The [false]positive side of screening

Screening for Disease: Is earlier always better?

That title sounds a little wrong, you are thinking 'well, yes of course it is'. But bare with me. We have all heard of screening tests and are likely to have been through them. What is the harm in this? There is a lot of misinformation that is congregated around screening tests, leading to a lot of misunderstanding. Superficially, it appears to be good advice to give to ‘get something or other checked’. If there is something wrong in your body, you’d want to get it checked, yes? So, logically, we should be tested for everything regularly, yes? Well, no. We have an unfortunate thing in science called false positive. Meaning we would get a lot of anomalous results leading to a diagnosis and further tests to analyse something that isn’t actually there. 

Screening healthy people is a task that should be approached with caution. If you decline a screening, you will always have a little nagging voice in your head saying “what if?’ – you will, it is the nature of the human mind. So, should you have been offered the screening in the first place? I am going to focus on one type of screening in this blog; PSA. This is due to me researching into it naturally, and was not all too shocked at the information found. It was something I always somewhat knew, but not quite to this extent.

Prostate Screening

Prostate cancer is a very common cancer in men, occurring worldwide. There are two categories within prostate cancer, we have the aggressive and high death rate form and the slow growing, less likely to even have any symptoms. The latter of the two is most prominent and never really progresses to cause any health dangers during a patients’ lifetime, it is thought that 50% of men actually have the cancerous cells present - which will not develop. The screening test for prostate cancer is blood test in which they are looking for prostate specific antigen (PSA). A PSA test is looking at the levels of antigen in the blood, the test isn’t a ‘yes it is there’ or ‘no it is not there’, it requires interpretation. In an ideal world, we would like to have the rapid growing, life threatening cancers detected rather than the slow growing cancers as these don’t normally threaten a patients’ life. The side effects of prostate surgery to remove the cancer are invasive, scarring and leads to impotence, incontinence and cardiac problems.

PSA

PSA is an enzyme that is produced by prostate cells. Small amounts of PSA are observed in the blood at around 0.1-2.5ng/ml. Although, this appears to be very convoluted in the literature, many report the level is around 4-10ng/ml. So, if we don’t really have a consensus of the level that should be present normally, why would we look at it to detect cancers? These levels are said to be “normally” raised when prostate cancer is present. However, there are many other things that will effect PSA levels, including: ejaculation, weight, aspirin, infections and non-cancerous tumours. Evermore and more shockingly there is no clear cut-off level in which medical professionals use to differentiate those who have cancer and those who do not based on PSA levels. It is reported that 1 in 5 with clinically significant cancer will have a PSA level that is within the ‘normal’ reported range. If a doctor is using the 2.5nm/ml as the cut off, he could report cancer in a case with a PSA level <4.0 but higher than 2.5ng/ml. Even this report published by harvard have a different view of the levels that vary with age. Despite these limitations and high ability for misinterpretation, PSA routine testing is advised by medical professionals and companies that are selling these tests.  

 

Is there any harm in this?

Two questions that are required with any screening technique:

• Is there evidence to prove that early detection equates to a better overall outcome?
• Is there any harm from the testing?

In 2010, a systematic review was published in Biomedical Journal concluded that, as expected, PSA screening increased the likelihood prostate cancer diagnosis. However, it was found that there was no evidence of any impact on the death rate from the cancer itself (or the death rate overall for that matter). Risk factors, age and disease all need to be taken into consideration. Double blind randomized trials give very conflicting results with regards to the effectiveness and the test concentrates on disease specific mortality as opposed to the mortality overall. Richard Ablin, the discoverer of PSA recently wrote that the PSA test is being misused and is highly unreliable. Talking to New Scientist, Dr Ablin was reported stating:

“So, first is that PSA is not cancer-specific. Second, the level of PSA deemed worrying is arbitrary – 4 nanograms per millilitre or higher. As PSA is not cancer-specific, no level is diagnostic. Third, prostate cancer can be aggressive or, more often, very slow-growing. We can’t tell which is which.

