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I was surprised that PLOS One published this paper

Posted by David_Colquhoun on 24 Apr 2015 at 22:25 GMT

James Coyne has given an admirably frank justification for his reasons for accepting this paper, at http://blogs.plos.org/min...

Nevertheless I'm not convinced that it was right for Plos One to publish it. Although the methods are clearly defined, there are essentially no results, positive or negative. The best thing about it is the recommendation that time and money should not be spent repeating it.

On the presumption that Plos One believes in Avogadro’s number, it’s obvious that the control pills are identical with the homeopathic pills. That being the case, positive trials of homeopathy should be published only as illustrations of the hazards of statistical methods that ignore the false discovery rate (e.g. http://rsos.royalsocietyp... ).

From that point of view, the study is quite interesting, because of its implications for real science. I was quite disappointed that PLOS One published this without making this obvious statistical point.

No competing interests declared.

RE: I was surprised that PLOS One published this paper

James_C_Coyne replied to David_Colquhoun on 25 Apr 2015 at 12:54 GMT

In hindsight, it would have been good if the article acknowledged that any positive findings would likely be false for obvious reasons of the inertness of homeopathy. I'm glad your comment corrects this.

Nonetheless, there is a large audience out there, including confused funding agencies which allow reimbursement of homeopathy in Germany, as well as research. I think the report of this attempted randomized trial raises ethical issues about conducting trials with no hope of accruing sufficient patients to get interpretable results. But what might be more pragmatically more important is that it underscores a complex ritual involved in deciding on and delivering a homeopathic remedy that could be a powerful placebo.

If we can't persuade funders from reimbursing homeopathic treatment nor conducting randomized trial, this article could still serve to indicate the necessity of controlling for nonspecific factors of attention, expectation, and support that might be sorely lacking in routine medical care.

If we can't discourage further randomized trials of homeopathic treatment, this article can at least provide the basis for insisting that the homeopathic treatment not be compared only to inadequate routine medical care, but needs a control condition with these factors of equivalent to the intervention condition.

I only wish that the importance of Avogadro’s number would in itself discourage study and reimbursement of homeopathic remedies.

I wouldn't have recommended that this trial be funded, but once the authors got funding and attempted the trial, it became important to report the results.

No competing interests declared.