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Lead: pre and post dilution effects

Currently the LEAD's first sentence containst this phrase:

"... that treats patients with heavily diluted preparations which are thought to cause effects similar to the symptoms presented."

That isn't accurate. The object of treatment is to cure or ameliorate symptoms, not exacerbate them by causing "effects similar to the symptoms presented".

We have previously had a more accurate version that went something like this:

"... that treats patients with heavily diluted preparations made from substances that, in their undiluted (or much less diluted) form, cause effects similar to the symptoms presented."

There is nothing "thought to cause" about it in this case, since the original substances used in provings are actually intended to cause the symptoms. Currently we are blending things. The original, undiluted, substances and the final remedies are not the same thing, and they have very different effects. The original substances actually cause symptoms, and the final products/remedies produced after dilution and succussion/potentization are thought to cause some type of cure. (Of course no reliable research has shown any such thing. ;-)

I suggest we reinstate the previous wording. We have a whole section on provings, and leaving out mention of provings in the lead is a serious lack. I know that the current provings section uses ONE source to back up an idea about the use of heavily diluted substances in provings, but I question this. If the proving and the remedy are the same, then how can one induce "effects similar to the symptoms presented"? We need more sources that deal with this so we can show that while there might be some homeopaths who use ultradilute substances in provings, others do not, and thus follow Hahnemann's original method. I don't recall the details of this discussion that got us into this situation, but how could one source totally reverse the previous content? -- Brangifer (talk) 23:15, 5 July 2009 (UTC)

I agree that the second version above is better, but should perhaps include the "thought", as often different "provings" prove that the same tincture "causes" opposites, such as constipation in one proving, but diarrhoea according to a different proving. Do we discuss this in the body? Rose Shapiro has a good section on this in her book "Suckers: How alternative medicine makes fools of us all". Verbal chat 18:17, 9 July 2009 (UTC)

We have a good source in the article supporting the statement that modern provings are carried out using the potentised remedies, not the undiluted substances. Brunton (talk) 21:28, 9 July 2009 (UTC)

Sourcing problem: critics' "concerns" could use more sourcing

We have previously had this content:

"Critics of homeopathy have cited other concerns over homeopathic medicine, most seriously cases of patients of homeopathy failing to receive proper treatment for diseases that could have been easily diagnosed and managed with conventional medicine and the..."

Recently it was changed here. While I think the addition was excellent, the deletion of the reference to Dr. Phil Plait's Discovery magazine column means that we are now missing proper documentation for our content ("Critics of homeopathy have cited other concerns over homeopathic medicine,..."), and unsourced content should be deleted. Since the obvious solution is to source it, we need to restore it and find even more sources so this doesn't happen again. We shouldn't allow the ongoing disputes on User talk:Avathaar to cause us to cave in to the specious arguments used there.

To fix this problem, we could do something which I will propose here. (We can still retain the added source.)

There are numerous skeptical sources that state in various ways that reliance on homeopathy can kill or cause injury when it is used in place of proper treatment, and we could list several of them. In the case of the current wording, we are connecting such a criticism with an actual example. To strengthen this section while avoiding OR and SYNTH, we need more sources from critics which make this argument in connection with more cited cases. Right now we have Phil Plait, a very notable skeptic, making this criticism in connection with the Baby Gloria case. There are no doubt other skeptical sources that make the same connection. We can also use them, although his criticism is enough. Other cases than the Baby Gloria case could also be used as examples, and we could find skeptical sources that use this criticism in connection with those cases. Right now we are using one case (documented with a couple news reports) and citing one critical source as documentation for the skeptical position. That's good enough for me, but to satisfy the demands of editors who are believers in homeopathy, we could strengthen the section. What think ye? -- Brangifer (talk) 00:03, 6 July 2009 (UTC)

Homeopathy and HIV

Here's another situation where critics express their concerns, this time about HIV:

• British scientists ask WHO to condemn homeopathy for diseases such as HIV. Clinics throughout Asia and sub-Saharan Africa offering ineffective remedies for serious illnesses, putting lives at risk, researchers say.

-- Brangifer (talk) 01:51, 6 July 2009 (UTC)

Homeopathy and malaria

And yet another about malaria:

• Malaria & homeopathy

• Alternative malaria treatment may not work. July 14th, 2006 British health authorities are urging tourists not to rely on alternative treatment such as homeopathy to fight malaria.

-- Brangifer (talk) 01:51, 6 July 2009 (UTC)

The Guardian and Physorg/UPI sources are good. I see your point about the Plait material but have mixed feelings. We should use unassailable sources, and if the scientific perspective uses blogs (or blog-like) material then one can hardly object if the homeopaths want to use blogs too. Slippery slope and all that. There's also the BBC Newsnight story on malaria, which we already have cited.
You might also look at the Citizendium article for sources (both the disturbing "approved" version and the somewhat better Draft version). Don't dismiss the CZ article out of hand as there is some useful information there. Just be careful to separate the wheat from the chaff. There might even be some credible pro-homeopathy material in there -- remember, we're supposed to be writing a neutral article. Short Brigade Harvester Boris (talk) 02:23, 6 July 2009 (UTC)

Alternatives to the PhysOrg source are [1] [2] the BBC pieces that it was based on and [3], [4] related coverage. We shouldn't rely on PhysOrg, which does not provide reliable fact checking.LeadSongDog come howl 03:24, 6 July 2009 (UTC)

I agree. The other sources are better. Here they are in another format:

Regarding malaria:

• Malaria advice 'risks lives', BBC Two, 13 July 2006

• Homeopathic practices 'risk lives', BBC News, 13 July 2006

• Alarm over alternative malaria remedies The Independent, 14 July 2006

• Homeopaths 'endangering lives' by offering malaria remedies, The Guardian, 14 July 2006

-- Brangifer (talk) 04:08, 6 July 2009 (UTC)

(ec) SBHB, don't dismiss blogs out of hand. RS expressly allows blogs in some situations, especially when they are the official internet version of a magazine or newspaper column. That's the case for Plait's column. RS policy doesn't completely forbid blogs, and we're going to have to use more and more blogs as RS as they are being used more and more as official websites for organizations, companies, and even politicians. Of course the replies to blogs aren't RS. Here's what WP:RS says:

• "Note that otherwise reliable news sources--for example, the website of a major news organization--that happens to publish in a "blog" style format for some or all of its content may be considered to be equally reliable as if it were published in a more "traditional" 20th-century format of a classic news story. However, the distinction between "opinion pieces" and news should be considered carefully."

and found here:

• "In the case of articles which chronicle a developing current event it is not a violation of Wikipedia policy to temporarily include links to blogs which contain contemporary opinion and observations about the event. A diverse mix is recommended, but the extent and selection of specific blogs is a matter of content to be determined by the editors of the article."

and of course:

• Wikipedia:Blogs as sources

As far as CZ goes, I don't dismiss it, but I am cautious considering the small editorial staff and articles basically written by one author from a proponent's POV (non-NPOV). It's still a good place to look for ideas and sourcing we might be missing.

We're supposed to write NPOV articles, which means they are filled with reliably sourced non-neutral content. The only one being neutral in this situation is Wikipedia itself. It doesn't take a position on the issue, and the article shouldn't make it appear that it does. -- Brangifer (talk) 03:37, 6 July 2009 (UTC)

Suppression

Interesting statement in the comments on this recently added possible ref [for Baby Gloria case]: "Thomas did not apply creams normally applied to children suffering from eczema because it is generally known that the disease is driven inward." I've seen this idea of orthodox treatments "driving disease inwards" or "suppressing" disease, and thus making the patient's condition worse, used as an argument against using orthodox medicine. If a good RS can be found for "suppression" being cited by mainstream homoeopaths or by homoeopathic organisations perhaps this should be included in the "ethical and safety issues" section. Brunton (talk) 01:46, 6 July 2009 (UTC)

Yes, that could be used. It is an idea I have heard before, and not just from homeopaths. Many naturopaths and those who think like them (mixer chiropractors) believe this idea. It's a very, very old vitalistic-type idea. -- Brangifer (talk) 04:19, 6 July 2009 (UTC)

OK, I've found several possible references. Here's a selection:

• http://books.google.co.uk/books?id=Qa21jitZy7AC&pg=PA4&dq=homeopathy+suppression&lr

• http://books.google.co.uk/books?id=E1fVzLCmk5gC&pg=PA16&dq=suppression+homeopathy&lr

• http://books.google.co.uk/books?id=J7oestO-BnAC&pg=PA98&dq=suppression+homeopathy&lr

• http://books.google.co.uk/books?id=UZ72uQy385wC&pg=PA147&dq=allopathic+suppression

• http://books.google.co.uk/books?id=BNR1KGJXX9cC&pg=PA198&dq=homeopathy+suppression&lr

Note in particular that the first one states that the normal mode of action of "many conventional drugs" is "inhibiting or actually suppressing the disease, which ultimately pushes the disease deeper into the person, creating more serious and often chronic diseases that manifest themselves later". The second one states "homeopaths have observed that minor skin ailments suppressed with drugs give rise to asthma", which can, if "treated suppressively" then lead to "colitis, arthritis, heart disease etc." Brunton (talk) 12:25, 6 July 2009 (UTC)

http://www.minimum.com/reviews/science-homeopathy.htm is a good source: "Vithoulkas believes-rightly-that it is important for the practitioner of homoeopathy to have a sound grasp of pathology. This being so, it is a pity that his book should contain some rather startling medical statements.... Much more serious, especially in a book that may be read by many laymen, is the author's belief that when primary syphilis is treated by high doses of penicillin over a period of two weeks (p. 135-my italics) the patient will go on to develop secondary and tertiary syphilis with involve- ment of the central nervous system. This thoroughly irresponsible statement is no mere proof-reading error; it appears in the course of an argument designed to show that "allopathic drugging" is harmful and must be avoided. The unfortunate layman might well be misled by Vithoulkas' rhetoric into refusing orthodox treatment for his syphilis; can this really be what Vithoulkas intends?"

http://www.minimum.com/reviews/answer-science.htm - Vithoulkas replied, defending his claims of "suppression". George Vithoulkas is one of the leading homeopaths, that he advocates this nonsense is strong evidence that this quackery is widespread in the homeopathic community. Shoemaker's Holiday (talk) 22:06, 9 July 2009 (UTC)

The concept of suppression is important and even integral to homeopathy and homeopathic thinking. The homeopaths' critique of much of what is called "proven scientific treatment" is that the specific treatment has been proven to suppress the disease process into the body, i.e. painkillers, fever suppressing drugs, steroidal drugs, just to name a few, providing short-term relief but creating more serious chronic disease syndromes. DanaUllman^Talk 03:51, 21 July 2009 (UTC)

The concept of suppression should be covered in the article. As far as your statement that "...the specific [proven scientific] treatment has been proven to suppress the disease process into the body...", "proven" is not evident. That's a homeopathic POV and claim, but if it's been "proven", then let's follow the guidelines at WP:MEDRS and see that evidence. You're welcome to your homeopathic POV, but let's be careful about making such claims here. Brangifer (talk) 05:10, 21 July 2009 (UTC)

We seem to have some sort of consensus here, so I'm adding it to the "ethical and safety issues" section. Brunton (talk) 08:38, 21 July 2009 (UTC)

Updating Info on Replication of studies

The reference to non-replication of homeopathic studies is from 1995 and is therefore a tad dated. There have been four large studies showing efficacy in the treatment of influenza by Oscillococcinum

It seems time to change what is written here about the non-replication of studies because that is no longer true. DanaUllman^Talk 17:45, 25 July 2009 (UTC)

A quick googling finds Clinical Research in Complementary Therapies, pp. 234-237 which seems to say that studies are not conclusive at all and that the better studies show worse results for homeopathy.

Also, that 2006 Vickers paper says in its conclusion:

Though promising, the data were not strong enough to make a general recommendation to use Oscillococcinum for first-line treatment of influenza and influenza-like syndromes. Further research is warranted but the required sample sizes are large. Current evidence does not support a preventative effect of Oscillococcinum-like homeopathic medicines in influenza and influenza-like syndromes.[5]

Notice that Talk:Oscillococcinum is packed full with discussions about this matter, and includes sources like Ernst 2002 " It is concluded that the best clinical evidence for homeopathy available to date does not warrant positive recommendations for its use in clinical practice."[6] and Guo 2007 "Current evidence from randomized controlled trials [of homeopathy in seasonal influenza] is sparse and limited by small sample sizes, low methodological quality, or clinically irrelevant effect sizes. (...) These results strengthen conventional approaches for seasonal influenza."[7]. (Anyways, Guo is "only" another study although Erns is a co-author, the latest review of all homeopathy I think that it was Ernst 2002, while Vickers 2007 was "only" for Oscillococcinum in influenza)

The sources would probably allow to say that "several attempts of replication have not been able to establish (with enough confidence?) its efficacy beyond placebo, and more research is needed before recommending its clinical use." --Enric Naval (talk) 18:56, 25 July 2009 (UTC)

I fully support Enric's summary. Oscillococcinum (which is based on a thing which doesn't exist) is not effective; that's the conclusion from the evidence. It seems Dana was also already aware of all the points Enric raises, as he has been active on boards discussing these off-wiki. Verbal chat 21:50, 25 July 2009 (UTC)

There have been four (!) large (over 300 patients each) studies showing greater efficacy of Oscillococcinum than placebo in the treatment in influenza. This constitutes “evidence,” and it constitutes replication. Enric’s logic is akin to saying that a person can fly but because he doesn’t fly as fast as a jet, there is no evidence that he can fly. The bottomline here is that the Cochrane Report acknowledges that there is repeated evidence that Oscillococcinum provides greater relief than a placebo in the treatment of the flu. They describe these results as “promising,” and even though they do not recommend Oscillococcinum as a “first line” of treatment for the flu, wikipedia does not simply include references to “first line” treatments.

I also want to call your attention to a report on Oscillococcinum research published in the Lancet on April 22, 1989 (page 914), under the title “Quadruple-blind.” This report notes that, “A 7% difference in efficacy as defined would be a respectable proportion in most drug trials.” Can we assume that the Lancet is notable and a reliable source? This reference is important, and if Enric or Verbal still think that the "little" effect from Oscillococcinum is inadequate, that reference and discussion should be along side the reference from the Lancet that suggests that it is more than adequate.

How or why Enric would quote Gao (or anyone else) who suggests that the Oscillococcinum studies are small or not high quality is a bit unclear. I ask Enric to state for the record what is the minimum number in which all wiki articles should reference research? While you’re considering this question, please remember that even Shang included an Oscillococcinum study in his review.

If wikipedia were only to reference research that is fully proven, we would have to delete great amounts of material here. The bottomline is that the Cochrane Report and Pedriatrics Infectious Disease Journal are high-impact sources.

As for Enric’s reference to “Clinical Research in Complementary Therapies,” he has provided an additional reference for us adding some more references to research that has been replicated, including M. Wiesenauer, R. Ludtke, "A Meta-analysis of the Homeopathic Treatment of Pollinosis with Galphimia glauca," Forsch Komplementarmed., 3(1996):230-234.

Finally, Enric has suggested that the above reference concludes, “studies are not conclusive at all and that the better studies show worse results for homeopathy.” This statement is not a review or a critique of the above studies. DanaUllman^Talk 22:01, 25 July 2009 (UTC)

I find this kind of advocacy disturbing, especially so soon after a block. It flies against the evidence and shows a troubling attitude. What lessons has Dana learned? Few it seems. I hope the evidence page is undeleted so it can properly be reviewed. If what Dana said was true this would be big news, very big. Yet it isn't. Taken in totality, there is no good evidence that Oscillococcinum or any homeopathic treatment is more effective than placebo. Verbal chat 22:09, 25 July 2009 (UTC)

Verbal: This is not advocacy. He is explaining why he thinks the article is not accurate and not neutral. Almost all the studies about Oscillococcinum state that it is better than placebo. Keep in mind that the title summary of the The Cochrane review is "Homoeopathic Oscillococcinum does not prevent influenza but might shorten the length of the illness". They chose to summarize their review with these words. It could be added that "Though promising, the data were not strong enough to make a general recommendation to use Oscillococcinum for first-line treatment of influenza and influenza-like syndromes" because larger studies are needed.--JeanandJane (talk) 22:45, 25 July 2009 (UTC)

It clearly is advocacy, and I'm now worried about canvassing. "Might" does not translate into "Though promising". This was excluded, correctly, at the Oscillococcinum page - in a discussion you were involved with. Oscillococcinum is not recommended for any medical condition. Verbal chat 09:38, 26 July 2009 (UTC)

Is the new definition of "advocacy" those people who reference randomized double-blind placebo controlled trials published in high-impact journals? Yeah...I too am glad that there is a record of what I wrote AND of what type of strong POV responses it engenders. DanaUllman^Talk 23:58, 25 July 2009 (UTC)

Reviews (secondary sources) are better than trials (primary sources), and you know what the reviews say. --Enric Naval (talk) 00:26, 26 July 2009 (UTC)

Enric...you are confusing reviews of the entire field of homeopathy with reviews on homeopathic treatments of specific diseases. Please response to THESE specific reviews.DanaUllman^Talk 00:38, 26 July 2009 (UTC)

Which specific reviews? You started off by talking about "four large studies" of oscillococcinum for flu, but haven't cited anything supporting that apart from the Cochrane review, which while it described some results as "promising" says that the data were not strong enough to make a general recommendation. That's hardly a resoundingly positive result. Incidentally, it appears that the Cochrane review in question has been withdrawn from publication because "the authors are currently unable to update it". Looking at its history in that document it appears that no new studies were included since the review's original publication in 2000. There doesn't seem to be any new information here as far as oscillococcinum is concerned.

You say that there have been four (you even give it an exclamation mark the second time) "large studies showing efficacy in the treatment of influenza by Oscillococcinum". However, the citations you give for this are to the Cochrane review (which concluded on the basis of trials reported between 11 and 25 years ago that "confirmatory trials of Oscillococcinum as a treatment are warranted" - hardly an indication that sufficient replication has been achieved), and for some bizarre reason one of the Jacobs et al diarrhea papers. Have the "confirmatory trials" that the Cochrane review suggested been carried out in the three years since the review was last updated? Do you have references for these "four (!)" large studies? Brunton (talk) 10:09, 26 July 2009 (UTC)

Brunton : The best available review states that a therapeutic effect has been recorded. The summary title of the writers speaks for itself. "Homoeopathic Oscillococcinum does not prevent influenza but might shorten the length of the illness" . It is misleading not to report this information with the note "confirmatory trials of Oscillococcinum as a treatment are warranted" - anything else is inaccurate and shows a very strong point of view. --JeanandJane (talk) 14:01, 26 July 2009 (UTC)

Did you notice the word "might" in that title? The results are inconclusive. Brunton (talk) 15:09, 26 July 2009 (UTC)

If the results were inconclusive they would have reported it. We can use the same words they used without any changes. This is the most fair solution. --JeanandJane (talk) 15:33, 26 July 2009 (UTC)

You can access the latest Cochrane Report here: http://www.cochrane.org/news/articles/CD001957_standard.pdf

Once again, studies confirming as treatment as "first line" are not the only studies mentioned on wikipedia. If THIS is what you are asserting should be new wiki policy, please say so. While there is no evidence that Oscillo is effective in the prevention of influenza, there is evidence that it reduces the length of the disease itself. Further, my reference to the Lancet news and notes about one Oscillo study provides additional reliable source material. Please comment on this before denying inclusion for reference to these investigations. Are you, Brunton, suggesting that wiki now delete studies that are over 11 years old? Please clarify.

Please also clarify your concerns about the Jacobs papers (it seems that your comment on them was unfinished).

To clarify, I misspoke above when I said that all four trials have 300 patients. Actually, in total, the four treatment trials included 1,194 patients. DanaUllman^Talk 14:12, 26 July 2009 (UTC)

Actually, the latest version of that Cochrane review, from The Cochrane Library 2009 Issue 3 (rather than the 2009 issue 2 version you linked to) can be found here: http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD001957/pdf_fs.html It says: "The editorial group responsible for this previously published document have withdrawn it from publication", as I commented above.