Last, many men will develop prostate cancer by age 70. If an older man has a PSA level that prompts a biopsy, it is likely you will find cancer. Since you can’t tell if it’s aggressive, many men get treated unnecessarily – and risk life-altering side effects including impotence and incontinence”

 Source

This is all backed up by surmountable clinical trials. A study published in The New England Medical Journal screened over 1000 subjects before they saved one life. This lead, on average, to around 50 false positive patients, many of which unnecessarily undertook radiation therapy or even surgery. To put that into a simpler visual, this was taken from the Australian public health: 

“you have to screen 1408 men and treat an additional 48 men to prevent one prostate cancer death over 9 years. In other words, only 1 of those 48 men is going to benefit over the next 9 years; the other 47 … have undergone treatment for no benefit within this period.”

As stated prior, the treatment isn’t exactly nice and the side effects do change your life. We aren't seeing any better overall outcomes if we are including the unnecessary diagnoses (which we are) and we have a lot of harm from the testing, the over diagnosis. Thus, the two points that give the screening processes validation do not actually work.

Conclusion

Prostate cancer screening is easy, its just a blood test. But the results and the fallout are unaccountable. If 50% of men have the cancerous cells that wont progress into anything, then is it rational to have them undertake surgery? This screening method, like many others, is shadowed with over-diagnosis and the side effects from the treatment measures are significantly debilitating and life changing. So, should this still be being used? The decision is yours, the evidence is conflicting and mostly non-existent in the case for this particular screening technique. Don’t be fooled, this isn’t the only screening that actually has little success rate, there are many others - just as there are many others that are very effective. I am not discouraging (or trying to discourage) people from being screened from cancers, I just think there are many cases where it causes more harm and panic than good. At the bare minimum, the limitations of this and other screening processes should be clarified and communicated to a patient before the screening is carried out. 

There are plenty of books with sections on screening and the consensus amongst scientists with mass reviews of the evidence. I implore you to read them. 

Biomagnetics: Why are we still attracted?

Magnetic Healing

 I have been fortunate to have only red about this, but never really seen it, until know. Moving to a smaller city I have noticed a lot more chiropractic/homeopathic practices than I really do care to see. Whilst out shopping today I saw a fairly big stall branded ‘Magnetic Healing’ with a tagline of ‘Walk away pain free today; diabetic foot care’. I was more astonished by the amount of people crowding the stall than the stall itself. I first read about this in around 2013 and was thankful I had never seen it in the U.K., having only seen aspects of it before, seeing a full blown shop dedicated to it made me a little uneasy. 

What is Magnetic Healing?

Essentially, magnetic healing is exactly what it says; using magnets to heal pain. These magnets are in the form of charms, insoles and braces sold with the claims that they can relieve pain, increase energy and have a positive impact on mental and physical agility. It seems that the general public in the U.K. are still under the notion that pain can be healed by the use of magnetic energy. 

Source

Practitioners claim that the magnetic fields can positively effect blood and underlying tissues. I think this has gained much credibility via the use of magnets in clinical medicine. We use Magnetic Resonance Imaging (MRI) and we evaluate brain function with the measure of electrical impulses that travel through it. These practices are based on sound science and through years of research. As there is potential for a market by exploiting and bastardising magnetic properties, there are quacks to fill it. Essentially, what these people are selling are just regular magnets, such as the ones you put on your fridge. As you probably (hopefully) know, these have absolutely no effects. They will not penetrate beyond a few mm, let alone your skin to your tissues. Factually, haemoglobin isdiamagnetic (weakly, when oxygenated) the magnets, as stated, have fields way to low to have any effect (this website has some helpful diagrams and a much more in-depth explanation of this). If our body was affected by this weak of a magnet, then surely: 

 

a)    MRI would be made redundant

b)    We would be effected all the time

Any Evidence?

No. Only evidence (of value) is to the contrary. A study published quite a good while ago (1991) in The Journal of Nuclear Medicine studied the effects of magnets on the body and found that strengths of up to 1 Tesla had absolutely no effect. Many practitioners take away any basis of science and claim the effects are on the electromagnetic energy around the body, balancing and energising our auras. It has also been propagated as a treatment for cancer, diabetes and autism...

