Interview Strange Expertise on homeopathy

Homeopathy: strange „report“ of the British House of Commons

„So goes lobby“: A committee of the British House of Commons has just come to the conclusion that homeopathic remedies are nothing but a placebo. The „expert“ call on the legislator to remove funds from the National Health Service (NHS) service catalog and refrain from further research. Questioned, however, the evaluation criteria and the conclusion of the „report“, this raises great doubts about the significance. The document does not accurately reflect the state of international research and, in our opinion, essentially represents the personal position of a single person: Prof. Edzard Ernst. The editors Heilpraxisnet.de interviewed the journalist Claus Fritzsche in his assessment.

Mr Fritzsche, the UK House of Commons Science and Technology Committee, concluded in an opinion that homeopathic medicines are not effective and therefore should not be paid or licensed. How do you rate the quality of this report??

Claus Fritzsche: Against the background of many open questions, I do not yet dare to make a conclusive judgment. However, after a first diagonal flyover of the 275-page document, it is clear to me that the Evidence Check 2: Homeopathy incorrectly reflects the state of research on homeopathy and that the background to its emergence is not transparent.

In my opinion, the Science and Technology Committee of the British House of Commons has Large theatre played ... leaves open the question of why the arguments of the public hearing, for example, those of Prof. Harald Walach and Prof. George Lewith were ignored without comment, while those of Prof. Edzard Ernst dominate the entire document.

Many indications suggest that the results of the „report“ before the public hearing and Edzard Ernst in the background - not transparent to the public - directed. The hearing was definitely a pure alibi event.

Can you clarify that??

Claus Fritzsche: As far as I can judge at the moment, the entire reasoning of the „report“ - I put emphasis on the quotation marks - mainly on a single meta-analysis. On page 22, Prof. Edzard Ernst is quoted as saying:

„Professor Ernst pointed out that ... 5. Shang et al very clearly arrived at a devastatingly negative overall conclusion.“

This is the ominous work, due to the British medical journal The Lancet 2005 a bit premature that „End of homeopathy“ exclaimed. And on the basis of no less than eight studies.

What exactly are you criticizing?

Claus Fritzsche: Mr. Ernst does not mention here that the meta-analysis by Shang et al. 2005 were already refuted by control work of Lüdtke / Rutten in the Journal of Clinical Epidemiology and by Rutten / Stolper in the journal Homeopathy. The shortcomings of the meta-analysis were so blatant that even the The Lancet publisher Elsevier saw the press release „New evidence for homeopathy“ to publish.

If Ernst does not even mention the control works of Lüdtke, Rutten and Stolper, then I rate this as a deliberate and malicious deception of the public. It's sort of like Toyota is completely silent about its current recall in a report on the quality of its vehicles.

Was it for the British „report“ no review process?

Claus Fritzsche: This is a very good question. In any review process performed to international standards, the reference to Shang et al. 2005 without the simultaneous mention of Ludtke, Rutten and Stolper been complained. With such a blunder, it can be assumed that manipulated and muffled behind the scenes.

From whom derives the scientific expertise of the „report“?

Claus Fritzsche: That's the next exciting question that I can not answer. The only certainty is that those mentioned on page four - for the „report“ responsible persons who do not have the necessary scientific expertise. It is also certain that the document does not give an account of who evaluated and finalized the results of the public consultation according to which criteria. Who adopted certain arguments in the hearing and ignored other arguments? An answer to this question would be of great interest to me.

Do you have a guess?

Claus Fritzsche: (Laughs) After the document Edzard Ernst on each page „felt“ quoted at least thirty times, the evaluation criteria 1: 1 correspond to the well-known personal opinion of Edzard Ernst ... and after the work also the typical mistakes of Edzard Ernst such. For example, the concealment of Lüdtke, Rutten and Stolper, the overvaluation of the criterion „plausibility“ As well as the uncritical prioritization of randomized clinical trials (which have great weaknesses in addition to strengths), answering this question is very easy for me.

I can not tell you if that „report“ written by himself or just hidden souffliert was. For me personally, however, it is certain that Edzard Ernst has been directing in the background - not transparent to the public.

You mentioned in our preliminary talk a published on behalf of the Swiss government „competitor“-Expertise on homeopathy. What exactly was being investigated here?

Claus Fritzsche: In 2005, the Swiss Federal Office of Public Health published a Health Technology Assessment Report on homeopathy, which was published as part of the „Program Evaluation Complementary Medicine“ (PEK) was created. The aim of the PEK was to scientifically evaluate five important methods of complementary medicine (anthroposophic medicine, homeopathy, neural therapy, phytotherapy and traditional Chinese medicine). The PEK consisted of a field study project and a literature project. The scientific support was provided by a steering committee, an expert group and an international review board.

What are the differences between that „report“ of the British House of Commons and the Swiss HTA report?