I have not suggested that we should delete studies that are over 11 years old, as should be obvious from what I actually wrote. I'm pointing out that the Cochrane review you mentioned (itself originally published 9 years ago) was based on studies this old and older, and concluded that confirmatory studies were warranted. If confirmatory studies are warranted then there has evidently not been sufficient replication of results. Have any such studies been carried out in the 9 years since the review was originally published? I was also pointing out the age of the studies in the review you referenced as it seems relevant to your complaint that an only slightly older reference used in the article is "a tad dated".

I take it that The "four (!)" positive studies are the ones on which the Cochrane review based its not very conclusive conclusions, so nothing new here.

Finally, the point I was making about Jacobs was simply that you appeared to be using it to support your claim about the "four large studies" of Oscillococcinum for flu, and that it therefore doesn't appear relevant to the statement you were using it to support. Brunton (talk) 15:39, 26 July 2009 (UTC)

The Oscillo and Jacobs studies are different, and I had no intention of using one to support the other. My point is that there ARE studies in homeopathy that verify its efficacy: Oscillococcinum, the Jacobs studies, and the Ludtke allergy studies. It is inconsequential whether any of these treatments are "first line" or not. It would seem that our article at present is simply inaccurate, and we should make it accurate. Let's now discuss what is a way to make it more accurate. DanaUllman^Talk 16:21, 26 July 2009 (UTC)

The studies you cite do not verify homeopathy's efficacy. They show results that their authors believe warrant further study. It would be a big help to the article if we removed the homeopathic apologist fluff, ill logic and outright delusion. — NRen2k5^(TALK), 18:27, 26 July 2009 (UTC)

Welcome to this year's edition of wasting time with DanaUllman (talk · contribs). This article is going to cover its topic, not advocate for its adherents. Full stop. - 2/0 (cont.) 05:02, 27 July 2009 (UTC)

Actually, the studies cited above show a statistically significant difference between the treatment and placebo (with a p-value of <0.05) and have all had replications studies that has done likewise. I cannot but notice that noone here has yet to response to the Lancet news and notes about earlier Oscillo research. Let's avoid stonewalling, and I hope that NRen2k5 will be more specific in his criticisms of the studies...and remember that a treatment does NOT have to be "first line" treatment for inclusion in this article. This is not "advocacy" (other than advocating for accuracy). Referencing meta-analyses is not advocacy, especially when these meta-analyses have been published in high-impact journals. At present, the article's information about the non-replication of homeopathic research has been shown above to be inaccurate. Let's move to solution rather than stonewalling. I'm unclear if 2Over0 is suggesting that we stop referencing meta-analyses and replication studies (I hope not) DanaUllman^Talk 05:06, 27 July 2009 (UTC)

Do you have any further information about the Lancet paper you have cited? The Item at page 914 published on 22nd April 1989 (Vol. 333) is titled "Notes and News". I don't have access to the text of this. Do you have an author's name for the article titled "Quadruple Blind" to help track it down? Brunton (talk) 07:59, 27 July 2009 (UTC)

I've found a reference to it elsewhere - it seems to have been discussing Ferley 1989, one of the trials considered in the Cochrane review, so it doesn't appear to add anything to that. Brunton (talk) 08:04, 27 July 2009 (UTC)

Excuse me, Dana, would you mind clarifying exactly what you are contending? You write of "four (!) large ... studies showing greater efficacy of Oscillococcinum than placebo in the treatment in influenza", and later "the studies cited above show a statistically significant difference between the treatment and placebo (with a p-value of <0.05) and have all had replications studies that has done likewise". Which four studies are you referring to? Which study do you consider to be a replication of which other study? I am assuming the statistical significance refers to the primary outcome measure, that the replication studies follow essentially the same protocol as the first study but are done by an independent research group, that no other studies using the same protocol but obtaining a contradictory result have been published, and that all studies are of high quality (randomized, placebo controlled, double blind, etc.). If you are talking about something, else, please let me know. --Art Carlson (talk) 13:37, 27 July 2009 (UTC)

Thanx Art for your questions. The 4 studies to which I refer are a part of the Cochrane Report above, including a total of 1,194 patients. As the Lancet article, it IS important because some people have asserted that the benefit that the Ferley trial showed was too small to be clinically relevant, but the Lancet article asserts otherwise. The Lancet news and notes provides additional evidence for this study being a high quality trial and noteworthy (or they would not have mentioned it). The "News and Notes" section of the Lancet does not list authors. DanaUllman^Talk 14:01, 27 July 2009 (UTC)

The article doesn't seem to be making that assertion (or any other assertion) about the Ferley trial, so this isn't really relevant here. If we are going to consider the Ferley trial the peer-reviewed Cochrane review would be a better source than a "News and Notes" column from the Lancet. Brunton (talk) 14:33, 27 July 2009 (UTC)

Is it really the job of wikipedia to micromanage every possible study that is published on homeopathy? By chance alone, even if every study is done perfectly, and there is no publication bias at all, five percent of all published papers on homeopathy will show a significant effect. When you factor in the low quality nature of many of the studies, and the overwhelming publication bias in the "British Homoeopathic Journal" there is no surprise that you can find a few studies here and there that show a significant result. Do we really have to have a sentence for each one of these? Followed by the criticism of the study, the meta reviews, the criticisms of the reviews, ad infinity? Tmtoulouse (talk) 23:26, 27 July 2009 (UTC)

The wiki community thought that it was important to bring up the issue of replicability in this article, and I have simply provided references to RS and high-impact meta-analyses on the homeopathic treatment of specific ailments. Let's be constructive and make this article more accurate. When Tmtoulouse asserts that these studies are "low quality," he should be more specific while acknowledging which ones are high quality (according to RS sources). Is TMtoulouse questioning the Lancet's news and notes comment? Is the Jacobs study in Pediatric the bad one? DanaUllman^Talk 06:54, 28 July 2009 (UTC)

Back to the proposed wording

I proposed a wording some comments above: "several attempts of replication have not been able to establish (with enough confidence?) its efficacy beyond placebo, and more research is needed before recommending its clinical use." and I don't think that Dana has proposed any source that invalidates it, so I'll implement it in a couple of days. --Enric Naval (talk) 08:54, 27 July 2009 (UTC)

A better wording: "several attempts at replication have not been able to establish any efficacy beyond placebo, and it is not recommended for clinical use." (note attempts at replication)--86.146.119.24 (talk) 09:38, 27 July 2009 (UTC)

That wording is much harsher than what the sources actually say (Ernst, Vickers and Guo, linked at the start of the section above). Maybe "several attempts at replication had several flaws that don't allow them to establish convincingly efficacy beyond placebo, and current research does not warrant recommending its clinical use." --Enric Naval (talk) 11:39, 27 July 2009 (UTC)

How about: According to The Cochrane review "Homoeopathic Oscillococcinum does not prevent influenza but might shorten the length of the illness". The writers also noted that "Though promising, the data were not strong enough to make a general recommendation to use Oscillococcinum for first-line treatment of influenza and influenza-like syndromes. Further research is warranted but the required sample sizes are large."--JeanandJane (talk) 11:57, 27 July 2009 (UTC)

You mean Vickers 2006[8]? No, that's way too much weight to one positive review of the effects in one illness, specially in the lead, and specially one that is not conclusive, and that doesn't even recommend to use the remedy. See also all the other negative reviews in Homeopathy#Research_on_medical_effectiveness. --Enric Naval (talk) 12:24, 27 July 2009 (UTC)

No I mean The Cochrane review as I wrote. This is the best available review. This is what they reported - do you think that the conclusions of writers of the Cochrane review show any point of view ?--JeanandJane (talk) 13:16, 27 July 2009 (UTC)

The best available review would be Ernst 2002, which covers the whole field. And Vickers 2006 covers only a part of the field, and there are other reviews in the Cochrane database that found insufficient or no evidence, and it's not conclusive, and it gives a recommendation similar to Ernst: that it's not recommended for clinical use, so I don't see any contradiction. Ernst 2002 is the latest meta-review of the field, and it seems that it's still valid, and nobody has provided a secondary source saying that it's no longer valid or that the situation has changed. Anyways, it should be one more review under Homeopathy#Research_on_medical_effectiveness, and I have added it there since I couldn't find it anywhere in the article. --Enric Naval (talk) 15:05, 27 July 2009 (UTC)

Cochrane review = Vickers 2006 = doi 10.1002/14651858.CD001957.pub3 . We are just using different names. I left a note in your talk page. --Enric Naval (talk) 15:05, 27 July 2009 (UTC)

And we forgot meta-review Shang 2005 in The Lancet[9] accompanied by an anonymous editorial called "The end of homeopathy", reported by Time magazine[10] among others. --Enric Naval (talk) 16:00, 27 July 2009 (UTC)

(←) This is to replace the second sentence of the third paragraph of the lead, yes? The difficulties with replication are non-specifically subsumed by the next sentence, which just cites "problems" with the research base. We could nix that sentence entirely to no ill effect, reserving for the body the actual discussion of said problems. Objective efficacy is a fairly major point, though, so what if we were to rework the clinical studies paragraph to state - collective weight unsupportive; some promise, but methodologically problematic; best research fails to reject the null. To whit:

Claims of homeopathy's efficacy beyond the placebo effect are not supported by the collective weight of scientific and clinical evidence. Supporters claim that studies published in reputable journals support the efficacy of homeopathy; however, unambiguous conclusions are complicated by small sample size, lack of appropriate blinding, small effect size, and difficulties with replication. Several high-quality studies exist showing no evidence for any effect from homeopathy.

References and wikilinks to be inserted, of course. Studies in the last sentence might should also mention SRs and meta-analyses. - 2/0 (cont.) 15:00, 27 July 2009 (UTC)

I wish to assume good faith, but I am confused why Enric has written what he has written above. Enric's proposal is not based on the above cited evidence. Before I make my proposed changes, I will be curious what other people propose. DanaUllman^Talk 14:06, 27 July 2009 (UTC)

From what you wrote on 25 July, it is your contention that the article's statement that studies have not been replicated is no longer true. What source do you propose using for your "proposed changes"? The Cochrane review you have cited clearly indicates that replication is still required: "confirmatory trials of Oscillococcinum as a treatment are warranted", and the Jacobs study (as far as I remember - I don't have a copy to hand) references a series of studies by the same team. Brunton (talk) 15:11, 27 July 2009 (UTC)

OK. I'm homing in on it. The review is available here. The studies you refer to are Casanova 1984, Casanova 1992, Ferley 1989, and Papp 1998. I would first like to make these observations:

• The most recent of these studies is 11 years old, so this is not evidence that has recently become available, although of course it may not have been properly considered by the editors writing this article.
• It is not the case that there have been four studies, each of which has been replicated. While no two of these studies used identical protocols, my impression is that the two Casanova studies were rather similar, and the Ferley and Papp studies were rather similar, so I am guessing that you (Dana) are contending that Casanova 1984 was replicated by Casanova 1992, and Ferley 1989 was replicated by Papp 1998. Is this correct?
• The Casanova studies are done by the same group, so if they should be called replicated at all, they at least do not constitute replication be an independent group.
• Vickers and Smith point out numerous specific methodological and reporting problems with the Casanova studies. In addition, Casanova 1984 was "reported in a general medical magazine rather than in a scientific journal" and Casanova 1992 was not published at all.
• The Ferley and Papp studies were the only ones for which there was "sufficient information to complete data extraction fully".
• I could not find in the review the statistical significance reported by the individual studies, but Vickers and Smith observe that "the difference between groups in the meta-analysis only just reaches statistical significance. It can be checked, but it seems likely that the individual studies did not reach statistical significance.
• Vickers and Smith calculate the sample size needed to detect "moderate but worthwhile benefits" such as those suggested by the Ferley and Papp studies. The results vary from 2000 to 4000 to even 50,000, depending on the assumptions used. These numbers are to be compared to the total of 1194 participants in the four treatment trials, or the 487 participants in Ferley 1989 and the 372 in Papp 1998. In this sense, these studies may have been "large" compared to previous studies, but were apparently not "large enough".

On the basis of these facts, I conclude that the Casanova studies are not rigorous enough to be considered proof of any effect as controversial as homeopathy. Rather than Dana's statement that "the [four] studies cited above show a statistically significant difference between the treatment and placebo (with a p-value of <0.05) and have all had replications studies that has done likewise", I think a more accurate statement would be that Ferley's results suggested a positive effect, although they did not attain statistical significance, and that Papp's study "replicated" this, including the failure to attain rigorous statistical significance. I see no call or justification to change the article on account of these studies. Did I miss something, Dana? --Art Carlson (talk) 16:27, 27 July 2009 (UTC)

Art, thanx for your due diligence. The Ferley study showed a p-value = 0.03, while the Papp study showed 0.023. By definition, the Papp study was a replication trial of the Ferley trial(and by an independent group), and they both used the exact same primary measure. Once again, just because the Cochrane Report suggests that more research is warranted does not take away the fact that a replication trial was conducted and was found to be positive. Further, although the Cochrane Report considered the results to be minor, the Lancet reported otherwise. It would most beneficial to report both assertions and to give both references. It seems that these facts will test those people here who have strong POV against homeopathy and who are really trying to create a NPOV article on the subject.

The above two trials on Oscillo show replication by independent parties. Two of Jacobs' trials were replication trials of her first study, and although they were all designed by Jacobs, each of her three trials used different homeopaths as prescribers (these trials required individualized treatment). At present, the words of the article use the term replication and do not say or imply that replication by entirely different teams of researchers. As such, the Jacobs trials (and the Ludtke trials on allergy) should be referenced as trials that have undergone successful replication. We can provide a secondary reference to the book on complementary medicine research that Enric referenced above. DanaUllman^Talk 20:30, 27 July 2009 (UTC)

It makes sense to me. Sounds reasonable. --JeanandJane (talk) 21:22, 27 July 2009 (UTC)

Was the Lancet report peer-reviewed? And yes, replication is generally taken to mean by an independent team. Brunton (talk) 22:07, 27 July 2009 (UTC)

I do not know with certainty whether the "News and Notes" section is peer-reviewed, but it is certainly significant enough that this news report was published. It would seem that we all assume that the Lancet is a RS. If one person wants to give me their fax #, I am open to faxing a copy of this article to somebody.

As for "replication," let's see what wikipedia has to say on the subject: http://en.wikipedia.org/wiki/Replication_(statistics). As you might notice, replication by an independent team is not a necessary component of "replication." DanaUllman^Talk 22:54, 27 July 2009 (UTC)

If there's been a published review, we should (if we're going to include the relevant information) be referring to the conclusions of that rather than cherry-picking particular studies considered in it. Brunton (talk) 08:11, 28 July 2009 (UTC)

From the Cochrane Report, “Oscillococcinum appears to have a moderate effect in the treatment of influenza and influenza-like syndrome." Because the article at present makes specific mention that no homeopathic research has been replicated, the Cochrane Report disproves this assertion. DanaUllman^Talk 14:17, 29 July 2009 (UTC)

DanaUllmanTalk 14:17, 29 July 2009 (UTC)

Rather than taking a single sentence from the discussion section, we should be looking at the conclusions of the review. What did the Cochrane review conclude, Dana? Brunton (talk) 15:11, 29 July 2009 (UTC)

I think the quote from the Cochrane Report is relevant and should not be disregarded in favor of conclusions, but such conclusions should also be considered for inclusion. So we could say, something to the effect, "The Cochrane Report found that Oscillococcinum appeared to have moderate effect in treating influenza, however concluding ..." —Whig (talk) 15:41, 29 July 2009 (UTC)

Cherry-picking is something that you just don't do if you're trying to be neutral and academically honest. Friday (talk) 15:49, 29 July 2009 (UTC)

How is that cherry picking? —Whig (talk) 21:49, 29 July 2009 (UTC)

Using a single sentence from the discussion section, rather than the conclusions of the review (which also include the strength of the evidence and its implications for the conclusions) is cherry-picking. Brunton (talk) 07:16, 30 July 2009 (UTC)

There was no suggestion to remove the conclusions. I'm not sure that we are limited only to discussing the conclusions, however. —Whig (talk) 19:08, 30 July 2009 (UTC)

We don't normally include withdrawn papers; the Cochrane report on Oscillococcum has been fully withdrawn [11]. Hence, it should not appear in this article. Shoemaker's Holiday (183) 19:16, 30 July 2009 (UTC)

It's probably best to ignore Dana Ullman

Dana Ullman is spouting this same nonsense all over the internet. He appears to have an unlimited capacity for it. I don't think it's very useful for editors to engage him in discussion on this. We could easily waste endless time here, as happened last year before the arbitration case in which Ullman was banned for a year. Yes, I realize this sounds a lot like poisoning the well, but I would submit that the well has poisoned itself, and all I'm trying to do here is hang up a sign saying "Danger- poison well." Friday (talk) 20:58, 27 July 2009 (UTC)

Houston (and fellow wiki editors), we obviously have a problem here. Does someone want to alert user:Friday that references to reviews of randomized double-blind and placebo controlled trials in high impact journals are NOT nonsense? I hope the above questionable remark will be a warning to editors who want to diss RS on research just because the studies have had a positive outcome for homeopathic treatment over placebo. I will be curious to see what others say here. Let's see if we can make a good effort toward NPOV. DanaUllman^Talk 22:38, 27 July 2009 (UTC)

I fully support Friday's recommendations. You often misrepresent sources and interpret the most cautious statements as ringing endorsement of homeopathy. I'm glad to allow positive findings but I've learned that everything you write must be double-, triple-,or quadruple-checked to ensure its veracity. It is a drain on everyone's time to do this and just isn't worth the very occasional nugget of useful content. Here's a thought: instead of haranguing others, build up your own credibility by properly representing what sources actually say and resist the urge to add hype. Short Brigade Harvester Boris (talk) 22:49, 27 July 2009 (UTC)

I think Dana is quite reasonable and everybody should focus on the article. Lets avoid unhelpful comments.--JeanandJane (talk) 02:24, 28 July 2009 (UTC)

Agree in ignoring Dana. These discussions are useful but they quickly slip into uselessness as the same points are being brought up again after being discounted. Then they become a problem when the same points are raised again a few weeks later. --Enric Naval (talk) 12:49, 28 July 2009 (UTC)

Alright. I didn't mean to feed the trolls, but since Dana seemed to be talking about several large studies on a specific illness that were all replicated, I thought I might have missed something. Looking closer, it turned out he was talking about one study and one replication, both with nominally significant but marginal statistics, and both long known. Of course the article should rely on reviews, but it is worth looking into specific studies on the talk page now and then to make the reporting of those reviews more solid. I have always said I would like to see a separate article that goes into details on the major studies, but no one has taken me up on it, and it is too much work to do myself. So long, and good luck. --Art Carlson (talk) 07:37, 28 July 2009 (UTC)

Incidentally, Dana seems to have a particular COI with regard to his suggestion that the "four (!)" oscillococcinum studies should be included in the article, and that they have replicated each other. An article of his has recently been appearing around the web, making pretty much the claim that he now is suggesting including in the article. Brunton (talk) 09:30, 28 July 2009 (UTC)

Why dont you try to respond to what he says? I dont get this COI thing. If you publish an article about the x subject in another forum or website you should not edit wikipedia or participate in the discussion in the talk page? --JeanandJane (talk) 13:17, 28 July 2009 (UTC)

Dana has written and published an article giving a viewpoint on the Oscillococcinum research that is, as has been shown above, somewhat contentious. If the Wikipedia article is edited so it agrees with his article, it will give him greater credibility (and he makes his living as an authority on homoeopathy). He therefore has a COI.