In 2008, a systematic review of all credible magnetic therapy studies published in The Focus on Alternative and Complementary Therapies journal, shockingly, found zero evidence to conclude the basis of any claims made by practitioners. In fact, you can test any claims for yourself with a small experiment, as I will do right now. As they claim that the magnet will affect your blood flow, placing a magnet on your skin will make the skin appear red as the blood will surely come to the surface, as they are attracting. I have placed a magnet on my arm, and on my lower leg. 10 Minutes later, I see no result. 30 Minutes later, I see no result. After an hour, every pain in my body from this cold has gone. THIS ACTUALLY WORKS. Oh wait, no. My mistake; absolutely nothing happened.

Law

The stall I saw had a website: www.magnetichealing.com which I was surprised to find has absolutely no information. It is essentially a place to find quick links to other websites, strange. If you were selling a product to people that you truly believed works, in the face of surmountable evidence, why would you not want to promote such products? Never thought I would be in support of homeopathy, but at least they stand on their own….merits? (I use that term for a lack of a better word, homeopathy has no merits).

In the early 2000’s there were numerous court rulings on practitioners making false claims about these products. As previously they were marketing magnets for cures, the companies marketing such products were sued and now use stupid phrases such as: ‘supports the healing process’ and the less glamorous ‘helps with’.

Not Medical Doctors…Then Who?

As I cannot find anyone to blame for the stall I saw today (other than the people working there, but I wasn’t going to ask questions in the middle of a Saturday afternoon in a busy shopping centre during the Christmas period. I’m not mental). I have found the website: biomagnetismusa.com which is a fascinating and riveting website aimed at people who haven’t an ounce of sense in their human body. Within this site, the author, Helana Guerrero, describes to the general public as to what magnetic healing actually is. Obviously using the classic pseudoscientific words as a marketing scam: Toxin, Detox, my favourite section is this:

“Virus and fungus live in acidic enviroment, bacteria and parasite alkaline. By placing magnets of the same polarity on each point, we push the charges towards each other and the area gets balanced, equilibrium is restore to a neutral pH, then pathogens instantly die since pathogens can not live in a neutral pH and we get rid ot them.”

That is copied and pasted as found, proof-reading is clearly not vital, then again, nor is fact-checking. One word completely defies this sentence: Homeostasis. This is the tendency of a system within a living organism (not always living) to maintain an equilibrium by reacting in regards to a stimulus. You should surely remember this from high school. This belief flies directly into the fact of our homeostatic biological nature. There is nothing really you can do, with the exception of what is essentially poison, to change your blood pH level. We have multiple feedback loops that have evolved through the ages to correct our pH level, magnets are not going to change that. You can’t easily affect blood pH, essentially, that is called poisoning. And that will obviously kill you. More on pH quackery can be found here.

Then we get to a better section, the disclaimer:

Helena Guerrero has been Certified to provide BioMagnetism Therapy by the El Centro de Investigacion de Biomagnetismo Medico, S.C.in Mexico, The University of Chapingo, Mexico and by Dr. Isaac Goiz Duran.
She is not a Medical Doctor, she is not making a medical diagnosis or providing medical advice or care.
You should see a Medical Doctor for medical care, and you should view BioMagnetism Therapy care as additional therapy to the medical care provided by a Medical Doctor.
Biomagnetism Therapy is not a substitute for Physician consultation, evaluation, or treatment.

Essentially reworded to: I’m not a medical doctor. This doesn’t work as a cure for anything. See a physician for actual care. At the end of homepage is a list of things that biotherapy apparently helps. It’s a long and amusing list, and its all thanks to Dr Isaac Duran, who has patented this biomagnetic treatment with absolutely zero evidence for it’s claims. Unfortunately the website doesn’t have a price list for how much it would cost for such a treatment to help with any ailments. Maybe if I get my head cut off one day I’ll visit for the cure, I’m sure magnets can fix that. 