Claus Fritzsche: First of all, the Swiss took seven years time. It took five years to review the data and clarify conceptual issues. The actual evaluation and preparation of the HTA report took two years.

Who in Britain at the public hearing for Evidence Check 2: Homeopathy wanted to participate, who had exactly 17 days until the deadline. This is a clear indication of a circus event. The public should be given a broad knowledge base that does not actually exist.

Who examined the data in Switzerland?

Claus Fritzsche: Within the framework of the Swiss HTA, there was complete transparency about who evaluated data according to which criteria and why what conclusions were reached. All this is British „report“ unclear and non-transparent. The second big difference can be seen in the fact that Switzerland used international expertise, but the British only national. And even though the British expertise, represented by Edzard Ernst, George Lewith and Harald Walach (now in Frankfurt am Oder) would have been sufficient, the know-how of the latter experts was not taken into account without stating reasons.

Are there differences in the evaluation criteria??

Claus Fritzsche: There are differences here in that Switzerland oriented itself on international standards and the British - as I see it - resorted to the personal assessment of Edzard Ernst.

What does that mean in concrete terms??

Claus Fritzsche: Please allow me a little preliminary remark: Like me some time ago in a blog post with the headline „Doubtful meta-analyzes: how evident is evidence-based medicine?“ Using three plastic examples, research results are relatively easy to navigate in a direction desired by the researcher „to form“. By cleverly choosing the evaluation criteria, POSITIVE or NEGATIVE results can easily be achieved with the same data - in the name of truth and science „shaped“ become.

Does the British „report“ made use of this possibility?

Claus Fritzsche: It is exactly like that. At the Swiss HTA, this was done, which is internationally common today. The study type suitable for a specific question was chosen. If I want to know if therapy works under everyday conditions, randomized clinical trials (RCTs) are rather inappropriate because of their low external validity as a measuring instrument. Other study types such. B. Observational studies have a much higher external validity and are therefore used in health services research to provide information on the effect of therapy under everyday conditions.

However, if I want to know what exactly is working in a therapy, RCTs are the appropriate measuring instrument and observational studies because of their high internal validity, and good case series or longitudinal cohort studies are rather inappropriate measuring instruments. RCTs are well suited to measure specific and nonspecific effects. Here, too, they have great weaknesses as well as strengths. RCTs are overwhelmed with measuring specific effects when it comes to complex interventions. It is also controversial to what extent RCTs can be used to measure the effects of individual remedies - in classical homeopathy, each patient receives his own, personal and disease-specific drug.

Within the framework of the Swiss HTA, as is customary internationally, the measuring instrument suitable for the respective research question has been chosen. in the „report“ In contrast, the UK House of Commons has a one-sided prioritization of randomized clinical trials. This overvaluation of the strengths of RCTs and undervaluation of the weaknesses of RCTs is no longer internationally accepted. It contradicts the view of important authorities. The German Federal Ministry of Health's Advisory Council on Health Care Assessment and National Institute of Health's Chairman, Sir Michael Rawlin, believe the unilateral prioritization of RCTs is wrong.

What effect does the one-sided prioritization of RCTs have??

Claus Fritzsche: This can be done by experts such as Klaus Linde of the German Cochrane Center, Claudia Witt of the Berlin Charité or Rainer Lüdtke of the Karl and Veronica Carstens Foundation explain better than me. Let me put it bluntly: A flat-rate preference for randomized clinical trials operating across all issues and ignoring the known weaknesses of RCTs is worthwhile in the present case, if I attribute the result to homeopathy „to form“ want.

This form of result manipulation pays off in a political context, such as that in the UK, when competing experts are booted out and mass media (not experts) are the sole controlling body. The typical field forest and meadow journalist can not understand the connections explained here because of lack of know-how, time and often also lack of motivation. He tends to be an expert believer and can easily be lulled by scientific-sounding terms.

At least that is my opinion.

What was the outcome of the Swiss HTA report on homeopathy??

Claus Fritzsche: The conclusion of the Swiss HTA is:

„The effectiveness of homeopathy can be considered as proven, taking into account internal and external validity criteria, professional professional application as safe. “
(Source: Research Complementary Medicine 2006; 13 (suppl 2): ​​19-29)

The Swiss HTA, however, leaves open the question of why this is so. This question is still the subject of research such as: B. the Homeopathic Pathogenetic Trials by Harald Walach et al., which I post in my blog „New study design proves specific effects“ Had presented. The results to date of the controlled and blinded HAMP studies are spectacular and speak for specific effects of homeopathy. In the public hearing of the British House of Commons they were submitted in the form of a memorandum by Walach and Lewith ... but also by that ominous Mr. X, the unknown director of the British „report“, without giving reasons. But who cares. So lobby goes ... (Laughs)

Mr. Fritzsche, thank you very much for this interview. (heilpraxisnet.de, 02.03.2010)