Incidentally, I have already responded to what he has said about the Oscillococcinum research and the alleged replication of research, as have others. The fact that Dana and his supporters appear to be ignoring what has been written (in particular with regard to the conclusions of the Cochrane review, and the desirability to use the conclusions of reviews rather than cherry-picking individual papers considered by those reviews) hardly strengthens his position. Brunton (talk) 13:37, 28 July 2009 (UTC)

Brunton, why does it matter what I've written off-wikipedia, and have I ever mentioned any such writings here or linked to them? DanaUllman^Talk 14:25, 28 July 2009 (UTC)

If you don't understand that there is a potential COI involved in editing Wikipedia articles so that they agree with your own publications, I don't think I can put it any more simply than that. Brunton (talk) 14:34, 28 July 2009 (UTC)

"...have I ever mentioned any such writings here or linked to them?" Not that it's relevant to the point I'm making (which is about Wikipedia being edited to support your off-Wikipedia writings, not your off-Wikipedia writings being cited here), but how about your very first edit after your suspension? Brunton (talk) 14:47, 28 July 2009 (UTC)

I can tell you why I think it matters. Your writings have gotten you the reputation of someone who frequently misinterprets the material you cite. Whether this is due to an intent to mislead or merely a failure to understand is not something we should try to to debate here. It's enough to look at the end result. One can google around and find various websites, often blogs, where you and your critics have gone back and forth. These are not usable as sources, but they do paint a disturbing picture: You appear to have been making these same claims about these same sources elsewhere in recent months. Your statements about the sources have been debunked, elsewhere. Now you show up here and start saying the same things. I cannot figure out any way to consider your actions an earnest and competent attempt to improve Wikipedia. I have no confidence that you are capable of being neutral when it comes to this subject. Your actions here on Wikipedia, and your writings elsewhere, all help demonstrate this. Friday (talk) 14:39, 28 July 2009 (UTC)

Brunton, I fully acknowledged and was transparent about the link to my site, and I also noted that this link was for informational purposed only and should be considered RS. Further, several people defended this action because I provided a link to Professor M. Ennis' email to me in direct reference to the tv experiment in which she and I were involved. This situation was therefore unique, and in any case, please know that I am fully aware of the problems in referencing one's own site and have no plans to do it.

Friday, I urge you to evaluate my writings on wikipedia, not elsewhere. I also urge you to try to maintain a NPOV towards homeopathy and me. DanaUllman^Talk 22:28, 29 July 2009 (UTC)

Dana, do you mean when you referenced your website under the heading "Rephrase please" above? I don't notice anybody defending it. I acknowledge that you were open about it being your own site, and stated that you were not proposing it as a RS. I was just pointing it out in response to your implied claim (implicit in the words "have I ever mentioned any such writings here or linked to them") that you had not done so. Brunton (talk) 07:07, 30 July 2009 (UTC)

Rephrase please

"Scientific tests run by both the BBC's Horizon and ABC's 20/20 programs were unable to differentiate homeopathic dilutions from water, even when using tests suggested by homeopaths themselves." Was there a consensus on the part of the homeopathic community that these tests were appropriate, well designed and properly carried out? If only one or two homeopaths thought that these were proper tests then they should be identified and it should not be implied that most or even any other homeopath might have approved. Also, what made these tests "scientific"? —Whig (talk) 00:33, 20 July 2009 (UTC)

Why restrict this "consensus" to "the homeopathic community"? Why would they, and not the general scientific community, be appropriate to decide whether scientific tests are well designed and appropriately carried out? The tests were merely to detect a difference between homoeopathic dilutions and water, and didn't involve the application of any specifically homeopathic principles or practices, other than those involved in preparing the diluted remedies themselves. Brunton (talk) 08:00, 20 July 2009 (UTC)

The current wording refers to "tests suggested by homeopaths themselves" therefore the consensus of homeopaths is relevant, unless rephrased. If you think that the general scientific community also approved of these tests and have references to include that, then you can do so. Calling these tests "scientific" remains problematic as well without some basis. —Whig (talk) 16:10, 21 July 2009 (UTC)

As Short Brigade Harvester Boris has already pointed out, the article doesn't say that the tests were suggested by a consensus of the homoeopathic community, just that they were suggested by homoeopaths. It doesn't need a reference to support something it doesn't say. The input of homoeopaths to the tests, as currently stated in the article, is only to the fact that particular tests were suggested by homoeopaths (and even then it is just the particular homoeopaths who suggested them that are relevant, not a consensus of all homoeopaths. According to the ABC News article referenced, the homoeopath in question seems to have been Dana Ullman). Assessment of the design of these scientific tests, once they had been suggested, would not just be a matter for homoeopaths. Brunton (talk) 16:33, 21 July 2009 (UTC)

There seems to be consensus here that we should identify the homeopaths who approved of these tests if we can do so. If one or two scientists suggested a dumb experiment would it be appropriate to report that the experiment was "suggested by scientists"? —Whig (talk) 18:22, 21 July 2009 (UTC)

On the one hand, it's a stretch to think that the reader would assume "homeopaths" means "every homeopath who was alive at the time." On the other, if we can identify the individuals as "homeopaths John Doe, Mary Smith, and Joe Bloggs" it would be reasonable to do so. Short Brigade Harvester Boris (talk) 15:20, 20 July 2009 (UTC)

No such implication was made. That’s an inference on your part, and a faulty one at that. But I do agree that the homoeopaths who suggested the tests should be identified. — NRen2k5^(TALK), 22:43, 20 July 2009 (UTC)

The BBC's and ABC's "television science" was simply "junk science." Both tv shows sought to replicate the work of Professor M. Ennis, but she was not shown the precise protocol used until over a year after the BBC study was aired and just before the ABC study was conducted. She asserts that this "study" was NOT hers. The BBC has acknowledged this, and ABC carefully avoided saying that their study was a replication of the Ennis study, even though they used her as a consultant for the study (they did this as a requirement for my participation on air, though the 20/20 producer, Mark Golden, said that he only promised to consult with Ennis, not to do what she said or to even correctly replicate her work. To see Ennis' email on this subject, go to: http://www.homeopathic.com/articles/view,55 -- I realize that website is my own and is therefore not an appropriate RS for wikipedia...but for those of us who are wanting the truth about things, this article and others at http://www.homeopathic.com/articles/by_category.jsp?id=37 will provide insight. DanaUllman^Talk 03:36, 21 July 2009 (UTC) 03:34, 21 July 2009 (UTC)

We've discussed this before. You know that the tests were declared fair before they were run, and objections only arose afterwards. That you e-mailed her, quoted after-the-fact objections from Milgrom, and managed to get her to be upset does not amount to a reliable source, nor proof that they are junk science. Shoemaker's Holiday (talk) 06:52, 21 July 2009 (UTC)

Indeed - I see no issue here (as an uninvolved editor, I saw this raised on AN/I). --Cameron Scott (talk) 10:05, 21 July 2009 (UTC)

Hey Shoemaker, in due respect, you are not correct here. I objected to the experiment about 7 weeks (!) BEFORE the results were announced by ABC News. Ennis' email to me was on December 9, 2003. The show aired on January 30, 2004. These are facts. From which facts are you making your determination? And by whom (!) are you suggesting that the tests were declared "fair"? When I asked Mark Golden (the 20/20 producer) who his experts were, he told me it was "Robert Park" (who is a well-known skeptic of homeopathy who has never conducted any experiments on basophils!). He is neither an ideal or appropriate "expert" on this subject. Please note that I have never questioned that the study was not conducted in a well-controlled and double-blind fashion. My concerns were that of Ennis who noted that a chemical was used that killed the basophils before the homeopathic doses (or placebo) were applied, and the many other serious problems in this sophomoric effort to conduct real science. DanaUllman^Talk 17:34, 21 July 2009 (UTC)

According to the ABC News reference: "We then consulted leading university scientists who reviewed the test protocols and said they were "technically sound" and "meticulously conducted."" Brunton (talk) 18:32, 21 July 2009 (UTC)

It seems this user has a pretty strong personal WP:COI regarding this discussion, and should probably bow out of the discussion (feel free to provide RS or contribute in other areas). The Ennis email is not a WP:RS. Please don't bring your personal disputes to wikipedia. I agree with Scott, there is no issue with the text in the article. Verbal chat 17:57, 21 July 2009 (UTC)

I would have to agree with Verbal, though I appreciate that Dana has a strong interest in clearing the record as he sees it, this is not the proper forum for that. Only reliable sources can be used for Wikipedia. —Whig (talk) 18:18, 21 July 2009 (UTC)

I actually agree with Whig...and as you all may note, I asserted that the reference to Ennis' email was at my own website and is therefore not RS. Please also note that I do not deny that the study was "well controlled" but I do question what was done in the experiment. For those people who want insight from someone with a first-person experience, read about my experiences. I may engage in dialogue on this subject, but I will not edit on it due to COI. DanaUllman^Talk 19:16, 21 July 2009 (UTC)

Except article talk pages is not a place for you to be "dialoging" your POV on this topic. Tmtoulouse (talk) 00:39, 22 July 2009 (UTC)

Tmtoulouse is correct, Dana. Don't reference your website here, please. Even if it isn't for the article, this is not a Talk page for general discussion so it isn't appropriate. —Whig (talk) 03:10, 22 July 2009 (UTC)

This thread went off-track, but the sentence still needs to be rephrased as discussed above. —Whig (talk) 04:08, 1 August 2009 (UTC)

Proposed change on replication of trials

At present, the 3rd paragraph of this article asserts the following statement that has been shown to be inaccurate and that references an old (out-dated) reference. Supporters claim that studies published in reputable journals support the efficacy of homeopathy; however, there are only a handful of them, they are not definitive, and they have not been replicated.[12]

I recommend the following change, though I would like to reference to Lancet's News and Notes section Supporters claim that studies published in reputable journals support the efficacy of homeopathy. Some of these studies have been deemed to be high quality and have been replicated, including the treatment of influenza, in the treatment of childhood diarrhea, and in the treatment of hayfever Although some reports consider the homeopathic treatment of influenza to be relatively small and warranting more research, other reliable sources have considered the results of treatment to be “reasonable.”

Let's discuss what works or not here, and let's avoid shooting the messenger this time. DanaUllman^Talk 14:54, 28 July 2009 (UTC)

Have you read what's already been posted by others wrt this? It's clear that you are nowhere near consensus for this. Brunton (talk) 14:59, 28 July 2009 (UTC)

If this is supported by good sources I would agree - lets take a look.--JeanandJane (talk) 18:17, 28 July 2009 (UTC)

Dana, are you seriously balancing a Cochrane review of 2006 with a 20 year old news snippet from the Lancet, which doesn't even appear in PubMed or on the Lancet website? "other reliable sources" would seem to be talking up that source far too much. Fences&Windows 19:33, 28 July 2009 (UTC)

Dr.Jhingaadey: Another new request

It appears that User:Avathaar, who is Dr.Jhingaadey, couldn't resist the temptation and is using socks again.

• 117.192.134.64 (talk⁺ · tag · contribs · deleted contribs · logs · filter log · block user · block log · CA · CheckUser(log) · investigate · cuwiki)

Strong suspicion based on the duck test and timing.

* Dbrisinda (talk⁺ · tag · contribs · deleted contribs · logs · filter log · block user · block log · CA · CheckUser(log) · investigate · cuwiki)

The RfCU page is protected, so it's impossible to comply with the request in the template.

Brangifer (talk) 07:40, 30 July 2009 (UTC)

I replied in the SPI case. An article talk page is not the right place for discussing vague suspicions of this nature or technical problems with a project page. Hans Adler 11:31, 30 July 2009 (UTC)

With all due respect, whomever Dr. Jhingaadey is, if you were referring to me, I can assure you, I am not s/he: I am a new contributor. But more to the point, I've provided my contributions with references. I've noticed that they've been removed now twice. There is no reason for this, as they simply provide the mirror view when writing about A. Campbell's critical review of G. Vithoulkas' book that appeared in the British Journal of Homoepathy. G. Vithoulkas responded to this review, and it appeared in the same British Journal of Homoepathy. There is no neutral reason why these edits are being reverted. If you mention A. Campbell's critical review, you must also mention G. Vithoulkas' response and defense for balance, regardless of your personal beliefs on the topic.

--Dbrisinda (talk) 11:37, 30 July 2009 (UTC)

Thanks for the explanation. I have stricken the above (which I did long ago at the SPI). Brangifer (talk) 18:06, 2 August 2009 (UTC)

If you are a new contributor, and your edits are reverted 5 times in one day by three different experienced editors, you should entertain the possibility that the fault is yours and discuss your proposed edits on the talk page before making any further changes to the article. --Art Carlson (talk) 13:00, 30 July 2009 (UTC)

Possibility entertained, examined, reflected upon, and summarily dismissed. However, I am open to discussion. But I'm not sure what you mean by "fault." I am simply 1) attenuating highly biased and sometimes incorrect wording based on original sources (A. Campbell's own critical book review uses the word "penicillin *not* "antibiotic," and the specified duration of application was over an extended period of time, i.e., not a single treatment -- two weeks to be exact), and 2) *adding* additional content to provide balance to the discussion (contrast to deleting content). There appears to be a "reflex" action on the part of the community on this highly contentious topic, to immediately revert any changes that move discussion away from a negatively-biased view of homeopathy to a more balanced one. I would encourage everyone to re-read Wikipedia's rules for neutrality in the NPOV tutorial. Especially the sections on, a) Neutral language, b) Bias in attribution: Mind your nuances, and most importantly as it pertains to this article, c) Space and balance. Specifically the subsection on Information Supression: "A common way of introducing bias is by one-sided selection of information. Information can be cited that supports one view while some important information that opposes it is omitted or even deleted. Such an article complies with Wikipedia: Verifiability but violates NPOV. A Wikipedia article must comply with all three guidelines (i.e. Verifiability, NPOV, and No original research) to be considered compliant."

I added the references to Vithoulkas' response to this critical review which was published in the same journal, and the reference was deleted as it provided strong counter-weight. This is clearly a violation of Wikipedia NPOV as referenced in the last point above in space, balance, and information supression. I will start two separate subsections for the specific content of the two reversions in question. Comments are welcome. --Dbrisinda (talk) 18:40, 30 July 2009 (UTC)

Of course the article is biased; 5 min ago I just added the Cochrane conclusion about Osccil and it was reverted as ....withdrwawn . If you see above everybody regarded it as reliable but they do not want to report its conclusions unless they can edit out any positive remarks--JeanandJane (talk) 18:51, 30 July 2009 (UTC)

By using the word "fault" I did not mean to imply moral turpitude, and I did not say anything about the content of your edits. As a newbie, you may not be familiar with the culture and rules of Wikipedia. Disagreements, often passionate disagreements, are normal. However reverting to your own version more than 3 times in one day, no matter how right you are, is a violation of the three revert rule and can get you blocked. --Art Carlson (talk) 18:53, 30 July 2009 (UTC)

So the conclusion from the above discussion is that Cochrane review 2006 for osc will not be included as withdrawn? --JeanandJane (talk) 19:25, 30 July 2009 (UTC)

It's very hard to justify including a withdrawn paper in an article, particularly if the fact that it's withdrawn isn't mentioned. Shoemaker's Holiday (183) 19:32, 30 July 2009 (UTC)

it is not withdrawn. Everybody agreed with its inclusion before - correct?--JeanandJane (talk) 19:37, 30 July 2009 (UTC)

From http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD001957/pdf_fs.html [Edited slightly to restore lost formatting; Emphasis mine.]

“ Homoeopathic Oscillococcinum for preventing and treating influenza and influenza-like syndromes

Andrew Vickers1, Claire Smith2

1Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA. 2Weston Education Centre, King’s College, London, UK

Contact address: Andrew Vickers, Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10021, USA. vickersa@mskcc.org. (Editorial group: Cochrane Acute Respiratory Infections Group.)

Cochrane Database of Systematic Reviews, Issue 3, 2009 (Status in this issue: Withdrawn)

Copyright © 2009 The Cochrane Collaboration. Published by JohnWiley & Sons, Ltd.

DOI: 10.1002/14651858.CD001957.pub4

This version first published online: 8 July 2009 in Issue 3, 2009.

Last assessed as up-to-date: 19 May 2006. (Help document - Dates and Statuses explained)

This record should be cited as: Vickers A, Smith C. Homoeopathic Oscillococcinum for preventing and treating influenza and influenza-like syndromes. Cochrane Database of Systematic Reviews 2009, Issue 3. Art. No.: CD001957. DOI: 10.1002/14651858.CD001957.pub4.

The editorial group responsible for this previously published document have withdrawn it from publication.
REASON FOR WITHDRAWAL
This review was withdrawn from The Cochrane Library, Issue 3, 2009 as the authors are currently unable to update it.

”

It's withdrawn. It says as much, three times. Sure, it's a little odd of a reason for withdrawing it, but it still makes it pretty impossible to include it here, when other, non-withdrawn papers exist. That people agreed with its inclusion before it was withdrawn three weeks ago is irrelevant now. Shoemaker's Holiday ^{Over 183 FCs served} 19:41, 30 July 2009 (UTC)

Per the Cochrane Manual[12], authors of systematic reviews need to update them every couple of years, or give a good reason why not. So it's been withdrawn under a technicality; there's no indication that it was methodologically flawed. But including an article when it has been formally withdrawn from publication by the publisher is a no-no. Fences&Windows 21:12, 30 July 2009 (UTC)

Quite. The reason for withdrawing is unusual and Cochrane-specific, but it's still withdrawn, and that makes it very hard to justify any continued use. Shoemaker's Holiday ^{Over 183 FCs served} 21:18, 30 July 2009 (UTC)

Given the explanation by Fences and windows I think I disagree with the decision to disregard this review because of a purely technical withdrawal. As long as there is no indication that it might have been withdrawn for other reasons, it shouldn't be given less weight than older articles of the same quality that appeared under different circumstances. Note in particular the language "This review was withdrawn from The Cochrane Library, Issue 3, 2009". To me this suggests citing an earlier issue is fine because the review hasn't been withdrawn from that. Is that correct, or at least arguable?

Note that I am not fully aware of the context of this discussion (use of the reference, weighting issues etc.), as I am currently editing with a tiny screen. I am just commenting on this purely technical point. Hans Adler 21:54, 30 July 2009 (UTC)

It'd look strange, at the very least. I mean, at the least, we'd have to say it was withdrawn, I think, and then we'd probably have to justify why it's being mentioned at all - and at the end, you're spending an awful lot of time trying to justify a review that's at best ambiguous, instead of using the many other Cochrane reviews on homeopathic treatments. And if the reason this one is being supported is because, out of all those reviews, none others even have the slightest suggestion that homeopathy does anything, then it shouldn't have been added in the first place, as it misrepresents the Cochrane Collaboration's overall findings on homeopathy. Shoemaker's Holiday ^{Over 183 FCs served} 22:53, 30 July 2009 (UTC)

We all seem to be a tad confused on the meaning of this "withdrawal," though the review is still listed at their website Ultimately, the homeopathy article states that there are no replications to homeopathic research, and this is now clearly inaccurate. We can cite the Cochrane Report from 2006 or 2009 or reference the Lancet's News and Notes that mentioned that the results of the British Journal of Clinical Pharmacology were clinically relevant. Whig suggested a good compromise on wording, and although I'd prefer saying something else, I can live with his suggestion. DanaUllman^Talk 00:48, 31 July 2009 (UTC)

No. It has been explained to you, repeatedly, this year AND last year, why these are poor sources that do not state what you claim they do. Now we learn that the Cochrane paper has been withdrawn. Yet, you persist in bringing up the same erroneous points over and over again. Furthermore, it is becoming obvious that you are canvassing offsite for others to come here and support your position. I believe that it is time to request arbitration enforcement. Skinwalker (talk) 01:04, 31 July 2009 (UTC)

Skinwalker, it seems clear from the discussion above that there is not clarity on what the "withdrawl" means, especially since it is still at the Cochrane website. And whether we use that or not, the article says that there have not been replications of research, and this fact is clearly wrong, not just because of the Oscillo research but also the Jacobs childhood diarrhea trials and the Ludkte allergy trials. According to wikipedia's definition "replicability" (previously cited and linked), it does not require independent replication. I would hope that wikipedia is reasonably RS. As for "canvassing," please be specific (or back off)...it seems that everyone commenting here are the regulars. DanaUllman^Talk 02:13, 31 July 2009 (UTC)

I've made a minor edit that may address your point about replication. Brunton (talk) 11:29, 31 July 2009 (UTC)

In due respect, the Oscillo research is still very much alive on the Cochrane site: http://www3.interscience.wiley.com/homepages/106568753/CD001957_standard.pdf -- It seems to be the same body of information as in the 2006 article. I cannot find evidence at their website that it has been withdrawn. Can someone else? Further, if, by chance, someone finds such a reference, we need to understand what "withdrawn" means because there has not been any new research to disprove what their previous analysis provided. Unless someone provides this information, reversion to the original reference and description is in order. DanaUllman^Talk 17:47, 2 August 2009 (UTC)

It's. Quoted. And. Linked. In. This. Thread. The word "Withdrawn" appears three times, and are bolded. Shoemaker's Holiday ^{Over 184 FCs served} 19:17, 2 August 2009 (UTC)

Changes to lead: Homeopathy

The third paragraph of the lead-in for the article makes several highly biased statements. The paragraph is reproduced here for easy reference:

"Claims of homeopathy's efficacy beyond the placebo effect are unsupported by the collective weight of scientific and clinical evidence. Supporters claim that studies published in reputable journals support the efficacy of homeopathy; however, there are only a handful of them, they are not definitive, and they have not been replicated. Several high-quality studies exist showing no evidence for any effect from homeopathy, and many positive studies of homeopathic remedies have generally been shown to have problems that prevent them from being considered unambiguous evidence for homeopathy's efficacy."

