So ridiculous is homeopathy that I sometimes feel that I and my fellow skeptics are firing Howitzers at an ant when we take so much time and effort to explain why homeopathy is nonsense. On the other hand, it is homeopathy's monumental lack of scientific plausibility that makes it a perfect teaching tool to explain the difference between science-based medicine (SBM) and evidence-based medicine (EBM). Specifically, because clinical trials have unavoidable shortcomings and biases, even at a p=0.05, which would imply only approximately a 5% chance that a given trial's apparently positive results could be due to random chance alone. As John Ioannidis has taught us, in clinical trials as practiced in the real world, the chance is much higher that any given positive trial is a false positive. It also means that, the lower the prior plausibility of a remedy working, the higher the chance of false positive trials. This is exactly what we see in homeopathy, hence the panoply of homeopathy trials showing "positive" results in which the treatment group is barely different from the control and/or the results barely reach statistical significance. With something like homeopathy, which violates the laws of so many sciences, it is relatively easy to make the case that it takes a lot more than a few equivocal clinical trials to show that so much well-established science is wrong. Apparently positive clinical trials of homeopathy are measuring, in essence, the noise inherent in doing clinical trials.
Tuesday, May 15, 2012
Orac on Homeopathy and Clinical Trials
Orac on Homeopathy and Clinical Trials:
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