Conclusion

Obviously it is frustrating to anyone with an ounce of scepticism, critical thinking and basic scientific knowledge, that people are falling for this and still forking money over to these shills. Of course, I would be wrong to have reviewed and questioned the science and practicality of this in the eyes of practitioners, they will claim that there is insurmountable evidence to prove the claims made. Who am I to argue with that? Oh wait, someone who actually knows what they are talking about and is not biased-ly trying to sell something. Either way, this remains a fringe science with only circumstantial testimonials as evidence. If you went for surgery and asked if a treatment worked and they said ‘well, Tom from Leeds says that I fixed him’ you’d be a little suspicious. Why not apply the same scepticism to people selling you magnets for cancer treatment? Read that last sentence again. Done.

From Cancer to Eyesight, is There Anything Cannabis Can’t Cure?

Marijuana Exposure Prenatally Helps Eyesight

This week I read an article on The Metro online with the title of: ‘Babies Exposed to Marijuana in the womb actually have better eyesight’ and I shuddered at the sheer thought of how poor a study this would have actually been. Not all too shockingly this was shared all over Facebook timelines by stoners and the ilk, I am assuming none of which have read the newspaper article or even tried to access the study (which is actually open access, so its free. There’s no excuse for ignorance here). I imagine thousands of cannabis users and pro-cannabis folk rejoiced at the new information, cannabis can cure cancer and now it helps with eyesight in children if you consume it whilst pregnant. How come this isn’t legalised? Well, Read on. 

The Study and the Media

The study is an open access study published in The Journal of Scientific Reports entitled: Prenatal Exposure to Recreational Drugs Affects Global Motion Perception in Preschool Children. This article was picked up heavily by the Daily Mail and the aforementioned metro, heralding the study, stating that babies which are exposed to cannabis have better vision by the age of 4. In the study, they tested the meconium from the children and tested for the presence of drugs. Essentially, they tested the eyesight of children who had known prenatal exposure to drugs at the age of 4.5 using the global motion perception. They found that those that had been exposed to alcohol and cannabis prenatally had better eye tracking than those of the control. Let’s look further into why none of this is as accurate as it appears and why the media are completely wrong:

·      Visual processing skills are developed at different rates and through different techniques (PDF). The old nature V.S. nurture adage, how do they know that the parents haven’t spent more time helping their children develop than the control group? Y’know, had they actually had a reliable control group.

·      The participants (n=165), were split into two groups control V.S. study. Like me, you would think that the ‘control’ would be those that haven’t had a prenatal exposure to drugs? You’d be wrong, this line is straight out of the article:

Participants in the IDEAL study were recruited to two groups on the basis of prenatal methamphetamine exposure (methamphetamine exposed vs. controls). Many mothers of methamphetamine-exposed children were poly-drug users. The control group included children who were also exposed to a range of drug combinations with the exception of methamphetamine as well as non-drug exposed children.

So, the control has been exposed to drugs, just not methamphetamine. That seems like an excellent measure. How do they know that one of the other drugs being consumed is making the eyesight worse and that the methamphetamine isn’t actually affecting the eyesight at all? Simple, they don’t, because they don’t have a proper control group. Even more, their control group only encompasses 15% of their sample group. So they have 165 subjects, 25 of which are the sample group and 140 are the analysis group. That should make for a highly unbiased statistical analysis….

·      The statistical analysis carried out compared the relationship between cannabis, nicotine, alcohol and methamphetamine on motion perception. As an add on, they assessed the relationship between the extent of drug exposure of cannabis and motion perception. Meconium analysis is an entirely feasible method for drug analysis. However, it doesn’t detect all drugs. Drug misuse has to occur in the 2^nd and 3^rd trimesters to be detected in the meconium, this study does not address this fact and includes the first trimester as a measure. It also doesn’t take into account the unreliability of the subjects’ recollection. For instance, the subjects could have taken multiple doses of drugs in one night, or even abstained but thought they had consumed more. Even more, from working in a drugs lab, I know that they may very well not be consuming what they think they’re consuming (with the exception of cannabis, I mean, that’s pretty obvious).