Wikipedia's NPOV document states in the subsection Bias in attribution: Mind your nuances, that use of the word "claimed" is often an indicator of a lack of neutrality and that alternate language should be chosen. In fact, Wikipedia guidelines suggests a set of words to avoid, and has this to say about the word "claim":

"Claim" can be appropriate for characterizing both sides of a subjective debate or disagreement. Do not use "claim" for one side and a different verb for the other, as that could imply that one has more merit."

Also, the statement "unsupported" in the first sentence in this context implies no support, only to be softened afterwards by the somewhat contradictory phrase "collective weight", implying some support. The suggested NPOV modification for the first sentence is:

"Evidence of homeopathy's efficacy beyond the placebo effect is not well-supported by the collective weight of scientific and clinical evidence."

This leaves the door open for some support however sparse it may be, which is what the public record shows.

"Supporters claim that studies published in reputable journals support the efficacy of homeopathy; however, there are only a handful of them, they are not definitive, and they have not been replicated."

Again, the use of the word "claim" is problematic for reasons mentioned above. Also, there are not "only a handful of them" as the statement indicates. Hundreds of clinical trials have been performed spanning decades. Even Linde (1999) indicates that it reviewed 89 such clinical trials. Another publication by Linde et al. (2001) examined 207 clinical trials. Kleijnen et al. (1991) examined 107 clinical trials that spanned the period from 1966 to 1990. This is clearly not "a handful" even if some of these are duplicated between separate studies. Finally, the last phrase "and they have not been replicated" requires clarification. There are a few instances of trials that have been successfully replicated, just not of sufficient rigor to be unambiguously acceptable by the scientific community. So this statement ought to be modified to take this into consideration. A suggested more neutral and accurate rendering of this sentence would read:

"Supporters point out that studies published in reputable journals support the efficacy of homeopathy; however they are not definitive, and they have not been replicated to meet sufficiently rigorous scientific standards."

The start of the third sentence is rather sloppy. Instead of saying, "Several high-quality studies exist..." this ought to be replaced with "Several placebo-controlled double-blind studies exist..." That makes the point more clearly and more powerfully. However, we still need counter-weight and balance. The entire paragraph offers a heavily non-homeopathic point of view. Some space, if even only a sentence, is required to offer the alternate perspective. I propose the following addition, simpler and more brief than my original edit:

"Even though early analyses investigating homeopathic remedies showed positive results among the studies examined, such studies have indicated that positive evidence of clinical trials is not sufficient to draw definitive conclusions, because most trials are of low methodological quality and because of the unknown role of publication bias."

The editor [Brunton] reverted the original edit, citing that "the suggestion that positive outcomes are independent of trial quality is contradicted by more recent reviews, e.g. Linde 1999." Recency of a study does not imply that all previous studies are no longer valid and should be ignored. This is especially true if the results of studies differ: both provide valuable contributions to the discussion. In any case, the argument against homeopathy's efficacy has already been very strongly made with many references. What is needed is at least partial counter-balance in the way of providing references to literature that shows the opposite viewpoint, even if qualified. Remember, this is not about pushing a viewpoint, but about providing as well-rounded a treatment of the subject matter as possible.

These changes, I submit, are necessary to satisfy Wikipedia NPOV guidelines. The proposed third paragraph in it's entirety would read:

"Evidence of homeopathy's efficacy beyond the placebo effect is not well-supported by the collective weight of scientific and clinical evidence. Supporters point out that studies published in reputable journals support the efficacy of homeopathy; however they are not definitive, and they have not been replicated to meet sufficiently rigorous scientific standards. Several placebo-controlled double-blind studies exist showing no evidence for any effect from homeopathy, and many positive studies of homeopathic remedies have generally been shown to have problems that prevent them from being considered unambiguous evidence for homeopathy's efficacy. Even though early analyses investigating homeopathic remedies showed positive results among the studies examined, such studies have indicated that positive evidence of clinical trials is not sufficient to draw definitive conclusions, because most trials are of low methodological quality and because of the unknown role of publication bias."

Dbrisinda (talk) 03:01, 31 July 2009 (UTC)

I do not think this is an improvement; the proposed language is, to me, bloated and redundant. Can you try a more direct and concise formulation? Thanks - Short Brigade Harvester Boris (talk) 03:19, 31 July 2009 (UTC)

Yes, you are right there is redundancy. The longer sentence in the middle can be trimmed, as well is the repeat of the phrase relating to "definitive" as it is subsumed by the final sentence. A couple additional word changes gives:

"Evidence of homeopathy's efficacy beyond the placebo effect is not well-supported by the collective weight of scientific and clinical evidence. Advocates point out that studies published in reputable journals support the efficacy of homeopathy; however they have not been replicated to meet sufficiently rigorous scientific standards. Furthermore, several placebo-controlled double-blind studies exist showing no evidence of any effect from homeopathy. Even though early analyses investigating clinical homeopathic trials showed positive results among the trials examined, such analyses have indicated that positive evidence of clinical trials is not sufficient to draw definitive conclusions, because most trials are of low methodological quality and the unknown role of publication bias."

Dbrisinda (talk) 04:02, 31 July 2009 (UTC)

I think it would be helpful to clarify what is meant by "low methodological quality" as well. If this means for instance the successful trials were not double blinded, then we should say that. —Whig (talk) 17:08, 31 July 2009 (UTC)

That first sentence doesn't actually make sense in your sentence. "Evidence.... is not well-supported by... evidence." ...Eh? Anyway, it guts the mainstream critical view's force, by giving strong weight to the minority positive view. I don't think that's acceptable. The mainstream, scientific view is that homeopathy is nonsense, to make it out as if there was strong scientific debate on this point is misleading. Shoemaker's Holiday ^{Over 184 FCs served} 17:01, 31 July 2009 (UTC)

The first proposed sentence is easily fixed, "Homeopathy's efficacy beyond the placebo effect is not well-supported by the collective weight of scientific and clinical evidence." —Whig (talk) 17:11, 31 July 2009 (UTC)

Not bad - since there are different views among scientists.

[For instance, http://www.ncbi.nlm.nih.gov/pubmed/18834714 Homeopathy had a significant effect beyond placebo (OR=0.76; 95% CI: 0.59-0.99; p=0.039). When the set of analyzed trials was successively restricted to larger patient numbers, the ORs varied moderately (median: 0.82, range: 0.71-1.02) and the P-values increased steadily (median: 0.16, range: 0.03-0.93), including Shang's results for the eight largest trials (OR=0.88, CI: 0.66-1.18; P=0.41). Shang's negative results were mainly influenced by one single trial on preventing muscle soreness in 400 long-distance runners. CONCLUSIONS: The meta-analysis results change sensitively to the chosen threshold defining large sample sizes. Because of the high heterogeneity between the trials, Shang's results and conclusions are less definite than had been presented.--JeanandJane (talk) 17:31, 31 July 2009 (UTC)

I'm sorry, buit that article violates cardinal rules of study design: You don't get to redefine your parameters after the fact until you get ones you want. You have to set them out before then, which is what Shang does, and that study does not. It's pretty much incompetent or unethical. Shoemaker's Holiday ^{Over 184 FCs served} 18:18, 31 July 2009 (UTC)

This is a reliable source in a mainstream journal. Mine or your personal opinion on the paper does not count. I think this is the rule here. --JeanandJane (talk) 18:39, 31 July 2009 (UTC)

I think it appears to be a RS, it doesn't mean everyone has to agree with the conclusions of this study or the conclusions of Shang's. We present all sides from reliable sources. —Whig (talk) 19:31, 31 July 2009 (UTC)

How about swapping it into the active voice? "The collective weight of scientific and clinical evidence does not support the efficacy of homeopathy." --FOo (talk) 19:42, 31 July 2009 (UTC)

As you can see above this is not accurate and neutral.--JeanandJane (talk) 19:46, 31 July 2009 (UTC)

Sure it is. And we should be more concerned with collective weight than with individual studies. When you have to squint this hard to find studies that say that maybe it was more effective than placebo, this tells us something. We don't need to analyze every new bit of evidence that people bring up. If the collective weight of evidence eventually paints a different picture, we can explain this at that time. We're an encyclopedia, and homeopathy has been around a good long time. It's appropriate to present a broad overview here, which shouldn't generally require scouring individual sources when the collective weight already presents a clear picture. Friday (talk) 19:51, 31 July 2009 (UTC)

I believe that would be a WP:NPOV violation. We present all sides from reliable sources, not only the majority view. —Whig (talk) 19:55, 31 July 2009 (UTC)

@Shoemaker's Holiday: Yes, Whig is correct, the first sentence is easily fixed by removing the first word "Evidence" as he suggested. The updated paragraph would then read in its entirety (with removal of the word "placebo" since this is redundant through the use of the word "controlled"):

"Homeopathy's efficacy beyond the placebo effect is not well-supported by the collective weight of scientific and clinical evidence. Advocates point out that studies published in reputable journals support the efficacy of homeopathy; however they have not been replicated to meet sufficiently rigorous scientific standards. Furthermore, several controlled double-blind studies exist showing no evidence of any effect from homeopathy. Even though early analyses investigating clinical homeopathic trials showed positive results among the trials examined, such analyses have indicated that positive evidence of clinical trials is not sufficient to draw definitive conclusions, because most trials are of low methodological quality and the unknown role of publication bias."

Your contention that this modification "guts the mainstream critical view's force, by giving strong weight to the minority positive view" is completely inaccurate. What gutting!? The main points of the original paragraph are still contained in the revision, only with NPOV by removing ridiculously non-neutral wording such as "claims" which was used repeatedly, and stating the facts of qualified positive results at the end in one sentence. Further, the entire following paragraph goes into a very direct assault on homeopathy, citing notable figures characterizing it as "psuedoscience" and "quackery" -- which I am not currently contesting. There is sufficient controversy regarding homeopathy that alternative viewpoints must be given consideration even if they are not "mainstream" as you say. In any case, the so-called "alternative viewpoint" that I am proposing doesn't even make a strong case for homeopathy, but simply indicates that positive results have been achieved, and qualifying this by saying "most are of low methodological quality" -- which is the wording used in the scholarly paper cited. The main problem I see here is that you insist on thinking for everyone else by censoring information. Provide the necessary information, facts, references, figures, etc. including both sides of the debate, and then let people make up their own minds.

Also, your statement: "the mainstream scientific view that homeopathy is nonsense" is not accurate. There is controversy, plain and simple, even among the scientific community and also among members of the medical establishment. For example, a survey of 293 general practitioners in The Netherlands showed that 45% of them think that homeopathic remedies are efficacious in treating upper respiratory tract infections or hay fever. You can argue these findings ad nauseum, but they are there, published and available in the public record. You can't just scrupulously select your references to suit your viewpoint and then not allow others to do the same. That's a violation of NPOV through censorship.

@Whig, In consideration of the phrase "low methodological quality", this was the precise phrase used in the original publication abstract summary. The details of the study indicated that criteria used for methodological soundness included, 1) patient characteristics adequately described (10 points), 2) number of patients analyzed (30 points), 3) randomization (20 points), 4) intervention well-described (doses, duration, method of manufacture) (5 points), 5) double blinding (20 points), 6) effect measurements relevant and well-described (10 points), and 7) presentation of the results in such a manner that the analysis can be checked by the reader (5 points). But is this amount of detail really necessary? Dbrisinda (talk) 19:55, 31 July 2009 (UTC)

Well it does appear from these details that randomization and double blinding accounted for 40% of the quality score. —Whig (talk) 20:01, 31 July 2009 (UTC)

we cannot ignore reliable sources because they dont agree with the point of view that homeopathy is nonsense. I think the fact that different views exist in the scientific community is well documented in exceptional sources and it is not appropriate to predend they dont exist.--JeanandJane (talk) 20:04, 31 July 2009 (UTC)

@FOo and @Friday: Changing the first sentence into the active voice with the modification you suggested is problematic because it is misleading and inaccurate. It is essentially the same as the original (using "not supported" instead of "unsupported") with only the active voice changed. I've already dealt with this phrasing in my original comment:

Also, the statement "unsupported" in the first sentence in this context implies no support, only to be softened afterwards by the somewhat contradictory phrase "collective weight", implying some support. The suggested NPOV modification for the first sentence is:

[...]

This leaves the door open for some support however sparse it may be, which is what the public record shows.

Dbrisinda (talk) 20:14, 31 July 2009 (UTC)

This sentence in the text "and the unknown role of publication bias". See my comments about how that publication bias against homeopathy has been discarted by more recent sources [13][14], you are citing a study from 1991 but not the later studies. --Enric Naval (talk) 18:32, 1 August 2009 (UTC)

@Enric Naval: You assume that statements and concerns surrounding publication bias have been discarded by more recent sources; they have not. Ernst (2002) and the text quoted relating to their findings: "rejects that the predominance of negative results is caused by publication bias." First, they imply with this language that some negative results may be caused by publication bias through careful use of the word 'predominance'. But even more importantly, the article that you referenced by Linde (1999) in the text you have provided says, "[our] re-analysis 'weakened the findings of their original meta-analysis'". Notice the use of the word 'weakened', which suggests the results are still valid, only to a lesser degree than originally presented. Taking these together, it is clear that there is still a role for publication bias which has not been accurately and independently (non-biased) quantified. Consequently the statement "unknown role of publication bias" is still valid. In any case, it is also highly conceivable that a biased study to evaluate the degree of bias in other studies would itself need to be examined for bias, and so on. Especially in the highly controversial area of homeopathy. The role of publication bias will likely never be accurately quantified. Dbrisinda (talk) 20:03, 1 August 2009 (UTC)

No, Ernst is not saying "some negative publications are caused by publication bias". That's your interpretation of the text, and I don't agree with it at all. If you read Linde's quote under Homeopathy#Research_on_medical_effectiveness, you will see that they say that their update to the review "confirm[s] the finding that more rigorous trials have less-promising results", aso it's not saying what you think that it does. And you forgot the 2007 article in the Lancet. (As far as I concerned, it seems that, along time, as more trials were bing published, it became clear that there wasn't a publication bias against publishing negative papers in mainstream high-quality journals, and it was just that those only accepted high-quality papers, and that those papers happened to have more negative results.) --Enric Naval (talk) 00:09, 3 August 2009 (UTC)

You are right, Ernst is not saying that explicitly, because he is couching it in the negative. It is a question of logic: if you reject the statement "most negative results are caused by publication bias" then it is implied that you are accepting (or not rejecting) the complement of that statement: "some negative results are caused by publication bias". If you do not accept this latter statement, then you cannot accept the first statement. Instead you would need to re-word the first statement as a tautology: "no negative results are caused by publication bias", which he clearly cannot do.

It's not saying what I think it does? The wording is there for all to see! Read the words objectively at face-value as they appear, and try to refrain from overlaying what you wish to see. Again, we cannot rule out the role of publication bias until it's accepted by the community that "no negative results are caused by publication bias". The best that can be done here is to concede the word "unknown" and replace it with the word "uncertain". There isn't certainty. If there were, there would be no discussion. Dbrisinda (talk) 17:53, 3 August 2009 (UTC)

Hum, I just realized that you haven't read the source because then you wuld have noticed that a) the "preponderance" sentence is not a quote from Ernst, but a wording that I used in one of my comments[15], and b) I was summarizing the Results section incorrectly.

Re-reading the source, Ernst 2002 is talking about how ("more rigorous trials are associated with smaller effect sizes") and about how one of the re-analysis of Linde suggested that "the initial positive meta-analytic result [3] was largely due to publication bias [9]". No mention of any publication bias in the field. Please go to Ernst 2002 and read the text under "Results". --Enric Naval (talk) 02:22, 4 August 2009 (UTC)

P.D.: mind you, this error was caused by my misreading of the source, and I have made in other places the mistake that you made here, so please don't take my comment as a personal attack, it's just a correction. --Enric Naval (talk) 15:07, 4 August 2009 (UTC)

No, admittedly, I did not read that paper, as I simply assumed that you were quoting from it accurately given the force behind your statement. My argument rested on the quotation that you provided, assuming it to be the wording provided in the original -- a deconstruction of the language used -- which seems to have ended up being a deconstruction of your language instead. My whole point was that publication bias has not been ruled out. The discovery of publication bias in a meta-analyses implies that some of the original publications in a given field may be biased (intentionally or unintentionally). And sure, publication bias can occur in both directions. Which is why it's important to mention it so readers know they should take much of what they read on this very controversial subject with a grain of salt. The statement "uncertain role of publication bias" seems to adequately capture this generally.

One only has to briefly look at all the publications that have been published in respectable peer-reviewed journals to see controversy, and the attempts of one publication to diminish the conclusions of another, and vice versa, and new ways for examining the data using all kinds of statistical abstractions, post-analyses and re-analyses of those results, attempting to find something wrong with them, etc. etc. This whole business would be made exceedingly easier if all trials and meta-analyses were done by an independent body that has no interest in the final result.

Thanks for the clarification and helping to increase clarity and diminish confusion; your comment has not been taken as a personal attack. Dbrisinda (talk) 17:05, 4 August 2009 (UTC)

Well, the problem that I have is that the only paper saying that publication bias has an "unknown role" is the one from 1991[16]. Ernst 2002 said that one re-analysis of one review said that the result had been affected by publication bias, but he didn't claim any publication bias himself. Shang 2005 reports a bias in the trials themselves, but he doesn't mention any publication bias that affected the reviews themselves [17] and Goldacre said in 2007 in the Lancet that the meta-reviews had already accounted for the publication bias [18]. It would seem that the 1991 paper has been superceded by more recent research wich hasn't got a problem with publication bias or claims that it has managed to acount for it. --Enric Naval (talk) 19:17, 4 August 2009 (UTC)

In addition to the paper by Kleijnen et al. (1991), I've located several additional papers that are both recent and RS that address the issue of publication bias much more strongly than Kleijnen et al. did. Juni et al. (1999) show that the use of summary scores to identify trials of high quality is problematic, and affects the conclusions of meta-analytic studies. Kiene et al. (2005) show the failure of the meta-analyses of Shang et al. (2002) to exclude false negative bias. Frass et al. (2005) found bias in both trials and reporting of trials of homeopathy, and refer to it as a "fundamental breakdown in peer review and standards." Caufield et al. (2005) performed a systematic review of how homeopathy is represented in the various journals, with the conclusion being 30% of articles in CAM journals presented negative findings, whereas 69% of articles in traditional journals presented negative findings, and concluded that a publication bias against homeopathy exists in mainstream journals. Bellavite et al. (2006) state that recent controversies on deciding whether homeopathy is a placebo response is indeterminate because "evaluation of the evidence and the inclusion or exclusion of papers from meta-analyses vary according to pre-selected criteria." Sood et al. (2007) show that publication bias for CAM trials in the highest impact-factor journals is partly due to geographical bias (significantly less bias in Europe vs. U.S.)

In light of these findings, I would suggest striking the phrase "unknown role" from the proposed sentence, and instead following with a new sentence that briefly addresses the role of publication bias as described above in some abbreviated form. I will formulate an updated proposal to the 3rd paragraph lead to include some of the changes/additions that have been suggested in the sub-topic "Changes" below as well. Dbrisinda (talk) 21:48, 5 August 2009 (UTC)

I think there are some good elements in the several proposed changes thus far. I would like to combine the elements there with modifications to the original proposal to arrive at a new proposal with RS references included, which will also show how references will be used.

