotlight, all with summary articles citing the Lancet as the authority. That’s quite a stir when you consider that the vast majority of articles published in peer reviewed medical journals seldom generate sufficient interest in the mainstream media to warrant any attention whatsoever.

Of course, none of the information about the actual meta-analysis accompanied those brief but prominent articles. No one was interested in publicizing information about the financing for the analyses; their structure and execution; or the materials, facilities, and methods used. Nor was there any mention whether actual homeopaths—or homeopathy as qualified homeopaths practice it--were involved in any way. The means by which the conclusions were drawn were never publicly illustrated or questioned. Though much was made about the Lancet as an authoritative journal, not one of the well-publicized reports made mention of the fact that the Lancet’s publication history includes the publication of at least one Homeopathy-positive study, which was also “peer reviewed” but never so widely published. No one ever paused to consider the existence of such a contradiction, or to ponder why the Lancet’s previous conclusions about homeopathy were now being made to seem so misguided. Though this type of critical thinking may be second nature to people in the Homeopathic community (who’ve seen hundreds of similar, dismissive statements in the press before), it may not be the way the general public would respond to such information. Which brings us to the December poll’s question:

“What will be the effect of the Lancet meta-analysis and editorial on homeopathy in the long run?”


The majority of the 132 respondents to the poll believe that the outcome of the meta-analysis will be a good one (43.2%), while 32.6% believe the publicity will have no effect on homeopathy at all. 18.2% of our respondents do fear a negative outcome will result (it is by far a minority, but it is almost 20% of all respondents—-a significant number). Only 6.1% of our respondents felt that they “couldn’t say” what the outcome of the publicity would be.

Among those who felt the impact would be good for homeopathy were those who felt homeopathy would continue to become more widely accepted despite bad press, such as “Rangan”, who wrote:

“…in my opinion, the lancet report will not make any impact on the homeopathy lovers in India. Those want to get treated by homeopathic way will undoubtedly do so without bothering about the medical journal report.”

Many such as Dr. Rehka Srinivasan felt that one of the “good” outcomes would be an acknowledgement of the need for homeopaths to put together and publish sound research of their own. The Lancet article plays up the importance of uniting homeopaths in their work in terms of research, record-keeping, advocacy towards internationally accepted standards of education and practice, and methodology of practice, which can counter-act the kind of assumptions the conventional medical world makes about exactly how homeopathy is practiced. Others, like Hazel Lucy, believe the Lancet study will drive others scientists to research homeopathy with an open mind, and may attract many people as a method of treatment even if they don’t “believe” in homeopathy’s viability. After all, wasn’t it Constantine Hering who approached Homeopathy as a medical art to be ridiculed and exposed—-until he had to admit it worked very well? Think of where Homeopathy would be if he hadn’t been driven to publicly expose Homeopathy as a fraud!

The respondents who believe that article will have no effect were also represented. One such respondent, “Noelene”, states that:

“…Patients themselves will use what gives them a positive outcome. Many of my patients are new to homoeopathy but are impressed with the results even if they have previously heard that it is "next to useless". These same people are questioning other "authorities" and thinking for themselves. They also refer friends and family to "alternative practitioners."

Essentially, this group of respondents believe that those who do seek to know for themselves will always question authorities, particularly if they’ve tried things out for themselves and experienced good results. For people such as these, the Lancet’s opinion and findings will hold little sway. Homeopathy usually attracts those who will question authority in the first place, often for reasons that have to do with their own experiences of disillusionment or disbelief with what is predominantly believed to be "true" or "right".

“Homeopathy has been here before”, writes J. Havelock Davies, who describes the Lancet study as a bad one, yielding dubious results. The study is evidence that the struggle between conventional medical interests and alternative medical treatments continues, with no resolution in sight. “Snoopy” echoes these sentiments in her opinion, where she describes the impact of the success of homeopathy and the threat it poses to conventional medicine in general:

“…what can you expect from the Drug Industry-controlled media? They don't like us and they're not going to sit around and watch while we take their living away!

You know how it is in families that know homeopathy--no one sees a doctor! No one buys drugs!

We're always shocked when they go on the attack like this but, they're concerned for a reason!”

And that reason is that Homeopathy works, despite what current science can understand about its mechanism. As Banaras Khan Awan writes, very simply, “…unless there are…challenges and…contradictions one can not find and conceive truth. If there were no substance in Homoeopathy it would have vanished from the memory of mankind.”

Homeopaths are, of course, upset by the ongoing, unresolved struggle between the institutionalized medical forces and our own work with our own patients. How can we all see such clear results with Homeopathy, yet the “science” conducted in the name of objective study never bears our own experiences--or the experiences of our patients-- out? The Lancet study does serve to remind us to be aware of our own impact in the world, as practitioners, students, and patients of homeopathy. There is a great need for us to understand the political implications of Homeopathy in the larger context of the industry of medicine, where conventional, orthodox medicine and its proponents hold a great deal of power, resources, and influence on the general public, all theirs to lose. It’s not enough for us to know that homeopathy works and works well: in order for us to remain accessible to patients, as well as to remain viable as practitioners, we need to understand why such supposedly “open” resources as the media and “science” journals like the Lancet can be so easily employed to affect public perception against the very real efficacy of Homeopathic Medicine, and we need to find some way to counteract and/or stop this ongoing problem.

The Lancet’s meta-analysis illustrates clearly that what we do as practitioners, students, and patients of Homeopathy is currently defined by medical authorities who know little about the science of Homeopathy itself, the method by which it is practiced, and the effects of Homeopathy on human health altogether, even though we have so much empirical and scientific data to speak for us, favourably, on our behalf. Those who are currently in the position as “authorities” on Homeopathy often have no interest in representing it as it is actually practiced and experienced by students, homeopaths, and patients. This should never be acceptable to us as a community: never has this been more clear than it is now.

(originally published in Hpathy.com's Monthly e-zine, January 2006 at http://hpathy.com/papersnew/siciliana-lancet.asp)