The alcohol and marijuana use was determined by a subset of questions, such as how much was consumed and categorised into ‘light, moderate and heavy’. Most people who drink at home don’t measure their drinks – so one drink could be classed as light but it could be stronger than the average. Which brings use to the concentration, surely that plays an effect. If someone consumes 3 vodkas, lets assume they’re measured amounts, then they have consumed more alcohol than someone who has had 3 alcopops for example. Only 40% of the subjects had been exposed to cannabis. So the media are now reporting on an article that is comparing 66 subjects to 25. More then doubling the subject group over the control more than doubles the statistical outcome of the study.

Impact Measures

The impact factor is possibly something that should be taken into account with these type of articles. Now, this is much debated in the scientific community as to whether an impact factor has any credence, in my opinion, it does. The impact factor is the frequency in which an average article within a journal has been cited for a particular year. This is used to measure the importance of a journal in its respective field. Articles that are contained to more prolific journals are more likely to be trusted due to the more rigorous peer review that the article receives. So, is the journal a well established journal with a high impact factor such as Nature (which for reference has an average impact factor of 41)? No, we are looking at The Journal of Scientific Reports with an impact factor of….5.

Conclusion

This study is the height of inaccuracy and what is incorrect with studies published in these low impact factor journals. Comparing 140 people to a control group of 25 is beyond ridiculous, as you can imagine, any differences will be prolifically highlighted in the statistical analysis, which is exactly what these studies rely on for publishing. As for the media, well they do what they normally do. Don’t read the study, just get someone which as high-school GCSE in science to write the study, as they ‘know enough science’ to be scientific reporters, right? No, the impact of these articles could be phenomenal on people who already have their preconceived notions about cannabis. I feel like I have to say this; the results of this study should not (and, unfortunately, have been) be extrapolated to mean that cannabis and alcohol consumption whilst pregnant has any benefit to foetal development. Again, tracking is something that can be improved by nurturing a child there is very little evidence here to indicate that drug consumption has helped at all. 

 

Previously I wrote an article on here about how cannabis cannot be and is not used to cure cancer, if you are a pro-cannabis aficionado who believes that it should be legalised on this basis, I suggest you read.

Sildenafil and Diabetes

Can Viagra Cure Diabetes?

Every other week there is a new treatment for something new. I was delighted today to be alerted to a new cure for diabetes: Sildenafil. Sildenafil commonly trades under the name of Viagra. So yes, Viagra is the new cure for diabetes according to many news sources. As any rational person would, I get skeptical when the word ‘cure’ pops up around incurable diseases. Sildenafil works by inhibiting phosphodiesterase 5 (PDE5) found in various tissues within the body. This causes a relaxation in smooth muscle, increased blood flow and vasodilation. As you may know, Viagra is a common treatment for erectile dysfunction and less commonly known for its treatment of pulmonary arterial hypertension (high blood pressure). There are a lot of problems with sildenafil as a medicine and an even greater amount of problems with counterfeiting. The media has caught onto a study that indicates Viagra can increase the secretion of insulin and ‘prevent’ the onset of type two diabetes.

The Study

The study in question was published in the The Journal of Clinical Endocrinology & Metabolism university entitled: Treatment with Sildenafil Improves Insulin Sensitivity in Prediabetes: A Randomized, Controlled Trial. The study separated 42 people into two groups, one of which was orally dosed with 25mg of Viagra 3 times a day whilst the other group received placebo. Three months later, insulin sensitivity was significantly greater in the sildenafil group compared to the placebo. I have a few gripes with this study, we’ll take them one by one:


Firstly; the subjects. All subjects were overweight people with ‘prediabetes’. This is essentially a stage where not all symptoms of diabetes are present, but there is a disposition. So we have study using drugs to cure diabetes in patients who do not technically have diabetes. That’s the equivalent of saying eating grass cures cancer in people that don’t have cancer. Insulin secretion isn’t uniform within the subjects, hardly makes this fair game. We have 31 subjects taking other medicines throughout the study. In their chart of all the data, they include data for 9 people that were excluded from the study, which leads to highly inaccurate results. The table of information states that only 15 of the subjects (n=25 as we appear to be including those who were dismissed) had impaired glucose levels. I was under the impression they all had impaired glucose levels as they're pre-diabetic, or is that not a requirement of pre-diabetes?

