Sometimes…Even the Big Dogs Get it Wrong…

The Cochrane Collaboration is considered to be one of the best resources for evidence based practice within the medical community.  However, even the best sometimes get it wrong! 

But 1st a little bit of background information on the Cochrane Collaboration… 

The Cochrane Collaboration (CC) is an international non profit + independent organization, which is dedicated to facilitating world-wide health care professional access to the most up to date health information.  The CC produces systematic reviews on a variety of different healthcare related topics and promotes the search for evidence in the form of clinical trials.  The CC was founded in 1993, and was named after the British epidemiologist, Archie Cochrane.

I was recently browsing the CC website (found here: http://www.cochrane.org/ ) and I came across the following systematic review

http://www.cochrane.org/reviews/en/ab000353.html

The above review focuses on the use of homeopathy to treat chronic asthma. 

From the CC website…

Objective: “The objective of this review was to assess the effects of homeopathy in people with chronic stable asthma.”

Author’s Conclusion: “There is not enough evidence to reliably assess the possible role of homeopathy in asthma. As well as randomised trials, there is a need for observational data to document the different methods of homeopathic prescribing and how patients respond. This will help to establish to what extent people respond to a ‘package of care’ rather than the homeopathic intervention alone.”

Now I know what you are most likely thinking…

“That does not sound so bad…they did not recommend the treatment.  The author of the article indicated that further testing needed to be done!  What is wrong with that?”

In my humble opinion, a lot…

To begin with, the article is operating under the false premise that homeopathy is a legitimate treatment modality.  Before we can test whether or not a treatment works, we need to determine that there is some sort of plausible mechanism of action in order to explain how the treatment modality might work.  In the case of homeopathy, there is no plausible mechanism of action (for the un-informed, homeopathy is the “practice” of taking an active substance, diluting it in water until there is little or no active ingredient left in the final dilution.  The final dilution is then given to the patient as a treatment to “treat” their health concern.  However the patient is essentially receiving water.  Any resulting effect can be attributed to the placebo effect).  With the above information in mind, there is no reason to advocate further research/study of homeopathy in the treatment of chronic asthma, as there is no plausible mechanism of action to explain how homeopathy could even have a therapeutic effect. 

The 2nd problem with this review is the call for additional research related to homeopathy’s potential effectiveness in treating chronic asthma.  Give the lack of a plausible mechanism of action, I would argue that it is highly unethical to subject patients to a treatment regime that has no plausible mechanism of action, and consequently would prevent a patient from utilizing a legitimate treatment for a legitimate (and potentially fatal) disease/illness.         

The above text is an example of why (in my humble opinion) skepticism is so important…

Because sometimes even the big dogs get it wrong!

In order to function independently and be capable of processing the staggering amounts of information that we are exposed to on a daily basis, we need to keep our critical thinking skills up to snuff.  We must be capable of processing the information that we are exposed to and make some sort of judgement/decision…

And I would argue that skepticism facilitates this process…

This has been the Skeptical Samurai…

Working to serve through the process of inquiry…

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