But first, there is some misrepresentation of RS references in the original 3rd paragraph lead. Editors are using references to say something which they do not actually say. For example, the article by Altunc is misrepresented as supporting no evidence beyond placebo of homeopathic efficacy. When in fact the article states it achieved mixed results, but "the evidence from rigorous clinical trials of any type of therapeutic or preventive intervention testing homeopathy for childhood and adolescence ailments is not convincing enough for recommendations in any condition." Similarly, the references by Linde (1999) do not show "no better than placebo" but rather "there was clear evidence that studies with better methodological quality tended to yield less positive results." And Linde (2001) only show problems with methodology. We really need to be more careful with misrepresenting RS references. In any case, I've included the main RS references here (with the exclusion of Linde99 and Linde01 because I'm not sure how to include them--if there are others, then include them), and provided links to new references only, as the existing references are already in the original:

"Homeopathy's efficacy is highly controversial in view of the collective weight of scientific and clinical evidence.^{[NHS][AMA][BHA]} Several controlled randomized studies show little evidence for the efficacy of homeopathy,^{[Ernst][Altunc][Shang]} while other controlled studies do support the efficacy of homeopathy.^{[Kleijnen][Rutten][Linde97][Linde98]} According to a report by the AMA, "The efficacy of most homeopathic remedies has not been proven. Some think it a placebo effect, augmented by the concern expressed by the healer; others propose new theories based on quantum mechanics and electromagnetic energy."^[AMA] Advocates of homeopathy also bring attention to the inherent difficulty with controlled randomized clinical trials due to the highly individualized nature of homeopathic treatments.^{[Linde98][Weatherley-Jones][Thompson][Bell]} Meta-analyses investigating clinical homeopathic trials have shown both positive and negative results; though positive results have indicated that evidence is not sufficient to draw definitive conclusions.^{[Kleijnen][Linde97][Linde98]} A definitive view of the efficacy/non-efficacy of homeopathy is further complicated by assertions of publication bias in the field.^{[Juni][Kiene][Frass][Caufield][Bellavite][Sood]}

Dbrisinda (talk) 03:00, 6 August 2009 (UTC)

Ludtke/Rutten paper (from Journal of Clinical Epidemiology)

User:Dbrisinda is showing his knowledge of homeopathic research and how to maintain a NPOV in this article. I recommend that we delete “however they have not been replicated to meet sufficiently rigorous scientific standards” and “because most trials are of low methodological quality and the unknown role of publication bias.” I make these recommendations because:

Shang’s (2005) data showed that the 8 high quality homeopathic research that had large numbers did not show benefit above placebo; however, the 21 “high quality” trials (as determined by Shang) had a beneficial effect over placebo. These newer reviews show that the selection criteria for choosing which trials to include of these high quality trials determines whether one finds a positive or negative result. Further, selection criteria on what is and isn’t a high quality trial also influences whether one finds a positive or negative effect from homeopathic treatment. It is therefore not correct to say that “high quality” trials show that homeopathic medicines do not work.

As was also discussed above, there are now 3 conditions for which replication trials have found positive results, including those in the treatment of influenza, childhood diarrhea, and respiratory allergy. (Please note that, according to wikipedia’s own definition of replication, there is no requirement that it be done by independent parties.)

I am confused as to why the Ludtke/Rutten article in the prestigious journal is not presently referenced in this article…and it deserves a reference. DanaUllman^Talk 18:48, 2 August 2009 (UTC)

Agreed.--JeanandJane (talk) 23:42, 2 August 2009 (UTC)

No. Shang's analysis has widespread respect, Ludtke/Rutten is an exercise in data mining in order to see if any results can be made to show no effect. It's junk science, has no respect in the scientific community, and should not appear. As I recall, that analysis, among other things, uses a less appropriate statistical analysis, and I believe even states that if the original one was used, the effect is maintained.

In any case, it violates the rules of study design: You plan your criteria beforehand; You don't tweak tests and analysis until you get the results you want. Shoemaker's Holiday ^{Over 184 FCs served} 23:54, 2 August 2009 (UTC)

Again since it is published in a RS it has to be included. You cannot exclude it because you think it is not a good paper. I m surprised you are such an experienced editor and I msure you know the rules in wikipedia.--JeanandJane (talk) 00:02, 3 August 2009 (UTC)

The "it's in a RS so it has to go in" fallacy is widely known. WP:V and WP:RS do no say this. Short Brigade Harvester Boris (talk) 00:08, 3 August 2009 (UTC)

This is a peer reviewed paper published in a high impact journal. According to wiki it is a RS ( an exeptional one ).--JeanandJane (talk) 01:24, 3 August 2009 (UTC)

Shoe's assertion that the Ludtke/Rutten review is "junk science" is his personal POV, and this has no place on wikipedia. What secondary source do you have for that assertion? The article shows that the results of the "high quality" research can be interpreted in more ways that Shang has provided. The journal is RS, and Shoe's description of it is inaccurate and seems to reflect his POV and not a NPOV. As for Shang, his work has been rigorously and vigorously criticized. It is not surprising that 6 of the 8 homeopathic studies used in the "final" analysis of the Shang review provided no external validity (they tested one medicine given to everyone without any degree of individualization). The fact that NONE (!) of the final studies used were matched in any way broke the study's intent on comparing "matching studies" (heck, they even threw out the data from one large high-quality homeopathic study on polyarthritis under the questionable excuse of not finding a matching study (and then, the final analysis had no matching studies anyway). DanaUllman^Talk 00:44, 3 August 2009 (UTC)

The authors of the study write that under a meta-regression analysis "no single predicted OR [odds ratio] could be shown to differ significantly from unity". In other words, placebo. This, furthermore, is the correct statistical test given the shape of the full dataset, they trump up a junk science justification by showing that if you use very few trials, it's very very hard to see patterns - which is what's expected. So, they used the wrong statistical analysis, admitted the correct one didn't give the results they wanted, but nonetheless trumpeted the results as supposedly meaningful, as have you. This is pure junk science, and has no place in this article. Furthermore, may I point out that this insistence on including your preferre d trial at Talk:Potassium dichromate, despite all objections, is precisely what got you topic banned before. Shoemaker's Holiday ^{Over 184 FCs served} 01:22, 3 August 2009 (UTC)

This is not a place to publish our personal opinions on scientific papers. I might even agree with your personal opinion but we have to report the paper's conclusions since it qualifies.If another paper in another RS critisize this one - it should be also included.--JeanandJane (talk) 01:29, 3 August 2009 (UTC)

No, we are not required to include any source. But we are bound by [[WP:UNDUE|undue weight]: Shang is highly respected and widely cited by scientists. Ludtke is not. Hence, we give Shang a good amount of weight, and should exclude Ludtke's highly disputed attack on it. [19] Show us a few reliable sources that praise the Ludtke study. Meanwhile, the Shang study has the full backing of the Lancet editorial board. Shoemaker's Holiday ^{Over 184 FCs served} 01:35, 3 August 2009 (UTC)

What is the criterion for giving weight to Shang and excluding L. They are both peer reviewd and published in high impact journals. I m trying really friendly and sincerily to comprehend your objection.--JeanandJane (talk) 01:41, 3 August 2009 (UTC)

Because one is highly praised and extremely well-cited, the other is not? Furthermore, the Journal of Clinical Epidemiology is not particularly high impact.the JCE has an impact factor of 2.896, the Lancet, 28.409 - which is an awful lot more. Furthermore, the JCE's eigenfactor is a dismal 0.03; The Lancet, 0.50. The Lancet is just a much more prestigious and high impact journal. Shoemaker's Holiday ^{Over 184 FCs served} 01:42, 3 August 2009 (UTC)

It is not a matter of comparison. By the wikirules the journal qualifies as a exceptional source. That's why it is already used as a reference in our article - there is a quote in the article (from another paper) published in the same journal. Correct? {http://en.wikipedia.org/wiki/Homeopathy#cite_note-Linde1999-12--]]JeanandJane (talk) 02:04, 3 August 2009 (UTC)

"It is not a matter of comparison". Yes, it is. WP:WEIGHT says that you have to take into account the predominance among the sources and the significance to the subject, and not include tiny minorities at all, so appearing in a RS is not enough to appear in an article (and I notice that Shoemaker has already pointed you to WP:WEIGHT, which is just WP:UNDUE under another name, so why do you keep saying that).

Shang in the Lancet + the Lancet editorial has a lot of weight and significance, Ludtke/Rutten pales in comparison, and other editors have already pointed the flaws in the study, and the lack of other papers saying Ludtke/Rutten is right. --Enric Naval (talk) 17:06, 3 August 2009 (UTC)

I m talking about this quote: "The evidence of bias [in homeopathic trials] weakens the findings of our original meta-analysis. Since we completed our literature search in 1995, a considerable number of new homeopathy trials have been published. The fact that a number of the new high-quality trials... have negative results, and a recent update of our review for the most “original” subtype of homeopathy (classical or individualized homeopathy), seem to confirm the finding that more rigorous trials have less-promising results. It seems, therefore, likely that our meta-analysis at least overestimated the effects of homeopathic treatments.[13][16]"--JeanandJane (talk) 02:10, 3 August 2009 (UTC)

Yes, and that's because the papers by Linde are well-cited and considered excellent science by the community. But what's all this about an "exceptional source"? The journal's decent, but that doesn't make the Ludtke paper "exceptional". Shoemaker's Holiday ^{Over 184 FCs served} 02:16, 3 August 2009 (UTC)

Again lets remember : in Wikipedia we don't judge the authors and their papers . The journals do it. Otherwise Wikipedia would accept and decide which papers deserve to be published and which not. Since the paper is published in a good source and it complies with the rules - you cannot excluded it because of the writers reputation. I don't understand why you object. You keep changing the criteria - in the beginning the article had a problem, then the Journal was not good enough - now the writers are not highly praised. No offense - I m trying really to comprehend your view.Regards. --JeanandJane (talk) 02:28, 3 August 2009 (UTC)

We cannot include all of the thousands of possible sources that could be used. Hence, we decide, partially based on the undue weight policy. To include the unsupported and generally unaccepted Ludtke criticism would give undue weight to an fringe viewpoint on the Shang meta-analysis: The Shang meta-analysis has widespread support; the Ludtke criticism is not very well known, and expresses views that have been largely dismissed. We cannot include every reliable source supporting and holding up the Shang metaanalysis to put Ludtke into proper weight. Of the thousands of possible sources, there is no "right" for any one to be included. We choose sources to represent the scientific community's views, and those views are predominantly in support of Shang. To treat Shang as debunked by Ludtke would grossly misrepresent the levels of support, and there is no real way to include Ludtke without giving the impression that his views are a major viewpoint (which they are not). Hence, we exclude the source. Shoemaker's Holiday ^{Over 184 FCs served} 04:14, 3 August 2009 (UTC)

I understand your point but:

Undue weight :Neutrality requires that the article should fairly represent all significant viewpoints that have been published by a reliable source, and should do so in proportion to the prominence of each. It does not say to exclude the minority view especially in an article on the specific minority view (which according to the policy must be described in detail).

Needless to say that since a point of view appears in a decent mainstream journal is not fringe anymore.

For instance look how the American M Association speaks of homeopathy :the efficacy of most homeopathic remedies has not been proven. Some think it a placebo effect, augmented by the concern expressed by the healer; others propose new theories based on quantum mechanics and electromagnetic energy. http://www.ama-assn.org/ama/no-index/about-ama/13638.shtml

Or how look how BBC covers the Shang meta-analysis: Among other comments the article ends like that: A spokeswoman from the Society of Homeopaths said: "Many previous studies have demonstrated that homeopathy has an effect over and above placebo."It has been established beyond doubt and accepted by many researchers, that the placebo-controlled randomized controlled trial is not a fitting research tool with which to test homeopathy." http://news.bbc.co.uk/2/hi/health/4183916.stm

Are these sources fringe or do they favor homeopathy?Regards.--JeanandJane (talk) 05:02, 3 August 2009 (UTC)

It might be worth making an inquiry on WP:RSN. —Whig (talk) 05:05, 3 August 2009 (UTC)

Wasting time on WP:RSN won't be necessary; J&J is misrepresenting the sources. The AMA cite is mostly a discussion of the history of homeopathy and the discussion of its efficacy is, on the whole, negative. The BBC article is a thorough takedown of homeopathy. The quote from the SoH spokeswoman is the only kind words given to homeopathy in the entire article. J&J will have to do better than that. Ice Cold Beer (talk) 07:15, 3 August 2009 (UTC)

Ice : "misrepresenting the sources " ? Check yourself.

My point is that the mainstream sources ( press and journals ) represent Homeopaths point of view fairly. They report their beliefs somehow. The current article in wikipedia doesn't. --JeanandJane (talk) 07:25, 3 August 2009 (UTC)

It doesn't? Which belief is not reported in the article? Please be specific so we can fix it using good sources from notable believers.

BTW, please be more careful with your indents. I've been fixing them for you, but you should be doing it yourself. After you make a comment, use the preview button before saving. -- Brangifer (talk) 14:29, 3 August 2009 (UTC)

[Undent] For those who are still "confused" about the article not referencing the Ludtke/Rutten paper, see the discussion of the paper here: "the results of Lüdtke and Rutten do not in any way invalidate Shang et al.". Brunton (talk) 15:45, 3 August 2009 (UTC)

Is this a reliable source, publishing peer reviewed papers with decent impact same as the Journal of Clinical Epidemiology ?--JeanandJane (talk) 16:22, 3 August 2009 (UTC)

This is a talk page, not an article, so there is no reason not to consider an argument or critique put forward on a blog if it is relevant to the matter being considered - in this case assessment of the notability of the Ludtke/Rutten paper. We went over this on the Talk:Potassium dichromate page as well. Brunton (talk) 19:58, 3 August 2009 (UTC)

Brunton: no original research. We don't evaluate the content of the article. We just report its conclusions if the source qualifies. If there is RS criticizing the Ludtke/Rutten paper - we could also include it.--JeanandJane (talk) 20:29, 3 August 2009 (UTC)

Do you have any comment on Dr. Gorski's assessment of the Ludtke/Rutten paper and its impact on the conclusions of Shang? That is relevant as far as the notability of the Ludtke/Rutten paper is concerned. As has already been noted by others, we don't (and can't) include every paper that happens to have been published in a RS. Brunton (talk) 20:46, 3 August 2009 (UTC)

If a paper has to do with a scientific controversy and debate on the topic -we have to report it -even if it represents the minority view per wiki policy. And dont tell me that Homeopathy is not a controversial topic because major reliable sources state that it is. http://nccam.nih.gov/health/homeopathy/#contoversies --JeanandJane (talk) 20:54, 3 August 2009 (UTC)

You're mistaken. Wikipedia is not aiming at reporting everything that has ever been written about a topic, it's aiming at giving an overview, so minority views don't have to be included by all means. When there are different RS, we're allowed to choose the best of them. In order to do that it's not only acceptable but actually necessary to discuss the articles we use as references, which includes pointing out their weaknesses (even if they're published in a prestigious journal). --Six words (talk) 21:43, 3 August 2009 (UTC)

Pointing out articles ;s weaknesses and use the conclusions as criteria for inclusion or exclusion is Original Research. --JeanandJane (talk) 00:51, 4 August 2009 (UTC)

Nobody said everything; but also minority views on controversial topics. "Neutrality requires that the article should fairly represent all significant viewpoints that have been published by a reliable source, and should do so in proportion to the prominence of each. It does not say to exclude the minority view especially in an article on the specific minority view (which according to the policy must be described in detail)." Otherwise it is censorship. --JeanandJane (talk) 00:47, 4 August 2009 (UTC)

It's not OR to discuss a source on a talk page! I never said that we should discuss a source's accuracy in the article itself, and if it sounded to you like that I apologise. However, I read the paper and I have to say that - apart from other people's criticism on the paper - their own conclusion tells me we shouldn't include it. It says

"Our results do neither prove that homeopathic medicines are superior to placebo nor do they prove the opposite. This, of course, was never our intention, this article was only about how the overall results and the conclusions drawn from them change depending on which subset of homeopathic trials is analyzed. [...]"

so they showed that if you use other trials you may come to other conclusions. Shang et al. already pointed that out themselves, so I don't see that the Lüdtke article gives us new information.--Six words (talk) 10:40, 4 August 2009 (UTC)

As I say below, and as Siw words confirms above, this paper has no place in this article. Verbal chat 11:29, 4 August 2009 (UTC)

I agree that it shouldn't be included, per all the arguments above. We don't have to include every study ever on homeopathy, and we shouldn't include ones with glaring flaws. Verbal chat 16:33, 3 August 2009 (UTC)

@DanaUllman: Alright, since there has been some replication of results, the suggested wording would need to be changed. How about the following:

"however they have not been widely replicated."

or perhaps as a compromise:

"however they have not been widely replicated to meet sufficiently rigorous scientific standards."?

The issue of publication bias still seems to me to be quite important according to the results of the Ludtke/Rutten research or not. You mentioned these newer reviews show that the selection criteria for choosing which trials to include determines whether one finds a positive or negative result. I would think this to be common sense among the scientific community -- and is precisely the problem we seem to be faced with here -- determining objective non-biased studies from biased ones. And yet, many are contesting this study (Ludtke/Rutten) for example to be inadmissable because it is biased, junk science, not respected etc. But since it's already been accepted in a respected peer-reviewed journal, it has already been ruled *not* to be junk science, and respectable. What any of us might think about this ruling is really quite irrelevant -- unless we wish to bring into the question the competence of the publication peer-review committee for any given journal. Do we really want to go there? If we do, we risk opening up a pandoras box.

It is fair for a reference to Ludtke/Rutten to be included in order to conform to WP:NPOV and WP:RS. I would agree with certain assertions made that it should not be included -- if we had an overly unbalanced representation of this view vs. it's opponents, but that is not the case here. The large majority of RS references here are already towards publications that are in support of views that oppose homeopathy.

Many people here seem to be policing the allowable reliable sources, and I don't think that is honest editorial behavior. If it's been published in a respected peer-reviewed journal irrespective of whether it is high-impact or moderate-impact, then it's fair game, again, provided the ratio of for/against is not unfairly weighted in the content or sourced references, which is clearly not the case here.

The publication peer-review committees of the various journals already grappled with the issue of whether or not to include a given research article in their publication. We don't need to go through this process again here. In any case, most of us are probably not qualified to do so. If the source is reliable, it is reference-able in support of a contention, and if individuals insist on disallowing it based on fears that it may support ideas contrary to one's personal view, then perhaps we really do need to invite an independent group to evaluate this viz. WP:RSN as Whig suggested or other available means.

In regards to the WP:UNDUE|WEIGHT reference by Enric Navel, here's the pertinent section:

"Neutrality requires that the article should fairly represent all significant viewpoints that have been published by a reliable source, and should do so in proportion to the prominence of each. Now an important qualification: In general, articles should not give minority views as much or as detailed a description as more popular views; [...]"

However, please note the first sentence of the next paragraph:

"In articles specifically about a minority viewpoint, the views may receive more attention and space."

Dbrisinda (talk) 02:07, 4 August 2009 (UTC)

This article isn't about Belief in Homeopathy, it is about homeopathy - which has been studied scientifically and found no better than placebo therapy, and has no plausible mechanism. Hence the view of hoeopaths is a minority view in this article and should be treated as such, as this article is not about homeopaths beliefs. Verbal chat 11:29, 4 August 2009 (UTC)

Of course there is a plausible mechanism, Verbal, and it is disingenuous to suggest otherwise after the prior discussion which you yourself ended here as off-topic. —Whig (talk) 14:59, 4 August 2009 (UTC)

Wikipedia editors should report the claims of homeopathy in detail and the scientific papers published in RS including several papers which dispute the assumption or conclusion that homeopathy has no therapeutic effect other than placebo. The topic is controversial. So far the article excludes some of this info like the above paper. --JeanandJane (talk) 15:17, 4 August 2009 (UTC)

There is no plausible mechanism, and homeopathy is the subject of this article. The above paper is irrelevant. Verbal chat 15:39, 4 August 2009 (UTC)

see above about the paper. I don't know about plausible mechanism. I don't do OR. We can only report what American Medical Association states Some think it a placebo effect, augmented by the concern expressed by the healer; others propose new theories based on quantum mechanics and electromagnetic energy. http://www.ama-assn.org/ama/no-index/about-ama/13638.shtml--JeanandJane (talk) 16:05, 4 August 2009 (UTC)

No offence JeanandJane, but did you actually read the paper? You seem to think that if all 21 high quality trials were included there would be a significant difference between homeopathy and placebo (it doesn't say that). Instead of just repeating your opinion that it has to be included because it's RS, you could make suggestions on how to include it, because quite frankly I wonder what the paper tells us that we didn't know already. --Six words (talk) 16:07, 4 August 2009 (UTC)

I have no personal opinion about the subject. Even If I had I would not try to elaborate here. The paper just states that Shang's conclusion that homeopathy = placebo is less definite and it depends on the set of analyzed trials.Lets decide to include as a reference and we will find a formula.--JeanandJane (talk) 16:13, 4 August 2009 (UTC)

@Verbal, your statements would have some merit if this article was about Pseudoscience, for example, where a discussion of Homeopathy occupied some brief part. But that is not the case here.

