Homeopath threatens public health with fake flu clinic

Sugar pills won’t protect you from Influenza – or anything else.

As pseudoscience goes, homeopathy takes the cake for absurdity. It is an elaborate placebo system,  based on nonsensical ideas about biology, biochemistry and medicine. A decision to use homeopathy is a decision to do nothing at all, because homeopathic “remedies” have no medicinal ingredients in them at all. They are inert. Homeopathy is based on the idea that “like cures like” (which is simply a form of magical thinking) involving successive dilutions of products in water. The dilutions are believed to increase, not decrease, the potency of the final product. And these are serious dilutions. Think of putting one drop of a substance into a container of water. Only that container is 131 light-years in diameter. That’s the “30C” dilution used by homeopaths. Homeopaths believe that the water molecules retains a “memory” of the original substance (while conveniently forgetting all the other products it has come in contact with.) The final remedy is diluted so so completely that most “remedies” don’t contain a single molecule of the the original substance you started with.

A homeopathic nosode is a homepathic “remedy” made from infectious material. Unbelievably, Health Canada approves homeopathic “nosodes” for sale in Canada, despite a lack of any evidence they can do anything. Due to lobbying by groups like Bad Science Watch, Health Canada eventually agreed to force products to label nosodes with the caution “This product is not intended to be an alternative to vaccination”.   While this was better that the status quo, there was the fear that homeopaths and other alternative health providers (like naturopaths) would continue to promote homeopathy to prevent or treat communicable disease. And the skeptics were right. 

What does the new Tamiflu data really tell us?

Does Tamiflu have any meaningful effects on the prevention or treatment of influenza? Considering the drug’s been on the market for almost 15 years, and is widely used, you should expect this question has been answered after 15 flu seasons. Answering this question from a science-based perspective requires three steps: Consider prior probability, be systematic in the approach, and get all the data. It’s the third step that’s been (until now) impossible with Tamiflu: Some data was unpublished. In general, there’s good evidence to show that negative studies are less likely to be published than positive studies. Unless unpublished studies are included, systematic reviews are more likely to miss negative data, which means there’s the risk of bias in favor of an intervention.

The absence of a full data set on Tamiflu (oseltamivir) and the other neuraminidase inhibitor Relenza (zanamivir) became a rallying point for BMJ and the AllTrials campaign, which seeks to enhance the transparency and accessibility of clinical trials data by challenging trial investigators to make all evidence freely available. (Reforming and enhancing access to trial data was one of the most essential changes recommended by Ben Goldacre in his book, Bad Pharma.) In 2009, Tamiflu’s manufacturer, Hoffman-La Roche committed to making the Tamiflu data set available to investigators. Now after four years of back-and-forth between BMJ, investigators, and Roche, the full clinical trials data set has been made freely available. An updated systematic review was published today in BMJ (formerly The British Medical Journal), entitled “Oseltamivir for influenza in adults and children: systematic review of clinical study reports and summary of regulatory comments.” This will be a short post covering the highlights. As the entire study and accompanying data are freely available, I’ll await continued discussion in the comments.