Secondly; the sample size of the study. The study uses statistics to reinforce the result with a p-value of .049, which is excellent. Wait, in 42 patients? The number of samples in each group really affects reliability of these trials. That’s 21 patients in each group. 21 people without diabetes, but showing some high levels of blood sugar took sildenafil and had an increased insulin secretion. So, do we have a cure? Not necessarily, small sample sizes create very big holes in these studies. With over 400 people being diagnosed with diabetes in the UK alone each day, surely that sample size could be larger? It’s surely not hard to find somebody with pre-diabetes, 42 subjects don’t really cut it enough to make such a large conclusion. In America, where the study was produced, diabetics are on the rise, it is a huge problem over there, but they could only use 42 patients?

Thirdly; their conclusion. They conclude with saying that this is somewhat preliminary and semi-speculative along with the fact that this could possibly be used to prevent formation in ‘high risk’ patients. My problem here is that they don’t state there is a cure, so why does the media portray it so? Even more, they state that further research is required, which is about as scientifically useful as saying 'water is wet'. More research could always be carried out to reinforce a point, always.

Fourthly; the medical implications. No medicine is without risks, which doesn’t appear to have been assessed in the study. Metabolic problems of sildenafil include: unstable blood sugar and hyperglycemia. Obviously both common problems in diabetic patients. Lest we forget the common side effects of respiratory, dermatological and hematological problems involved with the absorption of Viagra.

 

Media

Obviously the media hasn’t looked at the study in the same way you would as if you were going to report on something. You read it. Many of the major news outlets such as SKY or BBC have not (as of yet) picked up on this news break. But many other news sources have. Using ‘Viagra can cure diabetes’ as the headline. The Mirror used this headline, up until around 7pm when it was changed to ‘could stop you getting type 2 diabetes’ – which is a little more accurate in context of the study, but not accurate in terms of a wider picture. I am somewhat relieved to see that this article and the express are the only ones to really pick up on this and run with it, although I have no doubt that others will emerge. The express has a little differentiation in the story to The Mirror using a larger subject sample size n=51. I have read this study twice already and this goes to show how well they actually read the study. 51 people started, with 9 being dismissed from the study, leaving a total of 42 subjects. They also state:

Doctor Nancy Brown, of Vanderbilt University School of Medicine in the US, said: "Weight loss and exercise regimens can be difficult to maintain, and some current medications have been limited by concerns about adverse effects."

Really? Concerns about adverse effects in comparison to sildenafil? In 2007, the FDA stated that all PDE5 inhibitors required extra labelling for the adverse effects and potential sudden loss of hearing.
A drug that has a high number of related cardiovascular problems and deaths is more beneficial than something like metformin with mild side effects?

Conclusion

I recently wrote about diabetes ‘cures’ and how the media utilized bad science to propagate pseudoscientific nonsense. When I read this article on my lunch break it said nothing of the type of diabetes; type one or two. It also only really used conclusive terminology; ‘will cure’. Let’s be clear here, if this preliminary study is repeated on a larger scale double blind clinical trial and found to have more conclusive results, then we haven’t found a cure. We are looking at people who have a disposition to type two diabetes, these are at a point in which they don’t have diabetes and can revert via a change in lifestyle. So, if a change in lifestyle can reverse the effects of type two diabetes, which it can (in the early stages) then why would you take medicine with a higher risk of side effects? There is no cure being discovered here, in the same way that injectable insulin isn't a cure in type one diabetes. The problems with articles like this is that they cause more harm than good. People can read the version of the article I read and fully (albeit, naively) believe it. Taking the drug when you have no medical need for such a thing is blindly stupid. Precaution should be taken and these studies read carefully, unfortunately peer review and publishing scientific papers isn't a smooth and flawless process, cracks form and some fall through that are below standard.

Although, it would be interesting to see the results of a larger scale study (and a better subject sampling), things like this are not funded due to the holes that already really exist. This study has many issues with the subjects and the criteria for statistical analysis. Many preliminary studies like this tend to just stay as is; preliminary.

The Downfall of Homeopathy

Maybe no more water and sugar pills on the NHS?