Allow me to repeat with some additional clarification from WP:UNDUE|WEIGHT:

"In articles specifically about a minority viewpoint, the views may receive more attention and space."

Homeopathy is a minority viewpoint. This article is specifically about Homeopathy, a minority viewpoint. Ergo, the views on Homeopathy can receive more attention and space. Dbrisinda (talk) 17:39, 4 August 2009 (UTC)

Homeopathy is an alternative medicine, and it was not minoritary in the 19th century. This article is about the discipline itself, not about one of the viewpoints about it. --Enric Naval (talk) 18:10, 4 August 2009 (UTC)

So the controversies [20] about homeopathy have no place in the article?--JeanandJane (talk) 18:15, 4 August 2009 (UTC)

For goodness sake, that's not what Enric said. The view of the scientific mainstream is always given greater prominence on matters of medical efficacy and such like - regardless of the subject of the article. Jefffire (talk) 18:25, 4 August 2009 (UTC)

This article is not about the beliefs of adherents, but about homeopathy itself. The beliefs of adherents is a minority viewpoint. Verbal chat 19:11, 4 August 2009 (UTC)

@Verbal and Enric Naval: In my description of homeopathy as a minority viewpoint, I'm looking at homeopathy broadly as compared to allopathic medicine. Allopathic medicine as a system of medicine is the mainstream or majority view, and homeopathy as a system of medicine is the non-mainstream or minority view. This article is about a minority view of medicine called Homeopathy. The point being that it is entitled to broad coverage in both content and references as per WP:UNDUE|WEIGHT. In otherwords, if an editor wishes to use an RS to support the premises of homeopathy, they should be free to do so without censure. Of course, you are also free to use an RS to attack the premises of homeopathy, again without censure. In any case, it seems to me we are moving past the policing of allowable RS references to instead showing examples of how to employ them in context. This is a step forward, and far more constructive in my view. Dbrisinda (talk) 03:16, 5 August 2009 (UTC)

No, "allopathic medicine" is not "the mainstream or majority view": it is a derogatory term invented by Sam Hahnemann for the orthodox medicine of his day. Although homoeopaths appear to have trouble understanding this, mainstream medicine has changed out of all recognition in the last 200 years, to the extent that the term "allopathy" no longer describes it (although it does describe many "alternative" modalities such as Ayurveda or TCM). Brunton (talk) 09:12, 5 August 2009 (UTC)

We are discussing here whether or not we follow the wiki policy about controversial topics : to present Homeopathy's claims in great detail, the majority point of yiew and the minority point of view; all these properly weighted since they have appear in decent RS. --JeanandJane (talk) 18:33, 4 August 2009 (UTC)

@Brunton, it doesn't matter what you call it, it's just a convenient label, call it allopathic medicine, conventional medicine, mainstream medicine, Western medicine, or some other term that communicates what we're talking about and doesn't confuse people. My underlying point (above) is the same and valid. In any case, the term allopathic medicine is widely used and accepted. If you don't like it, then use something else! Dbrisinda (talk) 18:55, 5 August 2009 (UTC)

Redundant facts

11. Homeopathy is not a fringe belief at all. It is not fair to call it a fringe belief.

Homeopathy is a fringe practice by almost any quantitative measure:

• Homeopathy's share of the world drug market is 0.3% [21]
• Money spent per person on medical items in the U.S. in 2004 was $5267 [22]. About 1% of that amount – $54 per person – was spent on all herbals, including homeopathy. [23]
• There were 315 professional homeopaths in the U.S. in 1993. Counting lay homeopaths (unlicensed), there were perhaps over 1000 [24] compared with 884,000 regular physicians in the U.S. in 2006 (There were only 50-100 homeopaths in the US in the early 1970s. [25][26])

Even in India, where about 15-20% of medical professionals are homeopaths, homeopathy is 3rd or 4th behind regular medicine and ayurvedic medicine. In numerous European countries in the last few years, like the UK and Switzerland, government support for homeopathic treatments has been decreased as study after study have failed to show its efficacy.

The final point certainly makes sense... But the other two do not. In a world run by businesses, where drug companies and pharmaceuticals are on the same corporate level as energy and tobacco giants, of course the market that runs by the ideal of "sell! sell! sell!", and that is backed by the industry's giants is going to have more sales. They sell products which alleviate symptoms for a few hours so that you go buy more, and they turn a bigger profit. This is a fundamental principal of business, so to say that they are not only out to turn a profit is turning a blind eye to the reality of our world (And I'm not saying that perhaps Homeopathy doesn't also do this on a small scale). To claim something as pseudoscience based on how well its products sell on the market is rediculous, and I strongly contest this point. All this shows is the direction that the market faces, which is obviously towards the business that already has the foothold. Many factors could attribute to these facts, including that western medicine and surgery can cost thousands of dollars, while homeopathic medicine is generally inexpensive; or that homeopathy is ignored by western medicine, and as such doesn't get recommended by western physicians. This is not business, it's science! -- ʄɭoʏɗiaɲ ^τ _¢ 22:24, 15 July 2009 (UTC)

The point being made there was not that how poorly its products sell proves that homeopathy is pseudoscience. The point being made there was that how poorly its products sell proves that homeopathy is a fringe belief. --FOo (talk) 09:19, 26 July 2009 (UTC)

No it only proves that people spend more money on western medicine... Which really in itself is just a broad range of sciences combined together in the last 250 years, and to compare such a large range of things to one specific science doesn't make sense - ʄɭoʏɗiaɲ ^τ _¢ 09:59, 26 July 2009 (UTC)

These Western drug and pharmaceutical companies also make or own the companies that make the homeopathic stuff. "compare such a large range of things to one specific science" what specific science? Also, homeopathy is a medical system that excludes and is at odds with mainstream medicine, so it is right to contrast them. I'm not quite sure what the point of this thread is; it is quite clear that homeopathy is a fringe belief and a fringe practice. Verbal chat

First of all, The specific science would be homeopathy... you know... the subject at hand? Western medicine is the application of several sciences (Anatomy, chemistry, physiology, neuropathy/neurophysiology, cardiology, etc.) into a single practice.

Secondly, you are wrong (Or just making assumptions). Boiron, one of the leaders in homeopathic research and production, is not owned by a higher company, and is focused on Homeopathic medicine only. They supply a majority of Europe and North America. It's very funny, because for every piece of "research" pharmaceutical companies put out to downplay the efficacy of homeopathy, there are just as many put out by individual researchers that claim the exact opposite.

It seems to me that this page is held on lockdown by a select number of individuals that refuse to acknowledge any research that shows any positive effects (An assumption which I can backup by the banning of a homepathic doctor from Wikipedia who was making edits to this page. If a homeopathic doctor isn't a reliable source for information on homeopathy, then logically we cannot rely upon physicians of western medicine to say anything reliable about western medicine.). The research seems to be based only on numbers (Number of studies), and obviously the amount of research put out by ~800,000 physicians (In America) is going to overshadow the amount of research put out by 350 homeopaths (In America). This page might as well be renamed Homeopathy in America... Because in Europe, homeopathy is far from a fringe belief... In fact, the British Royal Family has had a homeopathic physician for the last four generations, and several countries (France primarily) have started teaching homeopathy to all future physicians.

"According to recent surveys in France, an astounding 40% of the French public have used homeopathic medicines, and 39% of French physicians have prescribed them. At least six French medical schools offer courses leading to a degree in homeopathy, and homeopathy is taught in all pharmacy schools and in four veterinary schools." - "The Present Status of Homeopathy Internationally," by Dana Ullman, MPH Homeopathic Educational Services (1995)

This answer to a question on Google (Which I haven't thoroughly examined, but am only throwing here for examples) is a roundup of a number of quotations regarding the practice of alternative medicine in Europe/France (But obviously since they aren't made by physicians in America, they don't qualify as reliable sources). Even in America, alternative medicine (Which would be the multiple sciences equivalent to western medicine) is being used substantially more often than before ("Between 1991 and 1997 the use of herbal medicines in the United States grew by 380 per cent.")

Finally, homeopathy is not against western medicine - Western medicine is against homeopathy. Homeopathy, and all alternative medicine to be blunt, supports western medicine. Homeopaths just have enough common sense to know that a medicine that masks the side effects but does nothing to cure the problem will do nothing but make the patient sicker, since they will be busy instead of resting. - ʄɭoʏɗiaɲ ^τ _¢ 03:30, 27 July 2009 (UTC)

Please see Wikipedia:Talk page guidelines. "Talk pages are for discussing the article, not for general conversation about the article's subject...Keep discussions on the topic of how to improve the associated article." Short Brigade Harvester Boris (talk) 03:36, 27 July 2009 (UTC)

This is discussing the article, and the claims put around it by "members of the general scientific community", so I will continue. Comments like that only go to show that when backed into a corner, people jump off the subject and try to muzzle the commenter. - ʄɭoʏɗiaɲ ^τ _¢ 03:41, 27 July 2009 (UTC)

Interesting use of "scare quotes" around the word "research". Do you have any RS to support your implication that research with negative outcomes is "put out by pharmaceutical companies to downplay the efficacy of homeopathy" while "individual researchers" produce positive outcomes?

Homoeopathy is a fringe belief because the principles on which it is alleged to work are unsupported by and generally contrary to scientific knowledge, as explained in the article. Brunton (talk) 04:55, 27 July 2009 (UTC)

(←)Then that means it is a practice whose actions are unsupported by and generally contrary to scientific knowledge, but not that it is a fringe belief. It is perhaps a fringe belief in terms of sales volume and revenue, but certainly not in terms of how many people use it (Which is close to 50% in many nations, far from a fringe).

From the british medical journal:

"Many doctors do not believe that homoeopathy [sic] is an efficacious treatment as it is highly implausible that infinitesimally diluted substances retain their biological effects. It is also often said that homoeopathy has not been evaluated with modern methods -- that is, controlled trials. The first argument may be true, the second is not. [J.] Kleijnen et searched the literature and found 96 reports containing 107 controlled trials of homoeopathy. Most trials turned out to be of very low quality, but there were many exceptions. The results show the same trend regardless of the quality of the trial or the variety of homoeopathy used. Overall. of the 105 trials with interpretable results, 81 showed positive results of homoeopathic treatment. A complicating factor in such reviews, especially of controversial subjects such as homoeopathy, is publication bias. If the results of Kleijnen et do not reflect the true state of affairs, publication bias must be considered a great problem in evaluations of homoeopathy. In any event, there is a legitimate case for further evaluation of homoeopathy, but only by means of trials with sound methodology."

(Anonymous; "Clinical Trials of Homoeopathy," British Medical Journal, February 9, 1991. Cr. M. Truzzi.)

Anonymous? Hardly. See the paper: Kleijnen J, Knipschild P, ter Riet G (1991 February 9). "Clinical trials of homoeopathy". BMJ. 302 (6772): 316–323. PMC 1668980. {{cite journal}}: Check date values in: |date= (help)CS1 maint: multiple names: authors list (link) Note there are links there to several letters that responded to the paper, on pages 529 and 727 of the same volume. Please try to be thorough with citations. LeadSongDog come howl 14:13, 7 August 2009 (UTC)

While this is not specifically handing responsibility to some person or group, it is saying that most results are skewed (Despite showing mostly positive results). - ʄɭoʏɗiaɲ ^τ _¢ 09:27, 27 July 2009 (UTC)

Ernst 2002[27] rejects that the predominance of negative results is caused by publication bias. It also says that the meta-analisys by Linde 1997 also advanced this theory, and that the authors re-analyzed the data in Linde 1999 and said that "[our] re-analysis 'weakened the findings of their original meta-analysis'" (under the "Results" section). --Enric Naval (talk) 11:49, 27 July 2009 (UTC)

And later in 2007 Ben Goldacre wrote an article in The Lancet saying that the publication bias was the other way around[28]. --Enric Naval (talk) 16:03, 27 July 2009 (UTC)

Alright, I cannot find anything more recent on the internet without paying for journal websites, so I conceit to not having something to back up that particular statement on hand (I will see what my naturopath/homeopath has to offer in terms of published studies and add it later). However, getting back to the bulk of my big post, I still can back up with several RSs that Homeopathy is not a fringe belief (Aside from in terms of its share in the pharmaceutical market) in many countries of the world, unless of course you'd consider the use of it by over 40% of the population in some countries to be fringe. - ʄɭoʏɗiaɲ ^τ _¢ 19:17, 27 July 2009 (UTC)

I think that we are mixing "fringe belief in the scientific community" with "many people use it regularly" with "many people have used it at some point in time". The 40% figure is the last one. Under "Regulation and prevalence" we should add that in some countries like France 40% of population has at some time used a homeopathic remedy, and 36% of doctors have prescribed one. We should also include what % uses it regularly. --Enric Naval (talk) 07:12, 28 July 2009 (UTC)

Wordings should also all be changed to reflect that it is a fringe belief specifically amongst the "general scientific community", and not amongst the world in general. - ʄɭoʏɗiaɲ ^τ _¢ 19:51, 4 August 2009 (UTC)

General philosophy: Miasms and disease

The second paragraph of this subtopic cites A. Campbell's critical book review of G. Vithoulkas's book "The Science of Homoeopathy" as support for the statement that Hahnemann's miasm theory remains disputed and controversial within homeopathy today. In order for the statement to be accurately represented, we need to support this contention on both sides. One-half of the contention is supported by providing A. Campbell's critical book review. The other half of the contention is not supported -- and this is precisely what I was seeking to remedy, by providing the following addition:

"Vithoulkas provided a compelling response to Campbell's criticisms, citing several scientific studies supporting his statements. He concluded, "In view of these facts, it seems scientifically irresponsible to pronounce dogmatically that penicillin can completely abolish syphilis. Serious social dangers arise from the false notion that syphilis can be cured like a common cold."

In this statement I've reference the original work, linked to the original work inline, and quoted Vithoulkas' concluding remarks as a response to the previous quote from A. Campbell. In addition, I corrected the text preceding the A. Campbell quotation by using the words "high doses", and "penicillin", and specifying the duration as "extended period", as these appear in A. Campbell's statement in the original critical review (two weeks was specifically stated as the duration of application which he in-turn quoted from Vithoulkas). Also, I initially replaced the phrase "This conflicts with scientific studies" with "This conflicts with certain scientific studies" as not *all* scientific studies are in conflict, which the lack of the word "certain" or "specific" implies. However, upon further reflection, this later edit, and only this later edit, does not seem to be necessary, as it is implied from the context.

The remaining edits in this subsection, I submit, add valuable counter-weight to the discussion and necessary support for the original statement of "Hahnemann's miasm theory remains disputed and controversial within homeopathy today" and must be included for Wikipedia NPOV compliance. Specifically the subsection on Space and balance: Information suppression:

"A common way of introducing bias is by one-sided selection of information. Information can be cited that supports one view while some important information that opposes it is omitted or even deleted. Such an article complies with Wikipedia: Verifiability but violates NPOV. A Wikipedia article must comply with all three guidelines (i.e. Verifiability, NPOV, and No original research) to be considered compliant."

Dbrisinda (talk) 19:42, 30 July 2009 (UTC)

Saying that Vithoulkas' response was "compelling" is a clear POV violation - it's editorialising the content. Besides, how does a response from Vithoulkas disprove that the miasm theory is disputed within homeopathy? It obviously doesn't, so why are you trying to include his response? Also note that the miasm theory and the idea of suppression of disease by treatments is very far from mainstream science. Fences&Windows 21:38, 30 July 2009 (UTC)

Also, this is a spat from the late 70s. Is there nothing newer to be cited about the view of miasms within the field of homeopathy? Aha, how about "The miasm theory is therefore useless or superfluous in the light of modern pathological knowledge and should be eliminated completely from homeopathy."[29] Milgrom thinks they have something to do with quantum theory:[30] Outside the field of homeopathy, we are all of course aware of the Germ theory of disease, and have no need to invoke "vital forces". Fences&Windows 21:50, 30 July 2009 (UTC)

Campbell's writings are simply not notable enough to be included in this article. I recommend that we strike that paragraph entirely. Campbell's book is not in print, nor do I remember seeing any significant references from homeopaths to it over the years.

On a similar topic, I have found an inaccurate and unsupported statement under “General Philosophy”. The article at present asserts: "The law of susceptibility states that a negative state of mind can attract hypothetical disease entities called "miasms" to invade the body and produce symptoms of diseases.[25]"

The above statement is not accurate. It is simply invented and is not well-sourced. The bottomline is that a person's "state of mind" does not create or maintain a miasm. If one is going to reference something about miasms here, one should quote or reference Hahnemann, Kent, Allen, or some leading homeopaths, not a website of an antagonist to homeopathy who doesn't seem to have a NPOV to this subject.

As a result of looking at reference #25, I want to question how RS this source is. This source is not peer-review. It seems to be one person at a medical school's POV. I recommend that we evaluate all references to this site, especially in the light of this site providing reference to a clearly incorrect statement about miasms. DanaUllman^Talk 01:07, 31 July 2009 (UTC)

You're right. That is not supported. I'll delete the sentence. Brunton (talk) 02:08, 31 July 2009 (UTC)

Actually, it is supported by a different page on the same source - I've changed the ref. I don't see any indication that this source is the personal view of a single individual - it seems to be on the main pages of the Creighton University School of Medicine rather than on a personal page, and states that it is intended to provide "a critical evaluation of Homeopathy for health care professionals, students, and the general public". Brunton (talk) 16:00, 31 July 2009 (UTC)

@Fences&Windows: Alright. Then strike out the word "compelling" from my suggested edit or remove the paragraph citing Campbell entirely as DanaUllman suggested so no counter-balance is required. Why did I include it? Did you read Vithoulkas' response? He provides strong evidence refuting Campbell's treatment of the theory. And this disagreement between the two shows "dispute and controversy" in the field. Dbrisinda (talk) 02:33, 31 July 2009 (UTC)

Brunton, although you "found" the part of the article that has that statement about the "negative state of mind," please note that the source that you cite does not source that statement because it is non-source-able (in other words, it is wrong). This made-up statement gives us evidence that this site is not peer-reviewed or at least not adequately peer-reviewed. The wiki article makes it clear that miasms are related to infection and to genetics. How this statement about the "negative state of mind" got into that medical school article and into wikipedia should be investigated...but in any case, until it is sourced to a reliable source, it should be deleted.

