David Martin Shaw on "The Swiss report on homeopathy" (2/3) 利益相反

Dr David Martin Shawが、ホメオパシーを有効だとしたスイスの報告書について、問題点を指摘している。そのひとつが、「ランダム化比較試験」を逃げまくっていること。その動機ともいうべきものに、利益相反があるという...
[David Martin Shaw: "The Swiss report on homeopathy: a case study of research misconduct", Swiss Med Wkly. 2012;142:w13594]

Conflicts of interest

Given the preceding sections of this paper, it should come as no surprise that the majority of the report’s authors are homeopaths. In fact, only one of the medically qualified authors is not a homeopath or alternative medicine practitioner. Of course, the fact that someone is a homeopath does not mean they cannot be objective about homeopathy, but the potential for bias is substantial and that potential seems to have been fulfilled in the report. The authors of the report provide a conflict of interest statement:

Nobody involved in the compilation had any financial or other conflict of interest. Whenever expert advice was sought from a physician who himself uses the method in question, independent experts were also consulted [1].


Unfortunately, the first sentence is untrue. Homeopaths believe that homeopathy works, and as such have an inherent conflict of interest if they are involved in an assessment of homeopathy. Even if they are capable of objectivity, they have an obligation to declare this as a potential conflict of interest. But this is not the main issue here. As homeopaths, many of the authors would be professionally compromised if their report stated that homeopathy doesn’t work. Furthermore, the inclusion of homeopathy in insurance schemes, which required a favourable verdict from the report, potentially benefits many of the authors in terms of both prestige and money. The conflict of interest statement should actually have stated that many of the authors have financial and professional conflicts of interest. Note that the authors not only failed to declare these conflicts of interest but also denied that they existed. If a report endorsing a new drug was written by employees of a pharmaceutical company and they claimed they had no conflict of interest, they would be scorned; it is troubling that the same does not seem to have applied here. Note also that in the above quote the authors concede that a doctor’s use of homeopathy constitutes a conflict of interest; it is unclear why they do not apply this logic to themselves.


One particularly unusual facet of the authors’ conflicts of interest is that they actually form part of their argument in favour of homeopathy. For exemple, the report reinterprets Kleijnen’s famous study and argues that its conclusions were only negative because the authors believed that the mechanism of homeopathy was implausible. Given their acceptance (based on laboratory tests) that homeopathy is plausible, the authors argue that this means the results of the original study were positive. Thus their conflict of interest – they believe that homeopathy works despite evidence to the contrary – is key to their biased reinterpretation of results.


[1] Gudrun Bornhöft and Peter Matthiessen (eds.) Homeopathy in healthcare: effectiveness, appropriateness, safety, costs. Springer, 2012.
実際、著者にはホメオパス団体に所属していたり、補完医療推進団体PanMedion関連だったり、University of Bernの補完医療研究所所属だったりする:
PanMedion FoundationGudrun Bornhöft
Peter F. Matthiessen
Stefanie Maxion-Bergemann
Zurich Physicians for Classical HomeopathyMarco Righetti[Board, Lecturers]
Swiss Medical Society for HomeopathyDr. Klaus von Ammon[Treasurer]
The Swiss Association of Homœopathic PhysiciansDr. Denise Bloch[Vice President]
Institute for Complemtary Medicine KIKOM, University of BernUrsula Wolf
Stephan Baumgartner
André Thurneysen

[J Kleijnen, P Knipschild, and G ter Riet:"Clinical trials of homoeopathy", BMJ. 1991 February 9; 302(6772): 316–323. PMCID: PMC1668980]

... At the moment the evidence of clinical trials is positive but not sufficient to draw definitive conclusions because most trials are of low methodological quality and because of the unknown role of publication bias. This indicates that there is a legitimate case for further evaluation of homoeopathy, but only by means of well performed trials.

Kleijnen et al. (1991) undertook the most comprehensive review of homeopathic literature so far with a three-year literature search. They found a total of 107 studies which they evaluated according to their own quality score with mostly internal validity criteria. Of the studies with the best quality (Score ≥ 55 of 100) 15 showed significant effects in favour of homeopathy, 7 did not. They concluded: The amount of positive evidence even among the best studies came as a surprise to us. Based on this evidence we would be ready to accept that homeopathy can be efficacious, if only the mechanism of action were more plausible.’ As their reservations are only based on the plausibility issue, which we do not share in this form due to the preclinical research results known to us, we do not accept it and the result in favour of the effectiveness of homeopathy stands.

posted by Kumicit at 2012/06/06 00:16 | Comment(0) | TrackBack(0) | Quackery | このブログの読者になる | 更新情報をチェックする



コメント: [必須入力]