 

Today a colleague of mine mentioned an article on the blacklisting of homeopathy on the NHS. How did I miss that in my morning news feed? Thank you Apple news. But yes, the NHS is considering blacklisting homeopathic prescriptions, meaning your local GP will not be prescribing you any overly expensive water. Homeopathy played a massive part in the NHS House of Commons Science and Technology Committee (SciTech) concluded that it was nothing more than ‘magic’. There was a victory back in 2013 when the Advertising Standards Agency stated that homeopathic medicines have to be labelled as ‘homeopathic remedies’.

Costs

The article states that the total NHS bill for homeopathy and homeopathic hospitals is around £4 million per year. See here, the Bristol homeopathic hospital, because this is the world we currently live in - where homeopathic hospitals actually exist. £110,000 is said to be allocated to prescriptions from GPs for homeopathic medication whilst the rest is allocated to these hospitals. There appear to be four of which in the UK. With the money strains put on the NHS and the ridiculousness of homeopathy combined with the lack of any evidence, this just sounds on the face of it: utterly ridiculous. 

  

Here in the UK, we have certain classes of prescription drugs. Schedule 1 drugs are drugs that your GP should not prescribe. These are for many reasons, such as efficacy or costs. The question of the article is, if blacklisted, will we see a political move to make homeopathic medication a schedule one drug? I certainly hope so. Homeopathy is a booming market that is multi-million pound industry in the UK alone, which, luckily, has faded over time.

Evidence

I have written before about Homeopathy and its complete lack of evidence. A lovely meta-analysis carried out by excellent physicians and statisticians; NHMRC Information Paper: Evidence on the effectiveness of homeopathy for treating health conditions found the following conclusions:

• Homeopathy should not be used to treat health condition
• There is no evidence that homeopathy is effective in treating health conditions.
• Homeopathy has zero effect on anything – except dehydration, as that is essentially what homeopathy is; expensive water. 

 

Scitech itself also ruled that homeopathy was pure bull and had zero evidence (PDF). This isn’t anything new. These are a drop in the ocean of studies that prove homeopathy doesn’t work. So why is it still popular? It appears to be hard to justify the NHS pouring money into something that has been time and time again proven not to work. Even the people who are proponents of it seldom use scientific evidence to back it up, because the studies just do not exist. 

 

The article details the side of Dr Helen Beaumont, a GP and president of the Faculty of Homeopathic Drugs said:

“other drugs such as SSRIs (selective serotonin reuptake inhibitors) for depression would be a better target for saving money, as homeopathic pills had a "profound effect" on patients. She told the BBC News website: "Patient choice is important; homeopathy works, it's widely used by doctors in Europe, and patients who are treated by homeopathy are really convinced of its benefits, as am I."

That argument really doesn’t follow. Other treatments, such as treatments such as SSRI, come under a lot of fire due to their efficiency and side effects, but that doesn’t mean homeopathy works. She states she is convinced of the benefits of homeopathy. What benefits are those? If there was indeed ‘profound effects’, why have they not been found through double-blind clinical trials? Oh wait, they have? Yes…with zero net positives in the support of homeopathy. I think patient choice is highly important in medicine, especially more so when you are clued up on it. But this isn’t a question of choice, people are being given treatment that simply does not work at all. If people were informed correctly on what homeopathy actually is and its lack of evidence, they probably would not use it as a choice. Obviously, the placebo effect is a great and powerful thing. However, does this justify treatment in cancer for example? Placebo effects are objective, they are not actual benefits or cures, just because you feel better through delusion, does not mean that you actually are better, which can lead to further medical complications. 

Conclusion

How is it that this is still a thing? I didn’t think homeopathic hospitals existed in the UK anymore and was quite shocked to see how much money is plied into them. I mean, how much does water and lactose cost anyway? Let’s hope the MPs that are reviewing this in 2016 just put it straight onto the schedule 1 list where it belongs. Homeopathy should not be practiced or used by anyone, we live in a world that demands and uses evidence to prove assertion. Why on earth is this subject not been obliterated? Oh yeah, because people like Treddinick legitimately weigh in on scientific subjects  in our government. It makes perfect sense.