If people here haven't noticed yet, I am preferring to avoid making changes in the article itself, and instead, I would prefer being used here as a consultant and expert to other editors. DanaUllman^Talk 23:36, 31 July 2009 (UTC)

There seems to be a bit of circular reasoning going on here: you're claiming that the source isn't reliable because the information on it is "made-up", and that we shouldn't use the information from it because the source is not reliable. What you need to do is to find better sources with an explanation of this "law of susceptibility" that contradict this one, rather than just saying you don't like it. Brunton (talk) 06:03, 1 August 2009 (UTC)

I don't think that's how it works. If you want to talk about some "law of susceptibility" then you need to find a reliable source. If this is not a reliable source, then we can take the statement out completely. —Whig (talk) 07:30, 1 August 2009 (UTC)

If Campbell, consultant physisian at The Royal London Homeopathic Hospital, and I believe editor of the journal that later became Homeopathy, etc, is not notable, then why are all the people you're forever trying to force in more notable? Shoemaker's Holiday ^{Over 184 FCs served} 23:47, 31 July 2009 (UTC)

Whether Campbell is notable or not does not make this a RS. —Whig (talk) 04:02, 1 August 2009 (UTC)

You haven't given a single actual reason why it isn't a reliable source. Shoemaker's Holiday ^{Over 184 FCs served} 10:10, 1 August 2009 (UTC)

We seem to have two choices. If we consider that Campbell is RS just because he was a consultant to the Royal London Homeopathic Hospital, then we also should quote every other consultant to this hospital (cool!). If Campbell is RS because he was (for a short time) the editor of the journal "Homeopathy" (then called the "British Homeopathic Journal"), then we should consider every editor of this journal RS (fabulous, I would love to quote from its present editor, Dr. Peter Fisher). OR...we can realize that Campbell's work is not in the present debate (because he is not notable). DanaUllman^Talk 15:14, 1 August 2009 (UTC)

And we can quote Fisher, in order to show what homeopaths think. But, we're not going to present him uncritically, as if his views were equal to those of mainstream scientists. Campbell happens to be well in line with mainstream scientists, and echoes much that can be found in mainstream criticism, so, per NPOV, his mainstream view gets more weight than fringe views. Shoemaker's Holiday ^{Over 184 FCs served} 00:58, 2 August 2009 (UTC)

I would like to get others opinion on whether Peter Fisher is RS because he is the editor of "Homeopathy." I do not plan to quote him on THIS issue but many others. If others agree (or not) with Shoemaker that Fisher IS RS, I'm ready to make some recommendations for this article. If not, then, we may have to realize that Campbell is not RS. DanaUllman^Talk 01:09, 2 August 2009 (UTC)

We can quote and attribute Fisher's opinion as a notable homeopath, but not as to scientific facts. (He is also notable as the royal family's physician, which makes him rather notorious and dubious.) This cuts both was, since quoting him can be interesting because he also makes some very unscientific and dubious comments, which just happen to illustrate the typical homeopathic mindset. Those should also be included. Brangifer (talk) 18:23, 2 August 2009 (UTC)

I am concerned that Bullrangifer considers it "dubious" to be the Physician to Her Majesty Queen Elizabeth II, when it is clearly a high honor. It seems apparent that such a statement shows a POV that has little place in an encyclopedia. DanaUllman^Talk 22:32, 2 August 2009 (UTC)

Yes, the royal family's scientific expertise is widely recognized.[31] Short Brigade Harvester Boris (talk) 23:28, 2 August 2009 (UTC)

Indeed it is.[32] Brunton (talk) 10:37, 6 August 2009 (UTC)

Bingo! SBHB understands the abominable situation. Prince Charles and his dear mother are enamored with various fringe beliefs, homeopathy being one of them. It's a shame and brings their reputation into disrepute. Because of it they have no respect among scientific minds. There have been several attempts to shed light on Prince Charles' follies. I am working on an article, and there I have one of them listed. Yes Dana, I have a scientifically defensible POV, while you have a scientifically indefensible POV. Which POV is more worthy of having a place in a serious encyclopedia? If you want to exclude someone because of their POV, then look in the mirror before you start pointing fingers. Since both of our POV are needed here, how about dropping the personal attack? It doesn't help anything and obviously would exclude you from editing here if having a POV was a bad thing. -- Brangifer (talk) 06:43, 4 August 2009 (UTC)

Suggestion for a more neutral lead

I agree with this version as another user suggested.

"Homeopathy's efficacy is highly controversial in view of the collective weight of scientific and clinical evidence.^{[NHS][AMA][BHA]} Several controlled randomized studies show little evidence for the efficacy of homeopathy,^{[Ernst][Altunc][Shang]} while other controlled studies do support the efficacy of homeopathy.^{[Kleijnen][Rutten][Linde97][Linde98]} According to a report by the AMA, "The efficacy of most homeopathic remedies has not been proven. Some think it a placebo effect, augmented by the concern expressed by the healer; others propose new theories based on quantum mechanics and electromagnetic energy."^[AMA] Advocates of homeopathy also bring attention to the inherent difficulty with controlled randomized clinical trials due to the highly individualized nature of homeopathic treatments.^{[Linde98][Weatherley-Jones][Thompson][Bell]} Meta-analyses investigating clinical homeopathic trials have shown both positive and negative results; though positive results have indicated that evidence is not sufficient to draw definitive conclusions.^{[Kleijnen][Linde97][Linde98]} A definitive view of the efficacy/non-efficacy of homeopathy is further complicated by assertions of publication bias in the field.^{[Juni][Kiene][Frass][Caufield][Bellavite][Sood]}

--JeanandJane (talk) 01:32, 7 August 2009 (UTC)

Dead on arrival. Short Brigade Harvester Boris (talk) 01:36, 7 August 2009 (UTC)

Is this helpful?--JeanandJane (talk) 01:53, 7 August 2009 (UTC)

No. Copying and pasting a draft that's already been posted twice by another editor, and has since been further discussed, is not helpful. Brunton (talk) 07:34, 7 August 2009 (UTC)

Brunton I m trying to solve this dispute by proposing a more neutral lead improving and change the wording. If you notice the draft has small changes. What is you suggestion since the neutrality of parts of the article is disputed by different editors. At this point maybe we should ask Vassyana who is following the conversation. Should we tag the article using this and continue the conversation or do what? - lets act according to the rules. I would like to be advised by Vassyana. Vassyana ?--JeanandJane (talk) 14:55, 7 August 2009 (UTC)

Changes

Reading the article you'll find that it already presents both the homeopaths' and science's point of view on homeopathy. Why do you keep being so vague about what should be included? Make suggestions on wording we then can discuss. Like this, we'll never get anywhere. --Six words (talk) 20:14, 4 August 2009 (UTC)

This is my suggestion:

"Homeopathy's efficacy of most homeopathic remedies has not been proven. According to the AMA "some think it a placebo effect, augmented by the concern expressed by the healer; others propose new theories based on quantum mechanics and electromagnetic energy". Advocates point out that studies published in reputable journals support the efficacy of homeopathy; however they have not been independently replicated to meet sufficiently rigorous scientific standards. Furthermore, several controlled double-blind studies exist showing no evidence of any effect from homeopathy. Even though early analyses investigating clinical homeopathic trials showed positive results among the trials examined, such analyses have indicated that positive evidence of clinical trials is not sufficient to draw definitive conclusions, because most trials are of low methodological quality and the unknown role of publication bias. While notable homeopaths say that that individualization of the therapy only shows its best therapeutic results, scientists see no reason as to why Homeopathy should be excluded from being tested by using standardized scientific tools.

--JeanandJane (talk) 20:32, 4 August 2009 (UTC)

If nothing else - and I do think there's a lot of problems with that paragraph - but it starts off by implying that efficacy is proven for some homeopathic treatments, adds non-scientific homeopathic views which were already set out in previous paragraphs (or should be included in said paragraphs about what homeopaths think) into a paragraph about the scientific evidence; treats the advocates' view as correct (They "point out" things), and generally really, really overemphasises the weak evidence for homeopathy at the cost of the more common evidence against. Shoemaker's Holiday ^{Over 184 FCs served} 23:17, 4 August 2009 (UTC)

I assume everyone would regard AMA as a fine source. This a quote : "Homeopathy's efficacy of most homeopathic remedies has not been proven. According to the AMA "some think it a placebo effect, augmented by the concern expressed by the healer; others propose new theories based on quantum mechanics and electromagnetic energy". See above you can see the whole paragraph.

Do you agree so far?--JeanandJane (talk) 23:34, 4 August 2009 (UTC)

I want to commend J&J for making a concrete suggestion that can be discussed and tweaked until we can come up with a consensus version. I suggest that she add proper references so we can see the sourcing. That is critical to understanding the suggested wording.

The first sentence is grammatically wrong. If it's a quote, we can't just quote it as is. Let me propose what I think it means. If I'm wrong, then explain what it's intended to mean.

"The efficacy of most homeopathic remedies has not been proven."

Is that right? Brangifer (talk) 04:06, 5 August 2009 (UTC)

Yes. Thanks for the correction.This is a quote from The American Medical Association.This is the entire paragraph. You could say According to the AMA .....................

While most homeopathic remedies are not known to have harmed anyone (probably because of the extreme dilutions involved), the efficacy of most homeopathic remedies has not been proven. Some think it a placebo effect, augmented by the concern expressed by the healer; others propose new theories based on quantum mechanics and electromagnetic energy

-- JeanandJane (talk) 04:54, 5 August 2009 (UTC)

More reliable sources from the Cochrane Reviews.

No evidence that homeopathy is effective in treating dementia

Dementia is a distressing illness that has major implications for individuals with the disease and their carers. Homeopathy is a popular type of complementary medicine. It is however controversial because although there is some evidence that it is not just a placebo, no one understands how it could work. The researchers did not find any good quality trials and so cannot say whether it is or is not effective for treating this condition. As no information is available on how much homeopathy is used for dementia, it is difficult to say whether it is important to conduct more trials.

--JeanandJane (talk) 05:19, 5 August 2009 (UTC)

OK, now we have something to work with. My concerns are basically the same that Shoemaker has already expressed: this wording implies that the efficacy is proven for some remedies, and in my eyes that would be an overstatement. The last sentence also implies that individualisation somehow prevents "scientific testing". Some homeopaths may think that's the case, but it's not (e.g. the 1998 Linde/Melchart review used only individualised therapies).--Six words (talk) 12:03, 5 August 2009 (UTC)

Have no problem taking out the "most" but this is what the AMA says. If we trust the source we keep it. I dont know what they mean.Maybe Osciill. ? Homeopathy is a popular type of complementary medicine. It is however controversial because although there is some evidence that it is not just a placebo, no one understands how it could work. is also supporting the statement that there is some evidence that Homeopathy is not just placebo.--JeanandJane (talk) 14:45, 5 August 2009 (UTC)

Rephrasing:

According to the AMA "the efficacy of most homeopathic remedies has not been proven;some think it a placebo effect, augmented by the concern expressed by the healer; others propose new theories based on quantum mechanics and electromagnetic energy". Advocates point out that studies published in reputable journals shows that there is some evidence that Homeopathy is not just a placebo; however these studies have not been independently replicated to meet sufficiently rigorous scientific standards. Furthermore, several controlled double-blind studies exist showing no evidence of any effect from homeopathy. Even though early analyses investigating clinical homeopathic trials showed positive results among the trials examined, such analyses have indicated that positive evidence of clinical trials is not sufficient to draw definitive conclusions, because most trials are of low methodological quality and the unknown role of publication bias. .....( space for the recent meta analyses )...........

While notable homeopaths say that that only individualization of the therapy shows its best therapeutic results, some scientists have also test individualized Homeopathy and other scientists see no reason as to why it should be excluded from being tested by using standardized scientific tools.--JeanandJane (talk) 15:01, 5 August 2009 (UTC)

I don't see the problem with the current well supported and correct text. Verbal chat 15:05, 5 August 2009 (UTC)

I keep wondering about this "others propose new theories based on quantum mechanics and electromagnetic energy" stuff. I'm aware that the AMA said this, but did they explain what they're talking about? And are these "theories" in the scientific sense, or in the vernacular sense of just being unsupported speculation? If we cannot explain more what this means, I don't think we should include it. Friday (talk) 15:06, 5 August 2009 (UTC)

See quantum mysticism. QM is used like an appeal to magic; Jim Tucker also uses it to explain reincarnation, for which there is a similar level of evidence as homeopathy. QM offers no viable mechanism for homeopathy, or for reincarnation for that matter! It's very much in the vernacular, catch-all, sense, of unsupported and uneducated speculation. We could speculate why the AMA put it there, and my view would be to highlight the stupidity of the field. (Disclosure: I'm a researcher active in the quantum sciences) Verbal chat 15:14, 5 August 2009 (UTC)

Ok, I was suspecting that. It serves as a handwaving argument which could easily lead readers to believe there is a scientific explanation where none exists. And I don't see where it adds legitimate educational value to the article. So I don't think we should repeat this stuff here. Hopefully people aren't still spouting this "if it's in a source, we must use it" nonsense. Friday (talk) 15:20, 5 August 2009 (UTC)

Verbal. Maybe you are right. Maybe the editors of AMA are scientifically uneducated but "unfortunately(?)" AMA is considered a good source in Wikipedia. There are papers on this. Ask Whig. He knows more. If we decide to use the quote which seems a very neutral solution we have to report it exactly.--JeanandJane (talk) 15:26, 5 August 2009 (UTC)

My point is that the editors of AMA put it in to highlight the lack of understanding that the people making these speculations have. I'm sure the AMA have no belief in quantum mysticism. The AMA do not support these supposed mechanisms, and your can't get that from what they say here. They merely report the unfounded speculations of bad scientists and quacks. Verbal chat 15:35, 5 August 2009 (UTC)

We cannot know what they had in their minds. This is what they wrote. I assume they must mean what they write exactly; the rest is speculation.

That's why is much better solution to report the quote unaltered and not try to speculate what they really meant but they did not write it. It seems a very neutral solution we have to report it exactly. This is not non sense but the wikipedia policy. We don't do original research - we just report the content of the reliable sources on the subject without editorializing . --JeanandJane (talk) 15:26, 5 August 2009 (UTC)

No, as that would be misleading. They put the speculations in a critical report that dismisses homeopathy. If there is an RS with a plausible mechanism then maybe that should be included. This isn't it. Verbal chat 15:51, 5 August 2009 (UTC)

I would like to see the report.Link? I think that not reporting what RS say and trying to report what we think they meant is misleading.--JeanandJane (talk) 15:55, 5 August 2009 (UTC)

I think Verbal is talking about the report you've already linked to yourself. It certainly says nothing about the plausibility of these "theories based on quantum mechanics and electromagnetic energy"; the comment strikes me as almost a throwaway remark. One of the main proponents of "quantum" ideas in homoeopathy, Lionel Milgrom, describes his ideas as a metaphor rather than an actual mechanism. Incidentally, he runs into a bit of flack in the "eLetters" to that article, and fulfills Godwin's law when an actual physicist gets involved, Brunton (talk) 17:00, 5 August 2009 (UTC)

As I have said multiply times I just care to report what reliable sources say - not to decide if they are correct or not. Since our interpretation on what the reliable sources mean many times differs, I proposed to use the entire quote from AMA without editorializing or changing anything.

Now, this is good faith gesture since I assume that everybody regards AME as a reliable source.

Trying to change the wording of the source or to edit out info because you think it means something else which the writers failed to express or to address is almost the definition of non neutral editing. Lets be reasonable.--JeanandJane (talk) 17:22, 5 August 2009 (UTC)

I don't really understand what you mean when you say it's a "good faith gesture". Yes, you've been quoting the AMA, and in general I would call them a RS, but why would we want to change the current wording with multiple sources to a quotation of a single source? Also, it can only be used as a source for the first two sentences of your suggested wording. What are the RS for the rest of it? By the way, why did you decide not to mention that the AMA source reports quite negatively about the childhood diarrhea trial? --Six words (talk) 17:51, 5 August 2009 (UTC)

Agree, there is nothing in the AMA reference that requires us to change our current wording, and there is no need to add this ref as the section is well referenced. Verbal chat 17:55, 5 August 2009 (UTC)

Starting from the end. 1.I did report it. See above.2. Generally there are several mainstream sources which state that there is some evidence homeopathy is not only placebo which have not been used. For instance Homeopathy is a popular type of complementary medicine. It is however controversial because although there is some evidence that it is not just a placebo, no one understands how it could work. The current lead has good parts but in general has a POV problem. "Homeopathy's efficacy is unsupported ............" is misleading and Original research. Because it has some even limited and controversial support. AMA's report is more neutral for the beginning and no homeopath can blame you that you editorialized the text if you say ...according to AMA........bla bla bla --JeanandJane (talk) 18:07, 5 August 2009 (UTC)

My question about the diarrhea trial was badly phrased, it should read: why did you decide not to mention that the AMA source reports quite negatively about the childhood diarrhea trial in the paragraph you suggested? This is "editing out info", something you accuse others of. Just like using the Cochrane review you linked to to say there is evidence for efficacy, when the review concludes "No evidence that homeopathy is effective in treating dementia". Just so we're clear: I'm not suggesting to use any of those sources, but I'm against using one or two positive sentences (even as direct quotes) if the reviews outcome isn't positive.--Six words (talk) 20:38, 5 August 2009 (UTC

It would be nothing short of quote-mining to use a single sentence of a review which reported negative conclusions to support the claim that there is evidence that homoeopathy works. Brunton (talk) 21:30, 5 August 2009 (UTC)

According to the Cochrane review, there is no evidence that Homeopathy is effective for dementia but the writers added a general statement about Homeopathy's efficacy Homeopathy is a popular type of complementary medicine. It is however controversial because although there is some evidence that it is not just a placebo, no one understands how it could work.In the article you report the first sentence but you do not want to report the general statement. This is called cherry picking This is the term right ? . --JeanandJane (talk) 00:32, 6 August 2009 (UTC)

In any case, I don't think there's a very good case for replacing the multibly-sourced old paragraph (which actually has had a substantial reduction in number ofsecondary sources: we used to have far more sources for each sentence, but it was becoming hard to read, and the sources were sufficient to show the point.) The prroposed wording bends over backwards to say nice things about homeopathy - but we're waiting until the third paragraph to put forth the scientific point of view as it is; I think we can afford to state it clearly, simply, and without special pleading on homeopathy's behalf. Shoemaker's Holiday ^{Over 184 FCs served} 22:03, 5 August 2009 (UTC)

I personally don't mind if this sort of info is used in the article, but not in the fashion that it is currently being presented - which is in a "gotcha", now all the other evidence is gone, dead and buried. This is not encyclopedic. Shot info (talk) 22:44, 5 August 2009 (UTC)

As you can see above the neutrality of the article is disputed by 3 different editors. I did try to find a solution proposing a neutral quote from AMA ( to avoid POV tags etc ). This is the only general statement they have about Homeopathy's efficacy. The childhood diarrhea trial is an example they give - not a general statement. The same about the Cochrane review. There is no evidence that Homeopathy is effective for dementia but the writers added a general statement about Homeopathy's efficacy which I reported it. It is not included in the article as well. Shoemaker : You forget that the "nice words" about homeopathy are AMA words not mine; and this is the only generalized statement they have on Homeopathy. I think we need a more neutral approach. --JeanandJane (talk) 00:20, 6 August 2009 (UTC)

Minor twibble - we aren't "reporting", we are writing "encyclopedic content". Shot info (talk) 00:44, 6 August 2009 (UTC)

I think there are some good elements in the several proposed changes thus far. I would like to combine the elements there with modifications to the original proposal to arrive at a new proposal with RS references included, which will also show how references will be used.

But first, there is some misrepresentation of RS references in the original 3rd paragraph lead. Editors are using references to say something which they do not actually say. For example, the article by Altunc is misrepresented as supporting no evidence beyond placebo of homeopathic efficacy. When in fact the article states it achieved mixed results, but "the evidence from rigorous clinical trials of any type of therapeutic or preventive intervention testing homeopathy for childhood and adolescence ailments is not convincing enough for recommendations in any condition." Similarly, the references by Linde (1999) do not show "no better than placebo" but rather "there was clear evidence that studies with better methodological quality tended to yield less positive results." And Linde (2001) only show problems with methodology. We really need to be more careful with misrepresenting RS references. In any case, I've included the main RS references here (with the exclusion of Linde99 and Linde01 because I'm not sure how to include them--if there are others, then include them), and provided links to new references only, as the existing references are already in the original:

"Homeopathy's efficacy is highly controversial in view of the collective weight of scientific and clinical evidence.^{[NHS][AMA][BHA]} Several controlled randomized studies show little evidence for the efficacy of homeopathy,^{[Ernst][Altunc][Shang]} while other controlled studies do support the efficacy of homeopathy.^{[Kleijnen][Rutten][Linde97][Linde98]} According to a report by the AMA, "The efficacy of most homeopathic remedies has not been proven. Some think it a placebo effect, augmented by the concern expressed by the healer; others propose new theories based on quantum mechanics and electromagnetic energy."^[AMA] Advocates of homeopathy also bring attention to the inherent difficulty with controlled randomized clinical trials due to the highly individualized nature of homeopathic treatments.^{[Linde98][Weatherley-Jones][Thompson][Bell]} Meta-analyses investigating clinical homeopathic trials have shown both positive and negative results; though positive results have indicated that evidence is not sufficient to draw definitive conclusions.^{[Kleijnen][Linde97][Linde98]} A definitive view of the efficacy/non-efficacy of homeopathy is further complicated by assertions of publication bias in the field.^{[Juni][Kiene][Frass][Caufield][Bellavite][Sood]}

P.S. This post is a duplicate of the one under subsection "Changes to lead: Homeopathy" since they seem to be addressing the same thing. Dbrisinda (talk) 03:05, 6 August 2009 (UTC)

I like this, but I think it should be emphasised that there is no plausible mechanisms currently known and that research into such mechanism are being engaged in (or other such words). Shot info (talk) 07:52, 6 August 2009 (UTC)

The sources say "not supported", not "highly controversial". I still say this misrepresents the overall situation. Furthermore, aren't the Linde cites the metaanalyses he later reported was almost certainly mistaken? This proposal too often treats the few positive studies as exactly equal to the strong evidence that homeopathy doesn't work. This is unacceptable per NPOV. We are not trying to present each view as equal, we are trying to accurately reflect the scientific results - and that means strong language against homeopathy. Shoemaker's Holiday ^{Over 184 FCs served} 08:00, 6 August 2009 (UTC)

And I really must object to the use of a cherry-picked list of "medical conditions where positive findings for homeopathy have been reported in at least one systematic review, randomised controlled trial (RCT) or non-randomised study", published by an organisation which states that it "exists to promote homeopathy" to support a statement about "the collective weight of scientific and clinical evidence". Citing just positive studies is nothing to do with the collective weight of evidence. Brunton (talk) 09:48, 6 August 2009 (UTC)

I also notice that the proposed wording downplays negative reviews such as Ernst and Shang as "controlled randomized studies", implying that they are single results, while describing more positive reviews such as Kleinjen and Linde as "meta-analyses". Including Rutten (I assume this means the October 2008 Rutten and Stolper paper cited in the refs to this page) is probably not appropriate in view of the critique of it published in a subsequent issue of the same journal. Brunton (talk) 09:57, 6 August 2009 (UTC)

This review could also be included but I thought you object non peer reviewed papers [[33]]

I think there is no strong consensus about Homeopathy's efficacy in the scientific community. Earlier meta analyses found positive but inconclusive results, The lancet stated in a study that is was placebo, JCE ( less impact as we said ) stated that these results are not definite; meanwhile the Cochrane review another mainstream source in a generalized statement states that Homeopathy is a popular type of complementary medicine. It is however controversial because although there is some evidence that it is not just a placebo, no one understands how it could work. Don't forget World Health Organization -the best source ever!- which was criticized by the Lancet for supporting the efficacy of homeopathy.

This is evidence for a strong controversy and the lead should reflect all these info. --JeanandJane (talk) 14:26, 6 August 2009 (UTC)

What I was objecting to was using a 20 year old news story about a single study, when we have access to a much more recent, and peer-reviewed, sytematic review, covering all the available studies (albeit not coming to as positive a conclusion about the efficacy of homoeopathy). As for the WHO's paper on homoeopathy, it was produced by a single office of the WHO and as far as I'm aware has yet to be published by the WHO. And again, supporting the suggestion that there is some evidence that homoeopathy isn't entirely placebo by quoting a single sentence from a review which concluded that the evidence it looked at was so poor that it wasn't possible to decide whether or not it had any effect in the condition studied, and information about the prevalence of its use for the particular condition was unavailable, smacks of quote mining. Incidentally, the current wording of the lead does not say that there is no evidence for efficacy - it says, entirely accurately, that efficacy over placebo is unsupported by the collective weight of scientific and clinical evidence. Even the 1997 Linde review, which is frequently cited by homoeopaths, has been described by its authors as having "unfortunately been misused by homoeopaths as evidence that their therapy is proven". Brunton (talk) 15:59, 6 August 2009 (UTC)

You asked if the proposed Lancet article ( news or something )was peer reviewed. That was your question which I find reasonable and according to the rules. (Don't call it a 20 year old news story about a single study - its misleading - it is highly regarded source. The 20 years is not a criterion for inclusion or exclusion. If it were many studies would be excluded.) I just think that you were not consistent about peer review criterion. You just suggested an non peer review study for inclusion.

The WHO paper and the BBC just describes the controversy inside and outside WHO on Homeopathy - if we believe the Lancet and the BBC report. I guess we have to believe them and include the info in the article unless we concluded that the above sources are not neutral or reliable.

I have to repeat that the writers of the Cochrane review reported negatively on Homemopathy's efficasy on dementia and added a general statement about its efficacy which for some reason you object its inclusion.

I don't know what homeopaths do with the Linde review. TYhe wording I proposed includes that. "According to a report by the AMA, "The efficacy of most homeopathic remedies has not been proven."--JeanandJane (talk) 16:33, 6 August 2009 (UTC)

Brunton; thanks for your link. Did you see that the writers of the meta analysis you refer to, they also criticized the 2005 Shang metanalyses using strong language in the Lancet ?

"Therefore, restricting an analysis to the largest studies risks producing a false-negative result. Furthermore, since the main analysis is based on only eight and six (probably unmatched) studies, the outcome could easily be due to chance, as is suggested by the large confidence intervals. Given these limitations, Shang and colleagues' conclusion that their findings “provide support to the notion that the clinical effects of homoeopathy are placebo effects” is a significant overstatement.

The Lancet should be embarrassed by the Editorial5 that accompanied the study. The conclusion that physicians should tell their patients that “homoeopathy has no benefit” and that “the time has passed for … further investment in research” is not backed at all by the data. Our 1997 meta-analysis has unfortunately been misused by homoeopaths as evidence that their therapy is proven. We now find it extremely disappointing that a major medical journal misuses a similar study in a totally uncritical and polemical manner. A subversive philosophy serves neither science nor patients.

We declare that we have no conflict of interest." --JeanandJane (talk) 18:24, 6 August 2009 (UTC)

JeanandJane, you still don't understand WHY the Cochrane review can't be used to source a statement like "there is some evidence that it is not just a placebo", even if it's a verbatim quote, so I'll try to explain.

Let's pretend we'd use the review to source such a statement. People reading the article now would think that the review we took that statement from found some evidence for efficacy, when in reality the review's outcome was summarized as No evidence that homeopathy is effective in treating dementia! When we're quoting a review or study the quote has to be consistent with the review's/study's outcome, or we'll mislead the readers. --Six words (talk) 22:27, 6 August 2009 (UTC)

Indeed. Failure to accurately represent the source by picking individual misleading sentences is this famed "cherry-picking" that people keep bringing up. Honestly, anyone who doesn't get this should probably spend some time elsewhere on Wikipedia, learning the ropes, before trying to tackle a tricky article like this one. It's not fair to editors to expect them to spend their time teaching Encyclopedia 101 just to keep this article from deteriorating. Friday (talk) 22:33, 6 August 2009 (UTC)

Well.First: If someone wants to be accurate and neutral she reports both sentences the way I suggested. If someone wants to promote the idea that homeopathy has no effect at all then he can cherry pick the sentence which states that no evidence found that Homeopathy is beneficial for dementia and edit out the general statement.Homeopathy is a popular type of complementary medicine. It is however controversial because although there is some evidence that it is not just a placebo, no one understands how it could work. That of course is a violation of NPOV.

Second and most important. All the reliable sources above show that homeopathy's efficacy is a controversial topic but the current lead and article shows one side of this controversy and supresses info about the other. Some editors based this point of view on the lancet meta analyses which has been criticized in major reliable sources as shown above but these references are again suppressed .

So I agree with Friday : people should not cherry pick ( they way they do now ) but report all the information in reliable sources. --JeanandJane (talk) 00:01, 7 August 2009 (UTC)

I'm going to quote you verbatim, so I'm not accused of "cherry picking" your words to show how you intended to use the Cochrane review as support for homeopathy's efficacy: "[...] Generally there are several mainstream sources which state that there is some evidence homeopathy is not only placebo which have not been used. For instance Homeopathy is a popular type of complementary medicine. It is however controversial because although there is some evidence that it is not just a placebo, no one understands how it could work. [...]" This is YOUR use of the quote, and you explicitly state that you want to use it as a source for "evidence homeopathy is not only placebo". What I've been doing is called "paraphrasing" and I don't see there's a problem doing that. --Six words (talk) 00:33, 7 August 2009 (UTC)

It is clear what I mean : reporting the whole conclusion and not edit out the general statement about homeopathy.--JeanandJane (talk) 01:32, 7 August 2009 (UTC)

I would like to address several criticisms made of the suggested modified paragraph #3 lead. I think this is important so that we all understand the rationale behind several of the choices that were made. We can discuss the merit of these decisions in more detail afterwards. But first, I would like to reiterate that arguments based on disallowing RS references because they are too old, or because they have been criticized are simply not valid as already discussed above. Examples include citing that Kleijnen (1991) is not valid because it is too old, or that Rutten (1998) is invalid because it has been criticized are simply without substance. The same is true for Shang (2005), and yet even though there is *heavy* criticism of Shang (see the bias section for some of them), I still wouldn't advocate removing Shang as an RS reference. Why? Becase the paper has been published in a respected peer-reviewed journal, and is relevant. I do not wish to attack the merits of an article that peer-review committees probably grappled long and hard with on deciding whether to include it. There will always be some "problems" in the science, as perfection is probably not achievable. We really need to just accept this and move on to issues of substance. In any case, we have talked this to death above, with efforts now moving towards discussing proposals and the way references are to be used instead of simply disallowing references because they don't support our views.

That being said, let's address some of the substantive criticisms.

Plausible mechanisms (One shot). The mechanisms that have been cited include quantum entanglement and nonlocality viz. the famous Einstein, Podolski, Rosen experiment (EPR) and subsequent experimental validations. This could potentially explain the memory-effect in water with chemical substances it was once "entangled" with. However it still leaves open the question of how this new substance then affects the improved health of the organism it is applied to? We could include something like Shot info's suggestion after the AMA quotation: "However, no plausible mechanisms are currently supported, though research into such mechanisms are ongoing." A couple of references here would be good to show research in this area is being engaged.

"Sources say 'not supported' not 'highly controversial (Shoemaker's Holiday).'" What I'm trying to do here is broadly summarize the results, because I saw there were problems with taking one quotation from one source and attempting to overlay that one quotation on all the remaining sources for a given contention. In other words, we need to use the greatest common denominator in language when using several references to support that language. The sources actually say a *lot* of different things, both for and against. And the use of the phrase "highly controversial" seems to capture this generally, in the smallest space, and with neutrality, in my opinion. For example, if you read my prelude to the proposal you would have seen that I addressed this already viz. misrepresentation of resources. And if I accidentally do the same with some of my resources, I encourage you to bring it to the attention of the group and we can adjust. Shoemaker said that 'we are not trying to present each side as equal ... and that means strong language against homeopathy." This statement is problematic because the literature clearly shows that the issue is *highly* controversial. According to the British Homeopathic Association (they have supported their conclusions with links to papers and articles) "A total of 138 RCTs in homeopathy have been published in good quality scientific journals: positive effects have been reported in 60 (44% of the total) and negative findings have been reported in 10 (7%), while 68 (49%) have not been conclusively positive or negative." I'm not offering this quotation to support homeopathy here, but instead to show there is heavy controversy. T

Cherry-picked list; collective evidence (Brunton). Actually, that list is not what I intended to link to for the first sentence. Instead, this BHA page provides a more general description of controversiality. That list is more appropriate for showing the specifics of positive RS outcomes. Here, instead, we need to show that there is significant controversy in the area -- since there clearly is. This first sentence refrains from citing specific clinical trials/papers, and instead uses only strong secondary resources on both sides (NIH, AMA, and BHA), leaving specific paper references for later sentences. If you would like to include one or two more references, I don't have any objections as long as we don't have a list of 17 references for every sentence. Your point about "collective evidence" is well-taken. But I would like to reiterate, that collective weight is not about one reference, but about all references taken together, i.e., collectively. It doesn't matter if one quality reference is holding one far-left position, and another quality reference is holding the opposite position. Collectively, we can say we have substantial controversy. BHA is a valid reference for a general statement like this because they show a lot of evidence in support of homeopathy (and provide links and references to major supporting RS papers). While others references may show plenty of evidence against homeopathy or a lack of evidence. They are all good.

Meta-analyses, Ernst & Shang (Brunton). Some objections to the way I used Ernst and Shang with a lack of mention of meta-analyses in the second sentence. I can attempt to accommodate this objection by rephrasing that sentence as "Several controlled randomized studies and systematic reviews show little evidence for the efficacy of homeopathy,^{[Ernst][Altunc][Shang]} while other controlled studies and systematic reviews do support the efficacy of homeopathy.^{[Kleijnen][Rutten][Linde97][Linde98]}" And having brought my attention to it, I agree that I should remove the Rutten reference --but not for the reasons you cite, i.e., because it has been critiqued in a later publication, but instead because it deals with deconstruction of Shang's work rather than a systematic review in it's own right -- and so it doesn't belong here, since that's what we're supporting. However, it still has value elsewhere if it can be put to good use.

WHO (JeanandJane). Actually WHO is a strong secondary source and qualifies for inclusion. I would like to include this for the first sentence reference. In any case it provides additional perspective in conjunction with the NHS, AMA, and BHA articles. And again, if others wish to bring an additional strong secondary source that shows a strong negative point of view you are quite welcome.

Quotes, current lead, Linde (Brunton). I will not advocate taking additional quotes from the WHO source for the lead, only to reference it as a source that conveys views that helps to show controversy in the field. And it appears to do this well. Also you state that the current lead accurately states"that efficacy over placebo is unsupported by the collective weight of scientific and clinical evidence." However, this is exactly what we are bringing into serious question. I've been scouring the literature, and it is simply not true. The truth is that there is enormous (read: ENORMOUS) controversy, that evidence in support exists, evidence not supporting exists, in addition to a large body of inconclusive evidence. I'm afraid the existing lead is simply far too inaccurate to take very seriously in an controversial topic such as this. The Linde (1997) paper -- a meta-analysis published in the Lancet -- included 186 placebo controlled studies, from which data for analysis could be extracted from 89. The overall mean odds ratio for these 89 clinical trials was 2.45 (95% confidence interval 2.05–2.93) in favour of homeopathy (individualized treatment, single or complex homeopathic medicines, or isopathy). That is significant however you want to look at it. I don't know what happened afterwards (i.e., what politics were involved if any), but even subsequent analysis by Linde et al. showed that homeopathic treatment remained more effective than placebo -- though less strikingly so than in their previous analysis. So it's a question of simply citing the results and conclusions in all RS references without getting caught in the minutiae.

Here is the updated version with valued suggestions included (JeanandJane: can you provide the link and reference to the WHO article?)

"Homeopathy's efficacy is highly controversial in view of the collective weight of scientific and clinical evidence.^{[NHS][AMA][BHA][WHO]} Several controlled randomized systematic reviews show little evidence for the efficacy of homeopathy,^{[Ernst][Altunc][Shang]} while other controlled studies and systematic reviews do support the efficacy of homeopathy.^{[Kleijnen][Linde97][Linde98][BHA]} According to a report by the AMA, "The efficacy of most homeopathic remedies has not been proven. Some think it a placebo effect, augmented by the concern expressed by the healer; others propose new theories based on quantum mechanics and electromagnetic energy."^[AMA] No plausible mechanisms have been convincingly advanced, though research into such mechanisms is ongoing.^[One][Shot?] Advocates of homeopathy also bring attention to the inherent difficulty with controlled randomized clinical trials due to the highly individualized nature of homeopathic treatments.^{[Linde98][Weatherley-Jones][Thompson][Bell]} Though systematic reviews investigating clinical homeopathic trials have shown both positive and negative results, positive results have indicated that evidence is not sufficient to draw definitive conclusions.^{[Kleijnen][Linde97][Linde98]} A definitive view of the efficacy or non-efficacy of homeopathy is further complicated by assertions of publication bias in the field.^{[Juni][Kiene][Frass][Caufield][Bellavite][Sood]}

Dbrisinda (talk) 06:46, 7 August 2009 (UTC)

Here is the info about the WHO draft. http://news.bbc.co.uk/2/hi/health/4183916.stm BBC reports that the Lancet attacks WHO for supporting Homeopathy.--JeanandJane (talk) 06:56, 7 August 2009 (UTC)

Has the WHO published the draft? If not we can't cite it as the WHO's position.Brunton (talk) 07:09, 7 August 2009 (UTC)

Dbrisinda: the first sentence is conflating two things: the collective weight of the evidence does not indicate that homoeopathy's efficacy is controversial, it simply fails to support it, as stated in the current lead (note that this does not mean that there is no positive evidence, merely that it is outweighed by the negative evidence). The controversy arises because, while the evidence fails to support it, homoeopaths insist that it works. If you want to include the idea of controversy in this sentence (not that I think we should, as it smacks of the creationst/ID tactic of advocating "teaching the controversy") you will need to phrase the sentence to reflect this. Brunton (talk) 07:30, 7 August 2009 (UTC)

BTW, I have the complete quote of Linde et al.'s response to Shang's study that appeared in the Lancet, which Brunton partially quoted. Here is the fuller text with many criticisms, limitations and problems of the Shang study snipped for brevity:

"Given these limitations, Shang and colleagues' conclusion that their findings “provide support to the notion that the clinical effects of homoeopathy are placebo effects” is a significant overstatement."

"The Lancet should be embarrassed by the Editorial that accompanied the study. The conclusion that physicians should tell their patients that “homoeopathy has no benefit” and that “the time has passed for … further investment in research” is not backed at all by the data. Our 1997 meta-analysis has unfortunately been misused by homoeopaths as evidence that their therapy is proven. We now find it extremely disappointing that a major medical journal misuses a similar study in a totally uncritical and polemical manner. A subversive philosophy serves neither science nor patients.

Dbrisinda (talk) 07:36, 7 August 2009 (UTC)

JeanandJane, I was unable to locate the actual WHO draft report as it doesn't appear to have been published, so on this point I think Brunton is correct, we can't include it (even if we could find it -- this may change in the future though). But I did locate Fisher (2006) clearly showing the controversy and even politics of homeopathy as it relates to the unethical leak of the WHO draft report on homeopathy to the editor of the Lancet—Horton, by Dutch and Belgian doctors hostile to homeopathy. Not only, but the article shows that the conclusions of Shang are very problematic, as it fails, on multiple counts, to meet the generally accepted standards for meta-analysis—the QUOROM statement (Quality of Reports of Meta-Analyses of Randomised Controlled Trials), published in The Lancet itself in 1999. It appears that what we have here is a fundamental breakdown in the peer-review process at The Lancet, as well as serious assertions of Lancet anti-homeopathy bias. Dbrisinda (talk) 08:38, 7 August 2009 (UTC)

When one major medical journal ( the Lancet ) criticizes another major international organization one WHO for regarding Homeopathy as effective, this is strong evidence for an existing controversy inside the mainstream view on Homeopathy. This deserves a reference in an encyclopedia. Correct?--JeanandJane (talk) 15:04, 7 August 2009 (UTC)

Brunton, it looks as if you haven't read what I previously wrote addressing the issue of controversy, and that results are much better for homeopathy than the current lead purports. Again, "A total of 138 RCTs in homeopathy have been published in good quality scientific journals: positive effects have been reported in 60 (44% of the total) and negative findings have been reported in 10 (7%), while 68 (49%) have not been conclusively positive or negative." And that's only individual studies. Then there are the systematic reviews by Kleinjnen (1991) and Linde (1997, 1998, 1999), as well as the HMRG (1996) and even Mathie (2003) (see below under subsection "About controversies" for details). To repeat previously about the first sentence, Wikipedia's NPOV document states in the subsection Bias in attribution: Mind your nuances, that use of the word "claimed" is often an indicator of a lack of neutrality and that alternate language should be chosen. In fact, Wikipedia guidelines suggests a set of words to avoid, and has this to say about the word "claim":

"Claim" can be appropriate for characterizing both sides of a subjective debate or disagreement. Do not use "claim" for one side and a different verb for the other, as that could imply that one has more merit."

Also, the statement "unsupported" in the first sentence in this context implies no support, only to be softened afterwards by the somewhat contradictory phrase "collective weight", implying some support. Conflating the two here, is unnecessarily vague and confusing. In any case, further research has shown this statement to be false. There is more evidence that supports the efficacy of homeopathy than evidence that denies it. The (marginally) largest body of evidence is inconclusive. Therefore, "highly controversial" is a fair representative statement. The current wording is clearly not. Dbrisinda (talk) 07:45, 8 August 2009 (UTC)